The overall purpose of the project is to strengthen community participation in health sector governance in Coast, Eastern and Central regions of Kenya
Community participation is critical to the promotion of accessible, affordable, equitable and effective health care services at the grassroots level. The second National Health Sector Strategic Plan 2005 – 2010 (NHSSP II) embraces the principle of community involvement, as it aims to enhance access to health care in order to improve productivity and reduce poverty, hunger and child and maternal mortality. Indeed, the Kenya Health Sector Reforms (HSRs) and the primary health care (PHC) concept have both recognized the importance of implementing a rights-based approach to health in Kenya, ensuring that community members are actively involved in prioritizing and addressing local health issues.
As envisaged by the Ministries of Medical Services and Public Health and Sanitation, the implementation of the NHSSP II requires effective decentralisation of governance, management and service delivery in order to bring health sector decision-making and action as close as possible to the community and individual households. Therefore, the main purpose of the proposal is to strengthen identified community decision making processes in order to effectively identify community health needs and participate more actively in the improvement of community health care services.
Nyeri North DHMT Members
A major impediment to community participation in health sector governance and management is lack of awareness about Economic Social and Cultural Rights, including the right to health. Creating awareness of the right to health, including the rights-based approach, is the major priority of this project. It is hoped that with improved human rights awareness community members will be in a more informed position to demand for quality health services from the government. Similarly, they will be in a better position to select able representatives in Health Facility Committees, DHMB/Ts and hold them accountable in the execution of the duties and responsibilities as contained in their terms of reference.
As the achievement of community health needs is pegged on how well the community representatives on the various committees understand and undertake their respective roles and responsibilities, the project is enhancing their capacity to execute their mandates. This is been achieved by facilitating the committees to understand their mandates as community representatives, including training them on tasks such as planning and budget making, which forms part of their core business.
The quality of health services that communities in Kenya are receive from health facilities is wanting and only a few members of the community are aware that it is their right to be provided with quality health care services. The project is therefore creating awareness on the right to health by informing community members about the patient’s charter, which stipulates the services that a client is entitled to in a health facility. The project is going further to inform and educate the public about the complaints procedure in case there is an infringement of patients’ rights.
To ensure ownership and sustainability of patient’s charter, the project is facilitating selected health facilities in the target regions to adapt or develop their own charters with the participation of the community, government and other stakeholders in the district.
The project is also enabling community members to demand for transparency and accountability in the management and governance of the health sector at the district levels. To achieve this, members of the community are made aware about the health sector budget making processes, including the District Health Plans and Annul Operational Plans. Information is also been provided about the national budget making process – the Medium Term Expenditure Framework (MTEF) – including its linkage with the health sector Annual Operation Plans.
To ensure the community is informed about the devolved funds earmarked for the health sector such as the proposed – Health Sector Service Fund (HSSF) – the project is informing and educating the community about the fund, its purpose and how it should be spent. In addition, to boost the fund governance, the project is clarifying the roles and responsibilities of the proposed Facility Fund Committees, training them on project planning, budgeting, resource mobilisation, monitoring and reporting procedures.
Project targets
The project is targeting Health Facility Committees, DHMT, DHMB and MOH staff working at dispensaries, health centres and district hospitals, civil society and general public from Mbeere districts in Eastern, Nyeri North in Central and Kwale district in Coastal province.
Project period: 36 months (January 2009 to December 2011)
Expected project outputs.
1) Strengthened grassroots communities to progressively realize their right to access quality health care and to seek accountability from health facilities
2) Dissemination of human rights information on issues affecting health care services in Kenya with case studies drawn from intervention areas (Coast, Eastern and Central) through website, newsletters, MOH forums, conferences and workshops
3) Improved health status and reduced disease burden in the community due to quality health delivery systems at the community level.
4) MOH staff working at level 2, 3 and 4 (dispensaries, health centres and district hospitals respectively) trained on human rights and right based approaches
5) Roles and responsibilities of the DHMT, DHMB and Facility Committees explained to target communities
6) Strengthened grassroots communities participation in health sector budget process at district levels
7) Circulation and Dissemination of patient’s charter to communities in target regions to strengthen access to quality health care and seek accountability from health facilities
8) Participatory development and implementation of Facility Plans and District Health Plans
9) Health Facility Committees, District Health Management Boards/Teams capacity to represent community interests in the planning and implementation of health projects at district level improved
10) Demand for transparency and accountability in allocation and utilisation of Health Sector Service Fund channelled to health facilities
The community is empowered and respect for human rights enhanced.
