Devolution In Kenya Research Articles

Effects of Resources Availability on the Capacity to Conduct Social Accountability in Health Community Based Organizations in Kajiado County

The general objective of the study was to establish the effects of resource availability on the capacity to conduct social accountability among community-based organizations (CBOs)in Kenya with a specific focus on health-related CBOs in Kajiado County. The study was triggered by the fact that since devolution in Kenya, pressure has been put on local CBOs to engage with county leadership and hold them accountable to communities they serve. As a result of this, local communities, development partners and the county governments have put a lot of expectations on the CBOs. This has been more pronounced in sectors such as healthcare, which were fully devolved under the current constitutional dispensation. Despite this expectation, there is a dearth of information on whether the CBOs have lived to this expectation and whether they have the capacity to support social accountability initiatives. This study will be useful to development partners, county governments and donors in providing insights on key areas they need to focus their attention on in order to support the local CBOs to play their important role in promoting social accountability. In order to achieve the stated objectives, the study employed a descriptive research study design, and targeted a population comprising of the Twenty-eight CBOs implementing health related interventions in Kajiado County. The study primarily made use of the primary data which was collected using a structured questionnaire. The data was grouped, organized and categorized according to specific objectives and research questions. Analysis was done using descriptive statistics (frequency counts, percentages, mean and standard deviation) and inferential statistics including correlation and regression. A multiple linear regression model was used to analyze the data and establish the relationship between independent and dependent variables. Statistical Package for Social Sciences (SPSS) version 20.0 was used for analysis, and data was presented using tables. The study results indicate that there is a strong and positive correlation between availability of resources (r=0.567) and capacity to conduct social accountability in health community-based organisations. Increase in the availability of resources at the disposal of CBOs increase their capacity to conduct social accountability. The way in which CBOs addresses the issue of resource availability determines their capacity to conduct social accountability. The study concluded that improved availability of resources for health CBOs enhances their capacity to conduct social accountability. Future studies should replicate this study in other counties in Kenya to unearth the status of social accountability in community-based organizations.

Impact of Devolution on Local Governance and Service Delivery in Kenya

Purpose: The main objective of this study was to explore the impact of devolution on local governance and service delivery in Kenya.
 Methodology: The study adopted a desktop methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library.
 Findings: The findings revealed that there exists a contextual and methodological gap relating to the impact of devolution on local governance and service delivery in Kenya. The empirical review revealed the devolution in Kenya has brought about positive changes in local governance and service delivery. To sustain and enhance these gains, it is imperative to prioritize capacity building, accountability, and collaboration among counties. Devolution remains a powerful tool for fostering development and democratizing governance in Kenya, but ongoing commitment and effort are required to ensure its continued success in improving the lives of Kenyan citizens.
 Unique Contribution to Theory, Practice and Policy: The Decentralization theory, the Public Choice theory and the Institutional theory may be used to anchor future studies on the impact of devolution on local governance and service delivery in Kenya. There is a need for greater coordination and collaboration among counties. Many challenges, such as infrastructure development and resource allocation, transcend county boundaries. Counties should work together on regional development initiatives to maximize their impact and address common issues effectively. The national government can play a facilitating role in promoting inter-county cooperation through the provision of technical assistance and resources.

Public Accountability Practice and Devolved Administrative Structures in Selected Semi-arid Counties in Kenya

