Influence of devolution on healthcare service delivery in Busia County, Kenya

Abstract

The constitution of Kenya (2010) introduced a devolved system of governance which entrenches health as a right for every citizen, to the highest attainable standard. Further, it also designates the health services functions of the national government and County Government and principles under which such services should be provided. Following the first general elections under the constitution of Kenya (2010) and creation of County Governments, the need to address the administration, planning and management of health services in response to the changes became necessary. Notably, several Counties have been bedevilled with monumental challenges ranging from strikes, corruption and delayed salaries resulting to poor service delivery among others. The research general objective was to assess the influence of devolution on healthcare quality service provision in Busia County. The specific objectives were: to assess the influence of resource allocation, health leadership, organizational structure and health workforce competence on healthcare quality service delivery in Busia County. The study employed descriptive research design targeting healthcare workers and other County Government officials. Questionnaires and interview schedules were used in collecting Primary data from target population; Doctors, Nurses, Clinical officers, Pharmacists, Laboratory technicians, Hospital administrators, Medical superintendents and County health officials; County assembly health committee, health Director, Chief Officer for health and the County Executive Committee member for health. The sample size comprised of 200 individuals from the target population arrived at by consulting Yamane Taro formula. Descriptive and inferential statistics was utilized in data analysis and study findings were presented in form of frequency tables. The summary of the findings show‘s that resource allocation had to a great extent helped in the healthcare quality service delivery in Busia County. Similarly, health leadership, workforce competence and organizational structure were significantly effective in influencing healthcare quality service delivery in Busia County. The study concludes that the availability of resources have had a significant provision of quality health services in Busia County. The study thus recommends that: The county government management should ensure that they engage in proactive and effective resource allocation mechanisms like financing, technology and human resource to improve provision of quality healthcare services. The allocations should be deliberate with significant resources given to critical service delivery areas. The County Government management should use transformational leadership in their health leadership style. The County Government management should integrate a decentralized structure. The study has found that strongly decentralized structures perform well in several contexts, notably in service delivery and implementation of strategy. The management should also ensure that the workers are results oriented in a bid to improve the Healthcare workforce competence, and consequently improve the provision of quality healthcare services. Finally, the government through the Ministry of Devolution and Planning should improve on its devolution policy to further fortify health provision in the counties.