- Transparency in the procurement systems should be enhanced to contain allegations of corruption.
- Adherence to The Public Procurement and Asset Disposal Act, 2015 should be a sufficient and necessary condition in any procurement process.
Image: HANDOUT
World Health Organization affirms that leadership and governance are associated with the role of the government in health and its relation to other actors whose activities have an impact on health; this involves providing stewardship of the entire health system in order to secure the public interest.
Leadership and Governance at all echelons of the healthcare system are foundations for superior system performance and better health outcomes.
Citizens experience high-quality, inclusive, accountable, effective and responsive healthcare services when leadership and governance structures function optimally.
The absence of good leadership and resilient governance structures predisposes chaos in the health system.
Poor leadership and governance practices often lead to abuse of health system inputs including health workforce, health products and technologies, financial resources, infrastructure, among others impacting negatively on the quality of health services.
Ineffective leadership and governance structures in the healthcare sector in most low- to middle-income countries have remained a major challenge.
It often leads to the failure of health systems. However, leadership and governance challenges confronted by the health sector are not exceptional.
All sectors are enduring major shifts due to emerging leadership and governance dynamics.
WHO framework describes health systems in terms of six core components: service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership & governance.
Leadership and governance in healthcare is the most complex but critical building block of any health system. It is a cross-cutting component and provides the basis for the overall policy and regulation of all the other health system blocks.
The sector often experiences political interference impacting negatively on the ability of management to execute their responsibilities effectively.
This often leads to poor leadership including abuse of power, improper conduct, lethargy among public officers and resultant poor service delivery.
The head of the public service has unequivocally pronounced himself to chairmen and accounting officers of public institutions in regard to ‘instructions from above’.
He has sounded the warning bells and all public officers advised that they will be personally held responsible. This advice, if augmented by goodwill from the political class, will go further to ensure that transparency and accountability are observed.
Leadership and governance of the health system require an all-inclusive, well-thought-out policy direction that recognizes and assigns roles to all major players.
Government alone may not ensure the achievement of desired health outcomes. Leadership and governance thus entail a participatory and integrated approach by all actors among them and most significant being the health workforce.
Most developing countries have experienced strikes due to inadequate health workers force across all the cadres in healthcare calling for strengthened labour relations and leadership capacity both at the national and county government levels.
It is imperative that leadership competencies in the health sector are strengthened to enable the principal actors to manage and lead better for improved health outcomes. This calls for intergovernmental and inter-sectoral partnerships and collaboration.
Adaptive good management policies, systems, procedures and leadership practices are persuasive imperatives of change without which chaos often mars health sector institutions including semi-autonomous government institutions.
Transparency in the procurement systems should be enhanced to contain allegations of corruption. Adherence to The Public Procurement and Asset Disposal Act, 2015 should be a sufficient and necessary condition in any procurement process.
Government actors in the sector should embrace risk management and ensure strong internal audit practices to evaluate internal controls. Oversight bodies should play their role of ensuring compliance without patronizing and interfering with the sector institutions.
Improved leadership and governance in the health sector can be achieved through harnessing the data revolution and broad digitalization with resultant improved transparency and accountability.
Allegations of corruption in the sector can partly be attributed to inadequate digitization.
The Cabinet Secretary for Health in Kenya has been showing leadership in this area by instructing key state corporations under the Ministry of Health to embrace digitization through robust enterprise resource planning (ERP) systems.
Strengthening health leadership is a system-wide transformation that requires intervention at individual, stakeholder and system levels.
It requires radical and a transformative change management program. Leadership and governance involve ensuring strategic policy frameworks exist that are augmented by effective oversight, partnerships, regulation, system design, transparency and accountability.
Eliud Muriithi is the Director Commercial Services, KEMSA