Examining the operations and functioning of county health stakeholders’ forum in the context of devolution in Kenya

Reference Number: 
Dr Benjamin Tsofa, Dr Edwine Barasa and Dr Jane Chuma



In March 2013, Kenyan adopted a devolved government system which has given more discretionary authority to counties and county departments of health over strategic and operational leadership and governance over the health service delivery functions as outlined in the fourth schedule of the constitution of Kenyan 2010. The Kenya Health Policy 2014-2030 outlines three critical functions of health sector leadership and governance namely (i) the stewardship/management function of government (ii) the oversight/accountability function by communities and community representatives, and (iii partnership coordination arrangements. Though distinct, these three functions of health leadership and governance often overlap in practice – to define the organisation and function of a health system.

Over the past few years, we have; using a governance lens, been working on examining how the implementation of the devolved government system in Kenya since 2013 has affected the organisation and functioning of the Kenyan health system and county level – and in turn try to study how the devolution implementation which caused a major shock in the system, has affected health system resilience at county level. Our preliminary findings have underscored the role and importance of non-government actors in enhancing health system resilience in times of day-to-day and sudden system shocks. In our next phase of work we will be further exploring if and how the formal organisation and coordination   of none state actors and other stakeholders as envisioned in the KHP 2014-2030 is playing to server this role.

This proposed studentship is part of a series of sub-studies aimed at answering this broader question. Specifically – this studentship will focus on examining the current organisation and functioning of partnership and stakeholders’ involvement in the delivery of health services in Kilifi County.


Questions to be addressed by the student

  1. What are the current practices/mechanisms for engaging partners/stakeholders at the sub-national level in LMICs?
  2. What is the current practice/mechanism for engaging partners/stakeholders in Kilifi County and how well does it function
  3. What opportunities has devolution introduced that could facilitate in streamlining and strengthening health sector partnership/stakeholders’ coordination/engagement practices at county level in Kenya


Skills to be acquired by the student

The student will gain skills in the design, conduct and analysis of health systems and health policy research utilising qualitative methods including documents reviews, observations, and individual and group interviews.  He or she will also gain literature searching skills, and insights into health system governance.


Preferred training background of the student

  1. Health related or social science training
  2. Knowledge of the organization and functioning of the county health system in Kenya
  3. Experience in in-depth interviews and FGDs
  4. Ability to work independently
  5. Excellent communication skills and good team player


Application deadline: 11 February 2019