TOTAL QUALITY MANAGEMENT STRATEGIES AND CUSTOMER

LOYALTY IN NAIROBI: A CASE OF GLAXOSMITHKLINE

PHARMACEUTICALS LIMITED

BY

KABURU PERIS WAMBUI

UNITED STATES INTERNATIONAL UNIVERSITY_ AFRICA

SUMMER 2021

TOTAL QUALITY MANAGEMENT STRATEGIES AND CUSTOMER

LOYALTY IN NAIROBI: A CASE OF GLAXOSMITHKLINE

PHARMACEUTICALS LIMITED

BY

KABURU PERIS WAMBUI

A Research Project Report Submitted to the Chandaria School of Business in Partial

Fulfilment of the Requirement for the Degree of Master of Business Administration

(MBA)

UNITED STATES INTERNATIONAL UNIVERSITY_ AFRICA

SUMMER 2021

ii

STUDENT’S DECLARATION

This research project is my original work and has not been submitted to any other college,

institution or university other than the United States International University in Nairobi for

academic credit.

Signed: ……………………………………………… Date: ………………………………….

Kaburu Peris Wambui

ID No: 659416

This research project has been presented for examination with my approval as the appointed

supervisor.

Signed: ………………………………………………. Date: …………………………

Dr. Charity W. Muraguri

Signed: ………………………………………….. Date: ……………………………

Dean, Chandaria School of Business

iii

COPYRIGHT

This work is the product of the author; hence no part of this paper shall be reproduced or

transmitted electronically or mechanically including photocopying, reprinting or redesigning

without the prior permission of the author.

© 2021 Kaburu Peris Wambui

iv

ABSTRACT

The general purpose of this research project was to determine the effect of TQM strategies on

customer loyalty in Nairobi: A Case of GlaxoSmithKline Pharmaceuticals Limited. The study

was guided by the following research questions; What is the effect of product continuous

improvement on customer loyalty in the Nairobi Pharmaceutical Industry? What is the effect

of customer focus on customer loyalty in the Nairobi Pharmaceutical Industry? And what is

the effect of service quality on customer loyalty in the Nairobi Pharmaceutical Industry?

This study adopted a descriptive research design to determine the relationship between

dependent and independent variables. The research’s population was all the 40 organizations

that purchase pharmaceutical products directly from GlaxoSmithKline Pharmaceuticals

Limited. The sampling frame was a list of all the 40 GSK customers. The customers were

divided into five zones namely; Nairobi North, Nairobi East, Nairobi West, Westlands and

Nairobi Outskirts. The sample size, calculated using Yamane formula, was 21 GSK customers.

Convenient sampling was used in the study to select the sample. Simple random sampling was

used to select respondents for this study. Structured questionnaires were administered to the

21 respondents. Data collected was decoded and entries made into Statistical Package for

Social Science (SPSS version 26). Descriptive statistics such as frequencies and percentages,

measures of central tendency (means) and dispersion (standard deviation) were used. The study

also used cross tabulation and Chi-square analysis to profile pharmaceutical brand consumption

across demographics.

The study established that product continuous improvement impacts customer loyalty in

pharmaceutical industry in that customers are keen on purchasing medicine based on perceived

quality, they are keen on monitoring quality improvements as well as comparing medicine

quality across multiple companies before making a ‘buy decision’. Customers also refused to

purchase medicine based on perceived low quality, would not purchase medicine that has been

banned in Kenya due to degenerative quality, only make purchases from companies that have

consistent product continuous improvement strategies and always seek advice from fellow

professionals before trusting any perceived product improvements. The study findings also

established that, customers are keen on identifying customer focused pharmaceutical firms,

customers only purchase medicine from firms which have customer focus, customers always

give feedback on medicine to help the pharmaceutical organisation improve on their customer

focus strategy, GSK customers do not allow their customers to purchase products which they

v

believe are not customer focused, GSK customers advise customers based on their

pharmaceutical company's perceived customer focus measurement. Additionally, the study

established that service quality impacts customer loyalty in the Nairobi pharmaceutical industry

in that product information received from the medical representative impacts repeat purchase

decision of customers in GSK. The mode of presentation used by the medical representative

impacts customer’s loyalty to the brand. The product clearance services received at the

manufacturing site impact clients’ repeat purchase decision. Perceived bad service quality

would lead customers to stop purchasing the pharmaceutical's products. The study concludes

that product continuous improvement and customer focus highly influence customer loyalty in

the Nairobi Pharmaceutical Industry. There is also a significant relationship between service

quality in the Nairobi pharmaceutical industry and customer loyalty which means that service

quality does not influence customer loyalty as much as product continuous improvement and

customer focus do.

The study recommends that product continuous improvement processes generally require

pharmaceutical professionals and staff from different specialties, functions, or units to work

together in order to document how the process flows in its entirety and distinguish the key

interaction factors that assume an integral part in customer loyalty. This study also recommends

that since customer focus has an impact around customer loyalty in the Nairobi pharmaceutical

industry, it is essential for administrators in the Nairobi pharmaceutical industry to start

statistical surveying in order to discover client needs, give clear channels of correspondence

and address client grumblings as expected. There is need for the pharmaceutical company to

differentiate between itself from other pharmaceutical companies through` the competitive

environment which is accomplished through offering excellent types of assistance. Customer

loyalty is cultivated when a customer is content with the customer focussed attention they

receive from an organization.

vi

ACKNOWLEDGEMENT

I express my heartfelt thanks the Almighty God for enabling me to complete this research

project. I would also like to acknowledge my supervisor Dr. Charity Muraguri for the generous

support and knowledge offered to me. My further gratitude goes to my friends and family for

their immense support.

vii

DEDICATION

I dedicate this thesis to my family for their support during my academic struggles. With their

limited resources I found success in my education.

viii

TABLE OF CONTENTS

STUDENT’S DECLARATION ........................................................................................ ii

COPYRIGHT .................................................................................................................. iii

ABSTRACT .................................................................................................................... iiv

ACKNOWLEDGEMENT .............................................................................................. ivi

DEDICATION ............................................................................................................... viii

TABLE OF CONTENTS ............................................................................................... xiii

LIST OF TABLES ............................................................................................................ x

LIST OF FIGURES ......................................................................................................... xi

LIST OF ACRONYMS .................................................................................................. xii

CHAPTER ONE ............................................................................................................... 1

1.0 INTRODUCTION ...................................................................................................... 1

1.1 Background of the Study ............................................................................................... 1

1.2 Statement of the Problem .............................................................................................. 7

1.3 Purpose of the Study ..................................................................................................... 8

1.4 Research Questions ....................................................................................................... 8

1.5 Justification of the Study ............................................................................................... 8

1.6 Scope of the Study ........................................................................................................ 9

1.7 Definition of Terms .................................................................................................... 10

1.8 Chapter Summary ....................................................................................................... 11

CHAPTER TWO............................................................................................................ 11

2.0 LITERATURE REVIEW ......................................................................................... 12

2.1 Introduction ................................................................................................................ 12

2.2 Product Continuous Improvement and Customer Loyalty ............................................. 12

2.3 Customer Focus and Customer Loyalty ....................................................................... 16

2.4 Service Quality and Customer Loyalty......................................................................... 20

2.4 Chapter Summary ....................................................................................................... 26

ix

CHAPTER THREE ........................................................................................................ 27

3.0 RESEARCH METHODOLOGY.............................................................................. 27

3.1 Introduction ................................................................................................................ 27

3.2 Research Design ......................................................................................................... 27

3.3 Population and Sampling Design ................................................................................. 27

3.4 Data Collection Methods ............................................................................................. 29

3.5 Research Procedures ................................................................................................... 30

3.6 Data Analysis Methods ............................................................................................... 31

3.7 Chapter Summary ....................................................................................................... 32

CHAPER FOUR ............................................................................................................. 33

4.0 RESULTS AND FINDINGS ..................................................................................... 33

4.1 Introduction ................................................................................................................ 33

4.2 Demographic Information ........................................................................................... 33

4.3 Product Continuous Improvement and Customer Loyalty ............................................. 39

4.4 Customer Focus and Customer Loyalty ....................................................................... 44

4.5 Service Quality and Customer Loyalty......................................................................... 50

4.6 Chapter Summary ....................................................................................................... 55

CHAPTER FIVE ........................................................................................................... 56

5.0 DISCUSSIONS, CONCLUSIONS AND RECOMMENDATIONS .......................... 56

5.1 Introduction ................................................................................................................ 56

5.2 Summary .................................................................................................................... 56

5.3 Discussion .................................................................................................................. 59

5.4 Conclusions ................................................................................................................ 65

5.5 Recommendations....................................................................................................... 66

REFERENCES ............................................................................................................... 69

APPENDIX I: QUESTIONNAIRE ................................................................................ 76

APPENDIX I: TARGET POPULATION CUSTOMER LIST ...................................... 81

APPENDIX I: INSTITUTION REVIEW BOARD LETTER ........................................ 82

APPENDIX I: NACOSTI RESEARCH PERMIT ......................................................... 83

x

LIST OF TABLES

Table 3.1 Target Population………………………………………………………….…28

Table 3.2 Sampling Size Distribution……………………………………………….….29

Table 4.1 Response Rate…………………………...………………………………..….33

Table 4.2 Frequency of Purchase of Pharmaceutical Products……………...........…….38

Table 4.3 Reasons for Purchase of Pharmaceutical Products…..……………………….39

Table 4.4 Descriptive Analysis for Product Continuous Improvement on Customer

Loyalty in the Nairobi Pharmaceutical Industry………...…...……………....40

Table 4.5 Correlation Analysis for Product Continuous Improvement and Customer

Loyalty………………..……………………………………………………...41

Table 4.6 Model Summary Product Continuous Improvement ……...………..……….42

Table 4.7 Regression ANOVA Product Continuous Improvement ………...………….43

Table 4.8 Regression Coefficients Product Continuous Improvement …..…………….44

Table 4.9 Descriptive Analysis for Customer Focus on Customer Loyalty in the Nairobi

Pharmaceutical Industry……...……………………………………………....46

Table 4.10 Correlation Analysis for Customer Focus and Customer Loyalty…………...47

Table 4.11 Model Summary Customer Focus …………………………………..……….49

Table 4.12 Regression ANOVA Customer Focus ……………………………………….49

Table 4.13 Regression Coefficients Customer Focus ……………………………..…….50

Table 4.14 Descriptive Analysis for Service Quality on Customer Loyalty in the Nairobi

Pharmaceutical Industry………………...…………………………………....51

Table 4.15 Correlation Analysis for Service Quality and Customer Loyalty…………....52

Table 4.16 Model Summary Service Quality ………………………………..….……….53

Table 4.17 Regression ANOVA Service Quality ……………………….……………….54

Table 4.18 Regression Coefficients Service Quality …………………………………….55

xi

LIST OF FIGURES

Figure 4.1 Gender Composition………………………………………………………..34

Figure 4.2 Age of Respondents.………………………………………………………..35

Figure 4.3 Education Level of Respondents………………………………….………..36

Figure 4.4 Experience of Respondents in the Nairobi Pharmaceutical industry..……..37

xii

LIST OF ACRONYMS

DSRS Department of Standards and Regulatory Services

GSK GlaxoSmithKline

KPPB Kenya Pharmacy and Poisons Board

KQM Kenya Quality Model

KQMH Kenya Quality Model for Health

MBNQA Malcolm Baldrige National Quality Award

TQM Total Quality Management

1

CHAPTER ONE

1.0 INTRODUCTION

1.1 Background of the Study

Customers are consistently seeking quality products that suit the purpose and that are able to

withstand the intended functions. With the increase of customer purchasing power supported

by multiple and flexible financing schemes, customers find themselves surrounded by many

options to choose from. Therefore, there is a need to understand customers’ emotions and

preferences thereby giving rise to the implementation of TQM strategies by organisations.

Along with the increased use of TQM strategies, organisations are increasingly focusing on

product continuous improvement, customer focus and service quality.

Practically, TQM strategies have been seen to affect customer loyalty in the pharmaceutical

industry. For example, In India, Mazumder, Bhattacharya and Yadav (2011) conducted a study

on TQM strategies in Pharmaceuticals: the analysts noticed that usage of a viable quality

confirmation strategy is the most significant objective of the drug industry. The idea of value

confirmation and quality control together guarantee the quality, wellbeing and viability of

pharmaceutical items. Along these lines, quality is a fundamentally significant fixing to

authoritative achievement today, which can be accomplished by TQM strategies; a hierarchical

methodology that centres around quality as an overall objective, focused on the anticipation of

imperfections as opposed to recognition of deformities. It is a way of thinking and practice of

integrative quality service framework embraced worldwide in pharmaceutical businesses

alongside other administrative prerequisites. The TQM strategies viewpoint deems quality as

the pivotal purpose of the organization. Present audit endeavours outfit a wide outline of the

TQM strategies idea and the service implies prompting quality improvement of drugs.

The basic achievement factors in TQM strategies incorporate customer loyalty which prompts

maintenance, upgraded worker commitment, quality authority, measured control and

improvement. The significance of meeting and surpassing client desire (customer satisfaction)

has been set up by the marketing hypothesis. Further, it is seen that quality-delicate

organisations can distinguish their internal and external; clients, ready to build up precisely

what their needs are, ready to adjust all authoritative exercises like advertising, creation,

finance and human asset management towards satisfying their customers, Feigenbaum (2011).

2

Therefore, quality is basically the significant fixing to hierarchical achievement today which

can be accomplished by TQM strategies in an organisational wide methodology that centres on

quality as a general objective, (Feigenbaum, 2011). The premise of this methodology is that

hierarchical units ought to be working agreeably to fulfil the client. Since the client's needs are

in consistent transition, the organisation must endeavour to persistently improve its framework

and practices. The TQM viewpoint sees quality as the focal motivation behind the

organisations, as opposed to the emphasis on productivity upheld by the operational

perspective, (Feigenbaum, 2011).

A study in Malaysia by Alhakim (2013) researched TQM strategies basic achievement factors

in neighbourliness industry and their effect on Customer Loyalty; a hypothetical model. It

necessitates that the standards of TQM strategies should be applied in each branch and at each

level in the organisation with an accentuation; a mix into strategic policies and a harmony

between specialized, administrative and individuals issues. Quality is viewed as an

exceptionally incredible significance in the hospitality industry. The point of service quality is

having the option to guarantee a fulfilled client. Be that as it may, the focal point of value

activities has been basically on choice and preparing of forefront staff. The issues of estimation

and cycle improvement have been generally disregarded.

In Thailand, Supawadee, Rashid and Sakamoto (2015), conducted a research on Factors

Affecting Drug Quality Challenges in Thailand. Drug items assume a significant function in

improving wellbeing and advancing the prosperity of a person. Low quality or unsatisfactory

medications may bring about genuine wellbeing suggestions, including treatment

disappointment, unfavourable impacts, expanded dreariness, mortality and advancement of

medication obstruction, Supawadee et al., low quality medications are items, whose

arrangement and fixings don't satisfy official guidelines as far as quality, virtue, bundling and

marking are concerned. The items might be ineffectual and risky to the patient. Packaging

ought to give proper security to drug items from unsafe ecological variables, for example, light,

oxygen, carbon dioxide, and dampness over the time span of usability. All drug producers

ought to study the stability of each drugs in the appropriate containers Supawadee et al.

In Indonesia, Suhendar (2019) researched the impact of item quality, impression of cost and

satisfaction to client reliability in Pharmaceutical Companies. The analyst certified that client

reliability turns into a significant resource for each industry. Accordingly, to get a high

3

steadfastness from shoppers then an item ought to have the option to create an elevated level

of satisfaction to its clients. Consumer satisfaction is affected by different elements that exist

in the item. Item quality and value recognition are the two factors that impact the degree of

satisfaction since customers see a result of value and value at that point looks at the two

elements. The outcomes indicated that item quality has an effect on customer loyalty; value

discernments influence customer loyalty and satisfaction influence client devotion.

Abdi and Al-Manhawy ( 2013), in his study on the effect of TQM strategies on Customer

Loyalty in Egyptian inns, utilizing Cronbach's Alpha mean and standard deviation, discovered

that there is an immediate connection between service quality and customer loyalty. Sumarjan

and Arendt (2010), additionally found that knowing the advantages that could be acquired from

TQM strategies will enable the service group to inspire their workers in utilizing and conveying

quality service as expressed in their investigation on implementation of quality practices in

Malaysian hotels. Moghadam, Sayadi and Moharer ( 2013) contemplated TQM strategies in

the inn business of sports in Iran. Results from discoveries indicated the helpless states of TQM

strategies procedures in the area of Iran industry of game housing that require more endeavours

in that field. There is likewise ongoing investigation in TQM strategies applications to different

zones, for example, hospitality industry Abdi and Al-Manhawy (2013), medical care

establishments Adeoti (2008) and assembling and services institutions Anvari, and Moghimi

(2011).

In Nigeria, Nassar, Yahaya and Shorun (2015) studied TQM strategies and clients’ satisfaction

in service enterprises in Ilorin, Nigeria. The specialist noticed that inn area is an imperative

aspect of the friendliness business and it is the most testing since they offer in excess of an

item, (for example, accommodation and food service) to visitors and clients. This implies

overseeing quality in inns is more testing to inn supervisors and staff than it is in other

accommodation business. Information was sourced through organization of survey

questionnaires on eighty clients of hotels in Ilorin Metropolis. The respondents were chosen

utilizing basic irregular and purposive inspecting procedures. Direct Regression Analysis

Model was utilized to break down and test the exploration hypotheses. Overall results showed

a positive relationship between TQM strategies and customers’ satisfaction.

4

Wanderi (2015) conducted a research on Factors influencing implementation of total quality

management in building firms in Rwanda. The researcher found that the part of development

quality and nonstop improvement is imperative in the advancement of development industry

of developing countries. Development quality and customary improvement is connected with

the reception of value that the board frameworks in development organizations. It is in this

manner significant that sufficient measures are set up to guarantee quality in the area. TQM

strategies are considered as one of the most significant ways to accomplish quality in

development Industry in Rwanda as well as the world over.

In Uganda, a study by Murungi (2013) investigated total quality management and competitive

advantage of pharmaceutical industries in Uganda: a contextual analysis of CIPLA quality

synthetic ventures restricted. The specialist discovered a contextual investigation configuration

utilizing both quantitative and subjective methodologies of information assortment. The

investigation populace was 200 staff from CIPLAQCIL and an example of 133 respondents

was chosen. Notwithstanding, this example was changed to 114 respondents as this was the

quantity of usable surveys returned. The investigation reasoned that CiplaQCIL surveys and

guarantees ceaseless expert turn of events and knows about change in norms or current

administrative practices; it was likewise found that the organization guarantees that creation

and related cycles can accomplish drug results of required quality that agree to their particulars

and CiplaQCIL works intimately with its clients and providers to set up the best guidelines.

