Kisumu County’s health system struggled with understaffed facilities, chronic medicine shortages, and crumbling infrastructure. Clinics lacked even basic security, while overburdened health workers grew demotivated. With no formal way for patients to give feedback, distrust grew, frustrated residents avoided clinics, worsening health outcomes and straining the system further. At St. Marks Lela Dispensary, monthly outpatient visits went as low as 100.
To address these challenges, the County introduced participatory accountability through Community Scorecards (CSC). The process for implementation and adoption:
- Training Community Health Committees (CHCs) to lead feedback sessions.
- Community dialogue meetings where residents, health workers, and officials discussed problems collaboratively.
- Scoring sessions where communities rated services (e.g., drug availability, wait times).
- Joint action planning to implement changes, like introducing a Service Charter and deploying Community Health Promoters (CHPs) to streamline triage.
The Impact
- Outpatient visits surged from 100 to 450 per month, including more Antenatal Care (ANC) patients.
- Health workers now actively engage in community dialogues, listening to concerns and co-creating solutions.
- Quarterly scorecard sessions ensure accountability while support groups sustain long-term change.
What initiative has your County taken to support and encourage community feedback in the health sector?
Visit https://maarifa.cog.go.ke/ to learn more about the successful initiatives on service delivery our Counties are undertaking.