Fragmented Security Capability: Financial and Technological Constraints In Healthcare Security Systems In Kenya

1. Introduction

The adoption of security technologies in healthcare systems has increased significantly in recent years, driven by the need to safeguard patients, protect sensitive information, and ensure the continuity of critical services. Technologies such as surveillance systems, access control mechanisms, and digital security platforms are increasingly embedded within healthcare infrastructure. However, the presence of such technologies does not necessarily translate into effective security outcomes, particularly in resource-constrained environments where institutional, financial, and technological limitations persist (He et al., 2021; Kruse et al., 2017).

In many healthcare settings, especially in developing countries, security technologies are deployed under conditions of constrained resources and limited technical capacity. As a result, systems are often implemented in a fragmented manner, with varying levels of functionality, integration, and sustainability. This creates a disconnect between technology adoption and operational effectiveness, raising concerns about the actual contribution of these systems to healthcare security (McLeod & Dolezel, 2018).

Existing studies have identified financial constraints and technological challenges as key barriers to effective security system implementation. Financial limitations affect not only the acquisition of technologies but also their maintenance, upgrading, and monitoring (He et al., 2021), while technological issues such as poor system quality, lack of integration, and operational inefficiencies further undermine effectiveness (Kruse et al., 2017). However, much of the existing literature treats these factors in isolation, with limited attention to how they interact in practice to shape overall system performance.

This study addresses this gap by examining how financial and technological constraints jointly influence the effectiveness of security technologies in healthcare facilities. It introduces the concept of fragmented security capability to explain the condition in which security systems are present but not fully functional, integrated, or aligned with user capacity and organizational processes. Under such conditions, technologies contribute only partially to security outcomes, resulting in uneven and constrained system performance.

Drawing on data from healthcare facilities in Mombasa County, Kenya, the study explores how financial and technological factors interact to produce fragmented security capability. By shifting the focus from technology adoption to technology effectiveness, the study contributes to a more nuanced understanding of security systems in resource-constrained environments. The findings have important implications for both policy and practice, particularly in guiding investments and interventions aimed at strengthening healthcare security systems.

2. Literature Review

2.1 Security Technologies in Healthcare Systems

Security technologies have become an integral component of modern healthcare systems, driven by the need to protect patients, safeguard sensitive data, and ensure operational continuity. Commonly deployed systems include surveillance technologies, access control mechanisms, alarm systems, and digital security platforms designed to mitigate both physical and cyber threats. The increasing digitization of healthcare services has further expanded the scope of security concerns, necessitating more sophisticated and integrated technological solutions (Kruse et al., 2017).

Despite this expansion, the effectiveness of security technologies in healthcare settings remains uneven. While many institutions have adopted basic systems, evidence suggests that these technologies are often implemented in a fragmented manner, with limited integration across platforms and inconsistent operational performance (He et al., 2021). This raises concerns about whether the mere presence of security technologies translates into meaningful security outcomes, particularly in resource-constrained environments.

2.2 Financial Constraints and Security Technology Implementation

Financial capacity is widely recognized as a critical determinant of technology adoption and utilization in healthcare systems. Studies have consistently shown that limited financial resources constrain not only the acquisition of security technologies but also their maintenance, upgrading, and long-term sustainability (He et al., 2021; McLeod & Dolezel, 2018). In many cases, healthcare institutions prioritize immediate clinical needs over security investments, resulting in underfunded and inconsistently supported systems.

Importantly, financial constraints do not only affect whether technologies are adopted, but also how they are implemented. Limited budgets often lead to selective or tiered adoption, where organizations invest in basic and visible technologies, such as CCTV and alarm systems, while deferring more advanced and integrated solutions. This pattern has been observed across multiple healthcare contexts, where resource limitations encourage incremental rather than comprehensive technological development (Kruse et al., 2017).

