Stakeholder Engagement Practices and Sustainability of AMREF Health Africa Funded Projects in Nairobi City County, Kenya

Abstract

Sustainability has become a critical concern in the implementation of development projects, particularly in the health sector, where long-term impact is essential for improving community well-being. The sustainability of donor-funded health projects in Nairobi City County, Kenya, remains a major challenge, despite continued financial support from international donors. As such, the purpose of this study was to evaluate the effect of stakeholder engagement practices and sustainability of AMREF Health Africa funded projects in Nairobi City County, Kenya. The specific objectives of the study were to examine the effect of stakeholder participation on the sustainability of AMREF Health Africa funded projects in Nairobi City County, Kenya; to assess the effect of stakeholder communication on the sustainability of these projects; to investigate the effect of stakeholder collaboration on sustainability; and to evaluate the moderating effect of regulatory compliance on the relationship between stakeholder engagement practices and the sustainability of AMREF Health Africa funded projects in Nairobi City County. The study was anchored on Stakeholder Theory, Participatory Development Theory, Sustainability Theory and Institutional Theory, providing a comprehensive theoretical foundation for understanding the dynamics of project sustainability. An explanatory research design was employed on a census of 176 participants. Findings demonstrated that stakeholder participation, communication, and collaboration all had significant positive effects on project sustainability. Pretest was done on 18 respondents from AMREF funded projects in Kiambu County, representing more than 10% of census. The study targeted a census of 176 respondents, out of which 144 successfully returned completed instruments, representing a response rate of 81.8%. The findings revealed that the effect of stakeholder participation, communication and collaboration was statistically significant, p=0.000, respectively. Stakeholder communication was the strongest predictor of the sustainability of AMREF Health Africa funded projects in Nairobi City County, Kenya. NGO Board regulations independently reinforced sustainability and, when combined with engagement practices, raised explanatory power to 50.4%. However, the interaction term was insignificant (p=0.887, p>0.05), indicating that regulations complemented but did not moderate the engagement sustainability relationship. These results refine institutional theory by clarifying that regulatory frameworks strengthen accountability and transparency but do not alter stakeholder practices’ intrinsic effects. The study concludes that participation, communication, and collaboration are fundamental drivers of project sustainability, while regulatory compliance plays a complementary governance role. It recommends institutionalizing participatory frameworks across project cycles, strengthening multi-channel communication systems, and fostering collaborative structures that build trust and resilience. Policymakers should integrate NGO Board oversight with capacity-building to ensure compliance enhances, rather than constrains, sustainability outcomes. The findings align with Sustainable Development Goals (SDGs) and advance the social pillar of Kenya Vision 2030, which emphasizes equitable and community-driven healthcare, and support Africa’s Agenda 2063 (Vision 2050), which prioritizes resilient health systems, participatory governance, and institutional accountability as pathways to long-term continental transformation.