The Citizen Report Card (CRC) survey in Uasin Gishu County, Kenya, was conducted to assess local democracy and health care service delivery. The CRC survey provides a critical platform for citizens to voice their experiences and perspectives on local governance and services, particularly related to health care. This survey allows the local government to learn from citizen feedback and make data-driven improvements.
Survey Process
The survey was conducted across Uasin Gishu County using a stratified random sampling method.
A total of 361 households were interviewed, covering both rural and suburban areas.
The survey included questions about core democratic values—participation, transparency, accountability, and equity—as well as specific questions related to health care services.
Distribution of households interviewed, Photo: Jedidah Kiprop
Demographic Profile of Respondents
- 57% of respondents were women, and 43% were men.
- 63% of respondents reported household incomes below the poverty line, with most working in small businesses or agriculture.
- 49% of respondents were aged 35 or younger, and 46% had completed high school.
- The majority of respondents (63%) lived in rural areas, while 32% lived in suburban areas
Key Findings
1. Participation in Local Democracy
- 56% of respondents reported participating in local decision-making processes, but women and young people (under 35) had less influence compared to men and older respondents.
- 63% of respondents live below the poverty line, and this group, along with suburban residents, faced more challenges in accessing information and participating in decision-making processes.
2. Transparency and Accountability
- 61% of respondents reported that it was easy to access information about local government programs and services, but those living in poverty or suburban areas found it more difficult to access budget and spending details.
- Only 44% of respondents knew how to submit an official complaint to the local government, with women and low-income respondents being less aware of the complaint process.
3. Health Care Services
- Respondents in Uasin Gishu were generally more satisfied with their health care services compared to other counties. The Service Delivery Index showed a mean score of 0.86, indicating high satisfaction levels, particularly with access to cancer care services.
- Respondents suggested further improvements in areas such as increasing awareness of cancer prevention, expanding screening programs, improving health care facilities, and reducing treatment costs.
Enumerators and CHPs in the field administering the household questionnaires (14th-18th August 2023); Photos: Jedidah Kiprop
Key Takeaways and Recommendations
- Improving Participation and Transparency: Efforts should be made to increase awareness about local government programs and the complaint process, especially for women, young people, and those living in poverty.
- Health Care Services: While satisfaction with health care services is high, there is room for improvement in providing affordable and accessible care, particularly cancer treatments. Citizens suggested raising awareness, improving facilities, and ensuring equal access to services for all.
- Addressing Barriers to Democracy: Specific measures should be taken to empower marginalized groups, such as women and the poor, to participate more fully in decision-making and hold the government accountable.
This Citizen Report Card serves as a valuable tool for improving service delivery and ensuring that Uasin Gishu County’s local governance becomes more transparent, equitable, and participatory.
Showcasing Results: Uasin Gishu CRC at the Equitable Health Network Conference in Nairobi
In October 2024, ICLD held an Equitable Health Network Conference held in Nairobi, Kenya, where the results of the Uasin Gishu Citizen Report Card (CRC) survey were shared with attendees. These presentations highlighted the impact of CRCs in strengthening local democracy and improving public services. The photos capture moments from the event, including engaging sessions, the CRC poster presentations, and representatives from partner municipalities and ICLD staff sharing insights with attendees.
