Reproductive health financing in Kenya: an analysis of national commitments, donor assistance, and the resources tracking process

TLDR

Reproductive health services in Kenya face persistent challenges despite policies since 1994, making understanding resource flows essential for effective financing. The study aims to map Kenya’s reproductive health resource allocation, highlight tracking challenges, and recommend increased budgeting, poverty‑focused safety nets, and regular comprehensive accounts to meet MDG targets. The authors analyzed Kenyan budget estimates, reproductive health accounts, and the Resource Flows Project database, comparing 2005‑06 and 2009‑10 budgets and spending. Kenya’s government health spending is below the sub‑Saharan African average, with high donor aid and out‑of‑pocket costs, yet donor assistance has risen while the share allocated to reproductive health has fallen since 2005.

Abstract

Understanding the flow of resources at the country level to reproductive health is essential for effective financing of this key component of health. This paper gives a comprehensive picture of the allocation of resources for reproductive health in Kenya and the challenges faced in the resource-tracking process. Data are drawn from Kenyan budget estimates, reproductive health accounts, and the Resource Flows Project database and compare budgets and spending in 2005-06 with 2009-10. Despite policies and programmes in place since 1994, services for family planning, maternity care and infant and child health face serious challenges. As regards health financing, the government spends less than the average in sub-Saharan Africa, while donor assistance and out-of-pocket expenditure for health are high. Donor assistance to Kenya has increased over the years, but the percentage of funds devoted to reproductive health is lower than it was in 2005. We recommend an increase in the budget and spending for reproductive health in order to achieve MDG targets on maternal mortality and universal access to reproductive health in Kenya. Safety nets for the poor are also needed to reduce the burden of spending by households. Lastly, we recommend the generation of more comprehensive reproductive health accounts on a regular basis.