ISSN E 2410-3500

Entrepreneurial Spirit: Acceptance and Adoption of E-Commerce in the Health Sector in Kenya


Vol. 7, Issue 08, PP. 08-14, August 2020


Keywords: Entrepreneurship, SMEs, ICT, e-commerce, adoption, acceptance, use and e-health.

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Competition from large businesses threatens the existence of Small and Medium Enterprises (SMEs) in Kenya. However, with the acceptance and adoption of e-commerce SMEs can compete with the established businesses in both local and global markets, but recent studies indicate a worrying trend on adoption of e-commerce by health related SMEs in Kenya. This research tested the effect of three contextual variables that is individual, technological, and external environmental variables on the adoption of Information Communication Technologies (ICTs) by SMEs in the health sector in Kenya. A cross-sectional survey design was used, and 172 semi-structured questionnaires were administered to the end-users. A Logit regression was applied in analyzing the influence of the three contextual factors on acceptance and adoption of ICT by SMEs. Results indicated that age, CEO’s ICT knowledge, relative advantage, government policies on ICT applications, and pressure from suppliers and customers were the main determinants of ICT adoption. The study recommended that government should develop a differentiated ICT policy and incorporate compulsory training in computer applications in the national school curriculum. In addition, SMEs should set a mechanism for monitoring the changes in technological innovations as the electronic marketplace evolves.

Stephen M.A. Muathe: School of Business, Kenyatta University 

Charity Wairimu Muraguri-Makau: Chandaria School of Business, United States International University

Stephen M.A. Muathe Charity Wairimu Muraguri-Makau Entrepreneurial Spirit: Acceptance and Adoption of E-Commerce in the Health Sector in Kenya Vol. 7 Issue 08 PP. 08-14 August 2020 International Journal of Business Economics and Management Works.

[1]     Bii, H. & Gichoya, D. M. (2006). Challenges Of Establishing And Managing An Irm centre in a Kenyan public university: a Critical Review of Papers by Moi University’s IRM Centre Staff

[2]     Bowerman, B. L. & O’ Connell, R. T. (1990.). Linear statistical models an applied approach, 2nd edition. Boston: PWS-KENT Publishing Co,  

[3]     Burns, A.C. & Bush, R. F. (1998). Marketing research, 2nd edition. Prentice-Hall, Inc.,  Upper Saddle River, New Jersey.

[4]     Chapman, P., James-Moore, M., Szczygiel, M., & Thompson, D. (2000). “Building Internet capabilities in SMEs”, Logistics Information Management, Vol. 13 (6), 353-60.

[5]     Chepaities, E. V. (1996). The problem of data quality in a developing country, in Global Information Technology and Systems Management, Prashant Palvia; Shailendra C.Palvia; Edward M. Roche; (eds.), Ivy League Publishing,

[6]     Collins T. (2004). Final costs of NHS IT program rise to more than £18.6bn. Computer-Weekly.

[7]     Davis, F.D. (1989). “Perceived usefulness, perceived ease of use, and user acceptance of information technology”, MIS Quarterly, 13(3), 319-340.

[8]     DeLone, W.H., & McLean, E. R. (2003).“The DeLone and McLean model of  information system.... Journal of Management Information Systems, Vol. 13 (1), 145-166.

[9]     Department of Health and Children (2005). Health Information: A National Strategy. Dublin, Ireland   URL: [accessed 2008 Feb 1]

[10]  Iacovou, C.L, Benbasat, I. & Dexter, A.S. (1995). “Electronic data interchange and small organizations: Adoption and impact of technology”, MIS Quarterly, Vol. 19 ( 4), 465-485.

[11]  Igbaria, M., Parasuraman, S., & Baroudi, J.J. (1996). “A motivational model of microcomputer usage”, Journal of Management Information Systems, Vol. 13 (1), 127-43.

[12]  Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academies Press; June 1.  

[13]  International Finance Corporation (2005). Kenya, international finance corporation. African region department. Kenya SME country study. Washington, DC.

[14]  International Labor Organization (2001). World employment report – Life at work in the information economy, Geneva.

[15]  Kabaara (2004). Kenya’s draft ICT policy and strategy negates development goals’.,

[16]  Kaberia S. K. & Muathe, S.M.A. (2019). Nexus between Social Capital and Firm Performance: A Critical Literature Review and Research Agenda. International Journal of Business and Management.14(8) 70.

[17]  Kapurubandata, M. Arunatileke S., & Ginige, A., (2004). Application of eBusiness strategies for SMEs in developing countries, IEEE 2004, Taipei, Taiwan. Pp 49-59.

[18]  Karki, L. B. & Bauer, S. (2004). Technology adoption and household food security.  Analyzing factors determining technology adoption and impact of project intervention: A case of smallholder peasants in Nepal. Paper presented in the Deutscher Tropentag, held on 5-10 October, Humboldt-University of Berlin.

[19]  Kashorda, M. (2007). Measuring ICT usage in the SME sector ICT indicators and diffusion; paper present on 8th September at the 8th Strathmore University ICT conference.

