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We are toothless and hanging, but optimistic”

Sub county managers’ experiences of rapid devolution in coastal Kenya

Bibliographic Data

ID15396757
AuthorsMary Nyikuri (0000-0002-3338-7526, Kenya Medical Research Institute, corresponding author), Mary M Nyikuri, Benjamin Tsofa (0000-0003-1000-1771, Kenya Medical Research Institute), Philip Okoth (Kenya Medical Research Institute), Edwine W Barasa, Edwine Barasa (0000-0001-5793-7177, University of Oxford), Sassy Molyneux (0000-0001-9522-416X, University of Oxford)
Year2017
Volume16
Issue1
Pages113-113
Publication date2017-06-26
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal for Equity in Health (JOURNAL)
Journal identifiersISSN: 1475-9276 • E-ISSN: 1475-9276
PublisherBioMed Central (PUBLISHER • GB)
DOI10.1186/s12939-017-0607-x
PMID28911332
OpenAlexW2660186100
LanguageEN
Citations received10
References cited30

Our study illustrates the importance in accelerated devolution contexts for: 1) mid-level managers to adopt new ways of working and engagement with higher and lower levels in the system; 2) clear lines of communication during reforms to these actors and 3) anticipating and managing the effect of change on intangible software issues such as trust and motivation. More broadly, we show the value of examining organisational change from the perspective of key actors within the system, and highlight the importance in times of rapid change of drawing upon and working with those already in the system. These actors have valuable tacit knowledge, but tapping into and building on this knowledge to enable positive response in times of health system shocks requires greater attention to sustained software capacity building within the health system

Accountability · Business · Corporate governance · Devolution (biology · Government (linguistics · Health services research · Political science · Public health · Public relations · Qualitative research · Service (business · Service delivery framework · Social policy · Sociology · Global Maternal and Child Health · Medicine · Nursing · Poverty, Education, and Child Welfare · Public Administration · Public-Private Partnership Projects · Marketing

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Unique citing works10
Citations per year1,25
Citation span2018 - 2025 (8)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 9
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