Devolution and Health in Kenya: Consultative Meeting Report

Agency for International Development (USAID), convened a consultative meeting on 24 October 2012 at the Hilton Hotel in Nairobi to discuss the impact of devolution on the health sector in Kenya. The meeting aimed to brief participants on the steps taken by the ministries of health to move the devolution process along and to identify activities requiring immediate attention. The devolution process in Kenya involves the transfer of power from the central government to the counties, as outlined in the new Constitution. The ministries of health have prepared several guiding documents, including the Health Bill 2012 and a health policy framework paper, which have been cleared by the Cabinet for presentation to Parliament. The ministries have also prepared a bill to transform the Kenya Medical Supplies Agency (KEMSA) into an autonomous statutory body to improve its performance in managing pharmaceuticals. The meeting highlighted several challenges that the ministries of health must address as they prepare to transfer health functions to county governments. These challenges include ensuring that counties have adequate resources to deliver high-quality health services, handling the procurement of commodities to safeguard quality and standards, and addressing the fate of provincial hospitals. The meeting also discussed the need to support the efficient management of the healthcare workforce and to ensure that cash-poor counties can retain qualified staff. To address these challenges, the ministries of health came up with an eight-point roadmap to guide their immediate actions. The roadmap includes strengthening the core team guiding the devolution, merging the two ministries of health in 2013, unbundling functions in accordance with the Fourth Schedule of the Constitution, and making county teams aware of their roles, relationships, and reporting lines. The roadmap also includes taking stock of assets available in each county, preparing guidelines and tools to help counties plan health service delivery, and reviewing the roles of bodies such as hospital management boards and facility management committees. The devolution process in Kenya is a significant change that requires careful planning and implementation to ensure that the health sector is adequately prepared to deliver high-quality services to the population. The roadmap outlined by the ministries of health provides a clear direction for their immediate actions and is a crucial step towards achieving the goal of delivering high-quality health services to the people of Kenya. The Health Policy Project of the U.S. Agency for International Development (USAID) provided technical and financial support for the meeting, and the Transition Authority, the Ministry of Finance, and the Commission on Revenue Allocation shared their perspectives on devolution. The meeting was organized under the leadership of the Ministry of Medical Services and the Ministry of Public Health and Sanitation, and special thanks were extended to the Transition Authority, the Ministry of Finance, and the Commission on Revenue Allocation for their contributions. The devolution process in Kenya is a complex and multifaceted issue that requires careful consideration of various factors, including the allocation of resources, the management of the healthcare workforce, and the procurement of commodities. The roadmap outlined by the ministries of health provides a clear direction for their immediate actions and is a crucial step towards achieving the goal of delivering high-quality health services to the people of Kenya. The meeting highlighted the need for a multisectoral approach to devolution, with minimum disruption to public health services. The ministries of health must work closely with other government authorities, development partners, and other sectors to ensure that the devolution process is implemented smoothly and that the health sector is adequately prepared to deliver high-quality services to the population.