In Kenya, Apudo (2016) carried out a research on quality management practices and customer

retention in micro and small enterprises in Nairobi City County, Kenya. The activities and

methods of an organization which for the most part occur inside a quality setting characterize

its quality practices that conveyed items or services are of high calibre. Apudo (2016) expressed

that TQM strategies discernible aspects are shown by the acts of the organisation through which

the supervisors use to accomplish organization enhancements. The underlying and rudimentary

contributions to the usage of value among the executives in organisations, however, are not

restricted to the responsibility by the top service, the service of individuals, hierarchical

approach and its procedure, asset use and the board of the cycles along with other organizations

set up, Apudo (2016).

5

Chepkech (2014) investigated the effect of total quality management practices on

organizational performance in Kenya: an instance of tertiary foundations in Uasin Gishu

County. The analyst determined that, selection of TQM strategies rehearsed by organisations

in Kenya creates deliberate specialized guidelines, which enhance a wide range of business

tasks. These contribute towards making the turn of events and graceful items and services all

the more effective, more secure and cleaner, Chepkech (2014). To stay serious, benefit making

and non-benefit causing organisations in Kenya to have grasped TQM strategies. Quality

service rehearses fundamentally influence hierarchical performance accordingly; any tertiary

establishment directors intending to accomplish authoritative performance should give close

consideration to all the components of all out-quality service, Chepkech (2014).

A study in Kenya by Nzisa (2018) investigated quality management practices and customer

satisfaction in middle level colleges in Machakos County, Kenya. The scientist found out that

customer satisfaction is a benefit that ought to be monitored and kept up like other resources

in an organisation. The service needs to have embedded advance customer loyalty in service

arrangement in an organisation, centre level universities notwithstanding. It was determined

that preparing and advancement, client direction, consistent improvement and service styles

affected customer loyalty in Machakos educator trade school. Client direction is fundamental

for accomplishing customer loyalty and client direction basically influences time sensitive

effectiveness. Persistent improvement is a continuous steady upgrade where the school

proceeds with ordinary business exercises, while continually searching out new chances to

enhance their products, services and cycles. Leadership is a significant capacity of the

executives which assists with augmenting productivity and to accomplish hierarchical

objectives.

Wangui (2018) investigated effect of total quality management practices on operational

performance of food producing firms in Nairobi County, Kenya. The scientist uncovered that

TQM strategies have contributed towards activities of the executives’ key practices for

estimating corporate performance in the present quickly developing climate. Therefore, food

businesses are receiving TQM strategies to deal with their activities for upper hand just as

improved operational performance, Wangui (2018). The outcomes uncovered a huge positive

connection between TQM strategies performance and operational performance. The

discoveries additionally uncovered that among all TQM strategies rehearses, top service

responsibility had the most grounded relationship with operational performance, Wangui

6

(2018). The outcomes additionally demonstrated that the joint impact of TQM strategies

towards operational performance was critical. The specialist suggests replication of the

investigation in various areas and nations to upgrade comprehension of the connection between

TQM strategies performance and operational performance.

The Kenyan Pharmaceutical sector comprises of four sections namely retailers, hospitals,

distributors and the manufacturers, which play a key function to support the sector of health in

the nation. The Kenyan Pharmaceutical sector is mainly made up of Distributor Imports

although there are local manufacturing sites. Asoko Visions has recognized forty-five

registered pharmaceutical manufacturers by KPPB, Kenya Pharmacy and Poisons Board

(2017). Kenya has a substantial number of multinational pharmaceutical companies such as

AstraZeneca, GlaxoSmithKline and Novartis amongst others who import pharmaceutical

products into the market. Amongst the top local manufacturers are Lab & Allied Limited,

Universal Corporation Limited, Dawa Limited and Cosmos Limited. In 2016, there were 186

registered pharmaceutical distributors and approximately 700 registered wholesalers in Kenya,

operated by pharmaceutical technologists and pharmacists who are registered, based on the

medical directory Kenya Pharm Tech. The largest distributor of the pharmaceutical products

happens to be Kenya Medical Supplies Authority, Kenya Pharmacy and Poisons Board (2017).

As a requirement by the KPPB, the Pharmaceutical Distributors should be licensed in order to

operate. Before obtaining the license, the company should be assessed/ inspected by a member

of KPPB to ascertain that they meet the minimum required standards of maintaining product

integrity during storage and distribution of pharmaceutical products. The same assessment is

also performed by branded companies such as Novartis before a commercial contract or

agreement is signed in order to supply their pharmaceutical products. Quality Assurance is

therefore essential from a Health Authority and Multinational perspective, Kenya Pharmacy

and Poisons Board (2017).

The Kenya Pharmacy and Poisons Board is committed to its mission to ensure the availability

of pharmaceutical services in Kenya which satisfy the needs of all for the prevention, diagnosis

and treatment of diseases using safe, efficacious, high quality and cost-effective pharmaceutical

products. Pursuant to this mission, it is imperative that pharmaceutical products are distributed

by highly qualified personnel through outlets that are duly licensed and professionally run. The

operations in those premises should at all times be supervised by qualified personnel and the

risk of exposing the public to unsafe medicines avoided at all cost. Guidelines have been

7

prepared to provide distributors of pharmaceutical fraternity with a method of assessing

eligibility and the process of lawfully operating drug distribution outlets, Kenya Pharmacy and

Poisons Board (2017).

1.2 Statement of the Problem

The pharmaceutical industry is a vital segment of the health care system which conducts

research, manufacturing and marketing of pharmaceutical products; what's more, organic

products and restorative gadgets utilized for the finding and treatment of ailments. The low

qualities of prescriptions are a wellbeing danger, yet additionally a misuse of cash for both

government and individual purchasers, Sigei (2014). In this way, the support of value with

ceaseless improvement in offices is significant in pharmaceutical industry. The pursuit of

quality being approached through the concept of TQM strategies which is focused on

anticipation of imperfections as opposed to recognition of deformities. Quality must be

incorporated with a drug item during item and cycle plan and it is affected by the physical plant

configuration, space, ventilation, neatness and sterilization during routine creation.

Different studies have been conducted on the TQM strategies and organisational performance

both locally and universally. Gharakhani, Rahmati, Farrokhi, and Farahmandian (2013), took

a gander at TQM and performance of organisations in the United States of America. The

investigation set up that there is a solid relationship between the TQM strategies and

performance of the organisation. Munizu (2013) explored the Impact of Total Quality

Management Practices towards Competitive Advantage and Organizational Performance: Case

of Fishery Industry in South Sulawesi Province of Indonesia.

Locally, Muia (2014) studied the effect of TQM implementation in the performance of

microfinance institutions in Kenya. Gaya (2012), studied the influence that Total Quality

Management has on the human resource planning practices at Kenya Revenue Authority.

Mukonyo (2014) researched on the effects of Total Quality Management Implementation in

Performance of Microfinance Institutions in Kenya; Mutua (2014) investigated quality

management practices and financial performance of pharmaceuticals manufacturing firms in

Kenya. Wangai (2015) studied Total Quality Management and performance of pharmaceutical

manufacturing and distributing firms in Kenya. Mwaura (2017) studied the effect of Total

Quality Management on performance of Kenya Revenue Authority. Githuku (2015) researched

on Total Quality Management in Kenya’s healthcare industry. Diamond (2015) researched on

8

Total Quality Management practices and operational performance of private hospitals in

Nairobi County. Mwaniki and Okibo (2014) conducted a study on the effect that Total Quality

Management has on the performance of banking sector , National bank of Kenya being a case

study. Ocharo (2017) studied effects of implementation of Total Quality Management on the

performance of hospitality industry. What is the gap in these studies

Nevertheless, some efforts in the area of applicability of TQM strategies have been done in

various sectors but there exists lack of methodical empirical evidence about the effect of TQM

strategies on customer loyalty in the pharmaceutical industry in Nairobi. It is therefore in this

light that the study will assess the effect of TQM strategies on customer loyalty in the Nairobi

pharmaceutical industry: a case of GlaxoSmithKline Pharmaceuticals Limited.

1.3 Purpose of the Study

The determine the effect of Total Quality Management strategies on customer loyalty in the

Nairobi Pharmaceutical Industry: a case of GlaxoSmithKline Pharmaceuticals Limited.

1.4 Research Questions

1.4.1 What is the effect of product continuous improvement on customer loyalty in the Nairobi

pharmaceutical industry?

1.4.2 What is the effect of customer focus on customer loyalty in the Nairobi pharmaceutical

industry?

1.4.3 What is the effect of service quality on customer loyalty in the Nairobi pharmaceutical

industry?

1.5 Justification of the Study

1.5.1 Regulatory Authorities

This study will help regulatory authorities find out whether TQM strategies have any effect on

customer loyalty in products. Using this research’s findings, the regulatory authorities will be

in a position to make more informed regulations around TQM strategies in the Kenyan

Pharmaceutical industry.

9

1.5.2 Pharmaceutical Industry

Findings of this research will help shed light on whether customers’ loyalty is tied to the TQM

strategies employed by a pharmaceutical company. The Kenyan Pharmaceutical Industry can

then tailor make their decisions to fit the findings of the research so as to better manage their

customer loyalty.

1.5.3 Medical Researchers

This research will be used by future researchers in the medical field as part of the literature

resources available for backing or critique. Medical researchers will use this study to help in

making decisions regarding improvement of customer loyalty. The study will guide them in

capitalizing on the factors that lead to the highest customer loyalty.

1.5.1 Pharmaceutical Firms Management

The management of pharmaceutical firms will want to know how TQM strategies impact their

business and to manage and increase their sales through brand loyalty enhancement. The

findings from this study will enable the management of pharmaceutical firms to realize the

extent to which their customers are loyal to their brands and therefore develop sound sales and

customer retention strategies that maintain and enhance the loyalty of their customers.

1.6 Scope of the Study

The main focus of this research was to determine the effect of Total Quality Management

strategies on customer loyalty in the Nairobi Pharmaceutical Industry: a case of

GlaxoSmithKline Pharmaceuticals Limited. The geographical scope of the study was Nairobi.

This research’s population was 40 GSK customers that purchase pharmaceutical products

directly from GlaxoSmithKline Pharmaceuticals Limited. The sampling frame was a list of all

the 40 GSK customers. Convenient sampling was used in the study to divide the population

into five zones namely; Nairobi North, Nairobi East, Nairobi West, Westlands and Nairobi

Outskirts . The sample size was 21 GSK customers all based in Nairobi. Simple random

sampling was used to select respondents for this study. Structured questionnaires were

administered to the 21 respondents.

10

Moreover, the study faced limitations owing to reliability and adequacy of data collected. To

mitigate this, primary data was collected, and comparison/discussion made with secondary

data, thus, complement each other as both sources have their merits and demerits. While

secondary data was difficult to obtain, questionnaires were able to obtain information not

contained in the previous reports. The study was limited by the difficulty in getting the

respondents to fill-in the questionnaires owing to their busy schedule besides gauging the

objectivity or otherwise with which they answered the questionnaires. Additionally, the

conservative nature of some respondents made it difficult for them to divulge personal

information sought after by the study. However, these constraints were overcome by requesting

the respondents to fill-in the questionnaires at their own free time. The study also used the

introductory letter from the University to provide assurance of confidentiality of information

obtained.

1.7 Definition of Terms

1.7.1 Total Quality Management Strategy

According to Mehrota (2004), total quality management strategy is a management philosophy

that seeks to integrate all organizational functions to focus on meeting customer needs and

organizational quality objectives.

1.7.2 Customer Loyalty

Kotler and Pfoertsch (2006) observed that Customer Loyalty is all about attracting the right

customer, getting them to buy, buy often, buy in higher quantities and bring you even more

customers.

1.7.6 Product Continuous Improvement

Esin and Hilal (2014), continuous improvement, sometimes called continual improvement, is

the ongoing improvement of products, services or processes through incremental and

breakthrough improvements.

1.7.5 Customer Focus

This term is used to refer to the direction of an organisation towards helping meet its clientele’s

wants; better linking an organization and its customers Mehra, Hoffman and Sirias (2001).

11

1.7.4 Service Quality

Beryl and Brodeur (2007), service quality incorporates tangibles that is the physical proof of

the service: appearance of physical offices, apparatuses and hardware used to offer the

assistance, appearance of staff and correspondence materials, also is dependability which is the

capacity to play out the guaranteed service reliably and precisely: consistency of performance

and trustworthiness.

1.8 Chapter Summary

This chapter gives an overview of how TQM strategies relate to customer loyalty in the Nairobi

Pharmaceutical Industry. It has also detailed the background of the study, the statement of the

problem, the purpose of the study, the research questions, a justification of the study, the scope

of the study and definition of terms. Chapter Two seeks to highlight and acknowledge the

works done by other authors in relation to the research questions identified in Chapter One.

Chapter Three reviews the methodology of the study. It discusses the research design and

reasons for the choice therewith. It also discusses the population of study, sample and sampling

techniques, data collection methods as well as data analysis and data presentation methods

employed in the study. Chapter Four entails the results and findings of the study as set in the

research objectives and methodology. Chapter Five is the last Chapter. It presents a summary

of the study findings, discussion of findings, conclusions and recommendations. The findings

are summarized in line with the objectives of the study. The specific objectives of the study

were; product continuous improvement, customer focus, and service quality on customer

loyalty in the Nairobi pharmaceutical industry.

12

CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 Introduction

This Chapter seeks to highlight and acknowledge the works done by other authors in relation

to the research questions identified in Chapter One which are; What is the effect of product

continuous improvement on customer loyalty in the Nairobi Pharmaceutical Industry? What is

the effect of customer focus on customer loyalty in the Nairobi Pharmaceutical Industry? And

what is the effect of service quality on customer loyalty in the Nairobi Pharmaceutical

Industry? The purpose of this study is to determine the effect of TQM strategies on customer

loyalty in the Nairobi Pharmaceutical Industry: a case of GlaxoSmithKline Pharmaceuticals

Limited.

2.2 Product Continuous Improvement and Customer Loyalty

2.2.1 Upskilling

Esin and Hilal (2014) focused on the impacts of continuous improvement and performance of

firms in Turkey where a cross-sectional overview technique was utilized, and the unit of the

example was at the plant level. The results of the study demonstrated that organizations should

give essential learning opportunities, through contribution preparing, to every one of their

workers in order to improve their proficiencies in their undertakings. Powerful continuous

improvement in quality brings accomplishment for the organizations. Employees' successful

information and learning ability will give supportability of value to the executives in the firm.

Moreover, learning organisations adjust quickly to the progressions and create one of a kind

conducts which recognize them from different firms and empowers them to acquire better

outcomes. Product quality doesn't start in one division or capacity; it is the duty of the entire

firm. Training ought to be given to all employees based on the results of the training needs

assessment.

Kaziliunas (2010) focused on the effect of continuous improvement on quality assurance of

firms in Malaysia. The study noted that achievement factors for consistent improvement of

cycles incorporate top management improvement, improvement in remuneration frameworks,

group work, 13 persuasive variables and instruction and preparing. The investigation

discoveries derived that there was a connection between the aforementioned qualities and

prerequisites, hence supporting the quality assurance standard and organisations' vital

measurements. The study inferred that instruction and preparing of representatives is another

13

method of giving workers the information and aptitudes to meet their general work and

individual target. Whenever done reliably and strengthened in the working environment by

ongoing refreshers, education and training, it can form a solid base for continuous improvement

and hence quality assurance.

One of the early continuous integration pioneers in healthcare, Donabedian (2003), implies that

to have the option to oversee, improve and execute more broad quality activities and upgrades

it is important to watch, measure, and assess. Without doing this, how would we realize what

to improve and whether we have succeeded? There is a need to discover evidence for

enhancements to have the option to spread and actualize them as a major aspect of medical

services. In medical services, instruments have been created to gauge clinical outcomes and

results, for example, careful death rates and trial of new treatments, Berwick, James and Joel

(2003). Estimations additionally need to have importance to everyone included, that being;

physicians, other medical care staff, patients and whole healthcare organizations, McIntyre

(2012).

A Kenyan study by Wangai (2015) on Total Quality Management and performance of

pharmaceutical manufacturing and distributing firms in Kenya established that an appropriate

system of acknowledgment and prize is critical to any organization's TQM strategies,

especially as the quality improvement measure offers more prominent organisation open doors

for standard working individuals. Uplifting feedback through acknowledgment and prize

giving is basic for accomplishment through participative critical thinking ventures. Individuals

work for accomplishment, headway, expanded duty, recognition job interest as well as money.

A study was conducted by Wanyoike (2016), to examine the connection between the exhibition

of a given firm and Total Quality Management in Kenyan firms. The specialist utilized essential

information gotten through self-administered questionnaires. The examination received a cross

sectional study. The objective populace involved sixty drug manufacturing and distribution

firms in Kenya. The examination results demonstrated that persistent improvement in the TQM

strategies significantly affects the performance of firms operating in the manufacturing sector.

14

2.2.2 Engagement and Mobilization

In Indonesia Musrani (2013) conducted a study on The Impact of Total Quality Management

Practices towards Competitive Advantage and Organizational Performance: Case of Fishery

Industry in South Sulawesi Province of Indonesia. The specialist stated that non-stop

improvement is a basic component in a cutting-edge quality framework that targets improving

proficiency by advancing a cycle and taking out squandered endeavours that are underway.

Improvement endeavours are done in an organized way with suitable pre-characterized

convention and oversight. These endeavours are basically coordinated towards decreasing

inconsistency in the cycle and item quality attributes and are not for changing the principal plan

of an assembling cycle. Constant improvement items should as of now follow the particulars

and cycle improvement steps (For example, modification of cycle boundaries, presentation of

new gear of a similar plan, and working standards with cutting edge control choices).They

ought to be inside the first "plan space". That is, such improvement steps are not considered as

"changes" because product quality and performance (for example, bioavailability, shelf-life)

are assured.

An empirical study on Continuous improvement of quality medical care arrangement was

directed by Alexander, Weiner and Griffith (2006). The investigation was done on an example

of 1,784 public emergency clinics in the United States of America, which were chosen due to

their being reasonable and serving an enormous number of individuals. The study design was

a cross-sectional investigation of the 1,784 network emergency clinics. The data collection

techniques were through organized meetings and surveys. The findings were that continuous

improvement measures by and large necessitate that clinical experts and emergency clinic staff

from various fortes, capacities, or units to cooperate so as to archive the cycle functions

completely and distinguish the key cycle factors that assume a causal part in measuring

performance. It additionally requires assembling huge quantities of emergency clinic staff,

furnishing them with specialized aptitude in continuous integration strategies and apparatuses,

and enabling them to analyse and take care of patients’ wellbeing issues. Initiative and

organisational culture are important in implementing continuous improvement principle.

