Devolution and Universal Health Coverage in Kenya: Situational Analysis of Health Financing, Infrastructure and Personnel

Type Journal Article - International Journal of Economics, Commerce and Management
Title Devolution and Universal Health Coverage in Kenya: Situational Analysis of Health Financing, Infrastructure and Personnel
Author(s)
Volume 4
Issue 5
Publication (Day/Month/Year) 2016
Page numbers 1094-1110
URL http://erepo.usiu.ac.ke/bitstream/handle/11732/3016/4564.pdf?sequence=1&isAllowed=y
Abstract
Availability and comprehensiveness of health services offered at a health facility is critical in
realizing universal health coverage. This however partially requires a strong, efficient, as well as
well-run health system, a sufficient capacity of well-trained, motivated health workers and a
system for financing health services. The Kenya government with support of development
partners has over the years initiated various policies and strategies aimed at realizing universal
coverage. The paper aimed at taking stock of the country’s health financing, infrastructure and
personnel and how these impact on health care delivery as the country moves towards
universal coverage. To accomplish this, both primary and secondary data were collected in
terms of health care financing, health infrastructure and personnel and how they impact on
delivery of health care services. Notable findings include government’s commitment towards
universal coverage through increased revenue allocation as well as investment in both health
infrastructure and personnel aimed at enhancing geographical access. Notwithstanding this
however, there is limited solidarity in financing of health care and that a significant portion of the
financing is off-budget and skewed towards one donor raising sustainability and equity
concerns. In terms of infrastructure there exist significant gaps, especially specialized medical
equipment, maintenance of the equipment and the personnel to operate the equipment.
Similarly, a number of the facilities in the country have dilapidated infrastructure coupled with
disjointed health investments. Significant gaps were also identified in a number of key health
personnel with a number opting to join private practice, while others opting for career change in
spite of the resources invested in training them. In lieu of the findings, various recommendations
are made including embracing financing mechanisms that embrace social solidarity, fast tracking the enactment of Health Act, development of health investment policy that assures
coordinated, prioritized and sustainable investment; finalization and implementation of schemes
of service across counties. Other recommendations include policy guidelines and procedures
that support public private partnership initiatives such as the “Beyond Zero” campaign for
purposes of equity and sustainability; and finally continuous investment in human resources
guided by policy guidelines.

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