To what extent are counties prioritizing health in terms of expenditure?


Post Date: 03 August 2018   |   Category: Health   |   Hits: 249


Provision of health services is among the key devolved functions under the fourth schedule of the Constitution of Kenya 2010. Specific health services provided by the counties include: county health facilities and pharmacies; ambulance services; promotion of primary health care; licensing and control of undertakings that sell food to the public; veterinary services (excluding regulation of the profession); cemeteries, funeral parlours and crematoria; and refuse removal, refuse dumps and solid waste disposal.  

The objective of devolving the health services was informed by the need to enhance the participation of the people in the exercise of the powers of the state and in making decisions affecting them and to protect and promote the interests and rights of minorities and marginalized communities.  

Hence, the county governments ought to have reliable sources of revenue to enable them to govern and deliver health services effectively. To enhance attainment of this objective, the constitution makes the provision that for every financial year, the equitable share of the revenue raised nationally that is allocated to county governments shall be not less than fifteen per cent of all revenue collected by the national government. There is also established an Equalization Fund only to provide basic services including water, roads, health facilities and electricity to marginalized areas.

In 2017/18, the total transfers to county governments, inclusive of conditional grants, amounted to KSh 345.7 billion. In this Number of the week, we seek to find out the share of actual spending for health to gauge the prioritization.

Share allocation of expenditure in the counties

Source: Economic Survey 2018

Number of the Week: 24% the share of the expenditure on health services

  • The consolidated expenditure for all the counties in 2017/18 is projected to amount to Ksh 396 billion, representing Ksh 8,610 on per capita basis.   
  • Out of the total expenditure, compensation of employees is estimated Ksh 149 billion, equivalent to 37.6% of the total expenditure.
  • On the other hand, the largest share of the expenditure is on General Public Services which accounts for Ksh 141 billion, approximately 36% of the total projected spending in 2017/18.
  • Health services is second in the priority areas by the county government with a projected expenditure of Ksh 96 billion, about 24% of the total expenditure.

The high share allocated for health services imply that health is among the pressing needs in the counties.