Fening, Amaria and Frempong (2013) studied Linkages Between Total Quality Management

and Organizational Survival in Manufacturing Companies in Ghana. The specialists contended

that as rivalry increments, and changes happen in the business world, there is the need to have

a superior comprehension of value and that to actualize TQM strategies effectively, top

15

administration should initially put stock in it. Pekar (1995) notes that the authority of an

organisation must be focused on continuous improvement. This commitment must be visible

throughout all layers of management.

According to Donabedian (2003), an organization that executes a continuous integration

program, encounters a scope of advantages such as improved patient wellbeing results that

include both cycle results - for example, diminished dismalness and mortality- and improved

proficiency of administrative and clinical cycles. By improving cycles and results applicable

to wellbeing needs, an organisation lessens waste and expenses related to framework

disappointments and excess. Regular continuous integration measures are an impartial

financial plan, where the expenses to roll out the improvements are balanced by the cost reserve

funds brought about by evaded costs related with failures, errors, and poor outcomes.

Nyamari (2015) studied the effect of Total Quality Management Practices on operational

performance of commercial banks in Mombasa County, Kenya. TQM strategies are a critical

arrangement of the board for continuous enhancements to achieve upper hand. Today clients

are demanding for quality in items and administrations. An organization that satisfies such

needs gets an upper hand over contenders. All things considered; TQM strategies don't

straightforwardly improve the benefits of these banks. Zeroing in on quality and ceaseless cycle

improvement had been embraced to a huge degree while preparing and instruction, top

administration duty and groups (representative responsibility) responsibility had been received

to a moderate degree. Furthermore, TQM strategies rehearses were acknowledged to positively

affect operational performance allowing it to fluctuate to a huge degree. According to the

discoveries, powerful TQM strategies create high operational performance for business banks

in Mombasa County. In general, TQM strategies have been adjusted to a moderate degree and

the impact of TQM strategies on operational performance is additionally moderate.

2.2.3 Policy

Khanchanapong et al., conducted an empirical study on the multi-dimensionality of

International Standard Organization (ISO) practices in deciding quality assurance of Australian

firms. The fundamental suggestion was whether ISO epitomized two models of practices,

unthinking and natural, with each demonstrating an alternate effect in the affiliation and with

two various types of non-stop improvement, on quality and on development. The scientists

utilized some exact information accumulated from Australian firms and detailed some proof

16

on the recommendation after matching the robotic components of ISO with quality assurance.

The consequences of the usage on Pearson Correlation Ratio had indicated that there were some

positive and meaningful relationship between continuous improvement of ISO standard

components and quality assurance.

In 2001, the Ministry of Health in Kenya then, through the Department of Standards and

Regulatory Services (DSRS) initiated the advancement of the Kenya Quality Model (KQM) to

give a calculated structure to quality improvement in wellbeing administrations and

frameworks in the Country. Notwithstanding this activity, the preliminary cycle of KQM was

not participatory and its Principles were not known by numerous people and consequently

prompting disappointment in its performance. Along these lines, it got important to survey and

update the KQM. The KQM was evaluated in the 2008-2009 money related year and renamed

the Kenya Quality Model for Health (KQMH) and extended to provide food for clinical

consideration to the executives backing and administration. Kenya Quality Model for Health

is intended to gauge and improve the general quality wellbeing administration conveyance and

depends on seven standards. The seven standards delineated in the Kenya Quality Model for

Health are: Leadership, Customer Direction, Involvement of Individuals and Partners,

Continuous Quality Improvement, Evidence Based Decision Making, Process Orientation and

Systems Approach to Management, (Kenya Quality Model for Health, 2009).

2.3 Customer Focus and Customer Loyalty

2.3.1 Embed Customer Focus in Strategy

In the United States of America, Mehra and Ranganathan (2008) investigated Actualizing Total

Quality Management with an emphasis on improving customer loyalty. The analyst focused on

the significance of customer focus and mentioned that TQM strategies themselves are client

situated. Creators underlined the significance of the components of client dependability and

customer loyalty in the zone of customer focus. Focusing on the requirement for utilizing TQM

strategies to upgrade customer focus, the researchers expressed that organizations must move

their concentration towards customer loyalty. Given that customer focus is vigorously

referenced in the literature, Mehra, Hoffman and Sirias (2001) proposed that TQM strategies

of the future should be redefined to include customer focus.

17

Consequently, one can comprehend that TQM strategies by definition are a client situated way

of thinking, and customer focus is required to possess a dominating spot later on for TQM

writing, Mehra and Ranganathan (2008). This discovery is upheld by different researchers. For

example, Chien, Su, and Su (2002) state that for a firm endeavouring to actualize TQM

strategies, customer loyalty is a significant target to accomplish. They contend that the degree

of customer loyalty accomplished is firmly identified with an organization's TQM strategies,

and it influences an organization's performance.

In United Kingdom, Tsang and Antony (2001) carried out a study on Total Quality

Management in UK service organisations. Some key discoveries from an overview are focusing

on the requirements for TQM projects to have customer focus as its fundamental objective.

Tsang and Antony (2001) compose that understanding, fulfilling, and outperforming client

needs ought to be one of the primary objectives of actualizing TQM programs. Likewise,

according to these creators, workers ought to be customer focused. Along comparable lines,

Dean and Bowen (1994) contend that customer focus ought to be a key TQM strategy.

Summarizing the writing on TQM strategies, Mehra et al., recommend that TQM strategies of

things to come ought to be reclassified to incorporate client focus.

Shank (2002) conducted a research in United States of America on Customer's impression of

value, worth and satisfaction: The results were that the effect of apparent quality and

satisfaction on social activities has been a significant focal point of administration advertising

research. A view of service quality and satisfaction directly affects attractive results, for

example, the purchaser's purpose to suggest the administration. Seen esteem is progressively

perceived as a wellspring of upper hand; be that as it may, it has not been consolidated into the

satisfaction and quality examination stream. This exploration model has increased the value of

the constructs of quality and satisfaction by testing a model that portrays the relationship of

saw administration quality, seen value, and saw an incentive to explicit demonstration of

suggesting a service.

Ondiek (2018) studied the impact of Total Quality Management policy on customer satisfaction

at Kenya Power and Lighting Company in Uasin Gishu County, Kenya. An exploratory

investigation configuration was embraced in the examination focusing on workers of KPLC

(inward clients, 489) and clients being served by KPLC (outside clients, 32,750) in Uasin Gishu

County. An example of 30% of the workers was registered utilizing Kerlinger (1983) and

18

Kothari (2008) yielding 147 representatives. The investigation determined that a lion's share of

clients were commonly disappointed with gathering administrations at KPLC. Moreover, client

satisfaction to administrations had been given to a moderate degree and KPLC’s reaction to

basic occurrences was commonly low. The study recommended that emphasis should be put

on TQM strategies for successful impact of TQM policy on customer satisfaction and for the

success of the company.

2.3.2 Customer Engagement

Spiterl and Joseph (2003) conducted a research on Customer Value, Overall Satisfaction, End

User Loyalty, and Market Performance in Detailed Intensive Industries in United States of

America. These researchers uncovered that, organizations are dependent on their clients for

their reality and prosperity and ought to, in this manner, meet all perceived current and potential

client needs, meet client necessities and endeavour to outperform client desires by following

total quality management measures within the organisation. Steps in applying these cycles

incorporates understanding clients' needs and desires - this is fundamental over all parts of a

business, from item plan and improvement, creation, valuing, conveyance, after deals uphold

and other regions of the organisation that affect the relationship with the client. Satisfied clients

will be repeat clients; they will likewise give positive reference to other possible customers,

both of which are important in order to have a business prosper and grow.

Amaniampong, Salakpi and Bonye (2014) explored Total Quality Management and its Impact

on the Level of Customer Focus inside Construction Project Management in Ghana. The

specialists recognized that among the key strategies of absolute quality administration (TQM)

is customer focus, along these lines client prerequisites must be met first time without fail. The

accomplishment of an organisation relies upon how well the organisation comprehends its

clients and addresses their issues, Amaniampong et al. For all business elements, there are two

classifications of clients: the inside clients (being the employees) and external customers (the

last shopper or client of an item or/and administration). Worker satisfaction drives faithfulness

and fulfilled representative remain. In this manner, worker maintenance is guaranteed

accordingly diminishing work steady loss. Once more, fulfilled representatives are diplomats

for their separate firms. Steadfast representatives are beneficial workers who make positive

estimations of organizations.

19

Michael Porter (1985) reckoned that the top priority of any business is to build consumer

confidence in its brands. Without the consumers, the business would be inexistent. He

developed a business management tool by the name ‘Value Chain Analysis’. In his book, he

described Value Chain Analysis as the activities that an organization performs in order to create

value for its customers. This business model comes in handy when businesses want to build on

quality of their products but also want to maintain the lowest costs possible. He was able to

prove that there is a high degree of correlation between product quality and consumer

confidence in the brand. Asshidin et al., says “The Importance of product quality can be seen

through the company because, bad quality products will affect the consumer’s confidence,

image and sales of the company. It may even affect the survival of the company. Product quality

can also be seen through consumers because they are ready to pay high prices, but in return,

they expect best-quality products. If they are not satisfied, they will purchase from the

competitors.” Therefore, it is extremely important for an organization to listen to what the

customers need or want and then tailor make their products to suit the purpose.

2.3.3 Constant Information Gathering

According to Spiterl and Joseph (2003), understanding what clients require, consistently

adjusting to suit their changing necessities and improving the nature of administration is a great

course for powerful quality management. Adjusted methodology among clients and different

partners - clients are not by any means the only gatherings who have a job or an enthusiasm

for the accomplishment of a business and its exercises and accomplishments. Other invested

individuals who ought to be incorporated are workers, providers, accomplices, proprietors,

investors, providers, the local community, government and controllers, all who structure the

collective group of stakeholders, Spiterl and Joseph (2003). Understanding their individual

needs and offsetting them with the client's needs will guarantee a more complete way to deal

with and surpass client desires; a more prominent degree of service and a superior

comprehension of territories for development.

Conveying clients’ necessities and desires all through the organization - both clients’ and

partners’ needs ought to be imparted all through the organization to guarantee that all

representatives completely grasp these desires and prerequisites. This guarantees that from the

most junior to the most senior representative, in all the practical zones, are submitted to striving

towards meeting these expectations. This plays an important role in an effective quality

management process, Spiterl and Joseph (2003). Monitoring customer satisfaction and acting

20

on results - customer satisfaction is imperative to any business, no matter how large or small,

or what the industry may be. Both positive and negative feedback should be monitored

carefully, and all results should be acted on to allow customers to know that the organisation

values their input. All feedback should be seen as a way to aid continuous improvement and

should be addressed quickly and efficiently.

Managing customer relations is by far the most significant part of a customer focused

organisation, Spiterl and Joseph (2003). It is fundamental to keep up and develop relations with

customers and partners, and this should mean being reasonable and genuine consistently.

Regardless of whether there is a particular representative or division who manages client

relations, or this job tumbles to an assigned senior administration level worker,

straightforwardness and uprightness assume a fundamental function in building compelling

relations. Along these lines, the organization can pursue powerful quality administration as a

real customer focused organisation, Spiterl and Joseph (2003).

2.4 Service Quality and Customer Loyalty

2.4.1 Service Efficiency

In India, Neetha, Srinivas, Ramachandra, Manjunatha (2016) conducted a study on

Implementation of TQM strategies in Hospital to Improve Service Quality. The researchers

identified that the healthcare sector in India was witnessing a radical change in terms of its

operations, desire from clients, utilization of new innovation and strategies for clinical

treatment. India was likewise turning into an objective of wellbeing to traverse the world. The

significant test to the business was to guarantee A-list activities of medical clinics for meeting

the prerequisites of its clients. Giving top tier nature of service was of extraordinary

significance in the service of any help organisation. All organisations including medical service

organisations are made of services which consist of processes or sets of actions, intended to

create value for those who use or depend on them (customers/patients).

An Iranian study by Mehralian, Babapour, and Peiravian (2016) studied the Distributor-

Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale. The

proportion of value is the capacity of an item or service to satisfy the necessities or play out the

assignment for which it is planned. In contrast to an item, help is judged not just by the result

(specialized quality)‚ but also the way toward conveying an assistance is additionally surveyed

21

to assess its quality (useful quality). Various definitions have been offered for service quality

and different estimation scales have been grown appropriately. Service quality can be

characterized as the contrast between client desires and the apparent assistance performance.

At the point when the exhibition is lower than the desires, the quality advertised is not sufficient

and consequently the customers become dissatisfied and disloyal.

Mehralian et al., observe that service quality can expand the general achievement pace of the

medical services arrangement; it has become a significant theme to medical services suppliers

and advertisers and the focal point of numerous investigations. Service quality can likewise

generously influence tolerant satisfaction. Definitely, the expanded satisfaction improves client

unwaveringness and buy goal. Precise estimation of the nature of medical care services and

distinguishing proof of the idea of service conveyance framework are similarly significant for

the achievement of medical services suppliers. Numerous analysts and professionals are keen

on contemplating service quality since it straightforwardly influences business performance,

client faithfulness, productivity, and client satisfaction.

2.4.2 Reliability

A study in Jordan by Alhuwitat and Salem (2016), explored the effect of drug services quality

on building a solid connection among drug specialists and their clients. Drug store is a

significant calling in Jordan whereby it assumes an indispensable part in offering the drug types

of assistance required for the medical services of patients and it is a powerful factor in the

economy and advancement of the country. Public drug store is the drug office where solutions

are saved and administered to general society for a price.

For this reason, Alhuwitat and Salem (2017), found that it is important to zero in on the

(inward) variables of drug stores including their physical assets and staff by thinking about the

best approach to show the drug items, giving devices to encourage client benefits, including

augmentations which increase the sentiment of mental solace, consequently adding to the

achievement of the service given by drug stores and the advancement of the interior climate of

drug stores through preparing and proceeding with training for workers from logical viewpoints

regarding the offer of meds that don't need a clinical remedy (Over the Counter),

notwithstanding the aptitudes of correspondence with the clients. Likewise, with the terms of

the board, specialized and promoting perspectives. All these will contribute towards

constructing a solid connection among drug stores and their clients, participatorily giving their

22

needs and meet their wants with protected and secure ways finished with accomplishing

benefits for drug stores on moral and scientific basis.

Majeedu, Mäntymaa and Kabuye (2013) conducted a study on TQM and Competitive

Advantage of firms in Uganda. The examination discovered that in ventures, TQM

implementation is convoluted and has a long cycle. The investigation uncovered that one of

the key difficulties in service firms is the manner by which to control quality. While the quality

of manufactured items can be tested and controlled before conveyance, it is hard to control the

nature of service before conveyance, as a result of its indefinable nature. This suggests an

inadequate item can be supplanted yet a blemished assistance may make perpetual or

potentially durable harm. The investigation likewise uncovered that service firms utilize

moderately less quality management apparatuses contrasted with the assembling firms. The

application level of TQM implementation is lower in-service firms than in manufacturing

firms.

Marienga (2009) investigated “Determinants of quality service delivery by public institutions

in Kenya: a case of “National Social Security Fund”. He underscored that to achieve the

satisfaction and loyalty, clients require improvement of quality of services offered to them by

moderately taking the impression of clients about the properties of the administration. Thereby,

building adequate projects to oversee organisations’ clients and persistent correspondence by

archiving their private data regarding their needs and to give clients the correct time for the

advancement of safe behaviours promoting exercises for them with the assistance of specialists,

sustenance, and magnificence of some drug items that needn't require medical prescription.

2.4.2 Responsiveness to Customer Needs

Service quality is a multidimensional construct rather than having Uni-dimensional meaning,

Talib, Rahman and Qureshi (2012). Also, literature review further shows that estimating

service quality isn't a simple undertaking and a parcel of issues are there in estimating it. Most

types of estimation of service quality spotlights on customer loyalty. By and by, Talib et al.,

banks announced that TQM strategies prompt improvement of service quality, remembering

the trouble in satisfactorily estimating the service quality and impact of TQM strategies in

service area, they routinely led a customer loyalty overview to assess their exhibition against

past performance and benchmark themselves against their primary rivals. In this manner banks

persistently improve their service quality, include and spur their representatives and enable

23

them to be dynamic, consequently prompting ideal usage of TQM strategies in their

organization, Talib et al.

Beryl and Brodeur, (2007) studied, Determinants of Customer Loyalty: The International

Journal of Bank Marketing. The service quality measurements incorporate tangibles that are

the physical proof of the service: appearance of physical offices, apparatuses and hardware

used to offer the assistance and appearance of staff and correspondence materials. Second is

the dependability which is the capacity to play out the guaranteed service reliably and precisely:

consistency of performance and trustworthiness, service performed directly at the first run

through, the organization stays faithful to its commitments in exactness in charging and

keeping records correctly, performing the services at the designated time.

Third is the responsiveness that is eagerness, preparation of workers to support clients and to

offer brief assistance and additionally practicality of service: mailing an exchange slip

promptly and setting up arrangements rapidly. Fourth is confirmation which is the information

and graciousness of representatives and their capacity to pass on trust and certainty, Beryl and

Brodeur (2007). Ability (ownership of the necessary aptitudes and information to play out the

service), civility (thought for the client's property, perfect and flawless appearance of public

contact faculty), reliability, security (wellbeing and secrecy), ultimately is compassion that is

the arrangement of mindful, individualized consideration regarding clients: advising the clients

in a language they can comprehend, understanding client's particular needs and providing

individualized attention.

According to Beryl and Brodeur (2007), the interrelationships between service quality,

customer loyalty and client dependability may give inventive plans to improving services so as

to increase an upper hand in the retail banking area. Service quality is one of the basic

achievement factors that impact the intensity of an organisation. A bank can separate itself

from contenders by offering great support. Service quality is one of the most alluring zones for

specialists throughout the most recent decade in the retail banking area. In the financial area, a

bank can have solid dealing position because of the huge development of the banks.

24

Therefore, according to Beryl and Brodeur (2007), banks need to offer support cautiously in

view of the accessibility of numerous banks and miniature money foundations offering same

services to the clients. Banks need to improve the service level ceaselessly. There is no

assurance that what is fantastic help today will likewise be appropriate for tomorrow. To make

do in the serious financial industry, banks need to grow new systems which will fulfil their

clients. That is the reason service showcasing and bank promoting are significant regions in

the advertising literature.

