Implementation of public health policies in Baringo County, Kenya

Abstract

Implementation of Public health has been a concern to governments globally. Although, several public health policies have been formulated; implemented and evaluated, little progress has been made in addressing the public health challenges. For decades, public health policy makers have emphasized primary health care through implementation of promotive, preventive and rehabilitative public health policies espoused during the Alma Atta declaration of 1978. A few States are yet to implement this approach. Kenya, through recent health care reforms, is inclined to this strategy which forms the coronary of this research. The overall objective of this study was to assess the implementation of Public Health policies in Baringo County in Kenya by operationalizing the following objectives: to identify public health policies in Baringo County, the role of various stakeholders in the implementation process, the mode of financing of public health policies and finally the challenges that have undermined implementation. The study was guided by New Institutionalism theory propounded by March and Olsen, (1984) and Thomas Smith model (1973) of policy implementation. Cross-sectional survey was undertaken on sampled population. A purposive sampling was used to sample policy makers, NGOs officials and health professionals while stratified sampling was carried out on the community and local leaders based on their sub county population. Open and closed-ended questionnaires were administered to the sampled population of 400 respondents while interviews conducted on key policy makers, NGOs and health professionals. The data collected was analyzed quantitatively by use of SPSS (Statistical Package for Social Sciences) and qualitatively through categories of themes that emerged from the data. The studies found out that (72%) of respondents were aware of existence of public health policies in Baringo. This response confirms that most of the residents know existing programs being implemented within their locality despite majority of respondents attested having never been involved in any policy or programme implementation by the government. Resource scarcity and allocation appeared a great challenge in the implementation process. In addition, the results that emanated from the study noted that governances still remain a challenge in the implementation of public health policies. The study recommends health policy implementers to involve the community in the health care implementation for sustainability and ownership. In addition, community participation shall enhance good governance, foster transparency and accountability among the implementing actors. The study recommends increased funding to the sector and improvement of infrastructure such as establishment of dispensaries and health centers, equipments and drugs and health personnel especially in the rural and far flung areas. It further recommends the stakeholders to strengthen their relations for better and coordinated implementation.