As with all other sectors, the health sector in Kenya continues to grapple with various challenges occasioned by devolution and the shift of service provision responsibility from the national level to the county levels.
This is a book chapter taken from Sustainable Sanitation For All: Experiences, Challenges and Innovations.
This chapter is a case study of the certification processes related to establishing the open defecation free (ODF) status of communities. It identifies the key indicators for appraising ODF status as set out in the ‘Protocol for Implementing CLTS in Kenya’.
It traces and assesses the changes in certification processes as Kenya has moved to a devolved system of governance – processes that seek to achieve standardization and improve efficiency and cost-effectiveness while maintaining independence and objectivity. In particular, it analyses the strengths and challenges involved in implementing a decentralized and diversified third-party system of certification.