Moreover, in China, Wu (2006) researched on Service quality, Customer Satisfaction, and

Customer Loyalty, in customer electronics E-tailers: A structural equation modelling approach.

This study also investigated the connections among electronic help quality, customer loyalty,

and client devotion for buyer hardware e-posteriors, utilizing portion and snowball testing.

Members from the mainland United States got email solicitations and intentionally sent the

email solicitations to their loved ones, Wu (2006). An aggregate of 276 members finished the

online overview. Discoveries showed that electronic assistance quality was estimated by online

customers' view of service nature of buyer electronic e-posteriors through four dimensions of

the 17-indicator modified E-S-QUAL (efficiency, system availability, satisfaction, and

privacy), Wu (2006).

According to Wu (2006), electronic recovery service quality was measured by online shoppers'

perceptions of recovery service quality of customer electronic e-tailers through two dimensions

of modified E-RecS-QUAL (responsiveness and contact, and compensation). Findings also

indicated that perceived value and customer satisfaction were two significant variables that

mediated the relationships among customer expectations, electronic service quality, customer

loyalty, and customer complaints.

Notwithstanding, this investigation additionally found that electronic assistance quality and

client desires had no immediate impact on customer loyalty yet had roundabout constructive

outcomes on customer loyalty for purchaser gadgets e-posteriors, Wu (2006). Purchaser

hardware e-tailers' directors could figure intent to improve service quality and recuperate

service quality through elements of E-S-QUAL and E-RecS-QUAL. They likewise could plan

a serious system dependent on the adjusted Electronic Customer Satisfaction (e-CS) model to

keep current clients and to upgrade client connection the board.

25

In India, Talib et al., researched on the Impact of Total Quality Management and Service

Quality in the Banking Sector; Journal of Telecommunications System and Management. The

researchers found out that the idea of service quality has risen out of TQM theory and now it

is treated as a basic rule for powerful TQM performance. The writing survey recommended

that service quality can be ordered into number of ways, for example, client assistance quality;

online help quality; banking service item quality and computerized service quality with the

basic expectation to accomplish customer loyalty, improved money related performance and

intensity.

Mutyaba (2013) conducted a study in Uganda, on increasing Competitive Advantage through

guaranteeing quality of services in the banking industry. The discoveries of the investigation

uncovered that personalization of banking and insurance services are the top factor for

dedication and that organizations ought to effectively connect with their clients. With respect

to insurance agencies, insurance strategy claims seem to act like a grievance to the board insight

and a serious procedure can be worked around medical coverage. The outcomes likewise

uncovered that clients become more value touchy as their service costs go up; along these lines

clients with low expenses are more faithful than clients with significant expenses.

In Kenya, Onditi, Oginda, Ochieng (2012) studied Implications of Service Quality on Customer

Loyalty in the Banking Sector; A Survey of Banks in Homabay County. Client decision making

is characterized as the personal conduct standards of the buyers that go before, decide and

follow the dynamic cycle for the procurement of need fulfilling items, thoughts or services.

Loyal clients are bound to offer data to the specialist co-op (in light of the fact that they trust

the specialist co-op and anticipate from the specialist co-op to utilize the data with watchfulness

and to their benefits).

Managing loyalty is significant on the grounds that it implies overseeing conduct as well as

dealing with a perspective. It is contended that the discoveries in the field of brand steadfastness

didn't sum up to support devotion for the accompanying reason: service unwaveringness is

subject to the advancement of relational connections rather than faithfulness with substantial

items, if there should arise an occurrence of services, the impact of apparent danger is more

noteworthy and elusive credits, for example, certainty and dependability are the significant

elements to keep up the client reliability in the service setting Onditi et al. She additionally

distinguished the two elements of dependability (relative mentality and rehash support conduct)

26

and four classes of devotion which incorporate reliability (positive relative disposition, high

recurrent support), inert unwaveringness (positive relative demeanour, yet low recurrent

support), fake faithfulness (low relative demeanour, high recurrent support), and no dedication

(low on the two measurements).

Onditi et al., affirms that by and large the client is mentioning an assistance at the service

interface where the service experience is being acknowledged, at that point the service is being

given by the supplier and in a similar time conveyed to or devoured by the client. The principle

motivation to zero in on quality is to address client issues while remaining financially serious

in a similar time. This implies fulfilling client needs is significant for the undertakings to

endure. The result of utilizing quality practices incorporates understanding and improving of

operational cycles, identifying issues rapidly and efficiently and building up substantial, solid

assistance performance measures and estimating customer loyalty and other performance

results. Service quality can be identified with service potential, service cycle or service result,

in this route for instance, potential quality can be perceived as the colleague capability, measure

quality as the speed.

2.4 Chapter Summary

This chapter has presented each section in line with the objectives of the study; product

continuous improvement, customer focus and service quality. The chapter covers various views

and perspectives as contributed by different scholars. Chapter three presents research

methodology and looks into detail on research design, population, sampling frame and sample,

data collection methods, research procedure and data analysis.

27

CHAPTER THREE

3.0 RESEARCH METHODOLOGY

3.1 Introduction

This chapter reviews the methodology of the study. It discusses the research methodology

especially with respect to the choice of the research design. It also discusses the population of

study, sample and sampling techniques, data collection methods as well as data analysis and

data presentation methods employed in the study.

3.2 Research Design

A research design is defined as the blueprint and a detailed plan of how a research study is to

be conducted, Mugenda, O. M and Mugenda, A. G (2003). This study adopted a descriptive

research design. According to Saunders, Lewis and Thornhill (2009), a descriptive research

design, answers research questions about who, what, where, when and how is the problem.

Descriptive research design involves data collection from a population or a representative

subset, at one specific point in time and has an advantage over other research designs that only

seek individuals with a specific characteristic, with a sample, often a tiny minority, of the rest

of the population, Harris et al.

The descriptive research design provides data on completely representative population under

study. It is usually conducted to estimate the prevalence of the outcome of interest for a given

population. Besides, in descriptive research design all population elements are considered

ensuring that comprehensive findings are obtained on the subject matter as they integrate

qualitative and quantitative approaches. In this study, descriptive approach achieved this by

describing the data and characteristics about the population of the phenomenon being studied;

customer loyalty. That is, it was used to find out the current state of total quality management

strategies on customer loyalty to pharmaceutical products and the relationship between the two.

The design enabled the researcher to determine how the independent variables affects the

dependent variable.

28

3.3 Population and Sampling Design

3.3.1 Population

Population is the total collections of elements about which we wish to make some inferences

and about which research findings are generalized, Mugenda, O. M and Mugenda, A. G (2003).

According to Cooper, Schindler and Sun (2001), the study population refers to the total

collection of elements which one would like to study or make inferences. It is the total

collection of elements with common observable characteristics about which some inferences

can be made. The study population of this study was made up of all the 40 customers that

purchase pharmaceutical products directly from GlaxoSmithKline Pharmaceuticals Limited in

Nairobi. This population is tabulated in table 3.1 as follows;

Table 3.1 Target Population

Region Number of Customers % of Total Population

Nairobi North 7 18%

Nairobi East 6 15%

Nairobi West 7 18%

Westlands 7 18%

Nairobi Outskirts 13 33%

40 100%

Source: GSK Marketing (2020)

3.3.2 Sampling Design

3.3.2.1 Sampling Frame

A sampling frame should be a complete and correct list of population members only. It is a

record of all the sample units available for selection at a given stage in the sampling process,

Ngechu (2004). The sampling frame for this study came from the list of GSK’s customers.

3.3.2.2 Sampling Technique

Saunders, Lewis and Thornhill (2009) define sampling as a selection of units to represent an

entire population. In other words, it is to gather data from participants within a given population

and use that data as representative to describe the entire population. Stratified sampling is a

technique that recognizes the variations or sub-groups in the population. When sub-populations

29

vary considerably, it is advantageous to sample each subpopulation (stratum) independently.

Then other sampling technique can be applied within each stratum.

The sampling procedure that was used in the study is convenient sampling technique. Kumar

(2019), notes that convenient sampling is mainly guided by the researcher’s convenience in

terms of issues such as geographical proximity, ease of approvals, ease of access, familiarity

with respondents, among other factors. Each selected sample company had one respondent.

3.3.2.3 Sample Size

Using the convenient sampling technique, the study selected a proportionate sample of GSK

customers. Mugenda, O. M and Mugenda, A. G (2003) states that, when carrying out a study,

10% of the total population yields an adequate sample when the population is numerous. The

sample size of this study was composed of only the GSK customers based in Nairobi. The

sample size was calculated using Yamane formula bringing it to 21 GSK customers and the

selection is summarized in Table 3.2:

Table 3.2: Sampling Size Distribution

Region Number of Customers % of Total Sample Size

Nairobi North 5 24%

Nairobi East 5 24%

Nairobi West 5 24%

Westlands 6 29%

21 100%

Source: Author (2020)

3.4 Data Collection Methods

Primary data collection targeted 21 customers of GSK pharmaceutical products in Nairobi.

Questionnaires, as research instruments, were chosen as the data collection instrument. A

questionnaire is a printed self-report form designed to elicit information that can be obtained

through written responses of the subjects. The information obtained through a questionnaire is

similar to that obtained by an interview, but the questions tend to have less depth, Burns, Grove,

Burns and Gray (2012). Data was collected with the aid of questionnaires to evaluate product

continuous improvement, customer focus and service quality as customer loyalty strategies by

30

pharmaceutical companies. Questionnaires were decided upon because they ensure a high

response rate as they are distributed to respondents to complete and are collected personally by

the researcher, they require less time and energy to administer, they offer the possibility of

anonymity because the respondent’s name is not required on the completed questionnaires,

there are fewer opportunity for bias as they are presented in a consistent manner and most of

the items in the questionnaire are closed which makes it easier to compare the response to each

item. Apart from the items listed above, questionnaires have their weaknesses, for example,

there is the question of validity and accuracy, Burns, Grove and Gray (2012). The subjects

might not reflect their true opinions but might answer what they think will please the researcher,

and valuable information may be lost as answers are usually brief. To reduce this risk, the

respondents were given ample time to fill in the questionnaires. They were also affirmed that

their responses would be treated with confidentiality.

The questionnaire consisted of close-ended questions. The subjects were required to respond

in writing, and they were assured of anonymity. The questionnaire consisted of four sections.

Part A consisted of general questions aimed at gaining demographic data such as age, gender,

level of education and length of experience in the pharmaceutical industry. This information

assisted the researcher when interpreting the results, for example, the length of service in the

pharmaceutical industry. Part B, C and D aimed at answering the three research questions.

Instruction guidelines were attached to the questionnaires to guide the subjects on how to

respond to the questions.

3.5 Research Procedures

Questionnaires were personally distributed by the researcher to the respondents to complete.

The researcher completed one questionnaire for a respondent who was unable to write well at

the time of responding due to a deep cut on his thumb. The data was collected over a period of

two weeks. The researcher met all the respondents in the designated and authorized

pharmaceutical selling outlets for pharmaceutical brands. Reliability was ensured by

minimizing sources of measurement error like data collector bias. This was done through the

researcher being the only one to administer the questionnaires and exhibiting standard personal

attributes to all respondents such as friendliness and support. The physical and psychological

environment where data was collected was not altered to increase comfort but confidentiality

by requesting respondents not to write their names on the questionnaires.

31

The validity of an instrument is the degree to which an instrument of data collection measures

what it is intended to measure, Burns, Grove and Gray (2012). Questions were based on

information gathered during literature review to ensure that they would be representative of the

study objectives. All respondents completed the questionnaires in the presence of the

researcher. This was done to prevent respondents from giving questionnaires to other people

to complete on their behalf. Most persons approached to participate in the research completed

the questionnaires thus generalizing the findings to all members of the population is justified.

Written permission was obtained from the University and Authorities of respondents consent

was obtained before completing the questionnaire.

Anonymity and confidentiality were maintained throughout the research. Anonymity was

obtained by not putting the respondents name on the questionnaire while confidentiality was

maintained by keeping the collected data private and eliminating information that could

identify respondent. Questionnaires were numbered after the research was completed. Last but

not least, scientific honesty was maintained by recording truthfully the answers of the subject

who could not write.

The Likert Scale was chosen firstly because it is well-known and therefore most people should

be familiar with it and be confident about answering questions on such scale. Secondly, the

scale is simple and straight-forward and should therefore be easy to understand for the

respondents. Finally, the scale provides reliable outcomes that are easy to work with.

3.6 Data Analysis Methods

Data collected was decoded and entries made into Statistical Package for Social Science (SPSS

version 26). Descriptive analysis was used to analyse the primary data of quantitative nature

(close-ended questions). Descriptive statistics such as frequencies and percentages, measures

of central tendency (means) and dispersion (standard deviation) were used. The study also used

cross tabulation and Chi-square analysis to profile pharmaceutical brand consumption across

demographics. Additionally, multiple linear regression analysis was used to show the

relationship between customer loyalty and TQM strategies adopted by a pharmaceutical. The

analysed data was presented in tables and figures while explanations given in prose.

32

3.7 Chapter Summary

This chapter presents a detailed account of the research methodology; how the research project

was conducted. The research adopted a descriptive research design. Population was made up

of all the GSK customers within Nairobi, who are 40 in number. The sampling design consisted

of a well laid out sampling frame while making use of stratified and convenient sampling

techniques, a sample size of 21 GSK customers based in Nairobi calculated using Yamane

formula and use of questionnaires as the research instruments. Data analysis was done using

SPSS Version 26.

33

CHAPTER FOUR

4.0 RESULTS AND FINDINGS

4.1 Introduction

This chapter entails results and findings of the study as set in the research objectives and

methodology. The study findings are presented on the effect of Total Quality Management

Strategies on Customer Loyalty in the Nairobi Pharmaceutical Industry; A Case of

GlaxoSmithKline Pharmaceuticals Limited.

4.2 Demographic Information

This section presents the response rate of the data collected from respondents during the field

work. Moreover, this sub-section investigates the respondents’ background information, which

includes; gender of the respondent, age of the respondent, education level, length of time

worked in the pharmaceutical industry, frequency of purchase of pharmaceutical products and

reason for purchase of pharmaceutical products.

4.2.1 Response Rate

The data collection instruments, questionnaires, were administered to 21 GSK customers. Out

of the 21 questionnaires presented, 18 questionnaires were fully completed, and valid for use,

making a response rate of 86%. According to Mugenda, O. M and Mugenda, A. G (2003), a

response rate of 50% is adequate for a study, 60% is good and 70% and above is excellent.

Thus, a response rate of 86% was fit and reliable for the study as shown in Table 4.1.

Table 4.1. Response Rate

Category Frequency Percentage

Valid Questionnaires 18 86

Voided Questionnaires 3 14

Total 21 100

Source: Author (2021)

34

4.2.2 Gender Composition

The study established that gender composition in the Nairobi pharmaceutical industry is not

equal as shown in figure 4.1 below. Male respondents exceed female respondents, standing at

61% (11), while female respondents accounted for 39% (7). It was therefore concluded that

male respondents dominate the Nairobi pharmaceutical industry.

Figure 4.1: Gender Composition

Source: Author (2021)

4.2.3 Age of Respondents

The study established that respondents are in different age groups. Most respondents, 33% (6)

are between 36-41 years, 27% (5) are between 30-35 years and 17% (3) are between 24-29

years same as 17% (3) respondents who are in the age group of 18-23 years and another 6%

(1) is above 42 years. This analysis indicates that most respondents are the age group of 36-41

years as presented in figure 4.2 below.

Gender

Male

Female

39% 50

40

30

20

10

0

61% 70

60

35

Figure 4.2: Age of Respondents

Source: Author (2021)

4.2.4 Education Level of Respondents

The analysis in figure 4.3 below shows that respondents have differing education levels. From

the study findings, respondents with undergraduate education dominate the Nairobi

pharmaceutical industry accounting to 44% (8) while respondents with Masters level of

Education account for 17% (3). Respondents with certificate level of education accounted for

6% (1), respondents with diploma education accounted to 22% (4), while respondent with A-

level education accounted to 11% (2). There was no respondent with O-level education in the

Nairobi pharmaceutical industry. The study concludes that the Nairobi pharmaceutical industry

is dominated by educated respondents where undergraduate degree education is dominant.

18-23 years 24-29 years 30-35 years 36-41 years 42 years and

above

Age of respondents

6%

17% 17%

27%

33% 35

30

25

20

15

10

5

0

36

Figure 4.3: Education Level of Respondents

Source: Author (2021)

4.2.5 Experience in the Nairobi Pharmaceutical Industry

The study findings established that respondents have differing experience of operation in the

pharmaceutical industry. The study revealed that 28% (5) respondents have 2-4 years of

operation in the pharmaceutical industry compared to 22% (4) and another 22% (4) respondents

who have worked in the industry for 0-2 years and 5-7 years respectively. Moreover, 17% (3)

respondents have been in the industry for 8-10 years and 11% (2) respondents have been in the

industry for above 11 years and above. The study concludes that respondents with 2-4 years

dominate pharmaceutical industry. This is summarized on Figure 4.4 below.

44%

17%

22%

6%

11%

0%0

1

2

3

4

5

6

7

8

9

Bachelors

Degree

Masters

Degree

College

Diploma

College

Certificate

A-Level O-Level

No.

of

Res

po

nd

ents

Education Level

37

Figure 4.4: Experience of respondents in the Nairobi Pharmaceutical Industry

Source: Author (2021)

4.2.6 Frequency of Purchase of Pharmaceutical Products

The study analyzed the extent to which respondents purchase pharmaceutical products. From

the study findings, 2 respondents strongly disagreed, 2 respondents disagreed, 1 respondent

was neutral, 7 respondents agreed, and 6 respondents strongly agreed that they purchase

pharmaceutical products very frequently (M=3.6, SD=2.4). Moreover, 1 respondent strongly

agreed, 1 respondent disagreed, 0 respondent was neutral, 9 respondents agreed, and 7

respondents strongly agreed that they purchase pharmaceutical products frequently (M=3.6,

SD=3.7). A further 5 respondents strongly disagreed, 5 respondents disagreed, 1 respondent

was neutral, 3 respondents agreed, and 4 respondents strongly agreed that they purchase

pharmaceutical products somewhat frequently. (M=3.6, SD=1.2). The study also established

from 5 respondents strongly disagreed, 5 respondents disagreed, 1 respondent was neutral, 3

respondents agreed, and 4 respondents strongly agreed that they do not purchase

pharmaceutical products frequently (M=3.6, SD=1.6). However, 7 respondents strongly

disagreed, 8 respondents disagreed, 1 respondent was neutral, 1 respondent agreed, and 1

respondent strongly agreed that they were not sure if they purchase pharmaceutical products

(M=3.6, SD=3.2).

