Influence of Devolved Systems on Health Service Delivery: A Case of Kajiado County, Kenya

Devolution was introduced by the 2010 Constitution, allowing services such as Healthcare, Agriculture, Transport, and Cultural to be provided through county governments. The County governments have endeavoured to undertake these functions, albeit with a few difficulties. This study purposes to assess the influence of devolved governance on health services in level four hospitals in Kajiado County. The study examined the influence of the devolution of healthcare finance, healthcare management, and healthcare human resources on the delivery of healthcare services in the County. The study also examined the policies that could enhance the healthcare services delivery subject if enacted. Qualitative and quantitative research methods were used to actualize the study. The study was conducted in Kajiado Level Four Hospital Kajiado County with a target population of 500 participants from various sectors in Kajiado County. A sample of 100 participants selected from the total population representing twenty per cent was in the study. Data was collected by the use of questionnaires and scheduled interviews. Both primary and secondary data was be used in the study. Statistical methods through the SPSS program were used to analyse quantitative data. Visual such as figures and tabular presentations were used for the results of this study. During data collection, ethical considerations were respected and adhered to in full. The study observed that Kajiado Level Five Hospital received its financing primarily from the country government and a small proportion from Donor funding. Financing from National Governments was mainly through NHIF reimbursement and UHC-based disbursements from the ministry of health. Devolution has enhanced the administration of the hospital by equipping the leadership with decision-making freedom. This efficacy was noted among employees because the believed they were better off under county leadership than they were under national government. However, human resources at the hospital experienced a host of challenges including staff shortage and delayed payments.