Gender Responsive Monitoring and Evaluation Process and Performance of Cancer Care Programs in Nairobi City County, Kenya

Abstract

The effective performance of cancer care programs is a critical public health priority, particularly in urban settings like Nairobi County, where service delivery challenges are prevalent. This study examined the influence of Gender Responsive Monitoring & Evaluation (GRM&E) processes—specifically GRM&E Planning, Data Collection, Data Analysis, and Data Utilization—on the performance of cancer care programs in Nairobi City County, Kenya. The research was guided by the need to understand how integrating a gender perspective into M&E can lead to more equitable, effective, and sustainable health outcomes.  Adopting Explanatory sequential mixed method design, the study targeted a population of 167 respondents across the 35 cancer care programs in Nairobi City County. This population included health sector officials, M&E staff, and technical personnel involved in program implementation. Data was primarily collected using a self-administered questionnaire. The research instrument demonstrated high reliability, achieving a Cronbach's alpha of over 0.70. Data analysis employed both descriptive statistics (frequencies, percentages, means, and standard deviations) and inferential statistics (Pearson correlation and simple and multiple linear regression). Five null hypotheses were tested at a 0.05 level of significance. The findings revealed a significant positive relationship between each of the four GRM&E process dimensions and the performance of the cancer care programs. Specifically, the study found that GRM&E Planning, Data Collection, Data Analysis, and Data Utilization each had a statistically significant influence (all p<0.05). The combined effect of all four GRM&E processes on performance was found to be substantial and highly statistically significant (R²=0.585, p<0.05), collectively accounting for approximately 58.5% of the variance in program performance. The study concluded that the full adoption and integration of Gender Responsive M&E processes significantly enhance the performance and equity of cancer care programs. The findings are expected to inform policy formulation and guide health practitioners in implementing evidence-based, and gender-sensitive M&E systems to improve cancer service delivery in Nairobi County and similar devolved health systems.