Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties

Nelson Keyonzo, Julius Korir, Faith Abilla, Morine Sirera, Peter Nyakwara, Eva Bazant, Charles Waka, Nancy Koskei, Mark Kabue

Abstract

As international development partners reduce funding for family planning (FP) programs, the need to estimate the financial resources devoted to FP is becoming increasingly important both at all levels. This cross-sectional assessment examined the FP financing sources, agents, and expenditures in two counties of Kenya for fiscal years 2010/2011 and 2011/2012 to guide local decision-making on financial allocations. Data were collected through a participatory process. This involved stakeholder interviews, review of financial records and service statistics, and a survey of facilities offering FP services. Financing sources and agents were identified, and source amounts calculated. Types of FP provider organizations and the amounts spent by expenditure categories were identified. Overall, five financing sources and seven agents for FP were identified. Total two-year expenditures were KSh 307.8 M (US$ 3.62 M). The government‘s share of funding rose from 12% to 21% over the two years (p=0.029). In 2010/2011, the largest expense categories were administration, commodities, and labor; however, spending on commodities increased by 47% (p=0.042). This study provides local managers with FP financing and expenditure information for use in budget allocation decision-making. These analyses can be done routinely and replicated in other local counties or countries in a context of devolution. (Afr J Reprod Health 2017; 21[4]: 24-32).

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References

Ahmed S, Li Q, Liu L and Tsui AO. Maternal deaths

averted by contraceptive use: an analysis of 172 countries. Lancet 2012; 380(9837): 111–25.

Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A

and Innis J. Family planning: the unfinished agenda. Lancet 2006; 368(9549): 1810–27.

Ministry of Health. National family planning costed

implementation plan 2012–2016. Nairobi, Kenya:

Ministry of Health, 2012.

Kenya National Bureau of Statistics, Ministry of Health,

National AIDS Control Council, Kenya Medical Research Institute, National Council for Population and Development, The DHS Program, ICF International. Kenya Demographic and Health Survey 2014. Nairobi, Kenya, and Rockville, Maryland, USA, 2015 [cited 2016 May 16]. Available from: http://dhsprogram.com/pubs/pdf/FR308/FR308.pdf.

World Health Organization (WHO). Sexual and

reproductive health packages of interventions for family planning, safe abortion care, maternal, newborn and child health. Geneva: WHO, 2010 [cited 2012 Aug 18]. Available from: http://whqlibdoc.who.int/hq/2010/WHO_FCH_10.06_eng.pdf.

Cleland J, Conde-Agudelo A, Peterson H, Ross J and

Tsui A. Contraception and health. Lancet 2012; 380(9837): 149–56.

Osotimehin B. Family planning saves lives, yet

investments falter. Lancet 2012;380(9837):82–3.

Kenya National Bureau of Statistics (KNBS). Kenya

population and housing census. Nairobi, Kenya: KNBS, 2009.

Alkenbrack S, Chaitkin M, Zeng W, Couture T and

Sharma S. Did equity of reproductive and maternal health service coverage increase during the MDG era? An analysis of trends and determinants across 74 low- and middle-income countries. PLoS One 2015; 10(9): e0134905. doi:10.1371/journal.pone.0134905.

Muthamia M, Owino K, Nyachae P, Kilonzo M, Kamau

M, Otai J, Kabue M and Keyonzo N. The Tupange Project in Kenya: A Multifaceted Approach to Increasing Use of Long-Acting Reversible Contraceptives. Glob Health Sci Pract. 2016 Aug 18; 4 Suppl 2: S44-59. doi: 10.9745/GHSP-D-15-00306. Print 2016 Aug 11.

Keyonzo N, Nyachae P, Kagwe P, Kilonzo M, Mumba

F, Owino K, Kichamu G, Kigen B, Fajans P, Ghiron L and Simmons R. From Project to Program: Tupange's Experience with Scaling Up Family Planning Interventions in Urban Kenya. Reprod Health Matters. 2015 May; 23(45): 103-13. doi:10.1016/j.rhm.2015.06.010. Epub 2015 Jul 26.

Sidze EM, Pradhan J, Beekink E, Maina TM and Maina

BW. Reproductive health financing in Kenya: an analysis of national commitments, donor assistance, and the resources tracking process. Reprod Health Matters 2013; 21(42): 139–50. doi: 10.1016/S0968-8080(13)42738-6.

Alkenbrack S, Chaitkin M, Zeng W, Couture T and

Sharma S. Did equity of reproductive and maternal health service coverage increase during the MDG era? An analysis of trends and determinants across 74 low- and middle-income countries. PLoS One 2015; 10(9): e0134905. doi:10.1371/journal.pone.0134905.

Barnes J, O‘Hanlon B, Feeley F, McKeon K, Gitonga N

and Decker C. Private health sector assessment in Kenya. World Bank Working Paper No. 193. Washington, DC: World Bank, 2010 [cited 2016 May 16]. Available from: http://pdf.usaid.gov/pdf_docs/PNADS739.pdf.

