Political Devolution and Health Service Delivery in Siaya County, Kenya

Abstract

The 2010 Constitution of Kenya devolved to counties several services (health, agriculture, water, infrastructure, and environment to get the services closer to the people. This follows subsidiarity principle to improve government accountability and responsive human values to the wellbeing of people in democratic society. Devolution covers political, fiscal and administrative functions deemed to have effect on service delivery. This study explores how devolution through the decentralized health services can be people centered. The research question was: how does political devolution affect health service delivery in the counties of Kenya? Specific objectives of the study were: i) How does political devolution affect health service delivery? ii) What factors place people and community at the center of health service delivery? iii) Explain obstacles towards effective health service delivery. iv) The way forward to make health service delivery effective and transformative. The significance of this study will be to shape, improve and make health service delivery people centered through policy and governance structures. The study examines the literature review to understand health service delivery concepts, policies and structures at global, continental, regional and Siaya County. Conceptual framework is anchored on devolved structures and citizens as co-producers of health services and participation in policy decisions. The research was located in Ugunja Sub County of Siaya County through purposive sampling of political leaders, government administrators, health service managers and providers, and general population (women, men, youth, PWD). The data was collected through focus group discussion (FGD) and interviews.