Govenment Budgetary constrains jolt medical services - kenyadetails

On average, allocations to the health sector have been at about six per cent of the total Government budget in the last five years. This had made the sector  predominantly financed by private sector sources including households’

out-of-pocket spending. 

Available data shows the health sector is running on less than a third of its recommended budget. Though the real figures have been growing year on year, the increment has not matched the pace of the total budget. This means that health sector has not been prioritised at the same level as education and infrastructure.

Data compiled from the economic survey 2013, and budget estimates, reveal that the cut has been stiffest in the last three years where spending decreased from 7.2 per cent in 2010 of the Sh998.8 billion budget, to 6.1per cent in 2011 and falling further to 5.9per cent in the Sh1.5 trillion budget of 2012. The country has fallen much further below the 15per cent Abuja target. This trend is set to be replicated in this new financial year if the government sticks within its budget.  In the current spending plan, the government has set aside Sh34.7 billion for both the curative health programmes as well as the preventive and promotive health care services.

This allocation has already been termed by the new Health Cabinet Secretary James Macharia, as ’inadequate’. This is about 2 per cent of the Sh1.6 trillion budget.

Macharia recently told a meeting with governors that his docket needs Sh160 billion this year. Sh34.7billion allocation represents about 25 per cent, or a quarter, of this requirement.

But the figure is expected to increase slightly given that some health services have been devolved to the counties. However, it is highly unlikely to shoot above 5 per cent of the national budget given the pressing demands facing the newly created devolved governments.

Musyimi report                                                                                       

What is most disturbing with to medics is that the Government seems not keen to implement the Musyimi report that had recommended that treasury allocates Sh 62.87 billion over a period of three years (2012/13-2014/2015). It has already fallen behind schedule because it was to start with Sh20.98 billion for revitalisation of health infrastructure last year. The Government has also ignored stress calls ranging from practitioners in the sector to her development partners.  In the strike last year, doctors wanted the government to implement a health stimulus package amounting to approximately Sh217 billion. Doctors also wanted treasury to increase progressively, at 2 per cent per annum, the budgetary provision to the Ministries of health until we achieve the Abuja Target of 15 per cent.

The perennial underfunding of the  Health docket is also impacting negatively on health service delivery and has made it unlikely that Kenya will achieve MDG targets.

The budget is a crucial indicator of implementation of national policies and it should give a good overview of the policy priorities of a particular sector. Less funding to a sector is therefore an indicator of less priority of a particular on the Government. An analysis by GTZ, a German international agency, on its programmes in Kenya’s health sector on the 2010/11 budget notes that while the government has been reducing the spending on health in relation to the national budget, it has increased its borrowing basket.

For instance, in the year under review, the report notes that Kenya’s appropriation in aid (grants and loans from development partners) for the health budget rose by 130 per cent.

The report also notes that there were ‘significant development partner funds unaccounted for in Appropriation in Aid, resulting in unclear link to health sector priorities.