However, some studies suggest that financial limitations do not necessarily preclude effective system performance. Organizations may compensate for resource constraints through efficient allocation, strategic prioritization, and adaptive management practices (Li & Ye, 1999). This perspective challenges purely resource-based explanations and highlights the role of organizational capability in mediating financial constraints. Nevertheless, in many low-resource healthcare settings, the ability to offset financial limitations remains limited, resulting in systems that are operationally constrained despite their presence.

2.3 Technological Barriers and System Effectiveness

Beyond financial considerations, technological factors play a central role in shaping the effectiveness of security systems. Research has identified a range of technological challenges, including poor system quality, lack of interoperability, limited real-time monitoring capabilities, and frequent system failures (He et al., 2021; Kruse et al., 2017). These challenges reduce system reliability and limit the ability of healthcare facilities to respond effectively to security threats.

A key issue highlighted in the literature is system fragmentation, where multiple technologies operate independently rather than as part of an integrated architecture. This lack of integration undermines coordination, reduces situational awareness, and creates vulnerabilities within the security infrastructure. As healthcare systems become increasingly complex and digitized, the need for interoperability and system integration becomes more critical.

However, technological challenges are not always inherent to the systems themselves. Some studies argue that implementation and organizational factors play a significant role in shaping technological outcomes. For instance, Orlikowski (1992) emphasizes that technology use is embedded within organizational contexts, and system performance depends on how technologies are configured, managed, and integrated into workflows. Similarly, research grounded in the Technology Acceptance Model (TAM) suggests that user perceptions of system usefulness and ease of use significantly influence technology utilization (Davis, 1989; Venkatesh et al., 2003). Inadequate training and limited user competence may therefore contribute to the underutilization or perceived ineffectiveness of otherwise functional systems (Holden & Karsh, 2010).

2.4 Toward Fragmented Security Capability

While existing studies provide important insights into financial and technological constraints, they often examine these factors in isolation. As a result, there is limited understanding of how these constraints interact to shape overall system performance. In practice, financial limitations influence the quality, integration, and sustainability of technological systems, while technological challenges affect how effectively available resources are utilized. This interaction suggests that security outcomes are not determined by single factors, but by the combined influence of financial, technological, and organizational conditions.

This study builds on this insight by proposing the concept of fragmented security capability as a framework for understanding the gap between technology adoption and effective security outcomes. Fragmented security capability refers to a condition in which security technologies are present within an organization but are not fully functional, integrated, or aligned with user capacity and organizational processes. Under such conditions, systems operate with partial effectiveness, resulting in uneven and constrained security performance.

By conceptualizing security outcomes in this way, the study moves beyond binary distinctions between adoption and non-adoption, and instead emphasizes the quality, coherence, and usability of technological systems. This perspective provides a more nuanced understanding of security technologies in healthcare settings, particularly in resource-constrained environments where multiple limitations interact to shape system effectiveness.

3. Theoretical Framework

3.1 Introduction

This study is guided by an integrated theoretical framework combining the Resource-Based View (RBV), the Technology Acceptance Model (TAM), and Socio-Technical Systems (STS) theory. The use of multiple theoretical perspectives is necessary because no single theory sufficiently explains the complex interaction between financial constraints, technological conditions, and system utilization in healthcare security environments. While each theory provides important insights, their integration offers a more comprehensive understanding of how fragmented security capability emerges in practice.

3.2 Resource-Based View (RBV) Theory

The Resource-Based View (RBV) theory, advanced by Jay Barney (1991) and Birger Wernerfelt (1984), posits that organizational performance and capability are determined by the availability and strategic deployment of resources. According to RBV, valuable, rare, and well-managed resources enable organizations to develop sustained capabilities and achieve competitive advantage.

In the context of healthcare security systems, financial resources constitute a critical input that determines the acquisition, maintenance, and upgrading of security technologies. However, RBV extends beyond resource availability to emphasize resource allocation and utilization. Organizations may possess resources but fail to develop effective capabilities if those resources are insufficient, inconsistently allocated, or not strategically deployed.

