A recently released study by IDinsight in partnership with the Gates Foundation has revealed a limited integration of financial and non-financial health data within Kenya’s health system. Experts believe that integrating these data types is crucial for strengthening health system accountability, which is essential for enhancing service delivery.
During the report dissemination event in Nairobi, which covered a study conducted between September 2023 and June 2024, Dr. Frida Njogu Ndongwe, Regional Director for Eastern and Southern Africa at IDinsight, highlighted that many health financing decisions are primarily based on financial data, which does not necessarily correlate with better health outcomes.
“How are we linking resources to the burden, to the service quality, and to the outcomes? A lot of our health financing decisions are based largely on financial data. We are not really looking at health outcomes and health service utilization. These two need to speak to each other so that we are not only looking at whether money was released but also assessing whether the quality of healthcare services is improving,” Dr. Njogu posed
She noted that despite the health and education sectors consuming a larger percentage of the national budget, it remains challenging to determine if allocations within the health sector budget are effectively directed towards priority health programmes.
Despite substantial budget allocations in the sector, the study indicates minimal improvements in maternal and neonatal mortality over the years. For instance, maternal mortality rates between 2018 and 2020 were 365 deaths per 100,000 live births, compared to 355 deaths per 100,000 live births in 2021-2022. This trend highlights a disconnect between health spending and its impact on critical health outcomes.
“We’re seeing very little gains in maternal and neonatal mortality despite substantial investment in this space. We need to move towards Programme-Based Budgeting (PBB) and Outcome-Based Budgeting. We need to look at the quality of service delivery and identify where the gaps are,” remarked Dr Njogu
Dr. Martin Atela, IDinsight Project Director, emphasized the need for the government to embrace data and evidence in decision-making.
“We cannot be sending money to counties and ministries without a clear line of accountability for that money. How do counties share data on the finances allocated and the outcomes of how they used the finances upwards all the way to the treasury?” he asked
The Kenya Health Information Systems (KHIS) serves as the central platform for the aggregation and reporting of non-financial health data, operating in a coordinated hierarchy from the community level through facilities, sub-counties, and counties, up to the Ministry of Health. However, experts indicate that there is limited evidence on how this data is shared with Public Financial Management and accountability stakeholders, resulting in poor tracking of health outcomes against budgets and weakened oversight of health funds.
The report further suggests that increasing the country’s health expenditure is not necessarily linked to improved health outcomes. The disconnect between financial and non-financial data limits the ability to ensure that health resources are allocated effectively to priority programmes, thereby reducing the potential for accountability within the sector.
It recommends implementing Programme-Based Budgeting (PBB) and utilising technologies such as AI to support Public Financial Management reforms and enhance health service delivery.
