PRB

Kenya’s devolved system of governance creates both opportunities and challenges for county-level program planners and advocates trying to sustain and expand budget commitments for family planning and reproductive, maternal, newborn, child, and adolescent health (RMNCAH). Local decisionmakers must be convinced of the benefits of funding these services, and communities must be engaged to demand accountability. The Policy, Advocacy, and Communication Enhanced for Population and Reproductive Health (PACE) Project in Kenya, supported by the U.S. Agency for International Development (USAID), has developed an approach to increasing budget commitments in several Kenyan counties. Working in counties with poor health indicators—Baringo, Busia, Narok, Samburu, and more recently, Kajiado—PACE has provided technical support for budget advocacy to increase political and financial commitments for family planning and strengthen accountability for those commitments.

As a result of PACE’s systematic approach, detailed in this brief, county health teams are using data to support their budget requests for health, including family planning and RMNCAH services. They engage with executive committees and county assemblies at specific stages of the budget cycle, negotiating for increased allocations and tracking budget implementation. Public participation in the county budget process has also increased due to PACE’s work with local media, civil society organizations (CSOs), and youth advocates, who are demanding more accountability from their governments. For fiscal years 2018/19 through 2020/21, budget allocations for health services increased by hundreds of millions of shillings in Baringo, Busia, and Narok counties, and Narok and Samburu counties established dedicated line items for family planning. In three counties, budget allocations for health increased as a proportion of the total budget.