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Integrating social accountability in healthcare delivery : lessons drawn from Kenya (English)

The Constitution of Kenya provides that most functions of the state are decentralized in a devolution process. The devolved health system is four tiered: community health services, primary care services, county referral services, and national referral services. However, even though roles and responsibilities are elaborately outlined, in practice the transition from national to county governments has been marred by inconsistency, poor understanding of the system, management challenges, and lack of coordination between the national and county governments. This policy note provides observations from a pilot that tested integration of social accountability mechanisms in healthcare delivery in Kenya between 2011 and 2013.


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    Machira,Yvonne Wangui, Nizam,Rabya

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    Integrating social accountability in healthcare delivery : lessons drawn from Kenya

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    community participation;human rights based approach;equal access to health services;access to health care service;social accountability;health facility;health care delivery system;Health Service Delivery;delivery of health services;demand for health services;effectiveness of health care;participation in decision making;quality health care;quality of health care;health care service delivery;level of health care;primary health care facilities;empowerment of communities;health facility management;essential health services;Public Financial Management;social development staff;reproductive health care;access to information;freedom from discrimination;guarantee of success;affordable health care;community health services;equity in distribution;participation in management;social accountability mechanism;primary care services;health service provider;public health laboratory;social service provision;management of facility;primary health facility;capacity of citizens;Check and Balances;civil society institution;health seeking behaviour;improvement in governance;participation of citizens;demand for service;sense of ownership;participation of communities;distribution of resource;service delivery system;drugs of abuse;grievance redress mechanism;availability of drug;improved service delivery;participatory data collection;control over resources;health centre;outreach activity;supply side;community level;performance criteria;Health Workers;referral service;community engagement;citizen engagement;government commitment;job satisfaction;toll free;average score;rural area;community strategy;devolved system;health interventions;volunteer service;county health;healthcare services;national health;financial information;lessons learnt;community awareness;medical supply;community empowerment;local administrator;health program;political commitment;health agencies;community organisation;global experience;monitor performance;health activities;healthcare delivery;resource mobilisation;Public-Private Partnership;administrative support;Essential Drugs;increase productivity;local beneficiary;regulatory environment;shared ownership;healthcare worker;participatory approach;policy formulation;increased access;health outcome;procurement rule;stakeholder involvement;increased transparency;public policy;security concern;constructive engagement;citizen groups;promote citizen;Disease Surveillance;sector specialist;health matter;systemic corruption;social media;citizen action;community medicine;citizen involvement;preferential treatment;health status;quality service;community representative;back up;hospital level;opinion leaders;devolution process;health goal;health rights;aid effectiveness;performance contract;Disease Control;working condition;funeral homes;health technology;marginalized group;political setting;salary payment;complaints handling;outreach service;public perception;citizen participation;resource distribution;community activity;referral hospitals;low-income community;community representation;vernacular language;client responsive;contractual issue;legal obligation;health resource;government credibility;quality care;oversight body;citizen demand;social inclusion;client needs;phone number;active engagement;regional conventions;citizen information;informed choice;public official;display board;citizen voice;social justice;Public Services;participatory mechanism;human dignity;transport service;client ownership;significant factor;decentralized government;boosting efficiency;Health ministries;gender relation;drug supply;urban community;local constituency;local situation;community events;power relationship;changing attitude;budget coefficient;donor grant;citizen perceptions;community responsibility;waiting time;delayed disbursement;delivery note;



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Machira,Yvonne Wangui Nizam,Rabya

Integrating social accountability in healthcare delivery : lessons drawn from Kenya (English). Kenya devolution,no. 4 Washington, D.C. : World Bank Group.