An assessment of the state of public healthcare governance in Tana river County, Kenya
Mwikairi, Mwenda Nicholas
MetadataShow full item record
There are six (6) building blocks in the health systems, namely health service delivery, health information systems, healthcare financing, health workforce, medical technologies and products and health leadership and governance. Since devolution of healthcare services in Kenya in 2013, there has been an increased investment in the various building blocks of healthcare, with varied improvement in health outcomes. Health leadership and governance has not received much attention of the blocks of the healthcare system. To foster accountability, transparency, integrity, professionalism, customer focus and innovativeness, H.E Uhuru Kenyatta launched Mwongozo, the Code of Governance for State Corporations in 2015, as a firm foundation and guide for the management, governance and oversight to state corporations and public bodies as grounded in Kenya’s constitution’s values and principles as well as best global practices of governance. The code is to be implemented on a ‘Comply or explain’ basis, meaning that public bodies may adopt this code to suit their field, with the stakeholders’ being the goal. The general objective of this study was to assess the extent to which Tana River County has complied with the Mwongozo Code of governance for State Corporations. Data was collected from five health facilities’ governance bodies through use of structured and unstructured questionnaires and by use of a focus group discussion..‘R’, free software for descriptive statistical computing and graphics, was used for analysis. The study revealed that healthcare governance bodies in Tana River County are neither constituted nor operated in line with the Mwongozo code of governance for state corporations. The study also revealed that current health governance bodies have limited capacity to effectively offer strategic direction and oversight to the healthcare system in Tana River County. The study identified lack of legitimacy, financial weakness, low technical capacity and lack of a structured appointment of healthcare governance body members as some of the challenges facing healthcare governance. The study recommends creation of policies and structures to aid recruitment and empowerment of health governing bodies that are capable of effectively carrying out their roles according to the Mwongozo code and global best practices.