Kenya Medical Training College

Department of Health Systems Management

Health Systems Management Post Basic Module

Assignment Form

Name: RONALD LOSIKE LOUSE

College Number: HND/PSYCH/23003/034

Program: Psychiatric/mental health

Department: nursing

Campus: Mathare

Mobile phone: +25743943781

Email: ronaldlosike9@gmail.com

Date of submission: 18th October, 2022

Unit: Foundations of Health Systems

Assignment: Describe the pillars of a functional Health System-Kenyan context

For tutor’s use

Pass/Re-submission/Fail………………...........

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Examiner……………………...Signature……………... Date returned..............................

 ASSIGNMENT: UNIT ONE

1. Describe the pillars of a health system.

 Service delivery; Good service delivery comprises quality, access, safety and
coverage. A strong, well-functioning and sustainable health system – capable of
efficiently delivering and managing health care services – is vital to improving
the health status of a country. Healthcare systems in Kenya are constrained by
shortage and poor distribution of healthcare workers. Accessing quality health
services is especially difficult for women and youth.

 Heath workforce; A well-performing workforce consists of human resources

management, skills and policies. The World Health Organization has
characterized Kenya as facing an acute shortage of health workers. Universities
and training facilities are only producing 40 percent of the needed health
workforce, and poor distribution and retention is a serious concern particularly
in rural areas where the need is greatest.

 Health information; A well performing system ensures the production, analysis,

dissemination and use of timely and reliable information. Kenya still has
fragmented digital health systems that are not aligned with national standards.
Integrated health systems are critical to determining the health status of
Kenyans and informing policies and programs, Reporting rates in the District
Health Information System are currently high but lack completeness and
accuracy. The government is also working to strengthen the Community Health
Information System, improve reporting rates, and integrate it into the district
health information system. This will enable the Government of Kenya and all
other key stakeholders to access complete and accurate health information for
community based programs including reproductive health and family planning,
maternal and child health, nutrition, and HIV/AIDS.

Medical products, Vaccines and technologies; Procurement and supply programs

need to ensure equitable access, assured quality and cost-effective use. The Kenyan
Government has prioritized efforts to strengthen management of medical products
and technologies, with emphasis being placed on ensuring these commodities are
accessible and affordable, meet defined standards for quality, efficacy and safety,
and are appropriately utilized.
 New technologies are critical for both demand- and supply-side efforts to improve
health and well-being through stronger healthcare system. The rapid pace of change
in information and communication technologies has opened up exciting possibilities
for self-care and for the engagement of people and communities, developing
resources that people can draw on as part of their self-care efforts. A number of
efforts are under way to develop mHealth and eHealth platforms that expand the
reach of health services and support self-care (e.g. by making information available
when needed or by providing reminders for appointments or medications).
Information and communications technologies are also powerful tools for improving
the functioning of healthcare systems, such as by strengthening health management
information systems. Advances in information systems should be fully leveraged to
support and optimize the functionality of shared electronic health records, linking
them to other health facilities and services and supporting two-way referrals along
clinical pathways. Use of remote consultation services or telemedicine can be used
to improve information flows between patients and health workers as well as better
integrate primary care with referral care. Other technologies, such as artificial
intelligence and drones, are also being actively explored and may offer new avenues
to improve the quality and accessibility of services. As the field is developing,
ongoing research together with proper regulation and legislation, as required, is
needed to manage its potential harmful effects and potential for worsening
inequities. For example, the increase in mental illness in children, and suicide,
associated with the digital revolution is a negative impact that needs to be
managed.

 Health Financing. A good health financing system raises adequate funds for
health, protects people from financial catastrophe, allocates resources, and
purchases goods and services in ways that improve quality, equity, and
efficiency. The high cost of healthcare remains a major barrier to access,
especially for the poor who spend a larger share of their household income to
meet their healthcare needs. Moreover, the transfer of national revenues to
counties may impact health service delivery, as counties may not immediately
be able to optimize use of devolved health resources. A major focus for health
financing is to ensure that existing funds are used efficiently and to reach poor
and underserved populations. The Government of Kenya has developed health
financing policies and strategies, especially for the financing of free primary
health care and maternity services.. The government also continues to
strengthen the National Hospital Insurance Fund, including conducting a cost
analysis for an outpatient primary health care benefit package
 Leadership & Governance; Effective leadership and governance ensures the
existence of strategic policy frameworks, effective oversight and coalition
building, provision of appropriate incentives, and attention to system design,
and accountability. Strengthening the health system is at the core of the
Government of Kenya’s reform agenda. The formulation of foundational health
policies, laws, and guidelines stemming from the 2010 Constitution, is assisting
the Health Ministries transition to devolved county health governance systems.
The transfer of health service delivery to county governments requires new
capacity building and technical support for county-level health leadership.
Approach in leadership and governance is to assist the Government of Kenya to
strengthen governance structures and functions; institutionalize management
and budgeting procedures, create leadership and governance curricula; and
improve access to management training courses to ensure county readiness to
assume new devolved functions and responsibilities.

 Health infrastructure; Adequate resourcing of an appropriate physical

infrastructure is important in ensuring quality healthcare and is a particularly
crucial investment in the early stages of its development and implementation. A
successful shift of services and health workers from hospital-based care to
community settings will require adequate investments. Such investments – and
the resulting facilities equipped with appropriate diagnostic and therapeutic
products and technologies – will also be important to overcome any negative
perceptions about the quality of care provided in these settings, hence
promoting the effectiveness and efficiency of services, for example point-of-care
diagnostics.

Health research and development; Policies, strategies, and operational plans

should be informed by the best available evidence of what works and what does
not; operational research is key to providing this. This includes research on
interventions that support all components of the healthcare, strategies to engage
people in their own care and in service design, self-management of common health
problems, substitution of professionals, and transfer of care responsibilities along
integrated care pathways.
References and Useful Resources
Kenya medical training college, e-learning platform .Health System Management.

World Health Organization (1981). Global strategy for health for all by the year
2000. Geneva World Health Organization 1981 Accessed 14 October 2018.

Constitution of the World Health Organization. Geneva: World Health Organization