NAIROBI, Kenya- A new report from IDinsight, in collaboration with the Gates Foundation, has revealed a significant gap in Kenya’s health system: a limited integration of financial and non-financial health data.
According to experts, this disconnect is undermining efforts to strengthen accountability and improve service delivery.
The study, conducted between September 2023 and June 2024, points out that while financial data dominates health financing decisions, it fails to directly impact critical health outcomes, such as reducing maternal and neonatal mortality rates.
During the report’s release in Nairobi, Dr. Frida Njogu Ndongwe, Regional Director for Eastern and Southern Africa at IDinsight, emphasized a stark issue: the heavy reliance on financial data doesn’t reflect whether healthcare services are improving.
“How are we linking resources to the burden, to the service quality, and to the outcomes?” Dr. Njogu posed.
She highlighted that despite significant allocations to the health sector, it remains unclear if the money is going where it’s most needed.
For example, between 2021 and 2022, Kenya’s maternal mortality rate was 355 deaths per 100,000 live births—a slight improvement from 365 deaths in previous years, but far from the progress expected after substantial financial investments.
This lack of correlation between spending and outcomes suggests a need to rethink how budgets are planned and evaluated.
Dr. Njogu and other experts advocate for a shift toward Programme-Based Budgeting (PBB) and Outcome-Based Budgeting, where the focus is not only on money spent but also on the quality and effectiveness of services delivered.
A key issue raised by the report is the lack of integration between financial and non-financial data.
While the Kenya Health Information Systems (KHIS) tracks non-financial health data across different levels, this information rarely makes it into decision-making processes related to Public Financial Management (PFM).
As a result, health outcomes aren’t adequately tracked against budgetary allocations, leading to weakened oversight of health spending.
“We cannot be sending money to counties and ministries without a clear line of accountability,” remarked Dr. Martin Atela, IDinsight Project Director.
He stressed the importance of using data to monitor how counties utilize health funds. Without such oversight, it’s difficult to gauge whether resources are being used effectively.
To address these issues, the report recommends adopting Programme-Based Budgeting alongside technology solutions, such as AI, to enhance Public Financial Management reforms.
These innovations could help streamline how health funds are allocated and track the direct impact on service delivery.
Additionally, increasing the integration of financial and health outcome data would provide a clearer picture of whether budget increases lead to tangible improvements in health services.