Special Paper No. 19 of 2018 on an Assessment of Healthcare Delivery in Kenya under the Devolved System

Abstract

Access to and provision of quality health care is a basic right guaranteed by the 2010 Constitution of Kenya. In the Kenya Vision 2030, the government targets to have the entire population having access to quality and effective health services. Further, the government emphasizes on Universal Health Care (UHC) coverage in the “Big Four” Agenda. Devolution of the health services has granted county governments the role of coordinating and managing the delivery of county healthcare services including promotion of primary health care, public health and sanitation, ambulance services, disease surveillance and response among others. The national government coordinates and manages the national referral hospitals and laboratories, planning and budgeting for national health services, and Health Information Management Systems (HIMS). The roles of the two government systems are coordinated by the County Health Bill (2016) that provides a regulatory framework for health care services and service providers, health products and health technologies. Four years into devolution of public health care delivery, therefore provided a good opportunity to assess the status of health care services in the country. In this regard, KIPPRA undertook the study titled “An Assessment of Healthcare Delivery under Devolution” to evaluate the delivery and uptake of health care services in the country with the accession to devolved system of government in 2013. The study mainly focused on: the extent of citizen participation in planning and budgeting for the sector; exploring citizens’ uptake of and perceptions on primary health care services in the context of a devolved system; level of citizens’ satisfaction with the health services; availability of health inputs (human, capital, commodities) in primary health care facilities...