Aziza t ion of He lath Sys t emus : DCE is ions pace, Innovation ND Performa n c e) appointed, promoted, remunerated, controlled and deployed by the bureaucratic means applicable to all members of the organization.
(Smith 1979) ii Kenya has exercised decertification through provincial admit ii Refers tot he transfer of experimentations-making 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’. UNDO) ii Examples are pratfalls and such other corporate bodies like Municipal and City Boards under the Urban Areas and Cities Act ii Transfer of authorities to autonomous lower-liveliness g a I I 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. ii 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. (Steeplechaser’s- Fox a n d Stephen] .Mill s) ii Through devolution, new units of government that are created outside direct control of national government. ii Federalism is the strongest form of devolution.
ii There is no uniform design of devolution or all over the world Devolution in Kenya-An Overview ii The Sovereign power of the people exercised at the two levels of government ii Devolution simultaneousness recognized in Art. 10 of the Constitution principles ii Devolution runs through the all constitution and not confined to the devolved Chapter 11 of the Constitution ii The challenge is to galvanism the minds of Kenya especially those in authority to appreciate the reorganization of state in line with devolution The Form of Devolution in Kenya ii Art. (2) provides that “The governments at the national and county levels are distinct and interdependent and shall conduct their dual relations on the basis of consultation and cooperation. ” ii From the above it can be concluded that Kenya chose a Cooperative system of devolved government and not a system that emphasizes autonomy as the case is in Ethiopia, US and to some extend Nigeria Three Principles are key in Kenya 1) The Principleofdistinctiveness:Cloverleaf government have distinct boundaries, sources of resources and functions 2) The principle of of interdependence: They depend on each other, they serve same clients (Kenya), some functions overlap, one does policy and the other implements 3) The principles of oversight.Oversight is left to intergovernmental institutions such as independent offices and commissions Characteristic of Kenya Devolution ii Defined levels of governance- Two levels unlike other countries with three Constitutional protection of the defined levels. Counties cannot be abolished easily and the Bicameral legislature with Senate as the guardian angel of devolution ii Self governance plus shared governance ii Allocations of functions- Fourth Schedule ii Allocation of Resources- At least 15 percent, Equalization fund of budgetary allocation and ability to borrow and to receive grants ii Taxation powers-property and entertainment taxes to counties O Defined boundaries (still a challenge in Kenya see the case of Turkey) ii Mechanisms of intergovernmental relations. Creation of the Summit, Council of counties and the Tribunal Functions, Powers and Structures of Devolved Governance in Combativeness An Overview (Art 174) autobiographically exercise of power defroster diversity national unity and accountable by recognizing ii To give powers of self-governance to the people and enhance the participation of the people in the exercise of the powers of he state and in making decisions affecting them Objectives of Devolution in Kenya O Recognize the right of communities to manage their own affairs and to further their development ii Protect and promote the interests and rights of minorities and marginalia communities ii Promote social and economic development and the provision of proximate, easily accessible services throughout Kenya ii Ensure equitable sharing of national and local resources throughout Kenya ii Facilitate the decentralization of state organs, their functions and services ii Enhance checks and balances and the separation of powers Functions of the National and County Governments Outlined in Schedule IV Social functions are mainly performed by ND defense by national government. National government sets the policy framework while counties are implementers There are cases of concurrent functions with a possibility of overlap of mandates.
Art. 186(3) Government.Functions can be transferred BTW the two levels residual power lies with National Enormous responsibility for service delivery lies with the county Powers of County Governments ii Have all powers necessary to discharge their functions ii Powers to enter into contracts ii Powers to acquire, purchase, or lease any land ii Powers to delegate any of its functions to its officers, decentralized units or other entities thin the county ii Power to enter into APP ii Power to establish agencies County Governance; Challenges and Transition to County Government Act Guides Two Phases of Transition Phase I ii Audits of assets, liabilities, staff, infrastructure and equipment of goof and local authorities ii Civic education ii Initial preparation of county budgets ii Preparation of county profiles ii Determining mechanism for closure and transfer of public records ii Development of county FM system ii Transition of government and local authority staff, assets and liabilities ii Provide for mechanism to secure assets and liabilities held by local authoritiesPhase II-After the Elections ii Complete any activity that may be outstanding from Phase I ii Oversee the transfer of functions from the national government to the county government; ii Facilitate the county governments in the performance of their functions; ii Any other activity that may be necessary to enable county governments carry out their Transition Challenges ii Lack of political good will ii Vested interests among the midwives of devolution ii Institutional competence and capacity. ii Lack of knowledge and understanding on the Constitution and devolution ii Resource constraints Part D: Devolution and Health In Kenya Various Health Sector Reforms Devolved Acts The Kenya 2010 Constitution guarantees health for all Kenya ii Art.
26;Every person has the right to life ii Art. 42; Every person has the right to a clean and healthy environment ii Art. 43. 1) Every person has the rightвЂ? (a) to the highest attainable standard of health, which includes the right to health care services, including reproductive health care ii 53. (1) Every child has the to basic nutrition, shelter and health care ii 56. The State shall put in place affirmative action programmers designed to ensure that minorities and marginal’s groupsвЂ?(e) have reasonable access to eater, health services and infrastructure. Why devolve the health system? ii To promote access to health services through out ii To address discrimination of the “low potential areas” better health services than rural area ii To address problems of bureaucracy in matters of health service provision especially procurement related problems .
Urban areas have had ii Topromoteefficiencyinthedeliveryofhealth services ii Address problems of low quality of health services The IV Schedule distributes functions between national and county gobos Part I Part II National referral health facilities ii Health Policy 2 . County health services including.. Pharmacies; ii Ambulance services; ii Promotion of primary health care; ii Licensing and control of undertakings that sell food to the public; ii Veterinary services (excluding regulation of the profession); ii Cemeteries, funeral parlous and crematoria; and ii Refuse removal, refuse dumps and solid waste disposal. Functions are either; exclusive, concurrent or residual What happens to undefined functions? O Preventive and promotion health services ii HIVE/AIDS Programmer and other Sexually Transmitted Infections (Sty’s) ii Family planning ii Health Inspection and other public health revises.
ii Quarantine administration Why unbundled functions? The devil lies in the detail To ensure that overlapping functions do not cause confusion and conflict To ensure that the functions are allocated and performed by a body that can account. To distribute effectively the assets and liabilities between the County and National Government. Unbinding and analysis of functions is better captured in one law or relevant legislations depending on the sector. Who is doing it? The unbinding of functions is better handled through the Health Bill and the Draft How does one distinguish National from County Referral facility?