Purpose: Devolved administrative structures serve a critical role in insulating public officials against power abuse and enhancing the stability of the political environment. Since the inception of devolution in Kenya, proper operationalization of devolved administrative structures ought to be in place. The problem lies in the operationalization of devolved administrative structures that has led to poor service delivery. This study intended toibridge the gap by determining the effect ofipublic accountability practices on theidevolved administrative structures.
 Methodology: The study incorporated institutional theory explaining an institution as entities that are dependent on each other to form complete systems that are concerned with internal interdependence. The target population was 500 respondents from Taita Taveta and Makueni Counties. Purposive sampling was utilized to sample the top leadership who are mandated to oversee functions in the devolved administrative setups; the governor’s, deputy governors, speakers of county assembly and clerks of county assembly. Random sampling technique was utilized to sample members of county assemblies, county executive members, chief officers, county public service board members, directors, sub-county administrators, ward administrators, and village administrators
 Findings: The study found significant relationship betweenipubliciaccountability andidevolvediadministrativeistructures.
 Recommendation: This study recommends that top leadership in Counties must come up with project ideas which are persuasive and create improvement of devolved administrative structures that give persuasive transformation.

Resource Allocation Practice and Devolved Administrative Structures in Selected Semi-Arid Counties in Kenya

Purpose: Since the inception of devolution in Kenya, proper operationalization of devolved administrative structures ought to be in place. The problem lies in the operationalization of devolved administrative structures that has led to poor service delivery. This study intended to bridge the gap by investigating the effect of resources allocation practices on theidevolved administrative structures.
 Methodology: The study adopted a descriptive research design with aniobjective to determineiwho, what, where, when, and howimuch.iItiwasiconsidered appropriate because itisoughttto generate accurate profiles for ifactors, events and circumstances. The study incorporated transformational leadership theory that was poled as the creation of positive changes within an organization.
 Findings: This study found that, an epitomized rise in strategic leadership practices leads to enhanced operationalization of the devolved administrative structures, and institutionalization that stood to be helpful on devolved administrative structures operations, ensuring information movement should be done continuously and efficiently. As such, significant effect of resources allocation practices on the devolved administrative structures were found to exist.
 Recommendation: The research recommends that top leadership in Counties must lucidify the stratagems that project ideas which are persuasive and create improvement of devolved administrative structures that give persuasive transformation.

Electrification and devolution in Kenya: Opportunities and challenges

While there is a broad literature on ensuring access to affordable, reliable, sustainable and modern energy for all (SDG7), the positive impact of electrification on development and on electrification strategies, there is little literature on the topic of devolved electrification governance. The paper addresses this issue by analyzing opportunities and challenges of a devolved electrification governance with Kenya as a case study. Conceptually, we base our exploration on an analytical framework adapted from work on multi-level natural-resource governance, which not only includes actors and policies, but also their interactions and power relations, and the analysis of devolution outcomes in the light of (good) governance principles. Methodologically we rely on an extensive literature review and on 24 expert interviews in Kenya. Kenya is chosen as a case study because Kenya has, after its new Constitution came into force in 2010, implemented an ambitious devolution process and is one of the few countries in Sub-Saharan Africa that has devolved important energy functions. However, our results show that devolved electrification governance in Kenya is (still) fragmented and complex, partly due to the late enactment of the Energy Act (2019). Electrification is still mainly planned and implemented by actors on the national level, although decentralized structures and technologies have become more important in recent electrification policies. We found more challenges than opportunities in Kenya's devolved electrification governance. The biggest challenge is a lack of capability in the county governments; other challenges relate to legitimacy and overlapping responsibilities, transparency and information-sharing, accountability of national actors, as well as a lack of inclusiveness and participation of local communities. Despite existing challenges, our interviewees perceive devolution as dynamic and an opportunity for electrification and universal electricity access in the long run. Overall, the article shows that while devolution provides opportunities for electrification and associated development impacts, a devolved electrification governance is challenging and requires not only transparency and information-sharing, but also support for capacity building at decentralized levels.

Devolution in Kenya as a Mechanism of Inclusive Development: Challenges and Prospects

Kenya's Constitution of 2010 brought about radical changes, creating a decentralized governance system that became operational in 2013. This paper seeks to establish to what extent this system of government has worked out in line with its intended objectives. The author equally tries to establish some of the outcomes, shortcomings and prospects of this decentralization process and suggest the way forward.
 The analysis clearly shows that devolution has gained ground and achieved a lot regardless of some of the shortcomings observed. The paper highlights some strategic interventions that need to be implemented to improve the outcome of devolution in Kenya. Overall, the paper establishes that though devolution has become the main political landscape in Kenya, devolved institutions lack institutional protection from the central government. Hence the need for renewed strategic interventions to protect devolution, particularly by parliament, the Senate, and the Council of Governors.

