Management of Devolved Health Services and Healthcare Service Delivery in Arid and Semi-Arid Lands in Kenya

摘要

The 2010 Constitution provides a legal framework that guarantees an all-inclusive rights-based approach to health service delivery to Kenyans. It provides that Kenyans are entitled to the highest attainable standards of health, which includes the right to healthcare services including reproductive health care (Article 43). The purpose of this study was to investigate the the extent to which management of devolved health services influence health-care service delivery in Arid and Semi-Arid Lands in Kenya. This study was guided by fiscal decentralization theory and theory of performance improvement, as well as sequential theory of decentralization. This study used a triangulation of both positivism and phenomenology. The population under this study constitute the Sub-Counties in ASAL in Kenya with a sample size of 89 Sub-Counties being sampled and 3 patients from each of the 89 sampled sub counties. This study found that, since the onset of devolution, there has been introduction of more healthcare facilities at counties in ASAL resulting with sub-county leaderships have been largely considering the opinions raised by the residents while implementing health services decisions. Management of devolved health services, healthcare has greatly made health facilities and services more accessible to residents compared to before with the previous five years recording great improvement in the quality of the health services at county health centers. The national government should therefore consider increasing financial resources to counties, which would eventually enhance health manpower for better service delivery. This study therefore recommends that the hospitals management should come up with strategies that can help improve financial resources to fund facilities improvement.