What contentious revenue bill means for healthcare
The proposed revenue sharing formula could lead to loss of gains made in key health areas.
A number of counties are set to lose billions of shillings in the contentious revenue allocation proposals that Senator Irungu Kangata recently tabled in the House.
The formula seems to emphasise on population size despite the fact that several marginalised counties still experience challenges that cannot be overcome without county government funding.
People in marginalised areas, where population is lower, are mostly on the move with their animals. Their health seeking behaviour is different from people in the more fertile regions, who rarely move and can easily access the health facilities around them.
According to the United Nations Children Fund Deprivation Index published in 2013, children in Kenya’s the arid and semi-arid lands were more likely to suffer deprivation of food and other basic healthcare services compared to counterparts in cooler climate zones.
Experts are concerned the formula would endanger child survival rates in marginalised areas by taking funds away from health care services.
Poverty index
Ibrahim Alubala, a children rights advocacy expert at Save The Children, says several counties still have many health challenges and would be disadvantaged by the new formula.
“On health for example, the CRA indicator on health expenditure assumes all counties are at the same level in terms of access to health care facilities and that the residents’ health seeking behaviours are similar,” he says.
Alubala says the formula should be adjusted to account for availability of facilities and distance covered by families seeking healthcare.
“In marginalised areas, the average distance to the nearest facility is high in most cases and this has affected the health seeking behaviour among the residents,” he says.
He recommends the adoption of the Multidimensional Poverty Index that would cover a range of deprivations suffered by households. “This identifies multiple deprivations at the household and individual level in health, education and living standards,” he says.
