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Majority of Kenyans back counties, skeptical on devolution of health

While forty-four per cent of Kenyans wanted the provision of health services entirely left to the national government, thirty-six per cent of the respondents supported devolution of health/FILE

NAIROBI, Kenya, Apr 24 – A majority of Kenyans support devolution, five years since the creation of county governments albeit with reservations on functions to be executed by the devolved units.

According to an Ipsos-sponsored study conducted in 45 counties between March 4 and 12, support for devolution stood at 84 per cent, the highest being at the coastal counties where 90 per cent of respondents said they supported devolution.

The second and third highest support for devolution was from Nyanza and Eastern at 88 and 85 per cent respectively.

2,003 respondents sampled in the study with a margin of error of +/­- 2.16 per cent and a 95 per cent degree of confidence however differed sharply of devolution of health services with a majority backing the retention of the health function under the national government.

While forty-four per cent of Kenyans wanted the provision of health services entirely left to the national government, thirty-six per cent of the respondents supported devolution of health.

Ipsos Research Analyst Tom Wolf attributed the decline in support for devolution of health to rampant strikes that faced the country in 2017 which were mainly attributed to improper management of devolved health centers.

“The beginning of last year is when we saw the highest proportion wanting the national government to have the responsibility for medical services and there was a major crisis in Kenyans having access to medical services because of the doctors’ strike,” Wolf explained during the release of the study on April 6.

“Because the Constitution gives most of the responsibility in the provision of health services to counties, people then retreated in their opinions and move closer to the national government as an alternative to deal with the problem,” he pointed out.

Under the Fourth Schedule of the Constitution (2010), the national government is allocated national referral health centers with the rest of the hospitals allotted to respective county governments.

According to the Ipsos study, most Kenyans interviewed singled out the improvement of roads, water services, and creation of employment as the most pressing matters counties must seek to address.

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The three issues were rated at 27, 21, and 14 per cent respectively.

“More than a quarter of respondents said they wanted county governments to address the issue of poor roads, a fifth of the respondents identified the provision of water,” Wolf noted.

According to Wolf, the findings of the study needed to inform engagements during the fifth devolution conference in Kakamega where leaders from both the executive and legislative arms of government will be meeting to take stock of gains made under devolution.

The conference due to be opened by President Uhuru Kenyatta on Tuesday will focus on the Big Four Agenda, a four-point action plan for President Kenyatta’s development quest.

Towards the attainment of affordable health care, the Ministry of Health is gearing up for the rollout of Universal Health Care (UHC) piloting program/FILE

Under the Big Four Agenda of food security, affordable housing, manufacturing and affordable healthcare for all, the national government is keen on partnering with counties and private sector to harness the country’s development potential.

In Nairobi for instance, President Kenyatta’s administration announced plans to launch the construction of 30,000 low-cost houses in Eastlands.

According to State House Spokesperson Manoah Esipisu, 5,000 units will be put up in Sauri Moyo, 20,000 in Makongeni, 3,000 in Starehe and 2,000 in Park Road estates.

State House also announced its support in aiding the Nairobi county government to reach a deal with financial institutions in a bid to sign funding agreements for 100,000 housing units in three months.

While announcing the plan on April 13, State House disclosed that under a Nairobi regeneration team co-led by Governor Mike Sonko and Tourism Cabinet Secretary Najib Balala, 200,000 new housing units will be set up in the long run.

Towards the attainment of affordable health care, the Ministry of Health is gearing up for the rollout of Universal Health Care (UHC) piloting program.

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The test phase will include 100 per cent rollout in four counties of Kisumu, Isiolo, Nyeri, and Machakos, with 10,000 selected households in the remaining 43 counties placed on the pilot phase.

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