Sustainable Healthcare System Devolution Strategy Selection Using the AROMAN MCDM Approach

The social pillar strategy has various components, including education, science and technology, and health. Health care in Kenya is now a devolved function under county governments. This study aims to establish the challenges facing the implementation of the social pillar strategy of the Kenya Vision 2030 in the devolved health sector in Kisumu County. In addition, the study aims to determine the strategies being put in place to address these challenges. The data used in this study are obtained by consulting experts in the considered field. The experts use a one-to-seven-point scale to determine criteria weights, while the Alternative Ranking Order Method Accounting for Two-Step Normalization (AROMAN) is applied to rank the strategies. While the most critical issues are insufficient human resources for health, deteriorated health infrastructure, and shortage of pharmaceuticals and non-pharmaceuticals, the alternatives to consider are increasing investment in information communication technology (ICT), developing leadership through continuous learning, and enhancing investments in human resources and health infrastructure. To test the stability of the AROMAN method, the authors conduct a sensitivity analysis. This research not only identifies and explains the challenges associated with the establishment of sustainable healthcare devolution in Kisumu County but also significantly contributes to the body of knowledge by outlining and prioritizing the strategies required to address these challenges.