This study investigates the relationship between price negotiation and the performance of public health facilities in Homa Bay County, Kenya. Price negotiation plays a pivotal role in the pharmaceutical supply chain, yet its contribution to procurement performance remains underexplored. Data were collected from 286 participants, including healthcare workers, suppliers, policymakers, and patients, using structured questionnaires. A multivariable linear regression model revealed that price negotiation accounts for 25.0% of the variance in health facility performance (R2 = 0.250, F = 20.118, p < 0.001). High transparency and fair negotiation practices correlated with lower supply costs and improved medical services (B = 0.292, p < 0.001), and increased accountability (B = 0.152, p = 0.019). Budgetary constraints showed no significant effect (p > 0.05), indicating negotiation strategy’s greater influence over financial resources. The study recommends enhancing transparent negotiation procedures to improve procurement outcomes. These findings provide valuable insights for health managers and policymakers operating in resource-limited settings to strengthen procurement systems.
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