Media Framing of the First Administration of Devolution in Kenya

ABSTRACT The current research, which content analysed 565 news stories in the Daily Nation and The Standard, examined media framing of devolution in Kenya between 2013 and 2017. It examined the most dominant frame in the four-year coverage of devolution, whether the coverage used episodic or thematic framing, and whether the tone of newspaper reports was positive or negative. Findings show that the coverage of devolution was conflict-driven, episodic, and negative. The dominance of the conflict frames shows that the polarised nature of Kenyan politics continues to influence media coverage of devolution, leaving Kenyans without a deeper understanding of how the implementation of devolution impacts development or a grasp on the challenges the new system of governance continues to grapple with.

Perceptions of Agricultural Extension Staff towards Financial Support Before and After Devolution in Kericho County, Kenya

Agricultural extension services are put in place to improve rural development in many nations. Devolution of agricultural extension services have been tried in many nations with mixed results. Since the implementation of the devolved system of governance in Kenya, its effect on agricultural extension service delivery, in Kericho has not been studied and documented. The purpose of this study was to determine the perception of agricultural extension staff towards financial support in Kericho county before and after devolution in Kenya. The study adopted a descriptive research design, which is used to describe characteristics of a population or phenomenon being studied. The target population comprised of 117 agricultural extension officers in Kericho County. The study used a census sampling method because the target population was very small; thus, all the units in the target population were considered. However, inclusion criteria were applied by only including individuals who were in employment both before and after devolution. Data were collected using a questionnaire. The data collected were analysed using descriptive statistics (means, standard deviation, frequencies, and percentages) inferential statistics (paired correlation and paired t-test) with the aid of SPSS. The results show that the majority of the respondents, (86%) were either positive or very positive towards financial transparency before devolution as opposed to the only 4.3% after devolution. The t-test results showed a statistically significant difference in perception of agricultural extension officers towards funding of agricultural extension services before and after devolution in Kericho county. The study concludes that financial support was better before devolution compared to after devolution. The study suggests that the county government of Kericho should improve their financial commitment to promote effective and efficient delivery of extension services.

Achieving Sustainable Development in Respective County Governments in Kenya Through Market Failures and Sustainable Business Entrepreneurship Initiatives

Devolution has been considered as a key pillar of the Constitution of Kenya since the concept seeks to bring governance closer to the people. In line with the Constitution of Kenya 2010 county governments are now at the centre of dispersing political power and economic resources to specific communities. The Principles that underpin devolution in Kenya are that County governments established under the Constitution shall have reliable sources of revenue to enable them govern and deliver services effectively. This study seeks to examine how the principles of entrepreneurship and the issue of market failures can be harnessed by county governments to improve the economic wellbeing in their respective communities. On one hand, environmental economists argue that market failures bring about environmental degradation while on the other hand available literature on entrepreneurship argues that business opportunities arise from market failures. Environmental entrepreneurship details how entrepreneurs seize opportunities that arise from environmentally relevant market failures in order to succeed. Entrepreneurship literature therefore analyses how environmentally relevant market failures may represent opportunities for the achievement of business profitability. This being the case, then businesses can use part of the profits earned for corporate social responsibility in order to reduce environmental degrading economic behaviours. When there are increases in the quality of life and economic growth, there will be substantial negative effects on the natural environment which will diminish the sustainability of most economic systems. This conceptual paper looks at the entrepreneurship as a concept that can be applied in the management of community resources in order to achieve sustainable development and improve the welfare of its citizens. The paper recommends that the administration of county governments in Kenya need to study the environmental failures in their areas of jurisdiction to institute studies on how these failures can be utilised as opportunities for the improvement of the economic wellbeing of the citizens. In order to do these, entrepreneurship concept will become very handy in the said studies.

