what might be required for inspections to be considered fair?; comment on “what lies behind successful regulation? a qualitative evaluation of pilot implementation of kenya’s health facility inspection reforms”

Tama et al offer us an interesting analysis of a piloted regulatory reform that introduced a joint health inspections (jhis) system in three kenyan counties. the study highlights key factors facilitating or hindering the implementation of the reform. in this commentary we reflect on the concept of fairness, which is one of the topics that is discussed in the study. we describe four important dimensions of fairness in the context of inspections: expectation clarity, consistency of assessment, consistency of enforcement, and fairness to patients. we argue that all four dimensions are important in the regulatory design, in order for the inspection to be perceived as fair.