Accountability Mechanisms in Kenya’s Devolved Health System Consultancy in Kenya
Accountability Mechanisms in Kenya’s Devolved Health System Consultancy in KenyaBackgroundAs part of informing the next CDCS, USAID / Kenya and East Africa (KEA) has embarked on conducting a country-level Context and Systems Analysis (CSA), as well as deeper sectoral studies to complement the country-level CSA.
The country-level and sectoral CSAs aim to integrate Thinking and Working Politically (TWP) through applied Political Economy Analysis (PEA) into USAID/KEA processes and programs to ensure its investments have the necessary and sufficient level of local commitment and capacity to expedite Kenya’s Journey to Self-Reliance (J2SR).
The specific purpose of this research is to deepen the USAID/KEA Health Population and Nutrition (HPN) office’s appreciation of the status of accountability mechanism in place in Kenya’s devolved health services.
The findings and recommendations emanating from the PEA study will inform USAID/KEA’s HPN Office’s strategic programming over the next CDCS cycle.
In addition to select meetings with Ministry of Health officials and other non-governmental relevant stakeholders in Nairobi, the field research will be conducted in the following counties: HPN: Homa Bay, Busia, Migori, Kisumu, Kakamega, Baringo, Turkana, Mombasa, Uasin-Gishu, Nakuru, and Nairobi.
USAID’s Thinking and Working Politically through Applied Political Economy Analysis guidance, process and methodology will be employed to conduct this baseline study.
Core and Supporting Questions
What is the status of health sector accountability mechanisms? How have they changed since devolution took effect? What are the barriers and opportunities for improved accountability in the health sector at national and devolved levels? What set of incentives and disincentives are in USAID’s manageable interests to improve accountability mechanisms?
(preliminary) Supporting Questions
How effective are health Management and Information Systems (MIS) at county level?
What are these mechanisms actually doing to ensure accountable and transparent use of public and private health funds?
What are the institutional, legal and cultural factors that drive the underlying interests, incentives and constraints that animate decision-making among key powerbrokers in key Health subsectors?
What are the institutions and individuals that influence which policies are adopted and implemented, and which lack this influence?
Who supports (financial, technically and politically) health related civil society groups?
What is the status of budget accountability mechanisms and public policy formulation and implementation mechanisms?
Where has civil society succeeded and failed to influence decision making within the GOK on health sectors issues, and why?
Who are the key decision makers in the health sector (government and other)?
How can USAID invest wisely in promoting local stakeholders who are already working to promote a culture of good governance in the health sector without derailing or tainting their efforts?
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