[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/p/osf/thesis/xef7a.html
   My bibliography  Save this paper

Does Decentralization Improve Provision of Health Services? Evidence from Kisumu and Makueni Counties in Kenya

Author

Listed:
  • Makokha, Racheal Omukhulu
Abstract
The last five decades have seen uncountable debates on the impact of decentralization on provision of public services. While it has evidently improved public service delivery in some countries, it has worsened it in others. Kenya implemented devolution in 2013 in the hope of bringing public services nearer to the people. Health was one of the services identified. Yet, the local media has reported negative impact of devolution on provision of health services since 2013. This study sought to look at the actual effect of devolution on access to health care services by analysing secondary quantitative data from the government published data, official statistics, international development agencies’ surveys and reports. Two county governments; Kisumu and Makueni were chosen to represent the urban and rural populations respectively. Contrary to the wider literature on health decentralization, this study found out that devolution did not worsen access to health care services in Kenya. The study attributed this to the nature of devolution adopted in the country where the county governments have considerable authority, decision-making power and responsibility over their counties.

Suggested Citation

  • Makokha, Racheal Omukhulu, 2017. "Does Decentralization Improve Provision of Health Services? Evidence from Kisumu and Makueni Counties in Kenya," Thesis Commons xef7a, Center for Open Science.
    • Handle: RePEc:osf:thesis:xef7a
    DOI: 10.31219/osf.io/xef7a
    as

