Decentralisation in Kenya (2)
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Source: DECENTR-L@MAIL.MSH.ORG
I agree that Human Resources and Financial Management are the two major
components in operationalising decentralisation in a centralised health
service system such as the one in Kenya. Our systems are quite similar with
only one small but important difference. Public hospitals in Thailand have
been able to charge patients and retain the fees for improving their
services at least for the last 30 years. This has helped to increase the
potential of hospitals in the rural area, both at the district and
provincial levels. There are 76 provinces and around 800 districts in
Thailand with one hospital, big or small, in almost each of them.
We are doing studies in order to develop a system for more decentralised
budget management and hopefully will move on to more decentralised Human
Resource management in public hospitals in the near future. The expected
outcome is that public hospitals will be in a better position to effect
changes in health status in their own localities along with other health
facilities in the localities.
Somsak Chunahras
Health Systems Research Institute
Thailand
mailto:somsak@HSRINT.HSRI.OR.TH
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