By Lukoye Atwoli
Sunday Nation 05 May 2013
County governments across the country have in the past weeks been putting out press advertisements calling for applications and informing the public about budgeting and other policy initiatives. This is a good thing, and is encouraged and even demanded by our Constitution. Kenyans have also had the opportunity to listen to governors outline their budgetary allocations to the various sectors within their mandate.
Having interrogated a few county budgets presented to the public in the past couple of weeks, one would conclude that many governors are unaware of the important roles assigned to them by the Constitution. For instance, the Elgeyo Marakwet County government proposes to spend about Sh3.1 billion on the various functions mandated to it by law.
As part of expenditure, the governor has allocated Sh50 million to the health department. With the addition of sewerage and veterinary services, the allocation rises to Sh68.3 million, or 2.2 per cent of the entire budgetary allocation. We must remember that according to the Transition Authority, this county will be running the Iten District Hospital as well as the many dispensaries, health centres and hospitals in the county. The Constitution further requires the county government to address ambulance services and primary health care, among other health functions.
One wonders how the county government will deliver on its constitutional responsibilities with this paltry allocation to the health sector. The same budget allocates over Sh250 million to buy vehicles and Sh120 million to renovate offices, demonstrating the importance attached to various other services.
It is note-worthy that the situation in Elgeyo Marakwet is not unique. I would challenge all citizens to interrogate their county budgets to see what percentage is allocated to the health sector. Most county budgets have not taken into consideration the immensity of their responsibilities as far as health is concerned.
We must take the opportunity to remind government at all levels that we signed an agreement in Abuja to ensure that not less than 15 per cent of budgetary allocation is used on the health sector. This commitment cannot be said to bind the national government alone. Because of the extensive devolution of health services in our Constitution, it follows that this agreement binds any level of government involved in budgeting for health.
One may wonder why those of us in the health sector keep harping on about these resource allocation shortcomings. Is it driven by the self-interest of health workers, or is it informed by public interest?
I would argue that both perspectives are correct. Health workers are fighting for increased allocations to the health sector in order to improve the working environment. This would mean more health facilities that are properly equipped and staffed, as well as improved preventive, promotive and rehabilitative services in all our counties.
As a result of this improved health working environment, service delivery would improve, making health services available to all in the manner envisaged by the Constitution. Increased investment in the health sector is therefore of direct benefit to all citizens.
It is the responsibility of every Kenyan to agitate for proper funding of the health sector, given that only a healthy population can handle the numerous challenges facing our nation.
Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s school of medicine firstname.lastname@example.org; Twitter @LukoyeAtwoli