News Sources and Framing of Responsibility on Devolution in Kenya, 2013–2017

The present research examines two aspects of newspaper coverage of devolution during a 4-year period between March 27, 2013, and May 28, 2017: first, through the lens of attribution of responsibility, who the news media most blamed for problems facing devolution; second, whether reliance on official sources in reporting of devolution mirrors the indexing hypothesis. Findings show that the most-blamed actor and dominant news source on devolution is the county executive. Journalists continue to rely on the elite as their main news source and as a result they shape the discourse on devolution.

A Representative of the People

This article is dedicated to analyze Dominic Burbidge’s An experiment in devolution. Published by Strathmore University Press in 2019, the 319-page volume is a welcome addition to the growing scholarship on devolution in Kenya. This text, indeed, brings with it a much needed ‘empirical grit’ to a discourse previously saturated with historically and theoretically derived conjecture. The hallmark of the book is, therefore, this attention to the material, the meticulousness with which it relays empirical findings and finally, how the author manages to successfully marry empirical data and theory; resulting in an interesting telling of the story of devolution. Thus, Burbidge sets out to test the performance of devolution in the counties where it was most predicted to fail: the former Central Province. He investigates how devolution has actually played out in this region; taking into consideration the historically complicated relationship between Mount Kenya and Nairobi and the enduring scepticism as to the compatibility of devolution and the interests of Central Kenya.

Tracking health sector priority setting processes and outcomes for human resources for health, five-years after political devolution: a county-level case study in Kenya

BackgroundHealth sector priority setting in Low and Middle-Income Countries (LMICs) entails balancing between a high demand and low supply of scarce resources. Human Resources for Health (HRH) consume the largest allocation of health sector resources in LMICs. Health sector decentralization continues to be promoted for its perceived ability to improve efficiency, relevance and participation in health sector priority setting. Following the 2013 devolution in Kenya, both health service delivery and human resource management were decentralized to county level. Little is known about priority setting practices and outcomes of HRH within decentralized health systems in LMICs. Our study sought to examine if and how the Kenyan devolution has improved health sector priority setting practices and outcomes for HRH.MethodsWe used a mixed methods case study design to examine health sector priority setting practices and outcomes at county level in Kenya. We used three sources of data. First, we reviewed all relevant national and county level policy and guidelines documents relating to HRH management. We then accessed and reviewed county records of HRH recruitment and distribution between 2013 and 2018. We finally conducted eight key informant interviews with various stakeholder involved in HRH priority setting within our study county.ResultsWe found that HRH numbers in the county increased by almost two-fold since devolution. The county had two forms of HRH recruitment: one led by the County Public Services Board as outlined by policy and guidelines and a parallel, politically-driven recruitment done directly by the County Department of Health. Though there were clear guidelines on HRH recruitment, there were no similar guidelines on allocation and distribution of HRH. Since devolution, the county has preferentially staffed higher level hospitals over primary care facilities. Additionally, there has been local county level innovations to address some HRH management challenges, including recruiting doctors and other highly specialized staff on fixed term contract as opposed to permanent basis; and implementation of local incentives to attract and retain HRH to remote areas within the county.ConclusionDevolution has significantly increased county level decision-space for HRH priority setting in Kenya. However, HRH management and accountability challenges still exist at the county level. There is need for interventions to strengthen county level HRH management capacity and accountability mechanisms beyond additional resources allocation. This will boost the realization of the country’s efforts for promoting service delivery equity as a key goal – both for the devolution and the country’s quest towards Universal Health Coverage (UHC).

