Debunking The Public Health Puzzle Report.
The Economic and Social Rights Centre – HakiJamii has pioneered work on promoting social accountability in health sector governance in Kenya mostly undertaken through the organization, empowerment, and consolidation of communities and non-state actors to meaningfully participate in health sector governance including the budget-making processes, policy development and decision making towards improved service delivery. HakiJamii through past projects has provided leadership in effective citizen participation in crucial processes including the budget-making process (and the public participation that comes with it), annual development plans, influencing county strategic plans, and ensuring proper delivery of health services through investing in a stronger Community Health workforce. The work of civil society groups in the past few years focused on advocating for a budget increase for the health sector in the counties. This has been achieved significantly in Mombasa and Kakamega counties; with a few other improvements that have equally been noted in Makueni, Turkana, Meru, Kisii, and a host of other counties. However, any such increase in healthcare spending has not contributed to an equal level of improvement in service delivery and enjoyment of health rights. Instead, concerns over inefficiency, ineffectiveness, and low absorption of development funds have continued to be raised from both the supply side, and the demand side actors.
In particular, public health facilities face major challenges including unavailability of storage facilities, insufficient human resources, vicious lack of essential drugs and commodities, equipment, and mismanagement of funds and corruption. Although the constitution and devolution laws emphasize involvement and the participation of citizens in making financial decisions and setting priorities, this process has been abused and citizens used to rubber-stamp already concluded decisions. HakiJamii, therefore, seeks to re-focus the attention of policymakers and other stakeholders towards an understanding of healthcare as a space in which primacy is afforded to core values and principles including human rights, human dignity, service, compassion, and collective interests. The study builds on HakiJamii’s previous engagements with county government health systems, and the gaps in health governance and accountability established in the process.