Years of operation

8-10 years 11 years and

above

5-7 years 2-4 years 0-2 years

10

5

0

11%

17%

22% 22% 25

20

15

28% 30

38

Table 4.2. Frequency of Purchase of Pharmaceutical Products

Category N SD D N A SA M Sd

Very frequently 18 2 2 1 7 6 3.6 2.4

Frequently 18 1 1 0 9 7 3.6 3.7

Somewhat frequently 18 3 3 2 5 5 3.6 1.2

Not frequently 18 5 5 1 3 4 3.6 1.6

Not sure 18 7 8 1 1 1 3.6 3.2

Source: Author (2021)

4.2.7 Reasons why customers purchase pharmaceutical products

The study set out to establish the reason that prompts respondents to purchase pharmaceutical

products. From a total number of respondents, the study established the reasons that make

respondents to purchase pharmaceutical products, which were identified as follows; on whether

respondents bought pharmaceutical products due to promotions(M,=3, Sd=0.96), 4 respondents

strongly disagreed, 3 disagreed, 2 were neutral, 5 respondents agreed, and 4 strongly agreed.

On the reason of purchasing due to Price (M=3.6, SD=2.4), 2 respondents strongly disagreed,

2 disagreed, 1 was neutral, 6 respondents agreed, and 7 strongly agreed. On the Influence from

friends and referrals (M=3.6, SD=1.5), 2 respondents strongly disagreed, 3 disagreed, 2 were

neutral, 6 respondents agreed, and 5 strongly agreed. Regarding Loyalty to my brand (M=3.6,

SD=.33), 1 respondent strongly disagreed, 2 disagreed, 0 was neutral, 7 respondents agreed,

and 8 strongly agreed. On Packaging, (M=3.6, SD=1.0), 5 respondents strongly disagreed, 3

disagreed, 2 were neutral, 4 respondents agreed, and 4 strongly agreed. On influence of quality

(M=3.6, SD=3.7), 1 respondent strongly disagreed, 1 disagreed, 0 was neutral, 9 respondents

agreed, and 7 strongly agreed. Regarding the Status symbol of the product (M=3.6, SD=2.2),

7 respondents strongly disagreed, 5 disagreed, 1 was neutral, 3 respondents agreed, and 2

strongly agreed. On the influence of Taste (M=3.6, SD=1.4), 3 respondents strongly disagreed,

3 disagreed, 2 were neutral, 6 respondents agreed, and 4 strongly agreed, and Sense of

patriotism (M=3.6, SD=1.4), 2 respondents strongly disagreed, 4 disagreed, 2 were neutral, 5

respondents agreed, and 5 strongly agreed. This analysis was analyzed in table 4.3 as follows;

39

Table 4.3. Reasons for Purchase Pharmaceutical Products

Category N SD D N A SA M Sd

Promotions 18 4 3 2 5 4 3.6 .96

Price 18 2 2 1 6 7 3.6 2.42

Influence from friends and referrals 18 2 3 2 6 5 3.6 1.5

Loyalty to my brand 18 1 2 0 7 8 3.6 3.3

Packaging 18 5 3 2 4 4 3.6 1.0

Quality 18 1 1 0 9 7 3.6 3.7

Status symbol of the product 18 7 5 1 3 2 3.6 2.2

Taste 18 3 3 2 6 4 3.6 1.4

Sense of patriotism 18 2 4 2 5 5 3.6 1.4

Source: Author (2021)

4.3 Product Continuous Improvement and Customer Loyalty

The questions in this section have been developed to answer the question about the effect of

product continuous improvement on customer loyalty in the Nairobi Pharmaceutical industry.

The study used a scale of 1-5 where; 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree,

5= Strongly Disagree.

4.3.1. Descriptive Analysis

I always purchase medicine based on perceived quality (M=3.6, SD=1.9), 4 respondents

strongly disagreed, 2 disagreed, 1 were neutral, 6 respondents agreed, and 5 strongly agreed. I

always read the medicine ingredients to check for quality improvements (M=3.6, SD=2.2), 2

respondents strongly disagreed, 3 disagreed, 1 were neutral, 5 respondents agreed, and 7

strongly agreed. I compare medicine quality across different manufacturing companies before

making a ‘buy decision (M=3.6, SD=2.6), 2 respondents strongly disagreed, 2 disagreed, 1

were neutral, 8 respondents agreed, and 5 strongly agreed. I always read product improvement

quality reviews before purchasing medicine (M=3.6, SD=1.7), 3 respondents strongly

disagreed, 3 disagreed, 1 were neutral, 5 respondents agreed, and 6 strongly agreed. I once

refused to take purchase medicine because of its perceived low quality (M=3.6, SD=3.0), 1

respondent strongly disagreed, 1 disagreed, 1 were neutral, 8 respondents agreed, and 7

strongly agreed. I would buy medicine that has been banned in Kenya on the basis of

degenerative quality (M=3.6, SD=1.0), 4 respondents strongly disagreed, 5 disagreed, 2 were

40

neutral, 5 respondents agreed, and 3 strongly agreed. I would let a customer purchase medicine

whose formulation has not changed in years (M=3.6, SD=1.2), 5 respondents strongly

disagreed, 5 disagreed, 2 were neutral, 3 respondents agreed, and 3 strongly agreed. I only buy

medicine brands from specific companies even when there is no continuous improvement on

the product (M=3.6, SD=2.0), 3 respondents strongly disagreed, 2 disagreed, 1 were neutral, 6

respondents agreed, and 6 strongly agreed. I seek advice from fellow professionals before

trusting any perceived product improvements (M=3.6, SD=2.7), 2 respondents strongly

disagreed, 3 disagreed, 0 were neutral, 5 respondents agreed, and 8 strongly agreed.

Table 4.4. Descriptive Analysis for Product Continuous Improvement on Customer

Loyalty in the Nairobi Pharmaceutical Industry.

Product Continuous Improvement SD D N A SA M Sd

I always purchase medicine based on perceived quality 4 2 1 6 5 3.6 1.9

I always read the medicine ingredients to check for

quality improvements

2 3 1 5 7 3.6 2.2

I compare medicine quality across different

manufacturing companies before making a ‘buy

decision’.

2 2 1 8 5 3.6 2.6

I always read product improvement quality reviews

before purchasing medicine.

3 3 1 5 6 3.6 1.7

I once refused to take purchase medicine because of its

perceived low quality

1 1 1 8 7 3.6 3.0

I would buy medicine that has been banned in Kenya on

the basis of degenerative quality

4 4 2 5 3 3.6 1.0

I would let a customer purchase medicine whose

formulation has not changed in years.

5 5 2 3 3 3.6 1.2

I only buy medicine brands from specific companies

even when there is no continuous improvement on the

product.

3 2 1 6 6 3.6 2.0

I seek advice from fellow professionals fellow before

trusting any perceived product improvements

2 3 0 5 8 3.6 2.7

Source: Author (2021)

41

4.3.2. Correlation Analysis for Product Continuous Improvement and Customer Loyalty

in the Nairobi Pharmaceutical industry

Correlation is quantitative estimation of how two variables oscillate between each other.

When two variables increase or decrease in parallel, then the correlation they are said to be

positive. However, in the instance where a variable decrease as the other increases, then the

correlation is said to be negative. Correlation analysis was done to measure the strength of the

linear association between the dependent and independent variables, as shown in table 4.5.

The Pearson correlation coefficient, r, values range from +1 to -1, that is coefficient r can

show either a negative or positive relationship.

The results of correlation analysis between product continuous improvement and customer

loyalty indicated that these variables are positively correlated (table 4.6). The results for

Pearson Correlation test showed that there was a positive correlation between Customers

always purchase medicine based on perceived quality and customer loyalty, r (312) = 0.634,

p< .05. There was a positive correlation between Customers always reading the medicine

ingredients to check for quality improvements and customer loyalty, r (312) = 0.548, p< .05.

Finally, the results for Pearson Correlation test showed that there was a positive correlation

between Customers comparing medicine quality across different manufacturing companies

before making a ‘buy decision’ and customer loyalty, r (312) = 0.682, p< .05.

Table 4.5. Correlation Analysis for Product Continuous Improvement and Customer

Loyalty

Test Parameter

Customers always purchase medicine

based on perceived quality

Pearson Correlation 0.634

Sig. (2-tailed) 0.000*

N 18

Customers always reading the

medicine ingredients to check for

quality improvements

Pearson Correlation 0.548

Sig. (2-tailed) 0.000*

N 18

Customers comparing medicine

quality across different manufacturing

companies before making a ‘buy

decision’.

Pearson Correlation 0.682

Sig. (2-tailed) 0.000*

N 18

*Correlation is significant at the p<.05 level (2-tailed)

42

4.3.3. Regression Analysis for Product Continuous Improvement and Customer Loyalty

in the Nairobi Pharmaceutical industry

Regression analysis is a statistical method that is applied to establish the existing relationship

between or among variables of study. Hypothesis testing is the process of comparing a research

hypothesis to the null hypothesis. The null hypothesis is only rejected if its probability falls

below a predetermined significance level, in which case the hypothesis being tested is said to

have that level of significance.

4.3.3.1 Model Summary for Product Continuous Improvement and Customer Loyalty in

the Nairobi Pharmaceutical industry

Regression analysis was carried out to explore the level of influence of product continuous

improvement (independent variable) on customer loyalty (dependent variable). In this study,

multiple linear regression was run to predict the customer loyalty from the product continuous

improvement in pharmaceutical industry. In addition, multiple linear regression was run to test

whether the overall regression model is a good fit for the data, through F-ratio result. The

outputs for this analysis included regression model summary, ANOVA and regression

coefficients.

4.3.3.2 Regression Model Summary

The results for the model summary was presented in table 4.10(a). The table shows R, R2,

adjusted R2, and the standard error of estimate. R represents multiple correlation coefficients,

R2 represents coefficient of determination and adjusted R2 indicates the statistic value adjusted

with respect to the number of independent variables in the model. Thus, it reveals the fitness

of the regression model.

Table 4.6: Model Summary Product Continuous Improvement

Model

R R Square

Adjusted R

Square

Std. Error

of the

Durbin-

Watson

1 .952 .897 .886 .19344

2 .927 .859 .857 .37367 1.927

43

From the table 4.13(a), R=.927 shows a positive correlation, coefficient of determination

R2=.859, while adjusted R2=.857 shows that the regression model fits the data. This means

that product continuous improvement contributes about 86% variance in the overall customer

loyalty when other factors are held constant.

4.3.3.3 ANOVA for Product Continuous Improvement and Customer Loyalty in the

Nairobi Pharmaceutical Industry

Regression ANOVA is a statistical measure that helps in understanding the level, or the extent

of variability with regards to a regression model. Besides, its findings are used in setting a

base for testing significance. The study conducted regression ANOVA to test whether the

overall regression model was a good fit for the data, and to find out the level of variation

resulting from the independent variable X1 (product continuous improvement) in the

regression model. The R2=.859 (table 4.13a) and F-test results in ANOVA, table 4.10(b),

indicate that product continuous improvement explained 86% of the variance

(R2=.859,F(1,310) = 411.847, p<.05) in the regression model.

Table 4.7: Regression ANOVA Product Continuous Improvement

ANOVAa

Model

1

Sum of Squares

Regression 169.949 1 169.949 411.847 .006*b

Residual 127.922 310 .413

Total 297.871 311

a. Dependent Variable: Customer loyalty

b. Predictors: (Constant), Product continuous improvement *p<.05

4.3.3.4 Coefficients for Product Continuous Improvement and Customer Loyalty in the

Nairobi Pharmaceutical industry

Regression coefficient is the slope of the linear relationship between the dependent variable

and the part of a predictor variable that is independent of all other predictor variables. For the

regression coefficients, table 4.10(c), the study found product continuous improvement

coefficient value of β =.695, t(311)=20.29, p<.05 which was less than critical p-value of 0.05,

hence the study rejected the null hypothesis. This means that there was a significant and

44

positive relationship between product continuous improvement in pharmaceutical industry and

customer loyalty. In other words, any continuous improvement on the product in

pharmaceutical industry increases customer loyalty by factor 0.695 and 0.723 if the moderating

influence of organization structure is factored.

Table 4.8: Regression Coefficients Product Continuous Improvement

Model Unstandardized

Coefficients

Standardised

Coefficients

t Sig. Collinearity

Statistics

B Std.

Error

Beta

(Constant) 1.076 .140 7.701 .000* Tolerance VIF

1) Product

continuous

improvement

.695

.034

.755

20.294

.000*

1.000

1.000

Constant .894 .137 6.526 .003*

2) Product

continuous

improvement

.723

.039

.762

.002*

1.000

1.000

a. Dependent Variable: Customer loyalty; Model 1-with moderator, Model 2-with

moderator. *p<.05

4.4 Customer Focus and Customer Loyalty

The questions in this section have been developed to answer the question about the effect of

customer focus on customer loyalty in the Nairobi Pharmaceutical industry using a scale of 1-

5 where; 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree, 5= Strongly Disagree.

4.4.1. Descriptive Analysis

The study analyzed the effect of customer focus on customer loyalty in the Nairobi

Pharmaceutical industry. I am keen on identifying customer focused pharmaceutical firms

(M=3.6, SD=2.4), 2 respondents strongly disagreed, 2 disagreed, 1 were neutral, 6 respondents

agreed, and 7 strongly agreed. I only purchase medicine from firms which have customer focus

(M=3.6, SD=2.4), 1 respondent strongly disagreed, 2 disagreed, 2 were neutral, 7 respondents

45

agreed, and 6 strongly agreed. I always give feedback on medicine to help the pharmaceutical

organization improve on their customer focus strategy (M=3.6, SD=1.4), 3 respondents

strongly disagreed, 3 disagreed, 2 were neutral, 4 respondents agreed, and 6 strongly agreed. I

do not allow customers to purchase products which I believe are not customer focused (M=3.6,

SD=1.6), 2 respondents strongly disagreed, 3 disagreed, 2 were neutral, 6 respondents agreed,

and 5 strongly agreed. I advise customers based on my pharmaceutical company's perceived

customer focus measurement (M=3.6, SD=2.6), 2 respondents strongly disagreed, 2 disagreed,

1 were neutral, 5 respondents agreed, and 8 strongly agreed. I would purchase medicine from

a non-customer focused pharmaceutical company as long as the product functions properly

(M=3.6, SD=1.2), 5 respondents strongly disagreed, 5 disagreed, 2 were neutral, 3 respondents

agreed, and 3 strongly agreed. I consult with fellow professionals in order to measure perceived

pharmaceutical company's customer focus (M=3.6, SD=2.1), 3 respondents strongly disagreed,

2 disagreed, 1 were neutral, 6respondents agreed, and 6 strongly agreed. I consciously gather

information from customers to gauge their brand loyalty based on their perceived

manufacturer's customer focus (M=3.6, SD=1.2), 3 respondents strongly disagreed, 3

disagreed, 2 were neutral, 5 respondents agreed, and 5 strongly agreed.

46

Table 4.9: Descriptive Analysis for Customer Focus on Customer Loyalty in the Nairobi

Pharmaceutical Industry.

Customer Focus SD D N A SA M Sd

I am keen on identifying customer focused

pharmaceutical firms.

2 2 1 6 7 3.6 2.4

I only purchase medicine from firms which

have customer focus.

1 2 2 7 6 3.6 2.4

I always give feedback on medicine to help the

pharmaceutical organization improve on their

customer focus strategy.

3 3 2 4 6 3.6 1.4

I do not allow customers to purchase products

which I believe are not customer focused.

2 3 2 6 5 3.6 1.6

I advise customers based on my

pharmaceutical company's perceived customer

focus measurement.

2 2 1 5 8 3.6 2.6

I would purchase medicine from a non-

customer focused pharmaceutical company as

long as the product functions properly.

5 5 2 3 3 3.6 1.2

I consult with fellow professionals in order to

measure perceived pharmaceutical company's

customer focus.

3 2 1 6 6 3.6 2.1

I consciously gather information from

customers to gauge their brand loyalty based

on their perceived manufacturer's customer

focus.

3 3 2 5 5 3.6 1.2

4.4.2. Correlation Analysis for Customer Focus and Customer Loyalty in the Nairobi

Pharmaceutical industry

Customer focus was one of the independent variables of the study. The key question was: how

does customer focus in pharmaceutical industry affect the customer loyalty in Nairobi? The

research question was evaluated by considering the results for measures of central tendencies,

correlation and regression analysis, and analysis of variance. The following findings show how

data for customer focus was analysed.

47

Correlation is a statistical determination of the relational variations existing between variables.

Those variations can be either positive or negative in nature. The results of correlation analysis

between customer focus and customer loyalty indicated that these variables were positively

correlated. The results for Pearson Correlation test showed that there was a positive correlation

between customers’ keenness on identifying customer focused pharmaceutical firms and

customer loyalty, r (312) = .679, p< .05. There was a positive correlation between the customer

purchasing medicine from firms which have customer focus and customer loyalty, r (312) =

.685, p< .05. Finally, the results for Pearson Correlation test showed that there was a positive

correlation between customers’ always giving feedback on medicine to help the pharmaceutical

organisation improve on their customer focus strategy and customer loyalty, r (312) = .630, p<

.05. These results are presented in table 4.12.

Table 4.10: Correlation Analysis for Customer focus and Customer loyalty

Test Parameter Customer loyalty

I am keen on identifying customer focused

pharmaceutical firms.

Pearson Correlation 0.679

Sig. (2-tailed) 0.000*

N 18

I only purchase medicine from firms which have

customer focus.

Pearson Correlation 0.685

Sig. (2-tailed) 0.000*

N 18

I always give feedback on medicine to help the

pharmaceutical organisation improve on their

customer focus strategy.

Pearson Correlation 0.630

Sig. (2-tailed) 0.000*

N 18

*Correlation is significant at the p<.05 level (2-tailed)

48

4.4.3. Regression Analysis for Customer Focus and Customer Loyalty in the Nairobi

Pharmaceutical industry

Regression analysis is a statistical method that is applied to establish the existing relationship

between or among variables of study. Hypothesis testing is the process of comparing a research

hypothesis to the null hypothesis. The null hypothesis is only rejected if its probability falls

below a predetermined significance level, in which case the hypothesis being tested is said to

have that level of significance.

