Baseline Survey on Governance and Management of Health Sector Terms of References (TORs)

HERAF for 6 months through the support of the Christian Aid (CA) Programme Partnership Agreement (PPA) will be implementing a project titled ‘Baseline Survey on Governance and Management of Health Sector Terms of References (TORs)’ HERAF will be addressing the following specific objectives:

  1. To strengthen community participation in county policy and decision making processes.
  2. To strengthen community members’ skills for monitoring the standards of health services delivery at Narok county health facilities
  3. To increase citizen’s participation in health sector budgeting processes in Narok County.

The Project will be implemented in Narok, Siaya, Kiambu and Isiolo Counties. The aims of the project is to achieve improved health for women, people living with HIV, children and men through supporting interventions related to HIV, TB, Malaria and Maternal Child Health (MCH). The project will address 3 key thematic areas as follows:

  1. Community Health Systems Strengthening
  2. Equitable Social and gender norms
  3. Health governance.

The baseline survey has two components, to establish community member’s, community leaders, health care workers, health management committee members and county government officials understanding of human rights, the constitution, health policy framework and the concept of citizens participation in decision making and accountability processes in health sector. The other component is to assess the amount of budget allocated to health sector in target counties in order to provide evidence for supporting budget advocacy, strengthening the ability of civil society organizations and the public to influence budget making processes and decisions on allocation of resources to health programs such as Maternal, New-born and Child Health (MNCH). This study will also establish the project’s benchmarks for comparing and impact measurement at the end of the project.

The objectives of the baseline are:

Component A

  1. To assess levels of human rights and the right to health awareness among community members, health care workers and county government officials.
  2. To assess whether community members are involved in decision making processes in county health structures
  3. To gauge facility management committee members knowledge of health policy framework and their roles and responsibilities.
  4. To assess whether community members hold facility management committee members, health care workers and county government officials accountable.

Component B


  1. Determine the health sector budget trends for 2013/2014 and 2014/2015 financial years.
  2. Determine the amount of budget allocated to health sector as percentage of the county budget.
  3. Analyze county MNCH budget allocation for recurrent and development expenditures in 2013/2014 and 2014/2015.
  4. Determine factors that influence budget allocation to health sector at county level.
  5. Assess the involvement of CSOs and the public in prioritizing health needs, budget making processes and allocation at county level


The following are the outputs of the project:


  • Baseline survey on community members knowledge on right to health conducted
  • Community and county health services providers sensitised on right to health, legal and policy frameworks promoting the right to health and community participation in decision making processes and community monitoring
  • Stakeholder’s workshops for facility customers, community leaders, members of staff, committee members, health care workers, county health officials and other stakeholders held to develop/review/update service charter
  • Public informed and educated about service charter, the contents and importance of health facility service charter
  • Community members capacity to conduct social accountability in health services delivery and decision making processes at county levels enhanced
  • Capacity training for community members to participate and engage with county government in budget making and implementation processes improved
  • Citizen’s health sector alternative budget developed and used as an advocacy tool for increasing health sector budget allocation
  • County health sector 2014/2015 budgets tracked for transparency and accountability



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