News
From 13th to 18th October, 2024, Nyandarua County, Kenya in collaboration with the African Institute for Development Policy (AFIDEP) through the Institute’s Advance Domestic Health Financing (ADHF) project, and other partners convened health facility managers and in-charges for a training on basic financial management in Ol Kalou. The week-long event marked a significant milestone in own source revenue (OSR) collection, management and accountability in the health sector.
Addressing participants during the training, Nyandarua County Governor, His Excellency, Dr Moses Kiarie Badilisha affirmed the support of his administration in allocating additional budgetary resources through equitable sharing to facilitate seamless staffing and to purchase drugs and other supplies, thus ensuring the highest standards of care across all county facilities.
Over the course of the training, participants delved into a comprehensive curriculum, gaining skills in planning, budgeting and implementing budgets at facility level. Key topics included domestic resource mobilisation, procurement, expenditure, accounting, internal audit practices, data and evidence in budget advocacy and accountability, and financial risk management and compliance. The training equipped participants with robust understanding of the legislative acts relevant to health facility-level financial management, including the Facility Improvement Financing (FIF) Act 2023, Social Health Insurance (SHI) Act 2023, Primary Healthcare Act, 2023 and Public Finance Management Act, 2012.
The training’s timing was especially relevant, coinciding with the October 1, 2024 transition of health facilities from the National Health Insurance Fund (NHIF) to the Social Health Authority (SHA). The knowledge and skills gained is essential especially in the implementation of the FIF Act, 2023 and the SHI Act, 2023. As a result of this training, the County SHA System Usage Report as of October 29, 2024, shows Nyandarua leading with the highest system usage score at 92.3%, followed by Mandera and Wajir at 88.82% and 88.41%, respectively.
The FIF Act, 2023 gives the facility managers and in-charges the responsibility to collect, retain, plan for and utilise revenue received from user fees, charges, insurance claims and other relevant entities. The monies collected will enhance financial autonomy in the health facilities due to availability of funds to sustain daily operations and promote improved access to health services to all people.
Nyandarua County confirmed that all the public health facilities have registered with SHA. During the training, the participants shared knowledge and experience with the newly introduced Social Health Insurance and engaged in peer-to-peer learning to facilitate a smooth migration. Nevertheless, some systemic challenges were noted, emphasising the need for improvements to ensure smooth transition to SHA, a key step towards achieving universal health coverage (UHC) by 2030.
The county is also optimistic that training health facilities in-charges with these financial management skills will lead to successful implementation of the FIF Act 2023, enabling increased revenue collection and enhanced management of the collected resources at facility level. The expected increased resources for health in Nyandarua County will also enhance operational efficiency, and eventually improve service delivery.
As a devolved function, county governments are central in delivering quality healthcare services. Learning opportunities such as this training reinforces the potential for sustainable domestic health financing through OSR collection and prudent management leading to “more money for health” and “more health for the money” at the county level for better health service delivery.