Effects of Devolution on the Restructuring of the Provincial Administration in Kenya: A Case of Nairobi City County

Devolution in Kenya is about decentralising political, financial and administrative powers to forty seven counties. Kenya had practised devolution through the one year Majimbo government which lasted in 1964, before the highly centralised provincial administration was established. The provincial administration was centralised and gained control over all decentralized ministerial functions in the country; as an extension of the executive office of the president in the field. The Constitution stipulates that the provincial administration be restructured to align with the devolved administrative structure. Little research has been done on the structural frictions that arise from the fact that central governments are keen to retain or recapture the same authority that have been devolved to the lower level governments. Therefore, on this basis this study sought to establish the effects of implementing devolution on the operations of the Provincial Administration. The study was anchored on the objectives of establishing how devolution had shaped the structure of the Provincial Administration in Kenya; examine the extent to which functions of both County and National Government Administrators are interlinked and to identify the challenges faced in the implementation of Schedule Four of the Constitution. Both primary and secondary data were used. The study was guided by the Structural Functionalism theory of Emile Durkheim, which compare the society to an organism comprising of structures that influence each other for its own existence. A case study design was used with Nairobi City County as the study area. A simple random sampling technique was used to select the sample size for the questionnaires from the sample frame. Further the study used purposive sampling technique to select key informants for the interview guide. SSP version 21 and Content analysis were used to analyse the descriptive data. Data was presented in tables, charts and prose form. The study found out that the provincial administration had restructured through change of tittles and administrative units but not functions, there were points of roles interlinkages some of which are not procedurally and devolution was facing challenges such as: - revenue allocation, administrative and bureaucratic culture, organisational capacity and stakeholder mistrusts. The study concluded that duplication of functions by both levels of government still exists and that the aligning of the provincial administration with the schedule four was yet to be fully attained. Devolution advance national unity by recognising diversity and that it promotes participatory and transparent exercise of authority. The study recommends the enactment of legislation on functions to regulate the constitutional functions of the two levels of government and that commission on Revenue allocation to focus on Wards as the point of reverence in budgeting as they happen to be the service delivery vocal point. It further recommends the need for concerted efforts in creation of awareness on matters devolution through a structured civic education program. The fourth schedule needs to be implemented in tandem with the county government act 2012, for separation of functions between the National and County governments. There is need further research on devolution in future and to widen the study by including a bigger samples size, widening its scope and other variables not covered by this study.

Citizen political knowledge and accountability: Survey evidence on devolution in Kenya

AbstractDevolution complicates citizens’ ability to assign responsibility for the provision of public goods and services to different tiers of government. Misattribution of responsibility limits the effectiveness of electoral accountability in the nested principal–agent relationships comprising voters, politicians, and bureaucrats. This raises two important questions. First, how do citizens learn about the functions of different tiers of government under devolution? Second, how do levels of political knowledge condition citizens’ evaluations of subnational governments? Using cross‐sectional and panel survey data from Kenya (2014–2018), this article shows that voters accumulate knowledge through exposure to government services, and that gender and partisanship mediate knowledge accumulation. In addition, exposed citizens are more likely to give positive evaluations of subnational politicians, despite the fact that such exposure may reveal subnational governments’ low capacity, ineffectiveness, and governance gaps. These findings advance our understanding of the dynamics of political accountability under devolution.

Devolution in Kenya: The Good, the Bad and the Ugly

The adoption of devolved system of government in Kenya was a desire of citizens who wanted access to public services closer to them. The objects of devolution as provided for in Articles 174 and 175 of the Constitution about promotion of democracy and accountability in the exercise of power, fostering national unity by recognizing diversity, enhancing people’s self-governance, enabling communities manage their own affairs, protecting and promoting interests and rights of minorities and the marginalized and ensuring equitable sharing of resources. To achieve these, there must be framework put in place and enabling environment provided to all stakeholders involved in implantation of devolution. However, the environment for implementation of devolution has not been smooth due to various challenges experienced for the past five years. Issues like disagreements between the National Government and County government over funding for County functions, poor or absence of consultation on matters that affect County Governments, little technical support for the implementation of functions, insufficient allocations and delayed disbursements of funds to Counties by the National Treasury, lack of capacity and skills to deliver services, corruption, lack public participation, gender inequality are some of the challenges this paper is going to analyze. It is clear that these challenges have affected the implementation of devolution in Kenya. To achieve the goal of devolution there should be a better working relationship between the two levels of government. Parliament, County Governments, the IGRTC, the Ministries, Independent Offices and Commissions, civil society- all should work together in the spirit of Article 6(2) for the good of devolution. DOI : 10.7176/PPAR/9-6-02 Publication date :June 30 th 2019