[20]  Montague J. (1996): “Look ma, no wires!” Hospitals and health networks, Vol. 70 (8),  78-79.

[21]  Morris, M.G., Venkatesh, V., & Ackermann, P.L. (2005). “Gender and age differences  in employee decisions about new technology: an extension to the theory of planned behavior”, IEEE Transactions on Engineering Management, Vol. 52 (1), 69-84.

[22]  Muathe, S.M.A., (2010). The Determinants of Adoption of Information and Communication Technology by Small and Medium Enterprises within the Health Sector in Nairobi, Kenya, unpublished PhD thesis, Kenyatta University, Kenya.

[23]  Muathe, S.M.A., Wawire, N.H.W., & Ofafa, G.A., (2013). An Empirical Study on the Relationship between Organizational Factors and Adoption of ICT among Health related SMEs in Nairobi, Kenya. International Journal of Arts and Commerce Vol. 2 No. 3.PP. 1-16

[24]  Mugenda, O., & Mugenda, A.  (2003). Research methods, quantitative and qualitative approaches, Nairobi Acts press.

[25]  Müller-Falcke, D. (2001). The use of telecommunication and information technologies   in Small Businesses – Evidence from Indian Small Scale Industry.

[26]  Mwabu G. (1995).  Health care reform in Kenya: a review of the Process. Health Policy 1995; 32(1-/3): 245-55.

[27]  Nguo, J. (2004). “Role of ICTs in rural development”, Paper presented at the second national ICT convention, Nairobi, Kenya

[28]  Organization for Economic Co-operation and Development (2002). The impacts of  electronic commerce on business: Summary, DSTI/ICCP/IE (2002) 5/FINAL, OECD, Paris.

[29]  Palvia, P.C., Palvia S.C.J. & Whitworth, J.E. (2002). Global information technology: A meta analysis of key issues, Information and Management, Vol. 39 (5), 403-414

[30]  Simba, D.O. (2004). “Application of ICT in strengthening health information systems in  developing countries in the wake of globalization”. African Health Sciences, Vol. 4(3), 195-199.

[31]  Sillence, J. A. A. MacDonald, S., Lefang, B. and Frost, B. (1998). “E-mail adoption, diffusion, use and, impact with small firms”: A survey of UK companies, International Journal of Information Management, Vol. 18 (4),  231-242

[32]  Sun, H. & Zhang, P., (2005) An empirical study on causal relationships between perceived enjoyment and perceived ease of uses, proceedings of the Pre-ICIS 05 Annual Workshop on HCI in MIS (HCI/MIS’05), Las Vegas, NV. December

[33]  Tabachnick, B.G. & Fidell, L. S., (1996). Using multivariate statistics, 3rd ed. New York: Harper Collins.

[34]  Tawane, I.A. & Muathe, S.M. (2019). Strategy Implementation and Growth of Small and  Medium Enterprises in Garissa County, Kenya. Eastern Africa Journal of Contemporary Research, 1(2), 79-88.

[35]  Titus, S.W., Mburu, T.K., Korir, J., Muathe, S.M.A., & Obere, A. (2013). Organizational factors that Influence the Adoption of Inter-Organizational Information Systems by Universities in Kenya. International Journal of Education and Research Vol. 1 No.8

[36]  Todd, P. A. & Taylor, S.  (1995). “Understanding information technology usage: A test of competing models,” Information Systems Research, Vol.6 (2),144-176.

[37]  Thong, J.Y.L. (1999).”An integrated model of information systems adoption in small business,” Journal of Management Information Systems, Vol.15 (4), 187-214

[38]  Tung, L.L. & Rieck, O. (2005). Adoption of electronic government services among business organizations in Singapore. Journal of Strategic Information Systems, Vol. 14 (4), 417-440.

[39]  Erdener, K., Ekrem, T., & Veysel. K. (2005). “An analysis of the factors affecting the  adoption of electronic commerce by SMEs. Evidence from an emerging Market”, Journal of International Marketing Review, Vol.  22 (6), 623-640

[40]  Erumban, A.A. & de Jong, S.B. (2006). “Cross–country differences in ICT adoption: A consequence of culture?” Journal of World Business, Vol. 41(4), 302–314.

[41]  Evusa, J. E. (2005). Information communication technologies as tools for socio-economic and political development: the national council of churches of Kenya (NCCK) Huruma Community telecentre as a case study, a doctor of philosophy dissertation, Ohio University.

[42]  [42] Eysenbach G. (2001). What is e-health? Journal of Medical Internet Research; J Med Internet Res 2001; 3(2):e20. [URL: 2008 March 2]

[43]  Fallon, M., & Moran, P. (2000). Information communication technology and manufacturing SMEs, paper presented to the small business enterprise and Development Conference, University of Manchester, Manchester, 10-12 April, .

[44]  Field, A. P. (2005). Discovering statistics using SPSS, 2nd edition. London: Sage

[45]  Glesne, C. (1998). Becoming qualitative researchers: An introduction: 2nd Ed. New  York: Longman.

