The role of the constituency development fund on health care service delivery in Kenya: a case of Rangwe constituency
'Various studies have been done on the impact ofthe Constituency DevelopmentFund (CDF) and other devolved funds in Kenya. However, a few focuses on the role of such funds on health care service delivery despite health being an important factor in the development of any community. Therefore this study was geared towards bridging this knowledge gap and was undertaken in Rangwe constituency in Kenya. The objectives of this study were; to assess the influence of the annual constituency development fund allocations on health care service delivery, to assess the level of community participation in decision making and to examine the communication channels used by the CDF committee as well as to examine the influence of the monitoring and evaluation approaches used by the CDF committee on health care service delivery. The study employed a descriptive research designs with the questionnaires as the main instruments of data collection. The data analysis was performed using Statistical Package for Social Sciences (SPSS- 16) while the presentation of the infonnation was done in form of frequency tables, correlation and multivariate regression models. The study findings demonstrate that CDF has played a significant role in health care service delivery in the constituency as corrobomted by increased number of wards, consultation rooms, laboratories and even recruitment of additional medical personnel. Towards this end, 68.4 percent reported that the number of wards in the constituency has increased in the ranges of 1 to 3 in health centres while 34.8 percent of the respondents affirmed increase in consultations rooms in the dispensaries. The study established different levels of correlation between the levels of participation in the CDF funded health care projects and age of the beneficiaries, level of education and the awareness to the fund. In this regard, awareness has a positive but not significant influence on participation with correlation value (r) being 0.385 while age of the beneficiaries has a positive but not significant influence on the participation with a correlation value (r) being 0.042. This implies that the more the awareness increases, the more the likelihood of an individual to participate in the CDF health care funded projects. On the other hand, the level of education of beneficiaries had a negative and not significant influence on the level of individual's participation in the projects with correlation value (r) being 0.001. This implies that the lower the level of education of a beneficiary, the more one is likely to participate in the project. This is granted that the greatest mode of participation in the project is through labour provision, of which the highly educated and meaningfully economically engaged are not likely to be involved in. However, the level of community involvement, monitoring and evaluation are negatively but not significantly influencing the improvement in health care service delivery at correlation v-alues (r) -0.207 and- 0.024 respectively. This implies that the lower the level of community involvement, the less the improvement in health care service delivery. The study also demonstrates that there was some consultation between the CDFC and the community with the community feeling sidelined in monitoring and evaluation aspect of the fund's administration. The study therefore recommends that the facility administrators be actively involved in the entire process of the projects and that the amount of CDF allocations be increased to ensure completion and quality ofthe work done.