By Peter Orengo – The Standard
I have read with interest, Aghan Daniel’s blog on devolution and health financing in Kenya. Whereas I totally agree with his assertions and arguments, I would like to state that during the presentation of the 2013/14 national budget, President Uhuru allocated the national budget for health at Sh98 billion but Sh64 billion of this is to be devolved to the County governments. There is fear that most of this money may be redirected to other areas like putting up county offices and buying cars for county bosses.
The health budget should also be looked at the bigger picture premised on the Abuja Declaration of April 2001 when African Union countries meeting in Abuja, Nigeria, pledged to increase government funding for health to at least 15%, and urged donor countries to scale up support. Only one African country has reached that target. Overall, 26 have increased the proportion of government expenditures allocated to health and 11 have reduced it since 2001. In the other 9, there is no obvious trend up or down. Current donor spending varies dramatically, from US$ 115 per person in one country, to less than US$ 5 per person in 12 others.
What is more profound is that the allocation for health this year is less than last year and only a third of what Kenya and other African countries pledged to invest on healthcare two decades ago. It also makes 2013 the fourth year in a row that Kenya has cut health spending in a trend sector insiders say is grinding medical facilities to a halt.
In 2010, Kenya spent Sh7.20 for each Sh100 on healthcare. This fell to Sh6.10 in 2011 and last year, it was further cut to Sh5.9. This year, the national and county governments plan to spend Sh5.70 per Sh100 on the sector, translating to 5.7 per cent of the Sh1.6 trillion budget.
If you analyze the budget allocated to health this year, it is the same as saying that the national Government will spend Sh2.50 this year for every Sh100. Yet counties are likely to follow the precedent set by the National Government.
The underfunding is happening at a time when most medical equipment in public health facilities are more than 20 years old, some double their lifespan, and may experience frequent breakdowns.
The issue of funding health is a big one because even the Health Cabinet Secretary, James Macharia, has raised concern over the inadequate funds. Mr Macharia says his docket needs Sh160 billion, but only received Sh34.7billion.