Strengthening Health Systems Management under Decentralization in Kenya

JICA’s technical cooperation project in Kenya, “Strengthening Management for Health in Nyanza Province” (hereafter, the Project) ran from July 2009 to June 2013. Provincial and district health management teams were seen by JICA as the key to a strong health system that would improve the quality of health services for Kenyans. This delivery note explores how the Project developed the capacities of those teams. This delivery note illustrates challenges the Project faced, how they were addressed, and analyzes key factors contributing to its success.
It is also noteworthy that the health management teams’ capacities that were developed by the Project have been sustained even in the face of drastic changes in Kenya’s administrative structure that occurred immediately after completion of the project. The administrative structure in Kenya was centralized when the four-year project started. However, full-scale movement toward devolution occurred during the project, and the county system was introduced in July 2013. As a result, Nyanza province was restructured into six counties. Nonetheless, many former health management team members who were posted in Nyanza province and districts adapted to a new team under the devolved system and continued to contribute to the improvement of the working environment and the delivery of quality health services.