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Projects have become an integral part of organizations’ strategy. Health projects in particular, have been found to carry out a critical function in enhancing the well-being of society. In Kenya, many health projects are funded by donors. Although the amounts of funding from donors have been rising over the years, most donor funded health projects in Kenya are not performing well. According to the World Health Organization, almost 50 percent of health projects in Kenya do not achieve the performance measures of cost, time and quality. Recent studies have demonstrated that the macro environment comprising of the economic, social-cultural, political, technological, legal and the physical environment has a significant effect on the performance of government funded projects. However, there is scanty information on the effect of the macro environment on the performance of donor financed health projects in Kenya. This study specifically sought to determine the effect of social- cultural, economic, technological and political environments on the performance of donor funded health projects in Kenya. The moderating effect of top management support and the mediating effect of project risk management on the relationship between the macro environment, and the performance of donor funded health projects in Kenya were also investigated. The research was anchored on The Theory of Constraints and supported by Hofstede’s Cultural Dimensions Theory and The Goal Setting Theory. The study was guided by the positivism philosophy and it adopted an explanatory and descriptive research designs. A census of all the sixty-nine donor funded health projects initiated between 2008 and 2018, and were ongoing was conducted. Six section heads for the donor financed health projects at the Ministry of Health were also included in the study. Primary data was gathered by administering semi-structured questionnaires to identified respondents after seeking official authorization from relevant entities. Both descriptive and inferential statistics were applied in the analysis and presentation of data. Quantifiable data was examined using the Statistical Package for Social Sciences (SPSS) software while qualitative data was examined by content analysis based on patterns and themes. A multiple regression model was used to explain how the macro environment affects the performance of donor funded health projects in Kenya and to test hypothesis.The study found out that social-cultural, economic and political environment had a significant effect on the performance of donor funded health projects. The study further established that top management support moderated the relation between the macro environment and the performance of donor funded health projects. The research also determined that project risk management had a partial mediation on the relationship between the macro
environment and the performance of donor funded health projects. Consequently, the study recommended that the government of Kenya should develop policies and frameworks that will minimize the negative effects of the economic environment and maximize the positive effects of the social-cultural and political environments on the performance of donor funded health projects. The study also recommended that all decision makers and other donor funded health project stakeholders should devise strategies for enhancing the performance of their projects within their macro environment.It is also imperative for the government and other stakeholders in the donor funded health projects to embrace project risk management practices to ensure the projects are successful. Furthermore, the donor funded health projects top management should provide the needed support in the initiation, planning, and execution of the projects to enhance the performance of the projects.
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