Challenges of implementing the social pillar strategy of the Kenya vision 2030 in the devolved health sector in Kisumu county
Many organizations today have adopted strategic planning as a way to survive in the turbulent, dynamic and complex business environment. Strategy implementation is the action phase of any strategic management process and is often the most challenging than formulating strategies. Strategy should be effectively operationalized and institutionalized in the organization for it to be properly implemented. Organizations go through different challenges in strategy implementation including poor leadership, change management, organization structure, power and politics, inadequate human and material resources and poor information and communication technology. Strategy therefore has to evolve and adapt to the different and unique circumstances that each organization finds itself in. The social pillar strategy has various components including education, science and technology, health, water and sanitation, housing and urbanization. Health care in Kenya is now a devolved function under county governments. This study sought to establish the challenges facing the implementation of the social pillar strategy of the Kenya Vision 2030 in the devolved health sector in Kisumu County, and to determine the measures being put in place to address these challenges. This was a case study of Kisumu County and the primary data was collected using interview guides while secondary data was collected through scrutiny of documents such as minutes of previous meetings, County Integrated Development Plan, County Fiscal Strategy Plan, and County Health Sector Strategic and investment Plan. Key people interviewed were County Executive Secretary for Health, Chief Officer for Health, County Director for Health, Chief executive of Jaramogi Oginga Odinga Teaching and Referral Hospital and Medical superintendent of the Kisumu East County Hospital. Content analysis of collected data was done. The main challenges of strategy implementation in the devolved health sector in Kisumu County were inadequate human resource for health, bureaucratic organization structure, inadequate financing from central government, weak leadership and governance structures, dilapidated or inadequate health infrastructure, political interference, poor information and communication technology, and inadequate pharmaceuticals and non-pharmaceuticals. To remedy the situation the county is looking for more funding by seeking alternative sources including public-private partnerships, more investments in upgrading health infrastructure, recruitment and developing of more human resource, increased investment in preventive and promotive health care, and developing more accountable leadership. It is recommended that alternative financing be sought and collaborations with academic and research institutions be enhanced. Future research could focus on other aspects of social pillar like poverty reduction and youth empowerment, or on the effective models of implementing devolution as a governance strategy in health care.
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