This study applies RBV to explain how financial constraints contribute to fragmented security capability. Inadequate and inconsistent funding limits the scope and sustainability of security technologies, resulting in partial or uneven system development. Thus, RBV provides a foundation for understanding how financial conditions shape the structural capacity of security systems.

3.3 Technology Acceptance Model (TAM)

The Technology Acceptance Model (TAM), developed by Fred D. Davis (1989) and later extended by Viswanath Venkatesh et al. (2003), explains how user perceptions influence the adoption and utilization of technology. The model identifies two key determinants of technology use: perceived usefulness and perceived ease of use, which shape user attitudes and behavioural intentions. In healthcare settings, the effectiveness of security technologies depends not only on their availability but also on how users interact with them. Limited training, system complexity, and poor usability can reduce user engagement, leading to underutilization or improper use of available systems. Even where technologies are present, they may not be effectively used if users lack the necessary skills or perceive the systems as difficult to operate.

This study uses TAM to explain the human dimension of fragmented security capability. It highlights how gaps in user competence and system usability contribute to incomplete utilization of security technologies, reinforcing the disconnect between system availability and effective performance.

3.4 Socio-Technical Systems (STS) Theory

Socio-Technical Systems (STS) theory, as articulated by Wanda Orlikowski (1992) and further developed in healthcare contexts by Dean Sittig and Hardeep Singh (2010), emphasizes the interdependence between technological systems, human actors, and organizational structures. The theory posits that system effectiveness depends on the alignment between these components, rather than on technological factors alone.

In the context of healthcare security, STS theory is particularly relevant for understanding issues of system integration, interoperability, and organizational coordination. Security technologies often operate within complex environments where multiple systems, users, and processes interact. When these elements are not properly aligned, systems may function in isolation, leading to inefficiencies and vulnerabilities.

This study applies STS theory to explain how technological and organizational misalignments contribute to fragmented security capability. Lack of system integration, poor coordination, and inadequate support structures result in technologies that are present but not effectively connected or operationalized. STS thus provides a framework for understanding the system-level fragmentation observed in healthcare security environments.

3.5 Theoretical Integration and Conceptual Implications

While each of the above theories offers valuable insights, none is sufficient on its own to explain the complexity of security technology utilization in healthcare systems. RBV explains how financial resources shape system capacity, TAM highlights the role of user perceptions and competencies, and STS provides a broader perspective on the interaction between technology, users, and organizational processes. This study integrates these perspectives to explain the emergence of fragmented security capability. Financial constraints (RBV) limit the acquisition and sustainability of technologies, user-related factors (TAM) affect system utilization, and system-level misalignments (STS) constrain integration and coordination. Together, these factors interact to produce a condition in which security technologies are present but not fully functional, integrated, or effective.

The integration of RBV, TAM, and STS thus provides a comprehensive analytical framework for understanding the gap between technology adoption and effective security outcomes. It also supports the study’s central argument that improving healthcare security requires not only technological investment, but also alignment across financial, human, and organizational dimensions.

4. Methods

This study adopted a cross-sectional survey design to examine financial and technological constraints affecting security technology capability in healthcare facilities in Mombasa County, Kenya. The design enabled the collection of quantitative and qualitative data at a single point in time, providing a comprehensive assessment of patterns, relationships, and contextual factors influencing the adoption and utilization of security systems.

The study was conducted in Mombasa County, a major urban and economic hub characterized by a high concentration of public and private healthcare facilities and increasing security demands associated with urbanization and population density. The target population comprised security personnel working in these facilities, including security officers, supervisors, and security managers, selected due to their direct involvement in the implementation and management of security technologies.

A combination of stratified and purposive sampling techniques was employed. Healthcare facilities were first stratified into public and private categories to capture institutional variation. Proportionate sampling was then used to select respondents within each stratum, while purposive sampling was applied to identify key informants, including security managers and chief security officers, based on their expertise and decision-making roles. From a target population of 360 personnel, a sample of 90 respondents was selected for the survey, representing approximately 25% of the population. In addition, 10 key informants were included to provide in-depth qualitative insights.