Healthcare equity analysis: applying the Tanahashi model of health service coverage to community health systems following devolution in Kenya

BackgroundUniversal health coverage (UHC) is growing as a national political priority, within the context of recently devolved decision-making processes in Kenya. Increasingly voices within these discussions are highlighting the need for actions towards UHC to focus on quality of services, as well as improving coverage through expansion of national health insurance fund (NHIF) enrolment. Improving health equity is one of the most frequently described objectives for devolution of health services. Previous studies, however, highlight the complexity and unpredictability of devolution processes, potentially contributing to widening rather than reducing disparities. Our study applied Tanahashi’s equity model (according to availability, accessibility, acceptability, contact with and quality) to review perceived equity of health services by actors across the health system and at community level, following changes to the priority-setting process at sub-national levels post devolution in Kenya.MethodsWe carried out a qualitative study between March 2015 and April 2016, involving 269 key informant and in-depth interviews from different levels of the health system in ten counties and 14 focus group discussions with community members in two of these counties. Qualitative data were analysed using the framework approach.ResultsOur findings reveal that devolution in Kenya has focused on improving the supply side of health services, by expanding the availability, geographic and financial accessibility of health services across many counties. However, there has been limited emphasis and investment in promoting the demand side, including restricted efforts to promote acceptability or use of services. Respondents perceived that the quality of health services has typically been neglected within priority-setting to date.ConclusionsIf Kenya is to achieve universal health coverage for all citizens, then county governments must address all aspects of equity, including quality. Through application of the Tanahashi framework, we find that community health services can play a crucial role towards achieving health equity.

Stakeholders Engagement and Water Provision in Arid and Semi-Arid Lands in Kenya

With the onset of devolution in Kenya, county governments in Arid and Semi Arid Lands (ASAL) which is least developed and with high poverty index in the Country had a chance to correct the situation since devolution provided an opportunity for enhanced community participation,planning and ownership of projects. The purpose of this study was to establish the influence of stakeholders’ engagement on water provision in Arid and Semi-Arid Lands in Kenya. The study used positivism research orientation. Cross- sectional survey research design was adopted. The target population entailed the 113 sub-counties in ASAL where a sample of 89 sub-counties was targeted. Questionnaire was used in collecting primary data. Secondary data collection was done via desk study. Data collected was first checked on the level of response before actual data analysis was undertaken using IBM SPSS version 24, Microsoft Excel and MS Word. Content analysis was adopted in analysing qualitative data while quantitative data analysis entailed computing descriptive statistics (frequency, percentage, mean, standard deviation); and inferential statistics (correlation analysis, analysis of variance and regression analysis). Stakeholders’ engagement was found to have significantly effect on provision of water services. All the parameters of water provision were found to have improved as a result of stakeholders’ engagement.

