Introduction
Kakamega County is located in the former Western Province of Kenya. Its headquarter is Kakamega town. The county has a population of 1,660,651. This population is projected to be 1,940,149 people currently. The county’s poverty rate is is 53% according to KIHBS. Only 15.2% of the population lives in urban areas.
The county had a total of 216 health facilities in 2012. This has increased to 272 in 2015. The most notable health facilities are: Kakamega Referral Hospital, Butere, Iguhu, Malava and Lumakanda district hospitals.
Health Budget
In 2015/2016 the county government will spend Kshs 1.045 billion on health sector development projects. This is 17.42% of the total development budget for the county.
Health Sector contribution to Local Revenue
Health sector will contribute Kshs 275 million to the budget. This is the highest source of local revenue and it is an increase from the previous target of Kshs 262 million. Agricultural CESS comes in second in terms of revenue generation.
Expected Spending for 2015/2016
Upgrading County General Hospital – Kshs 242.9 M
Expansion of existing facilities to hospitals – Kshs 233.2 M
Malaria control program – Kshs 3.3M
HIV/AIDS/TB – Kshs 5.3M
Disease Surveillance – Kshs 3.3M
Beyond Zero Campaign – Kshs 6.6 M
Medical school – Kshs 30M
Imarisha Afya ya Mama na Mtoto – Kshs 90M
Jigger Treatment Campaign – Kshs 3.3M
Reproductive health – Kshs 1.6 M
Ambulance Services
The money allocated for hire of ambulance vehicles increased from Kshs 44 million in 2014/2015 to Kshs 62.8 million in 2015/2016. This is a 42.7% increase towards this item.
Kakamega County is one of the counties benefiting from the “Beyond Zero Campaign.” This campaign is lead by the First Lady Margret Kenyatta and its main objective is to accelerate implementation of Kenya’s national plan towards the elimination of new HIV infections among children. The second objective is to promote maternal, newborn and child health in Kenya. The campaign is sponsored by Vision 2030 and Equity Bank Group. Kakamega County had received 22 mobile clinics from the campaign by end of April 2015. The County Government of Kakamega allocated Kshs 6.6 million towards Beyond Zero Campaign for the Financial Year 2015/2016.
Challenges
· Kakamega County faces the challenge of budgeting for items which are not in the CADP. This is illegal according to Article 104 (1) of the County Government Act 2012.
· Funds allocated to some programs are inadequate to run those programs for a whole financial year. For instance, Kakamega County has a total of 48,500 adults living with HIV/AIDS. Only 43.3% or 21,014 adults receive Anti-retroviral Therapy (ART). On the other hand, out of the 9,452 children living with HIV only 2,224 receive ART. In total there are 23,238 people who need ART services.
· Delayed release of funds for purchasing medicine for county health facilities. This is caused by lack of procurement plans hence the delays.
· Shortage of Medical Staff to serve patients. In April 2015 Kakamega County reported a shortage of 2,500 medical staff for efficient service delivery.
· Lack of essential facilities such as laboratories to test some diseases.
Recommendations
· Kakamega County should always follow the CIDP and ADP in the budget process as required by the County Government Act 2012.
· The 5.3M allocated for HIV/AIDs is not enough considering the Kakamega County HIV Statistics.
· Efforts should be made to keep girls in school to delay earlier marriages and pregnancies.
· The county government of Kakamega and other stakeholders should increase welfare services to people suffering from HIV/AIDS
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