Data were collected using structured questionnaires and semi-structured key informant interviews. The questionnaires comprised both closed-ended items, which generated quantifiable data on financial constraints and technological barriers, and open-ended items that captured respondents’ experiences and perceptions. Key informant interviews were used to obtain detailed insights into institutional practices, operational challenges, and decision-making processes related to security technology adoption.

The research instruments were subjected to validity and reliability procedures. Content and construct validity were ensured through alignment with study objectives and expert review, while a pilot study conducted in a comparable setting was used to refine the instruments. Reliability testing using Cronbach’s alpha yielded coefficients above the acceptable threshold of 0.7, indicating satisfactory internal consistency.

Quantitative data were coded and analysed using the Statistical Package for Social Sciences (SPSS), employing descriptive statistics such as frequencies and percentages to summarize patterns in technology adoption and associated constraints. Qualitative data from interviews and open-ended responses were analysed using content analysis, with findings organized into explanatory categories. An integrated analytical approach was adopted, whereby qualitative insights were used to interpret and contextualize quantitative results, thereby enhancing the robustness of the findings.

Ethical approval for the study was obtained from relevant institutional and regulatory bodies, including university and national research authorities. Participation was voluntary, informed consent was obtained from all respondents, and confidentiality and anonymity were strictly maintained throughout the study. Data were used solely for academic purposes and securely stored to prevent unauthorized access

5. Results and Discussion

5.1 Financial Constraints and Fragmented Security Capability

The findings indicate that security technologies in healthcare facilities operate within a condition of fragmented security capability, shaped in part by persistent financial constraints that limit their effective deployment and utilization. While 52% of respondents reported the existence of budget allocations for security systems, a nearly equal proportion (48%) indicated the absence of such provisions. This distribution suggests that security financing is not institutionalized across facilities but remains contingent on organizational priorities, thereby creating uneven capacity for technology adoption.

As shown in Table 1, financial provision for security technologies is inconsistent and largely inadequate, reinforcing the argument that resource constraints contribute directly to fragmented security capability across healthcare facilities.

More critically, the presence of budget allocations does not translate into financial adequacy. A majority of respondents (55.5%) rated their budgets as insufficient or very insufficient, revealing a structural allocation–adequacy gap. This gap contributes directly to fragmented security capability by constraining the scope and quality of technological investment. In practice, this manifests as selective prioritization, where facilities focus on essential and visible systems such as CCTV and alarms, while more advanced and integrated technologies are deferred. This dynamic is clearly reflected in participant accounts, with one respondent noting that

“Even when funds are allocated, they are not enough… we are forced to prioritize basic systems while advanced technologies are left out,”

This illustrates how financial limitations translate into incomplete and uneven system development. This, in turn, reinforces the broader fragmentation observed in system performance and integration.

Financial constraints further reinforce fragmentation by undermining system sustainability. A majority of respondents (62.5%) reported experiencing budget-related challenges in practice, indicating that financial limitations persist beyond initial acquisition. These constraints manifest in delayed upgrades, inadequate maintenance, and reliance on outdated systems. The distribution of affected areas highlights a lifecycle imbalance, with procurement (31.9%) and maintenance (22.2%) being the most impacted. This reflects an acquisition bias, where initial investments are prioritized at the expense of long-term system functionality.

The cumulative effect of these constraints is the emergence of latent or partial capability, where security technologies are present but not fully operationalized. Limited funding for training and monitoring further reduces system effectiveness, reinforcing fragmentation across technological, human, and organizational dimensions. This finding aligns with prior research showing that inadequate investment in healthcare security infrastructure increases vulnerability and reduces system reliability (He et al., 2021; McLeod & Dolezel, 2018). However, alternative perspectives suggest that organizations may mitigate financial limitations through efficient resource utilization (Li & Ye, 1999). The present findings indicate that such adaptive capacity is constrained in resource-limited healthcare settings.

