Table 2.

Main roles and responsibilities for national and sub-national structures for community health planning before and after devolution

	Pre-devolution	Post-devolution
National	Health policy and strategy Quality assurance and standards Training health staff, including CHEWs Coordinating community health partners Budgeting and allocating resources (community health predominantly NGO funded) Recruitment and management of community health workforce (CHEWs)	Health policy; revised community health strategy Quality assurance and standards Capacity building and technical assistance for counties (although unclear communication and training channels) No longer coordinating partners, budgeting or recruiting workforce
Province	Direct link with national Guiding annual planning at district level, including for community health activities Supervision of community health activities	Does not exist
County	Did not exist	Development of CIDP (may/may not include community health) Budgeting and allocating resources (including for community health) Service delivery for public health, disease surveillance, community health services, primary health services, ambulance, county hospital services Recruitment and management of CHEWS Decision on stipend for CHVs Coordinating with partners (including for community health)
District/ sub-county	Annual planning and budgeting, including community health activities in coordination with partners Control of district budget Implementation of public health, disease surveillance, community health services, primary health services, ambulance, district hospital services	Annual planning and budgeting, including community health activities in coordination with partners No longer controlling budgets Implementation of public health, disease surveillance, ambulance, community health services, primary health services, county hospital services
CHEWs and CHVs	Develop annual workplan and budget in collaboration with community health committee and share with health facility in-charge	Develop annual workplan and budget in collaboration with community health committee and share with health facility in-charge CHVs can attend and participate during public participation meetings
Community members	Role for all community members during dialogue days with actions developed Community representation during community health committee, health facility management committee, quarterly district stakeholder meetings	Role for all community members during dialogue days with actions developed Community representation during community health committee, health facility management committee, quarterly district stakeholder meetings Involvement during public participation meetings

Roles that changed after devolution are in italics and unchanged roles are in plain text.