Applying an intersectionality lens to examine health for vulnerable individuals following devolution in Kenya

BackgroundPower imbalances are a key driver of avoidable, unfair and unjust differences in health. Devolution shifts the balance of power in health systems. Intersectionality approaches can provide a ‘lens’ for analysing how power relations contribute to complex and multiple forms of health advantage and disadvantage. These approaches have not to date been widely used to analyse health systems reforms. While the stated objectives of devolution often include improved equity, efficiency and community participation, past evidence demonstrates that that there is a need to create space and capacity for people to transform existing power relations these within specific contexts.MethodsWe carried out a qualitative study between March 2015 and April 2016, involving 269 key informant and in-depth interviews from across the health system in ten counties, 14 focus group discussions with community members in two of these counties and photovoice participatory research with nine young people. We adopted an intersectionality lens to reveal how power relations intersect to produce vulnerabilities for specific groups in specific contexts, and to identify examples of the tacit knowledge about these vulnerabilities held by priority-setting stakeholders, in the wake of the introduction of devolution reforms in Kenya.ResultsOur study identified a range of ways in which longstanding social forces and discriminations limit the power and agency individuals can exercise, but are mediated by their unique circumstances at a given point in their life. These are the social determinants of health, influencing an individual’s exposure to risk of ill health from their living environment, their work, or their social context, including social norms relating to their gender, age, geographical residence or socio-economic status. While a range of policy measures have been introduced to encourage participation by typically ‘unheard voices’, devolution processes have yet to adequately challenge the social norms, and intersecting power relations which contribute to discrimination and marginalisation.ConclusionsIf key actors in devolved decision-making structures are to ensure progress towards universal health coverage, there is need for intersectoral policy action to address social determinants, promote equity and identify ways to challenge and shift power imbalances in priority-setting processes.

Assessing Kenya's Cooperative Model of Devolution: A Situation-Specific Analysis

Kenya's form of quasi-federalism termed devolution was introduced under the Constitution of Kenya (2010) (‘ 2010 Constitution’). This governance system establishes 47 county governments which are constitutionally independent sub-national units with direct election of county level leaders. Given the complexity of devolution's relationship to national politics, as well as the broad variation in how devolution has unfolded in the 47 counties since 2013, this article argues in favour of a situation-specific assessment of devolution in Kenya. This analysis departs from the emerging scholarly consensus of devolution in Kenya represented in two predominant approaches. One approach contends that devolution in Kenya has simply devolved corruption and patronage from the national to the county level. Another approach argues that devolution has so far been relatively successful because it has introduced a new political system at the county level that has a robust system of checks and balances but that has empowered a new dynamic in Kenya's politics at the sub-national level. This article argues the first approach paints the emerging devolution experience with a broad brush that is not reflected in every county or even on every issue. This article has more in common with the second view. However, we argue for a more situation-specific, case by case analysis of devolution to show variations in how devolution has or has not facilitated the delivery of services and opportunities that were prior to 2013 likely to be unavailable particularly in the most economically disadvantaged counties.

\u201cSometimes it is difficult for us to stand up and change this\u201d: an analysis of power within priority-setting for health following devolution in Kenya

BackgroundPractices of power lie at the heart of policy processes. In both devolution and priority-setting, actors seek to exert power through influence and control over material, human, intellectual and financial resources. Priority-setting arises as a consequence of the needs and demand exceeding the resources available, requiring some means of choosing between competing demands. This paper examines the use of power within priority-setting processes for healthcare resources at sub-national level, following devolution in Kenya.MethodsWe interviewed 14 national level key informants and 255 purposively selected respondents from across the health system in ten counties. These qualitative data were supplemented by 14 focus group discussions (FGD) involving 146 community members in two counties. We conducted a power analysis using Gaventa’s power cube and Veneklasen’s expressions of power to interpret our findings.ResultsWe found Kenya’s transition towards devolution is transforming the former centralised balance of power, leading to greater ability for influence at the county level, reduced power at national and sub-county (district) levels, and limited change at community level. Within these changing power structures, politicians are felt to play a greater role in priority-setting for health. The interfaces and tensions between politicians, health service providers and the community has at times been felt to undermine health related technical priorities. Underlying social structures and discriminatory practices generally continue unchanged, leading to the continued exclusion of the most vulnerable from priority-setting processes.ConclusionsPower analysis of priority-setting at county level after devolution in Kenya highlights the need for stronger institutional structures, processes and norms to reduce the power imbalances between decision-making actors and to enable community participation.