    Download full text from publisher

    File URL: https://osf.io/download/5b098103febe5e0015a1f7ff/
    Download Restriction: no
    File URL: https://libkey.io/10.31219/osf.io/xef7a?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Dennis A. Rondinelli & James S. McCullough & Ronald W. Johnson, 1989. "Analysing Decentralization Policies in Developing Countries: a Political‐Economy Framework," Development and Change, International Institute of Social Studies, vol. 20(1), pages 57-87, January.
    2. World Bank, 2004. "Decentralization in the Philippines : Stgrengthening Local Government Financing and Resource Management in the Short Term," World Bank Publications - Reports 14412, The World Bank Group.
    3. Edwine W Barasa & Anthony M Manyara & Sassy Molyneux & Benjamin Tsofa, 2017. "Recentralization within decentralization: County hospital autonomy under devolution in Kenya," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-18, August.
    4. Kristiansen, Stein & Santoso, Purwo, 2006. "Surviving decentralisation?: Impacts of regional autonomy on health service provision in Indonesia," Health Policy, Elsevier, vol. 77(3), pages 247-259, August.
    5. Mwabu, Germano, 1995. "Health care reform in Kenya: a review of the process," Health Policy, Elsevier, vol. 32(1-3), pages 245-255.
    6. Junaid Ahmad & Shantayanan Devarajan & Stuti Khemani & Shekhar Shah, 2006. "Decentralization and Service Delivery," Chapters, in: Ehtisham Ahmad & Giorgio Brosio (ed.), Handbook of Fiscal Federalism, chapter 10, Edward Elgar Publishing.
    7. World Bank, 2012. "Devolution without Disruption," World Bank Publications - Reports 27157, The World Bank Group.
    8. Faguet, Jean-Paul, 2004. "Does decentralization increase government responsiveness to local needs?: Evidence from Bolivia," Journal of Public Economics, Elsevier, vol. 88(3-4), pages 867-893, March.
    9. Mr. Sanjeev Gupta & Miss Estelle X Liu & Mr. Carlos Mulas-Granados, 2015. "Now or Later? The Political Economy of Public Investment in Democracies," IMF Working Papers 2015/175, International Monetary Fund.
    10. Homedes, Nuria & Ugalde, Antonio, 2005. "Why neoliberal health reforms have failed in Latin America," Health Policy, Elsevier, vol. 71(1), pages 83-96, January.
    11. Magnussen, Jon & Hagen, Terje P. & Kaarboe, Oddvar M., 2007. "Centralized or decentralized? A case study of Norwegian hospital reform," Social Science & Medicine, Elsevier, vol. 64(10), pages 2129-2137, May.
    12. Vargas Bustamante, Arturo, 2010. "The tradeoff between centralized and decentralized health services: Evidence from rural areas in Mexico," Social Science & Medicine, Elsevier, vol. 71(5), pages 925-934, September.
    13. Campos-Outcalt, Doug & Kewa, Kelly & Thomason, Jane, 1995. "Decentralization of health services in Western Highlands Province, Papua New Guinea: An attempt to administer health service at the subdistrict level," Social Science & Medicine, Elsevier, vol. 40(8), pages 1091-1098, April.
    14. Bossert, Thomas, 1998. "Analyzing the decentralization of health systems in developing countries: decision space, innovation and performance," Social Science & Medicine, Elsevier, vol. 47(10), pages 1513-1527, November.
    15. Mary Nyikuri & Benjamin Tsofa & Edwine Barasa & Philip Okoth & Sassy Molyneux, 2015. "Crises and Resilience at the Frontline—Public Health Facility Managers under Devolution in a Sub-County on the Kenyan Coast," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-18, December.
    16. repec:bla:devpol:v:28:y:2010:i:6:p:669-691 is not listed on IDEAS
    17. Timothy Chrispinus Okech & Steve Ltumbesi Lelegwe, 2016. "Analysis of Universal Health Coverage and Equity on Health Care in Kenya," Global Journal of Health Science, Canadian Center of Science and Education, vol. 8(7), pages 218-218, July.
    18. Besley, Timothy & Coate, Stephen, 2003. "Centralized versus decentralized provision of local public goods: a political economy approach," Journal of Public Economics, Elsevier, vol. 87(12), pages 2611-2637, December.
    19. Mosca, Ilaria, 2006. "Is decentralisation the real solution?: A three country study," Health Policy, Elsevier, vol. 77(1), pages 113-120, June.
    20. Santosh Mehrotra, 2006. "Governance and basic social services: ensuring accountability in service delivery through deep democratic decentralization," Journal of International Development, John Wiley & Sons, Ltd., vol. 18(2), pages 263-283.
    21. Berman, Peter, 1995. "Health sector reform: making health development sustainable," Health Policy, Elsevier, vol. 32(1-3), pages 13-28.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Vargas Bustamante, Arturo, 2010. "The tradeoff between centralized and decentralized health services: Evidence from rural areas in Mexico," Social Science & Medicine, Elsevier, vol. 71(5), pages 925-934, September.
    2. Zarychta, Alan, 2020. "Making social services work better for the poor: Evidence from a natural experiment with health sector decentralization in Honduras," World Development, Elsevier, vol. 133(C).
    3. Gonzalez Block, Miguel Angel, 1997. "Comparative research and analysis methods for shared learning from health system reforms," Health Policy, Elsevier, vol. 42(3), pages 187-209, December.
    4. Sumah, Anthony Mwinkaara & Baatiema, Leonard & Abimbola, Seye, 2016. "The impacts of decentralisation on health-related equity: A systematic review of the evidence," Health Policy, Elsevier, vol. 120(10), pages 1183-1192.
    5. Park, Sungchul & Lee, Jason & Ikai, Hiroshi & Otsubo, Tetsuya & Imanaka, Yuichi, 2013. "Decentralization and centralization of healthcare resources: Investigating the associations of hospital competition and number of cardiologists per hospital with mortality and resource utilization in ," Health Policy, Elsevier, vol. 113(1), pages 100-109.
    6. Skoufias, Emmanuel & Narayan, Ambar & Dasgupta, Basab & Kaiser, Kai, 2011. "Electoral accountability, fiscal decentralization and service delivery in Indonesia," Policy Research Working Paper Series 5614, The World Bank.
    7. Gianmarco Daniele & Amedeo Piolatto & Willem Sas, 2018. "Who Sent You? Strategic Voting, Transfers and Bailouts in a Federation," Working Papers. Serie AD 2018-05, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie).
    8. Besfamille, Martin & Lockwood, Ben, 2004. "Are Hard Budget Constraints for Sub-National Governments Always Efficient?," The Warwick Economics Research Paper Series (TWERPS) 717, University of Warwick, Department of Economics.
    9. Fabio Sánchez, 2006. "Descentralización Y Progreso En El Acceso A Los Servicios Sociales De Educación, Salud Y Agua Y Alcantarillado," Documentos CEDE 2287, Universidad de los Andes, Facultad de Economía, CEDE.
    10. Mergele, Lukas & Weber, Michael, 2020. "Public employment services under decentralization: Evidence from a natural experiment," Journal of Public Economics, Elsevier, vol. 182(C).
    11. Kis-Katos, Krisztina & Sjahrir, Bambang Suharnoko, 2017. "The impact of fiscal and political decentralization on local public investment in Indonesia," Journal of Comparative Economics, Elsevier, vol. 45(2), pages 344-365.
    12. Ohto Kanninen & Hannu Karhunen & Jeremias Nieminen, "undated". "Effect of Secondary Education on Cognitive and Non-cognitive Skills," Working Papers 337, Työn ja talouden tutkimus LABORE, The Labour Institute for Economic Research LABORE.
    13. Anila Channa & Jean-Paul Faguet, 2016. "Decentralization of Health and Education in Developing Countries: A Quality-Adjusted Review of the Empirical Literature," The World Bank Research Observer, World Bank, vol. 31(2), pages 199-241.
    14. Hindriks, Jean & Lockwood, Ben, 2009. "Decentralization and electoral accountability: Incentives, separation and voter welfare," European Journal of Political Economy, Elsevier, vol. 25(3), pages 385-397, September.
    15. World Bank, 2007. "Local Government Discretion and Accountability : A Local Governance Framework," World Bank Publications - Reports 7859, The World Bank Group.
    16. Chiappinelli, Olga, 2020. "Decentralization and Public Procurement Performance: New Evidence from Italy," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 58(2), pages 856-880.
    17. Marta Espasa & Alejandro Esteller-Moré & Toni Mora, 2017. "Is Decentralization Really Welfare Enhancing? Empirical Evidence from Survey Data (1994-2011)," Kyklos, Wiley Blackwell, vol. 70(2), pages 189-219, May.
    18. Liangliang Liu & Yonghao Guan, 2023. "How do fiscal decentralization and intergovernmental fiscal transfers affect energy consumption in China?," Energy & Environment, , vol. 34(5), pages 1228-1242, August.
    19. Grégoire ROTA-GRAZIOSI & Emilie CALDEIRA, 2014. "La décentralisation dans les pays en développement : une revue de la littérature - Decentralization in developing countries: A literature review," Working Papers 201411, CERDI.
    20. Paula Salinas & Albert Solé-Ollé, 2009. "Evaluating the effects of decentralization on educational outcomes in Spain," Working Papers 2009/10, Institut d'Economia de Barcelona (IEB).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:osf:thesis:xef7a. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: OSF (email available below). General contact details of provider: https://thesiscommons.org .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.