Kenya Counties Adopt New Budgeting Approach, Commit US$2 Million to HIV
November 22, 2016
NAIROBI—Twelve counties in Kenya have adopted a new budgeting approach and increased their health sector allocations, following training and support in program-based budgeting (PBB). By implementing PBB, an approach that ties funds to priority health areas, the 12 counties increased their collective health sector allocations by Kshs 1.2 billion (approximately US$12 million) from the previous fiscal year (FY) 2015/16 budget. Each of the counties also included HIV as a distinct sub-program in their annual budgets, collectively allocating Kshs 186 million (approximately US$2 million) to HIV for FY 2016/17. In the previous year, only four of the 12 counties included HIV programs in their budgets.
The USAID- and PEPFAR-funded Health Policy Project, in collaboration with the Kenya School of Government, the Kenya Ministry of Health, the National Treasury, and Nathan Associates provided the PBB training to the 12 counties. The Health Policy Project and its successor, Health Policy Plus (HP+), followed up the training with hands-on mentoring and coaching and a template to standardize the budgeting process and help counties link their budgets to health outcomes.
Program-based budgeting differs from traditional line-item budgets, which provide little information about how money is spent and do not, necessarily, differentiate between spending on program versus administrative costs. PBB seeks to improve how expenditures are prioritized in order to allocate adequate resources to programs that will be of the greatest benefit to the community and encourages efficiency and effectiveness of service delivery by changing the focus of public spending from inputs to outputs and outcomes.
Kenya’s county governments are required by law to prepare PBB annual budgets, following efforts by the national government to link the annual budgeting process with various sectors’ annual workplans. To help counties meet this requirement, HP+ is extending the PBB training to 14 additional counties. Most recently, HP+ trained about 350 members of county health management teams in budgeting and how to identify key program performance indicators that can be linked to their annual budget.
HP+ will continue mentoring all 26 counties in PBB and generating evidence to inform resource allocation. HP+ will also support three select counties (Turkana, Isiolo, and Mombasa) to define roadmaps to address health financing and resource allocation issues and to improve healthcare access and equity.