From a Resource-Based View (RBV) perspective, these results demonstrate that organizational capability is not determined solely by the presence of financial resources, but by their adequacy, continuity, and strategic allocation. Intermittent and insufficient funding disrupts capability development, resulting in uneven and fragile security systems. Thus, financial constraints contribute directly to the production of fragmented security capability.

The pattern presented in Table 2 indicates that technological challenges are both widespread and recurrent, underscoring their systemic nature and their role in reinforcing fragmentation within security systems.

5.2 Technological Barriers and Fragmented Security Capability

Technological factors further reinforce fragmented security capability by constraining system performance, integration, and usability. An overwhelming majority of respondents (93.1%) reported experiencing technological challenges, indicating that such challenges are not incidental but constitute a near-systemic condition within healthcare facilities.

These challenges are both performance-related and structural. Common issues include poor system quality (62.5%), lack of real-time monitoring (56.9%), integration difficulties (52.7%), and frequent system breakdowns (50.0%). The prominence of integration challenges is particularly significant, as it demonstrates that systems operate as discrete and incompatible components, rather than as a unified security architecture. This fragmentation reduces coordination, limits information flow, and creates operational blind spots. This fragmentation is clearly reflected in practice. As one respondent noted,

“Our systems do not communicate with each other… CCTV and access control operate separately,”

highlighting the absence of an integrated security architecture. This illustrates how technological fragmentation is not only structural but operational, reinforcing fragmented security capability across healthcare facilities.

The recurrence of these challenges further underscores their systemic nature. Approximately 69.5% of respondents reported experiencing technological problems frequently or occasionally, suggesting that disruptions are embedded in routine operations. As one respondent explained,

“These technological problems arise regularly… affecting access control and emergency response,”

highlighting how recurring system failures directly undermine core security functions. This pattern reflects structural instability, where systems are unable to sustain consistent performance under operational conditions.

Technological fragmentation is further exacerbated by a human–technology gap. A substantial proportion of respondents reported inadequate or inconsistent training, limiting their ability to effectively utilize available systems. This contributes to underutilization, misinterpretation of system outputs, and increased likelihood of human error. From a Technology Acceptance Model (TAM) perspective, insufficient training reduces perceived ease of use and usefulness, thereby limiting user engagement (Davis, 1989; Holden & Karsh, 2010; Venkatesh et al., 2003).

However, not all technological challenges can be attributed solely to system limitations. Studies by Orlikowski (1992) suggest that technological difficulties may arise from implementation and organizational factors, including poor system configuration and lack of alignment with user needs. This perspective reinforces the argument that fragmentation is not merely technical but socio-organizational in nature.

System capability ratings further illustrate this condition. A majority of systems were rated as average or below (58.4%), indicating moderate-to-low technological capacity. This reflects a capability gap, where existing systems are not aligned with evolving security demands. While some facilities reported advanced systems, the uneven distribution highlights disparities in technological capacity across institutions.

As illustrated in Table 3, the predominance of average to below-average system ratings highlight a capability gap, further evidencing the fragmented nature of security technology effectiveness.

From a Socio-Technical Systems (STS) perspective, these findings reflect a misalignment between technological systems, human capacity, and organizational processes (Sittig & Singh, 2010). Technologies are deployed without sufficient integration, training, and support, resulting in systems that are technically present but operationally unstable. Consequently, technological barriers play a central role in reinforcing fragmented security capability.

5.3 Fragmented Security Capability as an Emergent Condition

Taken together, the findings demonstrate that financial and technological constraints do not operate independently; rather, they interact to produce and sustain fragmented security capability, which emerges as the central condition explaining the gap between technology adoption and effective security outcomes. Financial constraints limit the acquisition, maintenance, and upgrading of systems, leading to the adoption of incomplete and incompatible technologies. These limitations, in turn, intensify technological challenges related to system performance, integration, and usability. Similarly, inadequate funding for training and technical support exacerbates human–technology gaps, further reducing system effectiveness. The result is a cascading effect, where weaknesses in one domain amplify constraints in others.

