BUDGET-TRACKING FOR HEALTH SECTOR MOMBASA COUNTY
Presented by: Geoffrey Kerosi
Venue: Methodist Church Hall, Tononoka
Outline
- Abuja Declaration
- Stages of Budget Process in Kenya – Formulation, Approval, Implementation and Oversight.
- National Government- The Big Four Agenda, Universal Healthcare Coverage
- Reasons for budget tracking
- Recommendations for consideration
Introduction
The objective of this presentation is to guide citizens on how to track public resources in the health Sector in Mombasa. The need for budget tracking emerged after civil societies and social movements in Mombasa learnt that in the past budgets were allocated for various projects but none was implemented according to budget. Further, tracking county and national budgets has the following advantages:
- It is a fundamental right and a form of civic engagement
- Search for answers to socio-economic problems such as failed health system, poverty, inequality and underemployment
- Budget tracking supports evidence-based advocacy
- To identify and report misappropriation of funds;
- To ensure resources are used according to plan;
In Mombasa County the Coast Provincial General Hospital (CPGH) is at the apex of healthcare classification system. It is a Level 5 Hospital hence it serves its referral purpose with the county. Further, it serves patients from the neighboring counties along the coast.
Read More: Mombasa County Financial during first quarter FY 2019/2019
To ease pressure at the Coast Provincial General Hospital, Mombasa County is reported to have ongoing construction of Sub-County Hospitals at Mariman, Vikwathani, Chaani, Mrima, Mtongwe and Likoni. These hospitals once complete are expected to serve residents from Changamwe. Jomvu, Kisauni, Nyali, Likoni and Mvita.
In the programme Based Budget for Fiscal Year 2018/2019, Mombasa County reports that there are challenges facing Mombasa Healthcare service provision. These are: a) poor governance- a part of Coast General Hospital most of the other hospital are operating without boards which limits the ability of the hospitals to mobilize resources; b) inadequate financing; c) there is a shortage of health workers in Mombasa; d) inadequate referral system and e) inadequate health information.
Sources of Information for budget tracking:
1.0 National Level
- Implementation of Budget Reports – Office of Controller of Budget
- Audit Reports – Office of Auditor General Reports
2.0 County Level
- Programme Based Budget (PBB); – actual budget allocated to each programme
- Line item budget; – economic classification; projects
- Quarterly budget implementation reports;
- County Budget Review and Outlook Paper (CBROP); – revenue and expenditure performance
- Sector reports;
- Annual Development Plans;
- County Integrated Development Plan (CIDP);
- Programme Based Budget (PBB); – actual budget allocated to each programme
Below is an extract from the Program Based Budget (PBB) from FY 2018/2019. It shows how much is allocated to health and how the county is planning to use it in terms of recurrent and development spending.
PERSONNEL AND COSTS
This is a good practice in Mombasa County budget. For the first time, the county has provide information on personnel costs. This is a practice which should be encouraged at all times in the subsequent financial years.
Read More: The Case of Grabbed, inaccessible and neglected fish landing sites in Mombasa County
Check page (52-59) for more details on staff costs:
For instance, Mombasa County has reported that there are 67 Chief registered Nurses in Mombasa. They have been allocated Ksh. 180 Million to share among them. This is valuable information to assist social movements, media and researcher to determine the inadequacy of staffing reported by the county government.
2.0 HANSARD REPORTS
Construction of two water desalination plants in Mombasa, borrow any funds required in order to alleviate perennial water shortage within the county.
Is there a feasibility study?
Side effects:
- Brine production – highly concentrated salt water is released back into the sea or ocean. This will kill all forms of life from planktons to fish among others.
- Disposal of chemicals used for desalination (HCL, Chlorine, Hydrogen peroxide etc) have a negative impact on the environment.
- Energy use – the process is energy-intensive
To learn more about desalination visit: https://sciencing.com/disadvantages-desalination-5961767.html
- Office of Controller of Budget (OCoB)- Implementation reports
Development Projects (First Half-Year )
Proposed: Chaani Hospital
Location: Chaani Ward
Budget = 53.5 Million;
Expenditure: As at 31st Dec 2017 = 13.1 million
Absorption: 24.4%
This was the highest expenditure during the first half-year of 2017/2018.
Health budget info for 1st Half-Year
|
Budget Classification |
BUDGET |
EXCHEQUER ISSUE |
ACTUAL EXPENDITURE |
|||
|
Recurrent |
2,500 |
|
904.7 |
|
786.3 |
|
|
Development |
531.5 |
|
3.31 |
|
32.0 |
|
What next?
- After receiving information, share it on a centralized place –website, research reports, social media, blog, mobile application, etc
- Use the information as evidence for advocacy
- Engage policy-makers from a point of knowledge – value addition to policy discussions
- Let us not assume that the policy makers know it all. – sometimes they are not aware of the reality on the ground;
Health debates at the national level
- The national and counties allocate 0.5% of their total budget to mental health;
- There are no mental health budget lines in all the 47 County Government budgets;
- There is segregation and stigma associated with mentally ill patients in Kenya.
- This is an issue which needs to be considered and adequate budget allocated.
