In an article published in the Star newspaper, UN Resident Coordinator to Kenya Siddharth Chatterjee argues that while Kenya’s health financing is progressing gradually, only about 4% of the national budget is going towards healthcare.
In April 2001, heads of state of African Union countries met and pledged to set a target of allocating at least 15% of their annual budget to improve the health sector, which became a component of the Abuja Declaration of 2001.
Kenya, Chatterjee adds, is falling short of this goal, and additionally the country is being outperformed by some of its neighbours in the national budget allocation to health sector. In fiscal year 2014/15, Uganda allocated eight per cent of its national budget to the health sector compared to Kenya’s four percent.
Kenya is outperformed by some of its neighbours in the national budget allocation to health sector. In fiscal year 2014/15, Uganda allocated eight per cent of its national budget to the health sector compared to Kenya’s four per cent — UN Resident Coordinator Siddarth Chatterjee
The Government is the largest of the three main medical service providers operating in Kenya, the other two being the Commercial Private Sector and Faith Based Organisations (FBOs).
Therefore, the need for quality healthcare raises the question of government spending on the health sector.
So the question is, how much of Kenya’s total budget is going towards financing healthcare?
PesaCheck has researched the claim by UN Resident Coordinator Siddarth Chatterjee and finds the claim that Kenya is spending 4% of its total budget on the health sector to be FALSE for the following reasons:
Kenya’s allocation to the health sector has been increasing every fiscal year, rising for instance from about Sh5.2 billion in 2001/02 to Sh34.4 billion in 2008/09.
In the current fiscal year, Kenya allocated around Sh60.9 billion for healthcare services, compared to Sh60.3 billion in 2016/17. This is projected to increase in the medium term to Sh61.9 billion and Sh62.7 billion for 2018/19 and 2019/20, respectively.
The New Constitution devolved health services to the 47 counties leaving the national government with the function of policy, research and regulation of the sector. Additionally, the national government is responsible for Level Six hospitals, which are mainly referral facilities — the National Spinal Injury Hospital in Nairobi, Eldoret’s Moi Teaching and Referral Hospital and the Kenyatta National Hospital. The counties are responsible for facilities classified between level 1 and level 5.
Allocations to the Ministry of Health and related Ministries, Departments and Agencies (MDAs) stood at KSh41.70 billion in 2013/14, KSh54.10 billion in 2014/15, KSh61.70 billlion in 2015/16, and KSh73.60 billion in 2016/17. The allocation for the current financial year 2017/18 of KSh61.64 billion is from the 2017/18 budget estimates.
Given the fact that the national government also finances healthcare provision in the counties through conditional grants, we have to compare the total expenditure by the 47 county governments on health as a percentage of their consolidated budgets.
The health sector budget figures for the financial years 2013/14, 2014/15, 2015/16 and 2016/17 are from the recommendations on revenue sharing between the national and the county governments by the Commission on Revenue Allocation for the financial year 2015/16, 2016/17 and 2017/18. The total consolidated budget figures for the 47 county governments are from the annual Controller of Budget reports for the financial years 2013/14, 2014/15 and 2015/16, and the third quarter report for the FY 2016/17 .
We decided to go with expenditure rather than allocations for the counties because the horizontal sharing of revenue among the counties is not done at the sector level, and CRA has the records of total expenditure but not allocations for the health sector from the 47 counties only.
The combined budget for health by the national and the county governments as a percentage of their combined total budgets is as follows. 
The table above shows that Kenya is spending an average of 7.1% of its budget on the health sector as a total of the allocations made by the national and the county governments. This expenditure is up as compared to the financial years between 2009/10 to 2012/13. Still, this falls short of the expenditure recommended by the Abuja declaration at 15%.
Mr Chatterjee’s claim significantly understates the health allocation and spending in Kenya, as it uses only the budget from the national government allocated to the Ministry of Health (MoH) budget, leaving out the county government’s’ allocation and expenditure on health. The total allocation comes to an average of 7% for the 2014/15 financial year, not 4% as claimed.
By: George Githinji; Researcher | Devolution | Public Finance | Blogger | PesaCheck Fellow
Source: PesaCheck
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