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Case Studies

Health system decentralisation in Kenya

Kenya case


This case study focuses on the early stages (2013-2015) of the decentralisation of government functions that occurred after the adoption of Kenya’s 2010 constitution, in particular how these changes affected the local-level health system and service delivery to communities.

The case study is useful for stimulating students’ thinking about:

  • The influence of the broader political system on the health system;
  • The role of time and timing in health system change;
  • The (changing) relationships between actors and the software and hardware of the organisational contexts within which reforms come to life;
  • The sometimes counter-intuitive impacts of reforms; and
  • The impact that changes in one aspect of the broader government or health system can have on other aspects of that same system.

Download the case study