This interaction produces a condition in which security technologies are present but not fully functional, integrated, or reliable. In such contexts, security systems operate with partial capability, leaving facilities vulnerable to operational inefficiencies and security risks. Thus, fragmentation is not an incidental outcome but a structural feature of technology use in resource-constrained healthcare environments.

The findings contribute to theory by integrating insights from RBV, TAM, and STS. RBV explains how resource constraints shape capability development; TAM highlights the role of user competence and perception in technology utilization; and STS provides a holistic framework for understanding the alignment between technological systems and organizational environments. Together, these perspectives explain how fragmented security capability emerges at the intersection of financial, technological, and organizational factors.

Overall, the results demonstrate that improving security outcomes requires more than technological adoption. It requires integrated interventions that address financial capacity, system integration, user training, and organizational alignment simultaneously. Without such alignment, technological investments are likely to reproduce existing inefficiencies, perpetuating fragmented and ineffective security systems.

Taken together, these qualitative insights do not introduce new themes but reinforce the quantitative evidence, illustrating how financial and technological constraints are experienced in practice and how they contribute to fragmented security capability.

6. Conclusion

This study set out to examine how financial and technological constraints shape the effectiveness of security technologies in healthcare facilities, and to explain why the presence of such technologies does not necessarily translate into effective security outcomes. The findings demonstrate that security systems in healthcare settings operate under conditions best described as fragmented security capability, where technologies are present but not fully functional, integrated, or aligned with organizational and user requirements.

Financial constraints were found to be uneven and often insufficient, limiting not only the acquisition of technologies but also their maintenance, upgrading, and long-term sustainability. This results in selective and incremental adoption patterns, where basic systems are prioritized while more advanced and integrated solutions are deferred. At the same time, technological barriers including poor system quality, lack of interoperability, and recurrent system failures undermine reliability and coordination, further constraining system effectiveness.

Critically, the study shows that these constraints do not operate in isolation. Instead, they interact in a reinforcing manner, producing cascading effects across financial, technological, and human dimensions. Limited funding constrains system quality and training, while technological challenges exacerbate underutilization and operational inefficiencies. The result is a structural condition in which security systems function with partial capability, leaving healthcare facilities exposed to persistent vulnerabilities.

The study makes both theoretical and practical contributions. Theoretically, it advances the concept of fragmented security capability and demonstrates the value of integrating Resource-Based View, Technology Acceptance Model, and Socio-Technical Systems theory in explaining complex technology outcomes. Practically, it highlights the need for a shift from technology acquisition to capability development. Strengthening healthcare security systems requires coordinated interventions that address financial sustainability, system integration, user training, and organizational alignment simultaneously.

Without such integrated approaches, investments in security technologies are likely to reproduce existing inefficiencies, perpetuating fragmented and suboptimal security outcomes. Future research should extend this analysis to other sectors and explore longitudinal approaches to understanding how security capabilities evolve over time in resource-constrained environments

7. Policy Implications

The findings suggest that strengthening healthcare security systems requires a shift from fragmented, technology-driven investments to integrated capability development. Policymakers and healthcare administrators should prioritize sustainable and ring-fenced budgeting for security technologies, ensuring that funding extends beyond initial procurement to include maintenance, system upgrades, and continuous training. In addition, there is a need to promote system integration standards that enable interoperability across security platforms, reducing fragmentation and enhancing coordination. Capacity-building initiatives should be institutionalized to address user competence gaps and improve technology utilization. At the institutional level, security planning should adopt a socio-technical approach, aligning technological systems with organizational processes and human capabilities. Without such coordinated interventions, investments in security technologies are likely to yield limited returns and perpetuate fragmented security capability within healthcare facilities.