The devolution of health care service provision to counties anticipated a robust and improved service delivery to citizens. It envisioned a system that ensures access to the highest standards of health, affordable and efficient. Further, devolution was expected to bring resources closer to citizens and provide engagement and participation platforms that ensure collective planning, prioritizing and budgeting. This would give birth to a civic led approach to development driven by community priorities and needs.
Kakamega County is currently approximated to have a population of 1,940,149 (Ministry of Health). Up to 57% of people in the county live in poverty leading to high infant mortality rates, high HIV prevalence and respiratory diseases. Kakamega County General Hospital is the county referral. The facility which is expected to offer specialized treatment to citizens has in past few months been in the news for cases of negligence and poor service delivery. While statistics clearly point to progressive health budgets in the County, this is not commensurate with service delivery. The number of doctors, nurses and clinical officers remain considerably low and does not meet the required standards. The national government allocation for health sector is not reflective in county budgets; the discrepancy is overwhelmingly high. Although community health workers play a key role in management of primary health care, there role in Kakamega County is not explored to its potential. Not many organizations carry out advocacy work in the county. A quadruple helix model of partnership is employed between the government and non state actors. The county is however receptive and ready to work with civil society organizations.
Hakijamii believes in the power of collective and collaborative advocacy. The organization is convinced that once communities are organized and their capacity built, they are able to independently address their own issues as rights holders. Linking these groups with other Civil Society Organizations (CSOs) and organizing them around a theme makes it stronger and sustainable. After the mapping exercise, Hakijamii brought together all the identified groups with a view to building a strong coalition of community based organizations and other CSOs to enhance health rights advocacy work at the county level. Building a coalition is meant to harmonize and consolidate all the small interventions and structure one strong voice that can influence decision making at the county level. The coalition is meant to enhance participation of communities in decision making especially planning, prioritization and budgeting. It will further carry out monitoring to ensure effectiveness and utilization of public funds meant for healthcare improvement.