Last week, Makueni County hosted Kenya’s seventh devolution conference. The broad thematic area was on multi-level governance for climate action. A key sub-theme of the conference was on lessons learnt, impacts and interventions in healthcare services at county levels.
In this, a cross-cutting consensus was that, collectively, devolution of political, administrative and healthcare governance has added a good impetus in improving healthcare services in Kenya.
Healthcare challenges and disease burdens usually have an element of regional specificity. This guided the piloting of universal health coverage wherein the counties of Machakos, Isiolo, Nyeri and Kisumu were selected.
Machakos County was selected due to its high burden of road traffic injuries; Isiolo County due to its high number of nomadic communities, Nyeri county due to its high burden of non – communicable diseases and Kisumu due to its burden of communicable diseases.
Devolution provides the semi-autonomous counties with an opportunity to prioritize remedial solutions to such region-specific healthcare challenges, as opposed to the pre-devolution era in which blanket approaches were offered by the central ministry of health.
For example, the Nairobi Metropolitan services has, over -time, prioritized scaling up geographic accessibility of healthcare services that was previously lacking. This has resulted in a proliferation of new healthcare facilities to address a major pain point of Nairobi citizenry which was difficult access to healthcare services.
Over time, the cumulative effect of the country-specific interventions will be a mosaic healthcare system in Kenya that reflects different approaches to solving healthcare problems.
However, a critical cogwheel of making devolution work for healthcare in Kenya is for policy and decision-makers to maintain a 360 - degree view of healthcare services provision. This wholesome view includes balancing leadership and governance, service delivery, financing, workforce, medical products, vaccines and technologies; and health information systems.