Spotlight on a health budget advocate - Joyce Ng'ang'a

Joyce Ng’ang’a is a Policy and Advocacy Program Officer at WACI Health - An African region advocacy organization based in Nairobi. Read her story.

In 2015/16 she provided technical support to the African Women Leaders Network for Reproductive Health and Family Planning to successfully advocate for the inclusion of a budget line for family planning in Nyeri County, Kenya.

What was your strategy and who did you engage with?

2 original objectives: 1) break policy barriers to accessing family planning; 2) increase budget allocation towards family planning commodities. But after analysis of the budget, we noticed there was no budget line to family planning, so this became the priority.

Together with my colleagues in the African Women Leaders Network we found that one of the reasons there was no FP budget line is because the county prepared its budget based on a template shared by the national level, and the template did not include this.

We advocated to the national level – The Treasury and the Ministry of Finance – to include a family planning budget line in the county budget template. Within a few months, the revised template was circulated to all counties, including the Chief Officer for Health in Nyeri.

The next stage was ensuring allocation for FP in the county budget. We engaged community members and the County Health Management Team to participate in the budget development process to ensure the allocation to FP was met.

We brought on board the Office of the County First Lady to own the process and be a champion of family planning. The County First Lady chaired the newly formed Nyeri county Technical Working Group to implement the 10 year costed reproductive health and family planning strategy.

What was the result?

1) A 10 year costed reproductive health and family planning strategy – the Nyeri County Reproductive Health and Family Planning Strategy 2015-2025.

2) A budget line for family planning is now incorporated into the county budget template.

Why was this campaign successful?

Political will – the leaders in Nyeri were very receptive. Nyeri county is the only county in Kenya that has a public participation act, so we were free to engage with citizens.Nyeri county indicators for family planning were already good so they were happy to share and publicise this.

At what point did you realise that your campaign was being heard?

In the beginning the county leaders did not see the reason to focus on FP as they were making good progress. But we wanted to ensure that they sustained these gains and shared their example with poorly performing neighbouring counties for cross-learning. Celebrating their success and sharing their learning was the key.

Who was your greatest ally?

Nyeri County Health Management Team, particularly the CEC Health, Chief Officer and the Director of Health Services. Also the Nyeri county First Lady.

What did you learn that you might apply next time?

County governments can use their own resources (e.g. individual technical expertise, meeting rooms, office space and means to mobilise citizens) to lead and own these campaigns.

 What do enjoy most about your role as a budget advocate?

It’s fulfilling to see the results and impact of our work – finding domestic solutions to challenges in our own country.

What is your least favourite part of your work?

Advocacy is part of a long-term process – you need to be patient for change.

What skills are most important for a budget advocate?

Need to be dynamic, flexible, tactful and patient.

Top tip for working with the media?

The media can be very supportive. Make them part of the process all the way and keep them involved to maintain interest. Work with key figures (e.g. the First Lady) that the media are interested to meet.

What advice would you give to a young health budget advocate?

Build skills in advocacy, be patient and do not expect immediate results. Make sure you have evidence to support your campaign otherwise it definitely won’t work.

Activist or influencer?

Influencer.

Acknowledgments:

Thank you to Department of health - Nyeri County Government, African Women Leaders Network (AWLN) members, African Women’s Development Fund (AWDF), AFP and Jhpiego, 

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