kenya kipchumba presentation

Topics: Health care, Medicine, Health economics Pages: 23 (4124 words) Published: October 2, 2013
Devolution and the
Health System in
Kenya
Onesimus Kipchumba Murkomen
Attorney at Law & Consultant
Strategic Thinkers and Actors Consultants Ltd.
Omurkomen@yahoo.com
Twitter: @Kipmurkomen

Devolution and Health Consultative Meeting
Nairobi, Kenya
October 24, 2012

Outline

A.  Understanding Devolution; Concepts and Principles.
B.  The Objectives, Functions, Powers and Structures of
Devolved Governance in Kenya.
C.  Transition to county governance; Challenges and
Prospects
D.  Devolution and health system in Kenya

Part A:Understanding
Devolution; Concepts
and Principles

A. Devolution-Concepts and Principles
¡  Devolution is a form of decentralisation
¡  Founded on the principle of subsidiarity ( Dav i d

A. Bos ni c h,
T h e P r i n c i p l e o f s u b s i d i ar i ty h t t p / / w w w. ac t o n . o r g / p u b / r el i g i o n l i b erty/ vol ume- 6- numb er- 4/ p ri nc i p l e- s ub s i d i ari ty)

¡  Refers to restructuring or re-organisation of
authority that there is a system of co-responsibility
between institutions of governance at the central,
regional and local levels according to the principle of
subsidiarity ,...”(UNDP, Bureau for Devel opment Pol i cy, September 1997)

¡  Decentralisation seeks to promote individual freedom and public participation in governance

Forms of Decentralization
1

Privatization

¡ 2

Deconcentration

¡ 3

Delegation

4

Devolution

1

Privatization

¡  This form is not considered per se as a form of
decentralisation
¡  Better considered as a form of divestment which occurs when planning and administrative responsibility or other
public functions are transferred from government to
voluntary, private, or non-government institutions.
¡  A county government may enter into partnerships with any public or private organization in accordance with the
provisions of any law relating to public or private
partnerships for any work, service or function for which it
is responsible. (CGA 2012 Sec 6)

2

Deconcentration

¡  Involves the transfer of authority for specific decision-making, financial and management functions by administrative means to different levels under the same jurisdictional authority of the central government

¡  Also defined as 'shifting power from the central offices to peripheral offices of the same administrative structure' ( T B o s s e r t , D e c e n t ra l i z a t i o n o f H e a l t h Sy s t e m s : D e c i s i o n S p a c e , I n n ova t i o n a n d Pe r f o r m a n c e )

¡  In deconcetration, decentralised personnel are typically full-time career officials, appointed, promoted, remunerated, controlled and deployed by the bureaucratic means applicable to all
members of the organisation. (Smith 1979)
¡  Kenya has exercised deconcentration through provincial admin

3

Delegation

¡  R e f e r s t o t h e t r a n s f e r o f g o v e r n m e n t d e c i s i o n - m a k i n g a n d administrative authority and/or responsibility for carefully spelled out tasks to institutions and organizations that are either under government indirect control or semi-independent. Delegation

represents the shifting of responsibility to semi-autonomous 'agencies‘.(UNDP)
¡  Examples are parastatals and such other corporate bodies like Municipal and City Boards under the Urban Areas and Cities Act

4

Devolution

¡  Tr a n s f e r o f a u t h o r i t i e s t o a u t o n o m o u s l o w e r - l e v e l u n i t s l e g a l l y constituted as separate governance bodies. Transfer of functions, powers and authority to such units is often referred to as devolution and is the most common understanding of genuine decentralization. ¡  Devolution: a transfer of jurisdiction and authorities to territorial and Indigenous and self governments, from the federal government ranging from authority over such areas of health, to the regulation of lands and resources. ( S t e p h a n i e I r l b...
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