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By Shadrack Nyakoe
Act Change Transform (ACT) has unveiled its survey report on ten years since devolution advocating for health reforms among other key issues yet to be achieved.
The implementation of the programme will contribute to making devolution more effective in Kenya, with particular emphasis on improving service delivery and accountability.
The Programme has fostered partnerships with civil society organizations mainly through their networks at the county level to support mobilization, sensitization, and capacity building of the citizens to participate and engage with the county governments in devolved governance.
The aim is to ensure that the CSOs’ networks mobilize and support the citizens for meaningful engagement with their county governments in the county-level policy-making, planning, budgeting, and service delivery processes.
As part of its support to the KDCWG (Kenya Devolution CSO’s Working Group), KDP-Timiza Ugatuzi commissioned a study to obtain citizens’ perspectives on the impact of devolution and to provide credible evidence for advocacy by the CSOs in August 2023.
The survey examined the citizens’ perspectives on the relationships between the national and county governments, the operationalization of devolution objectives and the quality of delivery of devolved functions at the county level such as health, water, agriculture, and trade, among others.
Training and sustainable support of community health practitioners including the community health promoters (CHPs) as well as community awareness education and campaigns were identified as viable strategic activities under the research.
Devolution is hampered by conflicting functions by National Govt and poor domestication of policies Clifford Ochieng from Kisumu County told the audience.
“Increasing investments in primary healthcare is hereby suggested as a viable solution because of its effectiveness in controlling and reducing the prevalence of diseases and deaths, and would among others involve empowering the CHPs through training and equipping them with the required tools. Increased investments in healthcare infrastructure such as buildings, adequate staffing and equipping healthcare facilities based on need are also proposed as a strategic investment. Old and dilapidated health facilities should be renovated, equipped with modern medical equipment supplied with essential drugs and adequate staff at all levels and where necessary should be upgraded as needed,” Ochieng added on the resolutions
Adoption of emerging technology and innovative health monitoring, diagnosis and treatment solutions was viewed as critical to improving access to healthcare at the county level. Innovative practices such as mobile clinics and telemedicine which can improve healthcare delivery by increasing the sharing and access to specialised health services beyond the borders of a single county.
Investments in research and development for healthcare improvements were also recommended due to their potential to improve access to quality healthcare.
Improving the management and governance of health facilities by enforcing stringent anti-corruption measures in healthcare institutions was identified as critical for enhanced access to quality healthcare services.
Implementing strict legal auditing procedures and increasing transparency in the procurement and distribution of medical supplies.
It should also include establishing a trustworthy and confidential whistle blower mechanism for healthcare workers and patients.
Measures should be taken to ensure accountability at all levels of healthcare management to tackle and eliminate corruption.