Pradhan J, Sidze EM, Khanna A and Beekink E.

Mapping of reproductive health financing: methodological challenges. Sex Reprod Healthc 2014; 5(3): 90–8.

Sidze EM, Beekink E and Maina BW. Challenges

associated with tracking resources allocation for reproductive health in sub-Saharan African countries: the UNFPA/NIDI resource flows project experience. Reprod Health 2015; 12: 39. doi 10.1186/s12978-015-0033-8.

Worley H. Family Planning Champions in Kenya

Celebrate Success in Counties. Washington, DC: Population Reference Bureau, 2016. [cited 2016 May 5]. Available from http://www.prb.org/Publications/Articles/2015/kenya-county-advocacy.aspx.

The Constitution of Kenya. Revised edition 2010.

Nairobi, Kenya: National Council for Law Reporting, 2010 [cited 2016 January 13]. Available from: http://www.kenyaembassy.com/pdfs/the%20constitution%20of%20kenya.pdf.

Ministry of Medical Services (MMS) and Ministry of

Public Health and Sanitation (MPHS). Kenya national health accounts 2009/10. Nairobi, Kenya: MMS and MPHS, 2010 [cited 2016 May 16]. Available from:https://www.hfgproject.org/wp-content/uploads/2015/02/Kenya-National-Health-Accounts-2009_10.pdf.

Netherlands Interdisciplinary Demographic Institute

(NIDI) and African Population and Health Research Center (APHRC). Reproductive health and family planning financing in Kenya: a mapping of the resource flows. Nairobi, Kenya: APHRC, 2012 [cited 2016 May 17]. Available from: http://aphrc.org/wp-content/uploads/2013/12/Reproductive-health-and-family-planning-financing-in-Kenya.-A-mapping-of-the-resource-flows.pdf.

Office for Human Research Protections and U.S.

Department of Health and Human Services (HHS). Code of Federal Regulations, Title 45, Public Welfare. Department of Health and Human Services, Part 46, Protection of Human Subjects. Washington, DC: HHS, 2009 [cited 2016 May 17]. Available from: http://www.hhs.gov/ohrp/sites/default/files/ohrp/policy/ohrpregulations.pdf.

eHealth-Kenya. Kenya master health facility list.

Nairobi, Kenya: Ministry of Health, 2011 [cited 2012 February 23]. Available from: http://kmhfl.health.go.ke/#/home.

National AIDS Control Council (NACC). Kenya

national AIDS spending assessment report for the financial years 2006/07 and 2007/08. Nairobi, Kenya: NACC, 2009 [cited 2016 May 5]. Available from: http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/countryreport/2009/nasa_kenya_2007-2008_en.pdf.

Ministry of Health. Ministry of Health Summary Report

(MOH 711). In: Republic of Kenya: Health sector indicator and standard operating procedure manual for health workers. Nairobi, Kenya: Ministry of Health, 2008 [cited 2016 January 13]. Available from: https://healthresearchweb.org/?action=download&file=indicatorandSOPManual2008131008..pdf

Ministry of Health. Ministry of Health Summary Report

(MOH 717) In: Republic of Kenya: Health sector indicator and standard operating procedure manual for health workers. Nairobi, Kenya: Ministry of Health, 2008 [cited 2016 January 13]. Available from: https://healthresearchweb.org/?action=download&file=indicatorandSOPManual2008131008..pdf

Ministry of Public Health and Sanitation (MPHS). SDP

contraceptives consumption data report and request form. Nairobi, Kenya: MPHS, 2011 [cited 2016 January 13]. Available from: http://fptoolkit.or.ke/download/commodity_security/_improving_family_planning_commodity_security/CDRR.pdf.

Kenya Health Information System (KHIS). District

Health Information Software 2 (DHIS2). Nairobi, Kenya: KHIS [cited 2016 January 13]. Available from: https://hiskenya.org.

StataCorp. Stata Statistical Software: Release 12.

College Station, Texas: StataCorp LP, 2011.

Nguyen H, Snider J, Ravishankar N and Magvanjav O.

Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries. Reprod Health Matters 2011; 19(37): 62–74.

Ngethe PN. Family planning in Kenya: a review of

national and district policies and budgets. DSW (Deutsche Stiftung Weltbevoelkerung): Nairobi, Kenya, 2014 [cited 2016 March]. Available from: http://www.dsw.org/uploads/tx_aedswpublication/family-planning-kenya_update.pdf.

Nyikuri M, Tsofa B, Barasa E, Okoth P and Molyneux S.

Crises and resilience at the frontline—public health facility managers under devolution in a sub-county on the Kenyan coast. PLoS One 2015; 10(12): e0144768. doi:10.1371/journal.pone.0144768.

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