In 2010 responsibility for Kenya’s health sector was devolved from central government, and the countries county governments took on a lead role in the management of health services for their local communities.

These management, resourcing and budget decisions were devolved to allow the county governments to design innovative models and interventions to better suit the healthcare needs of their communities.

Following this change, services have been of variable quality, much of this is due to management teams not always having the skills and capabilities to develop budgets and plans which predict what resources will be required in their county.

To combat this The World Bank Multi Donor Trust Fund (MDTF) is working to develop the skills of health sector staff to help them create credible health plans and budgets. The aim is to improve staff understanding of the budget process and share techniques which will aid in matching resource allocation to the needs of the health sector – therefore filling the capacity gaps and improving the health sector services.

MannionDaniels has been contracted to provide technical assistance, mentoring and coaching to health departments in 18 counties. When the work started, only three of the 18 counties had formally reviewed their performance. We began by carrying out a capacity analysis on the remaining 15.

The second phase of the project has now begun. Staff have been helping county health departments develop the skills they need to inform better planning. We have assisted them to:

• Embed key structures and processes necessary for appropriate planning and budgeting
• Foster a culture which uses data for decision making in planning and budgeting
• Include stakeholders in the process of planning and budgeting
• Improve adherence to budget timelines.

The aim is to embed the culture of planning and budgeting within departments of health so that the effectiveness of future plans isn’t compromised by the relatively high turnover of staff that many departments experience. Further training will equip health sector staff with the skills and tools to track expenditure accurately, to ensure that the final resource allocation matches health sector priorities, ensuring funds are directed to their intended purpose.