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Embedding Quality Improvement in devolved health settings

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A presentation by Robinson Karuga on quality improvement in community health worker programmes in Kenya. This was given at the 2016 Global Symposium on Health Systems Research.

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Embedding Quality Improvement in devolved health settings

  1. 1. Learning to embed quality improvement approaches at community level in Kenya’s devolved health system Robinson Karuga Research Fellow LVCT Health 1 .
  2. 2. Constitutional Referendum Transition Devolution of Health Services Transition… Roles of National MoH • Policy formulation • Standards & guidelines • Capacity building • Technical support Roles of Counties • Implementation of policy • Financing health care • Human resource management
  3. 3. Challenges in Devolving Health 3 www.lvcthealth.org Low budgetary allocations Varying Prioritization of Health Human resource challenges Attitudes of Officials Delayed financial disbursements Source: http://gadocartoons.com/the-only-county-devolution-has-not-happened-yet/ Source: Health Policy Project (2015)
  4. 4. Political Process of Embedding QI in Devolved Setting Process Actors ContextContent • Understand National vs County Roles • Understand power dynamics • Align QI to National & County Priorities • Consider interests at each level • Simplify! • Understand pre-existing QI structures • Map other key QI actors • Ensure full consultation • Consider ALL Interests & Priorities • Institutionalize QI at all levels

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