The impact of devolution of health care systems in Kenya : a case study of Meru County health facilities

Abstract

The Kenyan constitution was promulgated on August 27, 2010, created a major shift from a central mode of governance to a devolved mode of governance. It created 47 county governments that are led by governors and Members of County Assembly and this created a platform to devolve functions of central government such as administrative, financial and political roles. The study purpose was to evaluate the impact of devolution in Meru County health systems. The following specific objectives were pursued: assessing the impact of devolution on health workforce, to examine the impact of devolution on health infrastructure and to assess the impact of devolution on health services provision. A descriptive design was used to collect information. Meru county health workers and patients were the study’s unit of research. Fisher’s formula was used in the determination of sample size of 385 respondents. Collection of data was done through close ended and open-ended questionnaires. The study found that devolution has yielded several benefits in Meru County health sector. Devolution had brought health services closer to the common mwananchi at affordable rates through an increase in health facilities and rise in the number of medical personnel in the county. However delayed financial disbursement from the national government, nepotism, corruption, and delayed promotions negatively affected implementation in Meru County health sector. The study recommends the national governments should come up with appropriate mechanisms that will help prevent delay of funds to the counties. The county government should put up measures in place to counter corruption by reporting corrupt individuals to the relevant authorities such as to the Ethics and Anti-Corruption Commission.