4.4.3.1 Model Summary for Customer Focus and Customer Loyalty in the Nairobi

Pharmaceutical Industry

Regression analysis was carried out to explore the level of influence of Customer Focus

(independent variable) on customer loyalty (dependent variable). In this study, multiple linear

regression was run to predict the customer loyalty from the Customer Focus in Pharmaceutical

Industry. In addition, multiple linear regression was run to test whether the overall regression

model is a good fit for the data, through F-ratio result. The outputs for this analysis included

regression model summary, ANOVA and regression coefficients.

4.4.3.2 Regression Model Summary

The result for the model summary is presented in table 4.17(a). The table shows R, R2, adjusted

R2, and the standard error of estimate. R represents multiple correlation coefficients, R2

represents coefficient of determination and adjusted R2 indicates the statistic value adjusted

with respect to the number of independent variables in the model. It demonstrates the fitness

of the regression model. From the table 4.55(a), R =.801shows a positive correlation,

coefficient of determination R2=.642, while adjusted R2=.641 shows that the regression model

fits the data. This means that customer focus explains about 64% variability of overall customer

loyalty when other factors are held constant.

49

Table 4.11: Model Summary Customer Focus

Model R R Square

Adjusted R

Square

Std. Error

of the

Estimate

Durbin-

Watson

1 .766 .589 .597 .92463

2 .801a .642 .641 .76341 1.844

a. Predictors: (Constant), Customer focus

b. Dependent Variable: Customer loyalty

4.4.3.3 ANOVA for Customer Focus and Customer Loyalty in the Nairobi

Pharmaceutical industry

Regression ANOVA is a statistical measure that helps in understanding the level, or the extent

of variability with regards to a regression model. Besides, its findings are used in setting a base

for testing significance. The study conducted regression ANOVA to test whether the overall

regression model was a good fit for the data, and to find out the level of variation resulting

from the independent variable X2 (customer focus) in the regression model. The R2=.642 (table

4.55a) and F-test results in ANOVA, table 4.17(b), indicate that customer focus explained 64%

of the variance (R2=.642, F(1,310) = 552.207, p<.05) in the regression model.

Table 4.12: Regression ANOVA Customer Focus

Model Sum of

Squares Df

Mean

Square F Sig.

1

Regression 321.825 1 321.825 552.207 .000*

Residual 179.502 308 0.583

Total 501.328 309

a. Dependent Variable: Customer loyalty

b. Predictors: (Constant), Customer focus; *p<.05

4.4.3.4 Coefficients for Customer Focus and Customer Loyalty in the Nairobi

Pharmaceutical Industry

Regression coefficient is the slope of the linear relationship between the dependent variable

and the part of a predictor variable that is independent of all other predictor variables. The

50

study result, β=.90, t(310)= 23.50, p<.05, led to the rejection of the null hypothesis, H05. This

meant that there was a significant relationship between the customer focus in pharmaceutical

industry and customer loyalty. The implication of the finding was that improvements in the

customer focus in pharmaceutical industry improve the customer loyalty by factor 0.901. The

results are presented in table 4.17(c).

Table 4.13: Regression Coefficients Customer Focus

Model Unstandardized

Coefficients

Standardised

Coefficients t Sig.

Collinearity

Statistics

(Constant) .376 .144 2.619 .009*

Customer

focus .901 .038

.801 23.499 .000*

1.000 1.000

(Constant) .129 .124 1.040 .009*

Customer

focus .875 .027

.814

23.534 .000*

1.000 1.000

a. Dependent Variable: Customer loyalty;

b. Predictors: (Constant), Customer focus; *p<.05

4.5 Service Quality and Customer Loyalty

The questions in this section have been developed to answer the question about the effect of

customer focus on customer loyalty in the Nairobi Pharmaceutical industry using a scale of 1-

5 where; 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree, 5= Strongly Agree.

4.5.1. Descriptive Analysis

The study analyzed Effect of service quality on customer loyalty in the Nairobi Pharmaceutical

industry. Product information received from the medical representative impacts my repeat

purchase decision (M=3.6, SD=2.8), 1 respondent strongly disagreed, 1 disagreed, 2 were

neutral, 7 respondents agreed, and 7 strongly agreed. The mode of presentation used by the

medical representative impacts my loyalty to the brand (M=3.6, SD=1.4), 3 respondents

strongly disagreed, 3 disagreed, 2 were neutral, 6 respondents agreed, and 4 strongly agreed.

The product clearance services received at the manufacturing site impact my repeat purchase

decision (M=3.6, SD=1.1), 4 respondents strongly disagreed, 3 disagreed, 2 were neutral, 5

51

respondents agreed, and 4 strongly agreed. Perceived bad service would lead me to stop

purchasing the pharmaceutical's products. (M=3.6, SD=2.5), 2 respondents strongly disagreed,

2 disagreed, 1 were neutral, 7 respondents agreed, and 6 strongly agreed. I equate respect for

people to service quality (M=3.6, SD=3.3), 1 respondent strongly disagreed, 2 disagreed, 0

were neutral, 8 respondents agreed, and 7 strongly agreed. I am happy to receive awards for

excellent service delivered to customers on behalf of the pharmaceutical company (M=3.6,

SD=3.1), 1 respondent strongly disagreed, 1 respondent disagreed, 0 were neutral, 7

respondents agreed, and 7 strongly agreed. I would refer other distributors to a pharmaceutical

company that offers superior services (M=3.6, SD=2.4), 2 respondents strongly disagreed, 2

disagreed, 1 were neutral, 6 respondents agreed, and 7 strongly agreed.

Table 4.14: Descriptive Analysis for Service Quality on Customer Loyalty in the Nairobi

Pharmaceutical Industry.

Service Quality SD D N A SA M Sd

Product information received from the

medical representative impacts my repeat

purchase decision.

1 1 2 7 7 3.6 2.8

The mode of presentation used by the medical

representative impacts my loyalty to the

brand.

3 3 2 6 4 3.6 1.4

The product clearance services received at the

manufacturing site impact my repeat purchase

decision.

4 3 2 5 4 3.6 1.1

Perceived bad service would lead me to stop

purchasing the pharmaceutical's products.

2 2 1 7 6 3.6 2.5

I equate respect for people to service quality. 1 2 0 8 7 3.6 3.3

I am happy to receive awards for excellent

service delivered to customers on behalf of the

pharmaceutical company.

1 1 0 7 7 3.6 3.1

I would refer other distributors to a

pharmaceutical company that offers superior

services.

2 2 1 6 7 3.6 2.4

52

4.5.2. Correlation Analysis for Service Quality and Customer Loyalty in the Nairobi

Pharmaceutical industry

Correlation is a statistical determination of the relational variations existing between variables.

Those variations can be both positive and negative in nature. The results of correlation

analysis between service quality and the customer loyalty indicated that these variables were

positively correlated. The results for Pearson Correlation test (table 4.34) showed that there

was a positive correlation between pharmaceutical operators ability to give product

information which impacts customer’s repeat purchase decision, r (312) = .680, p<.05. There

was a positive correlation between the modes of presentation used by the medical

representative which impacts customer’s loyalty to the brand. and the customer loyalty (312)

= .630, p< .05. In addition, the results revealed that there was a positive correlation between

the product clearance services received at the manufacturing site which impacts customer’s

repeat purchase decision and customer loyalty. These results were all presented in table 4.19.

Table 4.15: Correlation Analysis for Service Quality and Customer loyalty

Measurement Parameter Customer loyalty

Product information received from the medical

representative impacts my repeat purchase

decision.

Pearson Correlation 0.68

Sig. (2-tailed) 0.000*

N 18

The mode of presentation used by the medical

representative impacts my loyalty to the brand.

Pearson Correlation 0.63

Sig. (2-tailed) 0.000*

N 18

The product clearance services received at the

manufacturing site impact my repeat purchase

decision.

Pearson Correlation 0.724

Sig. (2-tailed) 0.000*

N 18

*Correlation is significant at the p<.05 level (2-tailed)

4.5.3. Regression Analysis for Service Quality and Customer Loyalty in the Nairobi

Pharmaceutical industry

Regression analysis is a statistical method that is applied to establish the existing relationship

between or among variables of study. Hypothesis testing is the process of comparing a research

hypothesis with the null hypothesis. The null hypothesis is only rejected if its probability falls

53

below a predetermined significance level, in which case the hypothesis being tested is said to

have that level of significance.

4.5.3.1 Model Summary for Service Quality and Customer Loyalty in the Nairobi

Pharmaceutical Industry

Regression analysis was carried out to explore the level of influence of product continuous

improvement (independent variable) on customer loyalty (dependent variable). In this study,

multiple linear regression was run to predict the customer loyalty from the product continuous

improvement in pharmaceutical industry. In addition, multiple linear regression was run to test

whether the overall regression model is a good fit for the data, through F-ratio result. The

outputs for this analysis included regression model summary, ANOVA and regression

coefficients.

4.5.3.2 Regression Model Summary

The result for the model summary was presented in table 4.24(a). The table shows R, R2,

adjusted R2, and the standard error of estimate. R represents multiple correlation coefficients,

R2 represents coefficient of determination and adjusted R2 indicates the statistic value adjusted

with respect to the number of independent variables in the model. Thus, it reveals the fitness

of the regression model. Form the table 4.41(a), R =.883shows positive correlation, coefficient

of determination R2=.719, while adjusted R2=.696 shows that the regression model fits the data.

This means that service quality explains 86% variability of overall customer loyalty when other

factors are held constant.

Table 4.16: Model Summary Service Quality

Model R R Square

Adjusted R

Square

Std. Error

of the

Estimate

Durbin-

Watson

1 .821a .674 .673 .73292

2 .883 .719 .696 .45152 2.161

54

4.5.3.3 ANOVA for Service Quality and Customer Loyalty in the Nairobi Pharmaceutical

industry

Regression ANOVA is a statistical measure that helps in understanding the level, or the extent

of variability with regards to a regression model. Besides, its findings are used in setting a base

for testing significance. The study conducted regression ANOVA to test whether the overall

regression model was a good fit for the data, and to find out the level of variation resulting

from the independent variable X4 (service quality) in the regression model. The R2=.719 (table

4.41a) and F-test results in ANOVA, table 4.24(b), indicate that service quality explained 72%

of the variance (R2=.719, F(1,310) = 641.285, p<.05) in the regression model.

Table 4.17: Regression ANOVA Service Quality

Model Sum

squares

Df Mean

square

F Sig.

1 Regression 344.478 344.78 641.285 .000*

Residual 166.522 310 .537

Total 511.000 311

a. Dependent Variable: Customer loyalty

b. Predictors: (Constant), Service quality; *p<.05

4.5.3.4 Coefficients for Service Quality and Customer Loyalty in the Nairobi

Pharmaceutical Industry

Regression coefficient is the slope of the linear relationship between the dependent variable

and the part of a predictor variable that is independent of all other predictor variables. The

results, table 4.24(c), β =0.852, t(311)=25.32, p<.05, led to rejection of the null hypothesis

(H03). This implied a significant relationship between service quality in pharmaceutical

industry and customer loyalty. This implied that an improvement in service quality of

pharmaceutical industry increases the customer loyalty by factor 0.852.

55

Table 4.18: Regression Coefficients Service Quality

Model Unstandardized

Coefficients

Standardised

Coefficients t Sig.

Collinearity

Statistics

B Std. error B

(Constant) .370 .124 2.981 .003*

Service

quality .852 .034

.821

25.324 .000*

1.000 1.000

(Constant) .113 .098 1.153 .006*

Service

quality .797 .031

.828

24.141 .000*

1.000 1.000

4.6 Chapter Summary

This chapter has presented the results and findings of the collected and analysed data. It was

guided by the questionnaire structure. The chapter has, through SPSS Version 26, provided

descriptive and inferential analysis to determine the effect of Total Quality Management

strategies on customer loyalty in the Nairobi Pharmaceutical Industry. The three independent

variables: product continuous improvement, customer focus and service quality were analysed

individually to allow the researcher to make independent conclusions relating to each research

question. Chapter Five focuses on the discussions, conclusions, and recommendations of the

study.

56

CHAPTER FIVE

5.0 DISCUSIONS, CONCLUSIONS AND RECOMMENDATIONS

5.1 Introduction

This chapter presents a summary of the study findings, conclusions and recommendations. The

findings are summarized in line with the objectives of the study. The specific objectives of the

study were; product continuous improvement, customer focus, and service quality on customer

loyalty in the Nairobi pharmaceutical industry.

5.2 Summary

The general purpose of the study was to determine the effect of Total Quality Management

Strategies on Customer Loyalty in the Nairobi Pharmaceutical Industry: a case of

GlaxoSmithKline Pharmaceuticals Limited. The study was determined to answer the following

research question; what is the effect of product continuous improvement on customer loyalty

in the Nairobi pharmaceutical industry? What is the effect of customer focus on customer

loyalty in the Nairobi pharmaceutical industry? What is the effect of service quality on

customer loyalty in the Nairobi pharmaceutical industry?

The study adopted a descriptive research design. That is, it was used to find out the current

state of total quality management strategies on customer loyalty to pharmaceutical industry and

the relationship between the two. The design enabled the researcher to determine how the

independent variables affected the dependent variable. The study population of this study was

all the 40 customers that purchase pharmaceutical products directly from GlaxoSmithKline

Pharmaceuticals Limited. Stratified sampling is a technique that recognizes the variations or

sub-groups in the population. Using the convenient sampling technique, the study selected a

proportionate sample of GSK customers. The sample size of this study was composed of only

the GSK customers based in Nairobi. The sample size was calculated using Yamane formula

bringing it to 21 GSK customers. Questionnaires, as the research instrument, were chosen as

the data collection instrument. A questionnaire is a printed self-report form designed to elicit

information that can be obtained through written responses of the subjects. Questionnaires

were personally distributed by the researcher to the respondents to complete. The data was

collected over a period of two weeks. The researcher met all respondents in the designated and

authorized pharmaceutical selling outlets for pharmaceutical brands. Anonymity and

confidentiality was maintained throughout the research. Descriptive statistics such as

frequencies and percentages, and measures of central tendency (means) and dispersion

57

(standard deviation) were used. Additionally, multiple linear regression analysis was used to

show the relationship between customers’ brand loyalty and total quality management

strategies adopted by pharmaceuticals. The analysed data was presented in tables and charts.

Regarding the first question, the results of correlation analysis between product continuous

improvement and customer loyalty indicated that these variables are positively correlated (table

4.6). The results for Pearson Correlation test showed that there was a positive correlation in

that, customers always purchase medicine based on perceived quality and customer loyalty, r

(312) = .634, p< .05. There was a positive correlation between customers always reading the

medicine ingredients to check for quality improvements and customer loyalty, r (312) = .548,

p< .05. Finally, the results for Pearson Correlation test showed that there was a positive

correlation between customers comparing medicine quality across different manufacturing

companies before making a ‘buy decision’ and customer loyalty, r (312) = .682, p< .05. The

study noted a positive correlation, coefficient of determination R2=.859, while adjusted

R2=.857 shows that the regression model fits the data. This means that product continuous

improvement contributes about 86% variance in the overall customer loyalty when other

factors are held constant. The R2=.859 and F-test results in ANOVA, indicated that product

continuous improvement explained 86% of the variance (R2=.859, F(1,310) = 411.847, p<.05)

in the regression model.

On the second objective, the results for Pearson Correlation test showed that there was a

positive correlation between customers’ keenness on identifying customer focused

pharmaceutical firms and customer loyalty, r (312) = .679, p< .05. There was a positive

correlation between the customer purchasing medicine from firms which have customer focus

and customer loyalty, r (312) = .685, p< .05. Finally, the results for Pearson Correlation test

showed that there was a positive correlation between customers’ always giving feedback on

medicine to help the pharmaceutical organisation improve on their customer focus strategy and

customer loyalty, r (312) = .630, p< .05. R =.801shows a positive correlation, coefficient of

determination R2=.642, while adjusted R2=.641 shows that the regression model fits the data.

This means that customer focus explains about 64% variability of overall customer loyalty

when other factors are held constant. The R2=.642 and F-test results in ANOVA, indicate that

customer focus explained 64% of the variance (R2=.642, F(1,310) = 552.207, p<.05) in the

regression model. The study result, β=.90, t(310)= 23.50, p<.05, led to the rejection of the null

hypothesis, H05. This meant that there was a significant relationship between the customer

58

focus in pharmaceutical industry and customer loyalty. The implication of the finding was that

improvements in the customer focus in pharmaceutical industry improve the customer loyalty

by factor 0.901.

The results for Pearson Correlation test showed that there was a positive correlation between

pharmaceutical operators ability to give product information which impacts customer’s repeat

purchase decision, r (312) = .680, p<.05. There was a positive correlation between the modes

of presentation used by the medical representative which impacts customer’s loyalty to the

brand. and the customer loyalty (312) = .630, p< .05. In addition, the results revealed that there

was a positive correlation between the product clearance services received at the manufacturing

site which impacts customer’s repeat purchase decision and customer loyalty. The results

showed that all the variance inflation factors (VIF) were below 10. This clearly indicated that

the relationship between service quality and customer loyalty was linear. R =.883shows

positive correlation, coefficient of determination R2=.719, while adjusted R2=.696 shows that

the regression model fits the data. This means that service quality explains 86% variability of

overall customer loyalty when other factors are held constant. The R2=.719 (table 4.41a) and

F-test results in ANOVA (table 4.41b), indicate that service quality explained 72% of the

variance (R2=.719, F(1,310) = 641.285, p<.05) in the regression model. The results (table

4.41c), β =0.852, t(311)=25.32, p<.05, led to rejection of the null hypothesis (H03). This

implied a significant relationship between service quality in pharmaceutical industry and

customer loyalty. This implied that an improvement in service quality of pharmaceutical

industry increases the customer loyalty by factor 0.852.

59

5.3 Discussion

5.3.1 Product Continuous Improvement and Customer Loyalty

The study found out that product continuous improvement highly influences Customer Loyalty

in the Nairobi pharmaceutical Industry. The results for Pearson Correlation test showed that

there was a positive correlation between customers always purchase medicine based on

perceived quality and customer loyalty, r (312) = .634, p< .05. There was a positive correlation

between Customers always reading the medicine ingredients to check for quality improvements

and customer loyalty, r (312) = .548, p< .05. These results are in consonance with the findings

from the multiple regression models. The study revealed from respondents that they always

purchase medicine based on perceived quality, always read the medicine ingredients to check

for quality improvements, they often compare medicine quality across different manufacturing

companies before making a ‘buy decision’, read product improvement quality reviews before

purchasing medicine. The findings agrees with those of Kaziliunas (2010) who noted that

achievement factors for consistent improvement of cycles incorporate top management

improvement, improvement in remuneration frameworks, group, persuasive variables and

instruction and preparing. The findings concurs with those of Nyamari (2015) who noted that

TQM strategies are a critical arrangement of the board for continuous improvements to achieve

upper hand. Today clients are demanding for quality in items and administrations. An

organization that satisfies such needs increases upper hand over contenders. All things

considered; TQM strategies don't straightforwardly improve the benefits of these banks. Zero

in on quality and ceaseless cycle improvement had been embraced to a huge degree while

preparing and instruction, top administration duty and groups (representative responsibility)

responsibility had been received to a moderate degree. Furthermore, TQM strategies rehearses

were acknowledged to positively affect operational performance with the end goal that is TQM

strategies practice shifts, the last fluctuates to a huge degree.

