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Does Decentralization Improve Provision of Health Services? Evidence from Kisumu and Makueni Counties in Kenya

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  • Makokha, Racheal Omukhulu

Abstract

The last five decades have seen uncountable debates on the impact of decentralization on provision of public services. While it has evidently improved public service delivery in some countries, it has worsened it in others. Kenya implemented devolution in 2013 in the hope of bringing public services nearer to the people. Health was one of the services identified. Yet, the local media has reported negative impact of devolution on provision of health services since 2013. This study sought to look at the actual effect of devolution on access to health care services by analysing secondary quantitative data from the government published data, official statistics, international development agencies’ surveys and reports. Two county governments; Kisumu and Makueni were chosen to represent the urban and rural populations respectively. Contrary to the wider literature on health decentralization, this study found out that devolution did not worsen access to health care services in Kenya. The study attributed this to the nature of devolution adopted in the country where the county governments have considerable authority, decision-making power and responsibility over their counties.

Suggested Citation

  • Makokha, Racheal Omukhulu, 2017. "Does Decentralization Improve Provision of Health Services? Evidence from Kisumu and Makueni Counties in Kenya," Thesis Commons xef7a_v1, Center for Open Science.
    • Handle: RePEc:osf:thesis:xef7a_v1
    DOI: 10.31219/osf.io/xef7a_v1
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    References listed on IDEAS

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    2. Edwine W Barasa & Anthony M Manyara & Sassy Molyneux & Benjamin Tsofa, 2017. "Recentralization within decentralization: County hospital autonomy under devolution in Kenya," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-18, August.
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