Crisis and resilience at the frontline: Coping strategies of Kenyan primary health care managers in a context of devolution and uncertainty

October 2016
Mary Nyikuri, Edwine Barasa, Sassy Molyneux, Benjamin Tsofa

Primary health care (PHC) plays a vital role in maintaining population health, preventing suffering and providing coverage of essential services.

In Kenya, primary health centres and dispensaries are often managed by the most senior clinical staff member at the facility who is responsible for performing both clinical and managerial duties. PHC managers, also known as in-charges, play a key role in the functioning of health services on a day-to-day basis. 

KEMRI-Wellcome Trust has conducted research in one of the 47 counties
in Kenya to better understand the role and responsibilities of PHC managers and their coping strategies within the context of devolution and uncertainty. The key findings from the research are set out in this brief, as well as recommendations to support PHC managers. 

Research findings

  • PHC managers carry out a variety of tasks to ensure facilities can function effectively. These include: developing annual workplans, ensuring coverage and delivery of services, providing leadership and management to frontline staff. 
  • Despite the challenges faced by PHC managers in the period since devolution, facilities remained open and functioning. A key support system for in-charges was the sub-county managers, some of whom had played the role of line managers to in- charges for decades. 
Governance Devolution Kenya