The findings also tallies with those of Donabedian (2003) who observed that to have the option

to oversee, improve and execute more broad quality activities and upgrades it is important to

watch, measure, and assess. Without doing this, how would we realize what to improve and

whether we have succeeded? There is a need to discover evidence for improvements to have

the option to spread and actualize them as a major aspect of pharmaceutical services. By

improving cycles and results pertinent to high-need wellbeing needs, an organization reduces

waste and costs associated with system failures and redundancy. Likewise, a Kenyan study by

Wangai (2015) on Total Quality Management and performance of pharmaceutical

60

manufacturing and distributing firms in Kenya established that an appropriate system of

acknowledgment and prize is critical to any organization's TQM strategies, especially as the

quality improvement measure offers more prominent organisation open doors for standard

working individuals. Uplifting feedback through acknowledgment and prize giving is basic for

accomplishment through participative critical thinking ventures. Individuals work for

accomplishment, headway, expanded duty, recognition job interest as well as money.

From the table 4.13(a), R=.927 shows a positive correlation, coefficient of determination

R2=.859, while adjusted R2=.857 shows that the regression model fits the data. This means

that product continuous improvement contributes about 86% variance in the overall customer

loyalty when other factors are held constant. According to Donabedian (2003), an organization

that executes a continuous integration program, encounters a scope of advantages such as

improved patient wellbeing results that include both cycle results - for example, diminished

dismalness and mortality- and improved proficiency of administrative and clinical cycles. By

improving cycles and results applicable to wellbeing needs, an organisation lessens waste and

expenses related to framework disappointments and excess.

The study conducted regression ANOVA to test whether the overall regression model was a

good fit for the data, and to find out the level of variation resulting from the independent

variable X1 (product continuous improvement) in the regression model. The R2=.859 (table

4.13a) and F-test results in ANOVA (table 4.13b), indicate that product continuous

improvement explained 86% of the variance (R2=.859, F(1,310) = 411.847, p<.05) in the

regression model. Esin and Hilal (2014) focused on the impacts of continuous improvement

and performance of firms in Turkey where a cross-sectional overview technique was utilized,

and the unit of the example was at the plant level. The results of the study demonstrated that

organizations should give essential learning opportunities, through contribution preparing, to

every one of their workers in order to improve their proficiencies in their undertakings.

Powerful continuous improvement in quality brings accomplishment for the organizations.

Individual learning points combined among team members leads to full team growth of ideas.

Thereby, employees' successful information and learning ability will give supportability of

value to the executives in the firm.

61

5.3.2. Customer Focus and Customer Loyalty

The findings show there is a positive highly significant relationship between customer focus

and Customer Loyalty. Pearson Correlation test showed that there was a positive correlation

between customers’ keen on identifying customer focused pharmaceutical firms and customer

loyalty, r (312) = .679, p< .05. These results are also in conformity with the findings from the

multiple regressions model. R =.801shows a positive correlation, coefficient of determination

R2=.642, while adjusted R2=.641 shows that the regression model fits the data. This means that

customer focus explains about 64% variability of overall customer loyalty when other factors

are held constant. The study analysed the effect of customer focus on customer loyalty in the

Nairobi Pharmaceutical industry. Customers are keen on identifying customer focused

pharmaceutical firms, a customer only purchase medicine from firms which have customer

focus, customers always give feedback on medicine to help the pharmaceutical organisation

improve on their customer focus strategy, do not allow customers to purchase products which

they believe are not customer focused, customers advise customers based on my

pharmaceutical company's perceived customer focus measurement, would purchase medicine

from a non-customer focused pharmaceutical company as long as the product functions

properly, customers consult with fellow professionals in order to measure perceived

pharmaceutical company's customer focus, customers consciously gather information from

customers to gauge their brand loyalty based on their perceived manufacturer's customer focus.

The results concur with Nganga (2010) who found a strong link between the delivery of high-

quality goods and services and profitability through customer satisfaction. Similarly, Spiterl

and Joseph (2003) uncovered that, organizations are dependent on their clients for their reality

and prosperity and ought to in this manner perceive all current and potential client needs, meet

client necessities and endeavour to outperform client desires by following total quality

management measures over the organization.

The study result, β=.90, t (310) = 23.50, p<.05, led to the rejection of the null hypothesis, H05.

This meant that there was a significant relationship between the customer focus in

pharmaceutical industry and customer loyalty. The implication of the finding was that

improvements in the customer focus in pharmaceutical industry improve the customer loyalty

by factor 0.901. The results are presented in table 4.55(c). Mehra and Ranganathan (2008)

underlined the significance of the components of client dependability and customer loyalty in

the zone of customer focus. Focusing on the requirement for utilizing TQM strategies to

62

upgrade customer focus, the researchers expressed that organizations must move their

concentration towards customer loyalty. Given that customer focus is vigorously referenced in

the literature, Mehra, Hoffman and Sirias (2001) proposed that TQM strategies of the future

should be redefined to include customer focus. Tsang and Antony (2001) compose that

understanding, fulfilling, and outperforming client needs ought to be one of the primary

objectives of actualizing TQM programs. Likewise, according to these creators, workers ought

to be customer focused. Along comparable lines, Dean and Bowen (1994) contend that

customer focus ought to be a key TQM strategy. Summarizing the writing on TQM strategies,

Mehra et al., recommend that TQM strategies of things to come ought to be reclassified to

incorporate client focus.

The result for the model summary is presented in table 4.55(a). The table shows R, R2, adjusted

R2, and the standard error of estimate. R represents multiple correlation coefficients, R2

represents coefficient of determination and adjusted R2 indicates the statistic value adjusted

with respect to the number of independent variables in the model. It demonstrates the fitness

of the regression model. From the table 4.55(a), R =.801shows a positive correlation,

coefficient of determination R2=.642, while adjusted R2=.641 shows that the regression model

fits the data. This means that customer focus explains about 64% variability of overall customer

loyalty when other factors are held constant. Managing customer relations is by far the most

significant part of a customer focused organisation, Spiterl and Joseph (2003). It is fundamental

to keep up and develop relations with customers and partners, and this should mean being

reasonable and genuine consistently. Regardless of whether there is a particular representative

or division who manages client relations, or this job tumbles to an assigned senior

administration level worker, straightforwardness and uprightness assume a fundamental

function in building compelling relations.

The study conducted regression ANOVA to test whether the overall regression model was a

good fit for the data, and to find out the level of variation resulting from the independent

variable X2 (customer focus) in the regression model. The R2=.642 (table 4.55a) and F-test

results in ANOVA (table 4.55b), indicate that customer focus explained 64% of the variance

(R2=.642, F(1,310) = 552.207, p<.05) in the regression model. Amaniampong et al., recognized

that among the key strategies of absolute quality administration (TQM) is customer focus,

along these lines client prerequisites must be met first time without fail. The accomplishment

of an organisation relies upon how well the organisation comprehends its clients and addresses

63

their issues Mehra et al., recommend that TQM strategies of things to come ought to be

reclassified to incorporate client focus.

5.3.3 Service Quality and Customer Loyalty

The study established that product information received from the medical representative

impacts repeat purchase decision of customers in GSK. The results for Pearson Correlation test

showed that there was a positive correlation between pharmaceutical operators ability to give

product information which impacts customer’s repeat purchase decision, r (312) = .680, p<.05.

There was a positive correlation between the modes of presentation used by the medical

representative which impacts customer’s loyalty to the brand. and the customer loyalty (312)

= .630, p< .05. The mode of presentation used by the medical representative impacts customer’s

loyalty to the brand. The product clearance services received at the manufacturing site impact

clients’ repeat purchase decision. Perceived bad service would lead customers to stop

purchasing the pharmaceutical's products. Other customers equate respect for people to service

quality, customers are happy to receive awards for excellent service delivered to customers on

behalf of the pharmaceutical industry, and customers would refer other distributors to a

pharmaceutical company that offers superior services. According to Beryl and Brodeur (2007),

service quality is one of the basic achievement factors that impact the intensity of an

organisation.

The results in table 4.41c, β =0.852, t (311) =25.32, p<.05, led to rejection of the null

hypothesis (H03). This implied a significant relationship between service quality in

pharmaceutical industry and customer loyalty. This implied that an improvement in service

quality of pharmaceutical industry increases the customer loyalty by factor 0.852.

These findings agrees with those of Onditi et al., who noted that fulfilling client needs is

significant for the undertakings to endure. The result of utilizing quality practices incorporate

understanding and improving of operational cycles, identifying issues rapidly and efficiently

and building up substantial, solid assistance performance measures and estimating customer

loyalty and other performance results. Service quality can be identified with service potential,

service cycle or service result, in this route for instance, potential quality can be perceived as

the colleague capability, measure quality as the speed. Talib et al., concurs with this by

observing that the idea of service quality has risen up out of TQM theory and now it is treated

as a basic rule for powerful TQM performance. The writing survey recommended that service

64

quality can be ordered into number of ways, for example, client assistance quality; online help

quality; banking service item quality and computerized service quality (clarified in next

segment) with the basic expect to accomplish customer loyalty, improved money related

performance, and intensity.

The study conducted regression ANOVA to test whether the overall regression model was a

good fit for the data, and to find out the level of variation resulting from the independent

variable X4 (service quality) in the regression model. The R2=.719 (table 4.41a) and F-test

results in ANOVA (table 4.41b), indicate that service quality explained 72% of the variance

(R2=.719, F(1,310) = 641.285, p<.05) in the regression model. This is an agreement with

findings of Mehralian et al., who observed that service quality can expand the general

achievement pace of the medical services quality; they have become a significant theme to

medical services suppliers and advertisers and the focal point of numerous investigations.

Service quality can likewise generously influence tolerant satisfaction. Definitely, the

expanded satisfaction improves client unwaveringness and buy goal.

Moreover, Durbin-Watson statistic was 2.161, quite close to 2 indicating that there was no first

order autocorrelation in the residuals. This finding confirmed that there was no autocorrelation

in the data. The findings agrees with the findings of Shank (2002) who noted that service

quality and satisfaction directly affects attractive results, for example, the purchaser's purpose

to suggest the administration. Seen esteem is progressively perceived as a wellspring of upper

hand; be that as it may, it has not been consolidated into the satisfaction and quality

examination stream. This exploration model has increased the value of the constructs of quality

and satisfaction by testing a model that portrays the relationship of saw administration quality,

seen value, and saw an incentive to explicit demonstration of suggesting a service.

The findings on customer focus were emphasised up by Spiterl and Joseph (2003) who

observed that managing customer relations is by far the most significant part of a customer

focused organisation. It is fundamental to keep up and develop relations with customers and

partners, and this should mean being reasonable and genuine consistently. Regardless of

whether there is a particular representative or division who manages customer relations, or this

job tumbles to an assigned senior administration level worker, straightforwardness and

uprightness assume a fundamental function in building compelling relations. Along these lines,

65

the organization can pursue powerful quality administration as a real customer focused

organisation.

5.4 Conclusion

The study found out that product continuous improvement highly influences Customer Loyalty

in Pharmaceutical Industry. From a total number of respondents, the study established the

reasons that make respondents to buy pharmaceutical products as; due to promotions, price, on

the Influence from friends and referrals, loyalty to my brand, influence of quality, status symbol

of the product and sense of patriotism. Hirschhorn (2000) argues that a central problem for

pharmaceutical industry is how to organize and manage improvements. To succeed with

change and improvement, behaviour, the culture of beliefs and values in the organization must

change. The complexity and culture in pharmaceutical industry has sometimes been mentioned

as a barrier that explains why change and improvement progress are slow, Leape & Berwick,

(2005).

The study found out that customer focus highly influences customer loyalty in pharmaceutical

industry, Nairobi. Customer focus indicators such as knowing patients’/customers’

needs/assumptions and utilizing customer necessities and assumptions as the reason for quality

and making of snappy reactions upon any request had the most elevated mean scores. The

investigation additionally reasoned that client centre was basic for client steadfastness in

pharmaceutical industry. The outcomes demonstrated that the drugs consistently endeavoured

to meet its client needs, address clients grievances as a need for the drugs, the drugs

administrators effectively performed market research to identify customer needs and that the

organization provided clear channels of communication to its customers.

This implied a significant relationship between service quality in pharmaceutical industry and

customer loyalty. It implied that an improvement in service quality of pharmaceutical industry

increases the customer loyalty. The study established that product information received from

the medical representative impacts repeat purchase decision of customers in GSK. The mode

of presentation used by the medical representative impacts customer’s loyalty to the brand. The

product clearance services received at the manufacturing site impact clients’ repeat purchase

decision.

66

5.5 Recommendations

5.5.1. Recommendations for Improvement

5.5.1.1 Product Continuous Improvement

Continuous improvement processes generally requires that pharmaceutical professionals and

staff from different specialties, functions, or units work together in order to document how the

process works in its entirety and distinguish the key interaction factors that assume a causal

part in client reliability. It additionally requires assembling enormous quantities of drug staff,

furnishing them with specialized mastery in continuous improvement strategies and

instruments, and engaging them to analyse and take care of patient security issues. Leadership

and organisation culture are significant in actualizing a constant improvement rule. Despite the

fact that collaboration among the workers and submitted administration achieves continuous

improvement, this study however does not underscore the role of patients in bringing about

improvement in the provision of pharmaceutical services.

There is developing proof that patients are creative in achieving improvement in drug

administrations as they are in a bad way. Donabedian (2003) suggests that to have the option

to oversee, improve and actualize more broad quality activities and enhancements it is

important to notice, measure, and assess. By improving cycles and results pertinent to high-

need wellbeing needs, an organization reduces waste and costs associated with system failures

and redundancy.

5.5.1.2 Customer Focus

This study also recommended that since client centre has an impact around client steadfastness

in the Nairobi drug industry, it is essential for administrators in the Nairobi drug industry to

start statistical surveying to discover client needs, give clear channels of correspondence and

address client grumblings as expected. Leaders in the Nairobi drug industry should distinguish

client relationship to quantify client needs and assumptions; include clients in quality

improvement and decide consumer loyalty. The accessibility of client grumbling data to chiefs

and the level of the utilization of client criticism to improve item quality uncover the degree of

client centre in an association. As client assumptions are dynamic, pharmaceutical industry

needs to survey customer expectations regularly and modify its operations accordingly.

67

In order to stay competitive, the pharmaceutical industry should have the option to react and

adjust to changing client inclinations and requirements Brahet et al. It is in this way significant

that each representative in the association is included and submitted towards setting up and

supporting an undeniable degree of consumer loyalty. The attention on clients might be more

grounded in drug industry because of their vicinity to and cosy relationship with the clients. It

is a need that both current just as future necessities of the clients are perceived and met, while

making and supporting a client situated association. This infers that drug industry should

effectively build up an assortment of components, empowering proficient methods of allowing

clients to contact the association with item requests and related inquiries, just as setting up

channels from which the organization can obtain knowledge about customer preferences. In

order to gain full advantage of this knowledge, it is important that incoming information and

changes in customer preferences are analyzed and understood.

5.5.1.3 Service Quality

There is need for pharmaceutical industry to differentiate between themselves and other

industries because of the competitive environment which is accomplished through offering

excellent types of assistance. Customer commitment is cultivated when a customer is content

with the amazing organization. For drug items supplier to be fruitful, they will depend on upon

the relationship they have with their customer. Administration touchy clients, who have a

higher eagerness to pay for administration quality, may float after some time to the

organizations that involve a high relative assistance quality/value position inside their market.

Distinguishing proof of predominant help quality measurements in various assistance

industries will assist in guiding operations managers to deploy specialized service design and

delivery to enhance service quality that meet consumers’ expectations.

The management of pharmaceutical industry ought to coordinate training and supplemental

classes for all drug industry workers on modules proposed to create reliability among drug

industry representatives too in the drug business to build up the character and great propensities

among the drug business staff. Such modules should likewise harp on the methods and ways

on improving productivity in the drug business. In spite of the fact that client care has been

assessed quite a while past, however it is as yet one examination that drug industry should keep

on directing to meet the adjustments in the business. New technologies pharmaceutical industry

must be incorporated as a factor to measure service quality in future researches. Researches

what's more, related polls should likewise be obliged with the new pharmaceutical industry

68

prerequisites of the client. A clearer arrangement regarding the grouping of connection between

administration quality, consumer loyalty and client steadfastness in the pharmaceutical

industry can help to ensure better targeting of customer using limited marketing resources.

.

5.5.2 Recommendation for Further Studies

This study recommends that future studies test the effects of the other elements of total quality

management rehearses (quality affirmation, quality control, measure centeredness, coordinated

framework, key and efficient methodology, actuality based dynamic and correspondence) on

hierarchical performance that were not part of this study. There is also a need to establish the

modern challenges in Total Quality Management implementation pharmaceutical industry.

69

REFERENCES

Abdi, W. Y., & Al Manhawy, A. (2013). TQM critical success factors in hospitality Industry

and their impact on Customer Loyalty, a theoretical Model. International Journal of

Scientific and Engineering Research, 4(1), 1–15.

Adeoti, J. O. (2011). Total quality management (TQM) factors: An empirical study of Kwara

state government hospitals. Studies on Ethno-Medicine, 5(1), 17–23.

Alexander, J. A., Weiner, B. J., & Griffith, J. (2006). Quality improvement and hospital

financial performance. Journal of Organizational Behavior: The International Journal of

Industrial, Occupational and Organizational Psychology and Behavior, 27(7), 1003–

1029.

Alhuwitat, M. A., & Salem, F. H. (2016). Impact of pharmaceutical services quality on building

a strong relationship between pharmacists and their customers; International Journal

of Scientific & Engineering Research Volume 4, ISSN 2229-5518.

Anvari, A., & Moghimi, R. (2012). The strategic approach to exploration review on TQM and

lean production. International Journal of Lean Thinking, 3(2), 13–26.

