Beyond allocation, we call for utilisation of health funds

In recent years, health budget advocates in Kenya have successfully convinced subnational governments to ensure that a significant proportion of their budget is allocated to the health sector. A review by the Controller of Budget shows that most county governments have maintained their health budget allocation at above 20% of their total county budget. However, advocates have identified that there are still some bottlenecks in the release and proper use of funds intended for health. This is the case for Bungoma County, a subnational government region in Kenya.

Timothy Wekesa, a journalist and member of the Bungoma Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) Network, looks at the utilisation of health budgets. Specifically, he works with media to find out how funds allocated by the Bungoma county government for the ‘RMNCAH programme’ are released and used to ensure that high-quality reproductive, maternal, newborn, child and adolescent health services are available.

In a radio feature on budget expenditure, Timothy has highlights, 

“There is a need for us to monitor the funds allocated and question if they were released on time and how they have been utilised."

How RMNCAH budgets impact on the lives of mothers and babies

In March 2021, the Bungoma RMNCAH Network, with support from the Options E4A-MamaYe project, held a workshop on budget expenditure analysis. Following the workshop, the Networks chairman, Sam Wamalwa, highlighted in a media interview that timely resource utilisation is essential for improving the quality of health services for mothers, babies and adolescents.

Shockingly, a report by the Controller of Budget show that of the 190 million Kenyan shillings (KES) allocated for RMNCAH programme by the County Government of Bungoma in the 2019/20 financial year, only KES 24 million (13%) was received and used. Further analysis has revealed that in the following financial year, 2020/21, there was zero expenditure of the RMNCAH budget in the first half of the year. Notably, the RMNCAH budget in Bungoma dropped from KES 190 million in 2019/20 to only KES 61 million in 2020/21.

In his radio feature, Timothy highlighted that women in the rural parts of Bungoma are concerned that many mothers and babies are dying from preventable causes during pregnancy and childbirth. Bungoma is among the top ten counties with the highest burden of maternal mortality in Kenya. The county lost 30 women due to pregnancy- and childbirth-related complications during the 2019/20 financial year, and 26 women were recorded as having died from similar causes within the first half of the 2020/21 financial year.

  • Bungoma RMNCAH Network member during budget expenditure analysis workshop
  • E4A-MamaYe team member supporting Bungoma RMNCAH Network in a workshop
  • Bungoma RMNCAH Network member facilitating a workshop

Engaging key budget decision-makers

Several members of the County Assembly of Bungoma also voiced their concerns during Timothy's radio programme. Hon. Jane Ingo emphasised that it is important to prioritise the health of women, children and young people in the county budget. Hon. Luke Opwora challenged the Governor to ensure that the funds allocated actually reach the relevant departments, at the right time and in the right quantities, so that the people of Bungoma receive the quality services they need. He also expressed his dissatisfaction in the decline in the RMNCAH budget allocation.

In addition, Hon. Makari George, the chairperson of the County Assembly Health Committee, spoke about funding for health. He mentioned that the Assembly had recently approved a supplementary budget that included an additional KES 590 million for health. Makari recognised RMNCAH as an important health programme and expressed confidence that it would also benefit from additional resources in the remaining period of the 2020/21 financial year.

Advocacy for funds to reach health facilities

Concerns raised by government and media in Bungoma County show that much has been done to increase the budget allocation for health. A next step is to track whether government funds actually reach health facilities – particularly at the primary health care level, where most women and children seek health care services – and, if they do, whether they are utilised in the most effective way to improve the health of women and children, enabling them to lead healthy lives and reach their full potential.


Special recognition to Timothy Wekesa, a journalist based in Bungoma County, Kenya and member of the Bungoma RMNCAH Network for the radio story that contributed to this story.

Written by Susan Sindani, Secretary, Bungoma RMNCAH Network. 

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