A new study has revealed that counties do not directly fund family planning programmes.
The survey by DSW Kenya found that despite millions of shillings being spent on family planning services, the counties under study were not expending the money directly.
Only an average of 4.7 per cent of the health budget in the financial year 2017/2018 was allocated for provision of family planning in the 11 counties sampled.
Collins Baswony, a senior communication officer with DSW, however noted that the counties sampled had showed willingness to put money directly into the programme.
“The study realised that counties are actually spending more on family planningwithout even directly budgeting for it and counties are working to ensure that in the upcoming budgets family planningprogrammes will be funded directly,” said Mr Baswony.
He pointed out that the study looked at some non-monetary input like time by health staff to come up with the figures.
“From the 11 counties under this study, it was evident from the discussions with the respondents (Chief Officer for Health, The Director, Reproductive Health Coordinator and other staff who were involved in budgeting) that there is no dedicated line item for family planning. This indicates that it is difficult to establish how much countiesare spending on family planning from the budgets allocated,” said the officer.
Five out of the 11 counties sampled had more than five per cent of the health budget set aside for family planning. These are Bungoma, Trans Nzoia, Meru, Uasin Gishu and Nyandarua counties. While West Pokot and Laikipia had set aside 3.3 per cent of the budget for contraceptives. Other counties under study were Kilifi, Nandi, Mombasa and Nakuru.
However, all the counties had recorded increased spending on family planningservices from the previous financial year.
Meru County had the highest amount set aside for these services at Sh184 million followed by Nakuru while West Pokot had the least allocation.
Nandi County is seeking to increase funding for family planning services by involving the youth in the County Budget and Economic Forum (CBEF) which decides on which areas to be funded in a financial year.
“Previously, there was no public participation in financing of public servicesbut with the current Constitution the people must be consulted in the budget-making process,” says Felix Kimutai, 29, a member of the Nandi CBEF.
Youth friendly centres
In West Pokot County, the two chief officers in the health and sanitation department – Ednah Krop and Ibrahim Longolomoi - admitted that lack of resources was a major challenge in achieving the reproductive health goals.
Ms Krop, the chief officer for sanitation, says that the county has been working closely with a number of youth programmes and there were plans to have youth-friendly centres though the noble initiatives are yet to be captured in the current financial year.
“The limiting factor has been resources but we are reaching out to partners to chip in and bridge the gap to help us meet our objectives and aspirations,” she said.
The county has allocated Sh1 million to the reproductive health department but it does not have a direct line budget for familyplanning services. “We are not able to actually manage the entire budget that we had proposed because the county gave us a budget ceiling,” says Mr Longolomoi, the chief officer health.
West Pokot has the lowest uptake for familyplanning services in Kenya, with only one out of four women of reproductive age using contraceptives.
Counties are seeking to end reliance on donor funding to run family planningservices. Trans Nzoia has witnessed an increase in funding for the services, with an estimated Sh136 million up from a Sh128 million the previous year. But all this has been indirect.
Kevin Kocheli, who works with the youth in family planning drive, says that the countygovernment is now spending more on reproductive health even as it seeks to fund the programme directly.
Kocheli, who sits in Trans Nzoia’s CBEF, said the County Integrated Development Plan wants youth-friendly set-up for servicesin each sub county, as is happening in Nandi. “Counties are grappling with the budget-making process and as long as young people are not in these spaces then they will not be considered,” he said.