Apudo, M. O. (2016). Quality Management Practices and Customer Retention in Micro and

Small Enterprises in Nairobi City County, Kenya. Unpublished MBA Project, University

of Nairobi-Kenya.

Attakora-Amaniampong, E., Salakpi, A., & Bonye, F. (2014). Total Quality Management and

its impact on the level of Customer Focus within Construction Project Management in

Ghana. International Journal of Business and Management Invention, 3(7), 36–48.

Berwick, D. M., James, B., & Joel C. M. (2003). Connections between quality measurement

and improvement. medical care, 41(1) Supplement, I30-38 Besterfield, D.H. (1995)

Total Quality Management, New Jersey, NJ: Prentice Hall Inc.

Beryl, J. M., & Brodeur, (2007). Determinants of customer loyalty: International Journal of

Bank Marketing. 12(6), 10-19.

Chelang’a, J. (2012). The Impact of Total Quality Management (TQM) Policy on Customer

Satisfaction at Kenya Power and Lighting Company (KPLC) in Uasin Gishu County,

Kenya. International Journal of Academic Research and Development, 3, 187–193.

Chepkech, W. K. (2014). Effect of total quality management practices on organizational

performance in Kenya: a case of tertiary institutions in Uasin Gishu County.

Unpublished MBA Thesis; Faculty of Commerce Kisii University.

70

Chien, T. K., Su, C. H., & Su, C. T. (2002). Implementation of a customer satisfaction program:

a case study, International Journal of Industrial Management & Data Systems, Vol.

102 No. 5, pp. 252-9.

Cooper, D. R., Schindler, P. S., & Sun, J. (2003). Business research methods; 7th Edition,

Prentice Hall, New York-USA

David, D. N. (2018). Quality management practices and customer satisfaction in middle level

colleges in machakos county, kenya. Unpublished MBA Thesis Kenyatta University.

Dean, J. W. Jr., & Bowen, D. E. (1994). Management theory and total quality: improving

research and practice through theory development, The Academy of Management

Review, Vol. 19 No. 3, pp. 392-418.

Diamond, I. M. (2015). Total quality management practices and operational performance of

private hospitals in Nairobi county. University of Nairobi.

Donabedian, A. (1989). Institutional and professional responsibilities in quality assurance,

Quality Assurance in Healthcare, Vol. 1, 3-12.(12): 1743-1748

Feigenbaum, A. V. (2001). How to manage for quality in today’s economy. Quality Progress,

34(5), 26. McGraw-Hill, Online Computer Library Center (OCLC) 18582947; New

York-USA

Fening, D. F., Amaria, D. P., & Frempong, E. O. (2013). Linkages between Total Quality

Management and Organizational Survival in Manufacturing Companies in Ghana.

International Journal of Business and Social Science, 4(10), 1-4.

Gaya, R. (2012). Influence that Total Quality Management has on the human resource

planning practices at Kenya Revenue Authority; Unpublished MBA Thesis, University

of Nairobi.

Gharakhani, D., Rahmati, H., Farrokhi, M. R., & Farahmandian, A. (2013). Total quality

management and organizational performance. American Journal of Industrial

Engineering, 1(3), 46–50.

Githuku, P. (2015). Total quality management in Kenya’s healthcare industry. Unpublished

MBA Thesis, University of Nairobi.

Grove, S. K., Burns, N., & Gray, J. (2012). The practice of nursing research: Appraisal,

synthesis, and generation of evidence. Elsevier Health Sciences.

Harris, K. M., Halpern, C. T., Whitsel, E., Hussey, J., Tabor, J., Entzel, P., Udry, J. R., &

Health, N. L. S. A. (2009). Research design.

71

Kaziliūnas, A. (2010). Impacts of different factors on the implementation of quality

management systems and performance outcomes. Current Issues of Business and Law,

5(1), 75–92.

Kerlinger, F. N. (1973). Foundations of behavioral research, 2nd Indian reprint, Delhi, IN:

Surjeet Publications.

Khanchanapong, T., Prajogo, D., Sohal, A. S., Cooper, B. K., Yeung, A. C. L., & Cheng, T. C.

E. (2014). The unique and complementary effects of manufacturing technologies and lean

practices on manufacturing operational performance. International Journal of Production

Economics, 153, 191–203.

Kothari, C. R. (2008). Research methodology, methods and techniques (pp. 109-110). New

Delhi: New Age Inter-National (P) Limited.

Kotler, P., & Pfoertsch, W. (2006). B2B brand management. Springer Science & Business

Media.

Kumar, R. (2019). Research methodology: A step-by-step guide for beginners. SAGE

Publishing, NEW YORK, USA

Majeedu A. (2011), Mäntymaa K. (2013), Kabuye G. (2013). Total Quality Management and

Competitive Advantage in Uganda’s Pharmaceutical Industry. Islamic University in

Uganda, Mbale.

Marienga, R. A. (2009). Determinants of quality service delivery by public institutions in

Kenya: a case of national social security fund. Kenyatta University, Unpublished

Research Project.

Mazumder, B., Bhattacharya, S., & Yadav, A. (2011). Total quality management in

pharmaceuticals: A Journal of Total Quality Management- Pujabhi-India 3(1), 365–375.

McIntyre, R. C. (2012) Improving quality improvement. The American Journal of Surgery,

204, 815-825.

Mehra and Ranganathan (2008). Implementing total quality management with a focus on

enhancing customer satisfaction; International Journal of Quality & Reliability

Management; Fogelman College of Business and Economics, The University of

Memphis, Memphis, Tennessee, USA.

Mehra, S., Hoffman, J. M., & Sirias, D. (2001). TQM as a management strategy for the next

millennia, International Journal of Operations and Production Management, Vol. 21

Nos 5/6, pp. 855-76.

72

Mehralian, M., Babapour, J., & Peiravian F. (2016). Distributor– Retailer Interface in

Pharmaceutical Supply Chain: Service Quality Measurement Scale. University of

Medical Sciences; Iranian Journal of pharmaceutical research. Autumn; 15(4): 973–

982.

Mehrotra, D. (2004). Applying total quality management in academics. Quality Guide to the

Non-Formal and Informal Learning Processes. SEEQUEL.

Moghadam, M. S., Sayadi, E., & Moharer, A. (2013). Study strategy Total Quality

Management in the hotel industry of sports in Iran. Global Advanced Research Journal of

Economics, Accounting and Finance, 2(1), 18–26, Teheran, Iran

Mugenda, O. M., & Mugenda, A. G. (n.d.). A.(2003). Research Methods. ACTS Press, Nairobi

Kenya.

Muia, M. (2014). Effect of TQM implementation in the performance of microfinance

institutions in Kenya; Unpublished MBA Thesis, University of Nairobi.

Mukonyo, M. F. (2014). Effects Of Total Quality Management Implementation In Performance

Of Microfinance Institutions In Kenya: A Case of K-Rep Development Agency

(KDA),15-33. Unpublished MBA Thesis, University of Nairobi.

Munizu, M. (2013). The Impact of Total Quality Management Practices towards Competitive

Advantage and Organizational Performance: Case of Fishery Industry in South

Sulawesi Province of Indonesia. Pakistan Journal of Commerce & Social Sciences, 7,

184-197.

Murungi, C. (2013). Total quality management and competitive advantage of pharmaceutical

industries in Uganda: a case study of CIPLA quality chemical industries limited.

Unpublished MBA Thesis; Nkumba University, Entebbe-Uganda.

Musrani, M. (2013). The Impact of Total Quality Management Practices towards Competitive

Advantage and Organizational Performance: Case of Fishery Industry in South

Sulawesi Province of Indonesia.

Mutua, J. (2014). Quality management practices and financial performance of

pharmaceuticals manufacturing firms in Kenya; Unpublished MBA Thesis, University

of Nairobi.

Mäntymaa, J. (2013). Gaining competitive advantage through quality of services in financial

industry; Unpublished Master’s Thesis; University of Oulu, Finland

73

Mwaniki and Okibo (2014). Effect that TQM has on the performance of banking sector

financially, a case of National bank of Kenya; Unpublished MBA Thesis, University of

Nairobi.

Mwaura (2017). Effect of total quality management on performance of Kenya revenue

authority; Unpublished MBA Thesis, University of Nairobi.

Nassar M. L., Yahaya K. A., & Shorun, C. Y (2015). Total quality management and customers

satisfaction in selected service industries in Ilorin, Nigeria. Journal of Sustainable

Development in Africa (Volume 17, No.6, 2015) ISSN: 1520-5509 Department of

Accounting, Faculty of Management Sciences, University of Ilorin, Ilorin, Nigeria.

Neetha, K., Srinivas, T. R, Ramachandra, C. G., Manjunatha, B. (2016). Implementation of

Total Quality Management (TQM) in Hospital to Improve Service Quality; National

Conference on Advances in Mechanical Engineering Science (NCAMES-2016).

Ngechu, M. (2004). Understanding the research process and methods. An introduction to

research methods. Unpublished MBA Thesis, School of Business: University of Nairobi.

Nyamari, P. M (2015). Effect of total quality management practices on operational

performance of commercial banks in Mombasa County, Kenya; Unpublished MBA

Thesis, University of Nairobi.

Ocharo, J. (2017). Effects of implementation of total quality management on the performance

of hospitality industry; Unpublished Thesis; Diploma in Business Service, Kisii

University, Nairobi.

Onditi, A., Oginda, M., & Ochieng, I. (2012). Implications of Service Quality on Customer

Loyalty in the Banking Sector; A Survey of Banks in Homabay County. International

Journal of Business and Social Science Vol. 3 No. 21; November 2012.

Pekar, P. (1995). Total quality management: Guiding principles for application. ASTM

publication. ASTM Manual Series: MNL 22 ASTM Publication Code Number (PCN) 28-

022095-34; Philadelphia, USA

Saunders, M., Lewis, P., & Thornhill, A. (2009). Research methods for business students.

Pearson Education.

Shank, M. Linda, P. (2002) Customer's perceptions of quality, value and satisfaction: A

behavioural consequences view. D.B.A. dissertation, Nova Southeastern University,

United States -- Florida.

74

Sigei, C. K. (2014). Total quality management and performance of multinational

pharmaceutical firms in Nairobi, Kenya; Unpublished MBA Thesis; Kenyatta

University.

Spiterl, L., and Joseph M. (2003). Customer Value, Overall Satisfaction, End User

Loyality, and Market Performance in Detailed Intensive Industries; PHD dissertation,

The H. Wayne Huizenga Graduate School of Business and Entrepreneurship, Nova

Southeastern University, UMI Number: 3100962.

Suhendar, U. (2019). effect of product quality, perception of price and satisfaction to customer

loyalty (study on Pharmaceutical Company in Indonesia); International Journal of

Economics, Commerce and Management; United Kingdom ISSN 2348 0386 Vol. VII,

Issue 3, March 2019.

Sumarjan, N., & Arendt, S. (2011). Quality practices implementation in Malaysian hotels: The

management perspective. International Joutrnal of quality management; Vol II. No. 3;

MPH Group Publishing, Kuala Lumpur, Malaysia

Talib F., Rahman Z., & Qureshi, M. N (2012). Researched on the Impact of Total Quality

Management and Service Quality in the Banking Sector; Journal of

Telecommunications System & Management, Vol. 8 No. 5, pp. 24-31.

Tsang, J. H. Y., & Antony, J. (2001). Total quality management in UK service organisations:

some key findings from a survey, Managing Service Quality, Vol. 11 No. 2, pp. 132-

141.

Wanderi, E. N (2014). Factors influencing implementation of total quality management in

construction companies in Rwanda: a case of Fair Construction Company;

Unpublished MSc Project Management; Jomo Kenyatta University of Agriculture and

Technology.

Wangai, N. J (2015). Total Quality Management and performance of pharmaceutical

manufacturing and distributing firms in Kenya; Unpublished MBA Thesis, University

of Nairobi.

Wangui, O. W (2018). Effect of total quality management practices on operational

performance of food manufacturing firms in Nairobi County, Kenya; Unpublished

MBA Thesis; Egerton University.

Wanyoike, R. W. (2016). Quality management practices and firm performance among

manufacturing firms in Kenya. Unpublished PHD Thesis (Human Resource

Management). Kenyatta University, Kenya.

75

Wu, Kuang-Wen (2006). Service quality, Customer Satisfaction, and Customer

Loyalty, in customer electronics E-tailers: A structural Equation modelling

approach PHD dissertation, Lynn University, UMI Number: 3213334.

Yala, H. O (2018). Impact of Total Quality Management policy on customer satisfaction at

Kenya Power and Lighting Company in Uasin Gishu County; Unpublished MBA

Thesis, Moi University.

76

APPENDIX I: QUESTIONNAIRE

Dear respondent this questionnaire aims to collect information related to the effect of quality

management strategies on customer loyalty in the Nairobi Pharmaceutical Industry. I therefore

inform you that you are one of the selected samples of respondents who will facilitate this study

with your views. All the information you will provide will strictly be used for this study and it

will be treated with utmost confidence. Kindly fill the questionnaire as per the instructions

shown.

PART A: DEMOGRAPHIC INFORMATION

1.Gender

Male [ ] Female [ ]

2. Age bracket (years)

18—23 year [ ]

24—29 years [ ]

30—35 years [ ]

36—41 years [ ]

42 years and above [ ]

3. Highest knowledge Level

O-level [ ]

A-level [ ]

Certificate [ ]

Diploma [ ]

Undergraduate [ ]

Masters Level [ ]

4. For how long have you been operating in the pharmaceutical industry?

Less than 2 years [ ]

2—4 years [ ]

5—7years [ ]

8—10 years [ ]

11 years and above [ ]

77

5. How often do you purchase pharmaceutical products?

Very frequently [ ]

Frequently [ ]

Somewhat frequently [ ]

Not frequently [ ]

Not sure [ ]

6. I buy pharmaceutical products because of …(Select all that apply)

Use a scale of 1-5 where; 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree, 5=

Strongly Disagree.

Category 1 2 3 4 5

Promotions

Price

Influence from friends and referrals

Loyalty to my brand

Packaging

Quality

Status symbol of the product

Taste

Sense of patriotism

78

PART B: Effect of product continuous improvement on customer loyalty in the Nairobi

Pharmaceutical industry.

The questions in this section have been developed to answer the question about the effect of

product continuous improvement on customer loyalty in the Nairobi Pharmaceutical industry.

Use a scale of 1-5 where; 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree, 5=

Strongly Disagree.

Product Continuous Improvement 1 2 3 4 5

I always purchase medicine based on perceived quality

I always read the medicine ingredients to check for quality

improvements

I compare medicine quality across different manufacturing

companies before making a ‘buy decision’.

I always read product improvement quality reviews before

purchasing medicine.

I once refused to take purchase medicine because of its

perceived low quality

I would buy medicine that has been banned in Kenya on

the basis of degenerative quality

I would let a customer purchase medicine whose

formulation has not changed in years.

I only buy medicine brands from specific companies even

when there is no continuous improvement on the product.

I seek advice from fellow professionals fellow before

trusting any perceived product improvements

79

PART C: Effect of customer focus on customer loyalty in the Nairobi Pharmaceutical

industry.

The questions in this section have been developed to answer the question about the effect of

customer focus on customer loyalty in the Nairobi Pharmaceutical industry.

Use a scale of 1-5 where; 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree, 5=

Strongly Disagree.

Customer Focus 1 2 3 4 5

I am keen on identifying customer focused

pharmaceutical organisations.

I only purchase medicine from organisations which

have customer focus.

I always give feedback on medicine to help the

pharmaceutical organisation improve on their

customer focus strategy.

I do not allow customers to purchase products which

I believe are not customer focused.

I advise customers based on my pharmaceutical

company's perceived customer focus measurement.

I would purchase medicine from a non-customer

focused pharmaceutical company as long as the

product functions properly.

I consult with fellow professionals in order to

measure perceived pharmaceutical company's

customer focus.

I consciously gather information from customers to

gauge their brand loyalty based on their perceived

manufacturer's customer focus.

80

PART D: Effect of service quality on customer loyalty in the Nairobi Pharmaceutical

industry.

The questions in this section have been developed to answer the question about the effect of

customer focus on customer loyalty in the Nairobi Pharmaceutical industry.

Use a scale of 1-5 where; 1= Strongly Disagree, 2= Disagree, 3= Neutral, 4= Agree, 5=

Strongly Disagree.

Service Quality 1 2 3 4 5

Product information received from the medical

representative impacts my repeat purchase decision.

The mode of presentation used by the medical

representative impacts my loyalty to the brand.

The product clearance services received at the

manufacturing site impact my repeat purchase

decision.

Perceived bad service would lead me to stop

purchasing the pharmaceutical's products.

I equate respect for people to service quality.

I am happy to receive awards for excellent service

delivered to customers on behalf of the

pharmaceutical company.

I am happy to receive reliable services (i.e. Fast

response to queries) from the pharmaceutical

company.

I would refer other distributors to a pharmaceutical

company that offers superior services.

81

APPENDIX II: TARGET POPULATION CUSTOMER LIST

CUSTOMERS

NAIROBI NORTH NAIROBI EAST NAIROBI WEST

Kenya Medical Supplies Ltd. City Link Pharma Ltd Coptic Nursing Home

Kenyatta National Hospital Makadara Chemists Ltd. Majid Al Futtaim Hypermarkets

Laborex Kenya Ltd Mama Lucy Kibaki Hospital Embakasi Nairobi Hospital

Medipoint Pharmaceuticals Ltd Mater Hospital Naivas Supermarket

Nila Pharmacy Ltd Meds Mission Essential Drugs Rangechem Pharmaceuticals Ltd.

Sun Enterprises Ltd Zenko (K) Ltd. Summer Africa Ltd

Transwide Medical Stores Ltd Tuskys Supermarket

WESTLANDS NAIROBI OUTSKIRTS

Chandarana Supermarket Ltd Beker General Business Plc

Freb Pharmaceuticals Burque East Africa (PVT) Ltd

Harleys Limited Dugda Agro Industry Plc

Omaera Pharmaceuticals Ltd Elementaita Pharmaceuticals Ltd

Pharma Access Africa Ltd. Equatorial Business Group

Shoprite Kenya Ltd Joint Medical Stores

Surgipharm Ltd. Kentons Ltd

Khetia Garments Ltd

Kipharma Ltd

S P Visram

Summer Africa Ltd

United Healthcare Distributors

Vine Pharmaceuticals Limited

Source: GSK Marketing (2020)

82

APPENDIX III: INSTITUTION REVIEW BOARD LETTER

83

APPENDIX IV: NACOSTI RESEARCH PERMIT