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Reversing the trend of weak policy implementation in the Kenyan health sector?--a study of budget allocation and spending of health resources versus set priorities.

GlenngÄrd AH, Maina TM - Health Res Policy Syst (2007)

Bottom Line: Failures to use a significant proportion of available funds, reallocation of funds between line items and weak procurements systems at the local level and delays in disbursement of funds at the central level create gaps between policy objectives and policy implementation.We found no evidence that the trend of weak policy implementation in the Kenyan health sector was reversed during 2005 but ongoing efforts towards hastening release of funds to the districts might help solving the issue of low absorption capacity at the district level.It is important, however, to work with clear definitions of roles and responsibilities and well-functioning communications between different levels of the system.

View Article: PubMed Central - HTML - PubMed

Affiliation: The Swedish Institute for Health Economics, P,O, Box 2127, 220 02 Lund, Sweden. ag@ihe.se

ABSTRACT

Background: Policy implementation in the context of health systems is generally difficult and the Kenyan health sector situation is not an exception. In 2005, a new health sector strategic plan that outlines the vision and the policy direction of the health sector was launched and during the same year the health sector was allocated a substantial budget increment. On basis of these indications of a willingness to improve the health care system among policy makers, the objective of this study was to assess whether there was a change in policy implementation during 2005 in Kenya.

Methodology: Budget allocations and actual expenditures compared to set policy objectives in the Kenyan health sector was studied. Three data sources were used: budget estimates, interviews with key stakeholders in the health sector and government and donor documentation.

Results: Budget allocations and actual expenditures in part go against policy objectives. Failures to use a significant proportion of available funds, reallocation of funds between line items and weak procurements systems at the local level and delays in disbursement of funds at the central level create gaps between policy objectives and policy implementation. Some of the discrepancy seems to be due to a mismatch between responsibilities and capabilities at different levels of the system.

Conclusion: We found no evidence that the trend of weak policy implementation in the Kenyan health sector was reversed during 2005 but ongoing efforts towards hastening release of funds to the districts might help solving the issue of low absorption capacity at the district level. It is important, however, to work with clear definitions of roles and responsibilities and well-functioning communications between different levels of the system.

No MeSH data available.


Allocation of printed health budget 2003/04-2005/06, million KSh. Source: MTEF 2006/07-2008/09 [19].
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Related In: Results  -  Collection

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Figure 1: Allocation of printed health budget 2003/04-2005/06, million KSh. Source: MTEF 2006/07-2008/09 [19].

Mentions: Disaggregated figures covering the year 2005/06 are only available for the printed budgets. The revised budgets that should have been available in February were still not decided in April when the collection of data for this study took place. Actual expenditures will not be available until the financial year is over. Thus, comparison over time based on hard data is only possible using the preliminary budget allocation for 2005/06. In Figure 1 the allocation of printed budgets for different items is illustrated for the financial years 2003/04, 2004/05 and 2005/06. The data is presented in absolute numbers.


Reversing the trend of weak policy implementation in the Kenyan health sector?--a study of budget allocation and spending of health resources versus set priorities.

GlenngÄrd AH, Maina TM - Health Res Policy Syst (2007)

Allocation of printed health budget 2003/04-2005/06, million KSh. Source: MTEF 2006/07-2008/09 [19].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1851957&req=5

Figure 1: Allocation of printed health budget 2003/04-2005/06, million KSh. Source: MTEF 2006/07-2008/09 [19].
Mentions: Disaggregated figures covering the year 2005/06 are only available for the printed budgets. The revised budgets that should have been available in February were still not decided in April when the collection of data for this study took place. Actual expenditures will not be available until the financial year is over. Thus, comparison over time based on hard data is only possible using the preliminary budget allocation for 2005/06. In Figure 1 the allocation of printed budgets for different items is illustrated for the financial years 2003/04, 2004/05 and 2005/06. The data is presented in absolute numbers.

Bottom Line: Failures to use a significant proportion of available funds, reallocation of funds between line items and weak procurements systems at the local level and delays in disbursement of funds at the central level create gaps between policy objectives and policy implementation.We found no evidence that the trend of weak policy implementation in the Kenyan health sector was reversed during 2005 but ongoing efforts towards hastening release of funds to the districts might help solving the issue of low absorption capacity at the district level.It is important, however, to work with clear definitions of roles and responsibilities and well-functioning communications between different levels of the system.

View Article: PubMed Central - HTML - PubMed

Affiliation: The Swedish Institute for Health Economics, P,O, Box 2127, 220 02 Lund, Sweden. ag@ihe.se

ABSTRACT

Background: Policy implementation in the context of health systems is generally difficult and the Kenyan health sector situation is not an exception. In 2005, a new health sector strategic plan that outlines the vision and the policy direction of the health sector was launched and during the same year the health sector was allocated a substantial budget increment. On basis of these indications of a willingness to improve the health care system among policy makers, the objective of this study was to assess whether there was a change in policy implementation during 2005 in Kenya.

Methodology: Budget allocations and actual expenditures compared to set policy objectives in the Kenyan health sector was studied. Three data sources were used: budget estimates, interviews with key stakeholders in the health sector and government and donor documentation.

Results: Budget allocations and actual expenditures in part go against policy objectives. Failures to use a significant proportion of available funds, reallocation of funds between line items and weak procurements systems at the local level and delays in disbursement of funds at the central level create gaps between policy objectives and policy implementation. Some of the discrepancy seems to be due to a mismatch between responsibilities and capabilities at different levels of the system.

Conclusion: We found no evidence that the trend of weak policy implementation in the Kenyan health sector was reversed during 2005 but ongoing efforts towards hastening release of funds to the districts might help solving the issue of low absorption capacity at the district level. It is important, however, to work with clear definitions of roles and responsibilities and well-functioning communications between different levels of the system.

No MeSH data available.