[46]  Getao, K.W., & Wausi. A.N. (2005). Cultural dynamics and. Information and Communication technology, School of Computing and Informatics, University of Nairobi

[47]  Gibbs, J., Kraemer, K.L., & Dedrick, J. (2003). “Environment and policy factors shaping global e-commerce diffusion: a cross-country comparison”, Information Society, Vol. 19 (1), 5-18.

[48]  KashordaM. & Mbui, W. (2007). ICT for trade and economic growth- Kenya study,  a paper presented at CODI V in Addis Ababa

[49]  Kiarie, J.N., Ng’ang’a S.I., Kitainge, K.M., & Too, J.K. (2006). Factors affecting adoption of ICT in small business in Eldoret town, Kenya. Makerere university business school, 12th annual International Management Conference November 21st – 24th l2

[50]  Kiveu, M.N., Namusonge, M., & Muathe, S., (2019). Effect of Innovation on Firm Competitiveness. The case of Manufacturing SMEs in Nairobi County, Kenya. International Journal of Business Innovation and Research, Vol.18. Issues 3.  PP 307-327

[51]  Kothari, C.R. (2007). Research Methodology Methods & Techniques 2nd.  Edition Jaipur, India

[52]  Lange, T., Ottens, M., & Taylor, A. (2000). “SMEs and barriers to skills development: a Scottish perspective”, Journal of European Industrial Training, Vol. 24 (1). 5-11.

[53]  Malhotra, N.K., & Birks, D.F. (2003). Marketing research: An applied approach, 2nd European edition, Financial Times Prentice Hall, Harlow,

[54]  Marjan, G. (2006). Internet adoption decision model among Iranian small and medium enterprises, unpublished MBA thesis, Iran, Lulea University of Technology.

[55]  Menard, S. (1995). Applied logistic regression analysis, Sage Publications. Series: Quantitative applications in the social sciences, No. 106.  

[56]  Ministry of Economy, Trade and Industry of Japan (2001). White paper on small and medium enterprises in Japan, SME Agency of Japan.

[57]  Poon, S. (2000). Business environment and Internet commerce benefits: a small  business perspective, European Journal of Information Systems, Vol. 9 (2), 72-81

[58]  Poon, S. & Swatman, P.M.C. (1999). An exploratory study of small business Internet commerce issues. Information and Management Vol. 35 (1), 9-18.

[59]  Premkumar, G., & Roberts, M.(1999). Adoption of new information technologies in rural small businesses. Omega 27 (4), 467–84.

[60]  Rashid, M. A. & Al-Qirim, N. A. (2001). “E-commerce technology adoption framework by New Zealand small to medium enterprises”. Research letters Information Mathematical Science, Vol.  2 (1), 63-70.

[61]  Republic of Kenya, (2006). National information and communications technology. Policy. Ministry of information and. Communications. January.

[62]  Republic of Kenya, (2007). Kenya’s vision 2030, Transforming national development, Nairobi: Government Printer.

[63]  Rice, R.E. & Katz, J.E. (2003). ‘Comparing Internet and mobile phone usage: digital divides of usage, adoption and dropouts’, Telecommunications Policy 27 pp. 597-623.

[64]  Rogers, E. (2003): Diffusion of innovations, 5th ed. New York, the Free Press.

[65]  Saunders, M. Lewis, P. & Thornhill, A. (2003). Research methods for business students, 3rd. edition, Great Britain, Prentice Hall

[66]  Seyal, A. H. & Rahman, M. N. A. (2003). “A preliminary investigation of e-commerce adoption in small & medium enterprises in Brunei”. Journal of Global Information Technology Management, Vol. 6 (2), 6-26.

[67]  Silber D. (2003). The case for e-health. (Presented at the European commission’s first high-level conference on e-health May 22/23 2003.) European Institute of Public Administration.

[68]  United Nations Industrial Organization (2003). To enhance the contribution of an efficient and competitive small and medium-sized enterprise sector to industrial and economic development, Islamic republic of Iran, Vienna, united nations industrial development organization.

[69]  United Nations Industrial Organization (2004). “Advanced technologies: from elusive promise to reality in sub-Saharan Africa”, UNIDO industrial report.

[70]  United States of America (2001). Information for health: A strategy for building the national health information infrastructure. Washington, DC: US Department of Health and Human Services; Nov 15.

[71]  Venkatesh V., M.G. Morris, G.B. Davis & Davis F.D. (2003). “User acceptance of information technology: toward a unified view”. MIS Quarterly Vol.27 (3), 425-78.

[72]  Waithaka, S.T., Mburu, TK., Korir, J. & Muathe, S, (2013). The Relationship between Technological Factors and Inter-Organizational Information Systems Adoption by Universities in Kenya. Engineering International Vol. 1 Issues 1.

[73]  World Health Organization (2005a). Information and communication technologies for improving performance of the health workforce Geneva..

[74]  World Health Organization (2005b). Global observatory for e-health (GOE) Geneva.