Why Kenya’s Health Governance Needs Values-Based Accountability, Not Just More Data

Abstract

University Health coverage (UHC) is a national agenda which has been strengthened by an investment in digital health infrastructure (1, 2). The emergence of new systems such as Digital Health Superhighway and Electronic Community Health Information System (eCHIS) could be considered a breakthrough in data generation. As a matter of fact, this information expansion is invaluable in the workings of health systems. Yet, the dire situation which is experienced by the health sector is not dearth of data but lack of governance on effective and efficient use of data (3, 16). It is evidenced that the availability of information alone does not guarantee its impact in terms of the allocation of resources or policy choices (4, 5). The devolved Kenya health system is often encumbered by disconnect between technical evidence and political action. For instance, despite the enhanced data flows, health results and equity measure continue to be uneven in counties (6, 17). Studies and reports by oversight institutions have identified persistent challenges like drug stock outs, mismatched budgets and gaps in the service delivery. It is important to note that these issues do not embody the root cause, but instead, evidence-based results are often substituted by objectives of political and bureaucratic actors (7). Information is regularly gathered, then gets filtered out and discarded, repressed or compromised by higher priority political or financial objectives (18).