Better healthcare is a key pillar of President Uhuru Kenyatta’s legacy projects, known as the Big 4, as he serves out his second and final term.
More healthcare funding was also a top campaign promise during the 2017 elections, with the ruling Jubilee Party promising to “transform the health services”.
In Kenya’s recent budget speech the national health sector was allocated KSh93.3 billion for the 2019/20 financial year. This is nearly three times that allocated in 2013/14, the first full fiscal year of Kenyatta’s presidency.
Before Kenya’s June 2019 budget speech, Sicily Kariuki, Kenya’s cabinet secretary for health, claimed funding to the sector had increased dramatically.
This, Kariuki said, was a step towards reaching sustainable domestic financing for health at both the national and county levels.
But do the numbers add up?
How were the numbers calculated?
Africa Check contacted the health ministry to get details of the minister’s calculations. We were asked to send an email but have not yet received a response. We will update this report should we get one.
At the start of every budgeting cycle in September, government departments submit their budgets. The most recent submission by the health sector shows that at the national level it is made up of the health ministry and seven “semi-autonomous agencies” or parastatals such as the Kenyatta National Hospital and the National Health Insurance Fund.
Primary healthcare and county health services are managed by the country’s 47 county governments, as set out in the constitution.
Both county and national governments must be included
To evaluate how much has been allocated for health, the budget amounts for both the national and county governments must be considered. This, John Mutua, the programmes coordinator at think-tank Institute of Economic Affairs Kenya, told Africa Check.
“If you want to talk about the health sector budget for the whole country, you have to include the budget allocations set aside for health at the two levels of government,” Mutua said. He has recently written about health financing in Kenya.
What do the numbers show?
|Health sector budget allocations for the two levels of government|
|Financial year||National government
|County governments (KSh billion)||Total (KSh billion)||Percentage year-on-year change in total|
*Numbers rounded off to one decimal point.
But that is just for the national government. At the county level, the budget allocation rose from KSh95.8 billion in 2016/17 to KSh112.9 billion, or 17.8%. (Note: See Africa Check’s calculations of county allocations to healthcare here.)
The change in the total budget allocation for the two financial years is 29.9%, which can be rounded up to 30%. But it isn’t “more than 30%”, as the minister claimed. We therefore rate Kariuki’s claim as mostly correct.
|Kenya health budget still under 15% of African target
Our check of health allocations found this has ranged between 7.9% and 9.7% of the total budget in the last five financial years. “In real terms, the allocation has reduced,” argued Atwoli. This is when the “increased need for health and other economic forces including inflation” is considered.
Kenya’s healthcare budget had not met the provisions of the Abuja Declaration, a 2001 pledge by African countries to allocate at least 15% of their annual budgets toward healthcare, he said.
“When that 15% percentage was arrived at, it was acknowledged that health expenditure affects all sectors of the economy.
“The understanding is that if this 15% is utilised appropriately, it will result in improvements in infrastructure, security, education and governance.
Conclusion: Numbers back minister’s claim about healthcare financing
At a recent international meeting, Kenya’s health cabinet secretary Sicily Kariuki claimed the country’s health budget had increased by “more than 30%” in the last two financial years.
We checked the numbers. When the allocations to the two levels of government are considered, they back up her claim. The increase is 30% though, not “more than 30%”.
We thus rate Kariuki’s claim as mostly correct. But an expert said that as a share of Kenya’s total budget, healthcare financing is still short of the 15% target set by African countries known as the Abuja Declaration.
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