Domestic health financing advocacy in action: Reflections from the SMART advocacy strategy implementation progress meeting with CSOs
22 April 2024
Author: Derick Ngaira
Attendees pose for a group photo during the follow-up meeting on domestic health financing SMART advocacy strategies implementation progress on March 28, 2024, in Machakos County, Kenya.

Civil society organisations (CSOs) in Kenya’s targeted counties—Tana River, Taita Taveta, Nyandarua, and Laikipia—are making significant progress in advocating for improved health outcomes and resource allocation within their respective counties. Trained in SMART advocacy by the Advance Domestic Health Financing (ADHF) project in September 2023, these CSOs are committed to realising their SMART objectives and work plans developed during the training.

On 28th March 2024, the ADHF project, which is co-led by the African Institute for Development Policy (AFIDEP) and Partners in Population for Development-African Regional Office (PPD-ARO) organised a follow-up meeting to assess the progress of SMART advocacy strategy implementation. The meeting convened county officials and CSOs trained by the project on SMART advocacy. During the gathering, CSOs shared their accomplishments in advocating for increased health funding and efficiency at the county level to enhance health outcomes in their respective counties.

Taita Taveta Civil Society Organisations Movement (TTCSOM)

In Taita Taveta County, the CSOs Movement is advocating for enhanced access to family planning (FP) and maternal and child health (MCH) services. Their SMART objective is clear: By June 2024, the Taita Taveta County Assembly should approve a budget increment for FP/MCH from Kshs.7.7 million to Kshs.14 million, aiming to broaden access to information and services for young people.

The CSOs Movement approached the County Speaker, County Executive Committee Member for Health, and Director of Health. The Taita Taveta county leadership have pledged their support for increased allocation to the sector.

Speaking on behalf of the group, Malusha Abedi emphasised the importance of utilising data and evidence for the advocacy efforts. He urged county officials to ensure meaningful and structured inclusion of CSOs in health sector governance to drive accountability within health systems.

National Council for Population and Development

The National Council for Population Development (NCPD) champions advocacy for family planning commodity financing in Kenya. Their SMART objective is advocating for the Principal Secretary for Medical Services in the Ministry of Health, Harry Kimutai CBS, to approve an increment of FP commodity domestic financing from Kshs.1 billion to Kshs.1.5 billion in the FY2024/25.

In her presentation, NCPD’s Beatrice Okondi, noted that the team had achieved key milestones to realise their objective. As part of the team’s work plan, NCPD developed a policy brief on FP commodity financing which was key in informing decision-making during key meetings, including the Medium-Term Expenditure Framework (MTEF) meeting. “As a result of this meeting, at NCPD we are glad that the National Treasury agreed to increase allocation towards family planning by Kshs.500 million,” noted Ms Okundi. Their recommendations emphasised the importance of coalition building and proactive engagement in policy processes.

Vision Makers

Vision Makers, a community-based organisation initially focused on dispelling tuberculosis (TB) misconceptions, has broadened its mission to address various health and social challenges in Nyandarua County. With a commitment to empowering and enlightening communities, Vision Makers’ SMART advocacy objective entails ensuring that the Nyandarua County Assembly approves a budgetary allocation increase from Kshs.26.43 million to Kshs.41.7 million by June 2024 to strengthen community healthcare units.

Representing the organisation, Peter Wahungu highlighted significant progress towards achieving their objective. This includes engaging stakeholders and decision-makers such as Hon. Mwangi Gichuki, County Attorney, Hon. Mwangi Gichuki, Minority Leader and member of the Health Committee, and Hon. Muhindi Kariuki nominated Member of County Assembly, to support advocacy for increased health allocation in the county assembly.

Moving forward, the group plans to expand their engagement to include the County Director of Public Health and other technical personnel in Nyandarua as they work towards achieving their goal by the end of the 2023/2024 fiscal year.

Kenya Red Cross

Kenya Red Cross is spearheading efforts to increase the health budget allocation in Tana River County. Their SMART advocacy objective is that by June 2024, the Tana River County Assembly approves an increment of the health budget from 21% to 25% for financial Year 2024/2025.

Six months down the line, the team has developed and shared a memorandum with both the county executive and county assembly. In addition, through their community budget champions, they conducted an analysis of historical trends and patterns with regard to domestic health resource allocation and are scheduled to meet the County Assembly Committee for Health to further deliberate on the issue.

Of importance, Red Cross’s Dahir Daud noted that the Chair of the County Assembly Committee for Health embraced the idea of increasing the allocation for health because out of the Kshs.1.3 billion allocated to the sector, Kshs.967 million is meant for salaries and a paltry Kshs.300 million is directed towards maintenance and development in the health department.

Supported by evidence from the budget analysis, the team looks forward to participating effectively in the upcoming public engagement forums for the budget estimates for FY 2024/25 and see to it that more resources are allocated towards the health sector.

Laikipia County Civil Society Forum

In Laikipia County, the Laikipia County Civil Society Forum (LACCSOF) champions constitutionalism and social accountability to promote good governance. Through strategic engagements with county officials and proactive collaborations, LACCSOF has earned support and recognition, fostering dialogues on budget planning and public participation.

Their SMART objective centres on augmenting budgetary allocations for FP/MCH services from Kshs.2 million to Kshs.4 million for the FY 2024/25.  Despite facing challenges such as resource constraints, LACCSOF emphasises the significance of synergy and political goodwill in achieving their advocacy goals.

Recently, capitalising on opportunities such as budget public participation forums, they persisted in advocating for equitable health financing, stressing the importance of structured inclusion and coalition building. Presenting on behalf of the team, Peter Waguhu highlighted their meeting with Clerk of the County Assembly of Laikipia, Jasper Mutwiri, to garner support for the realisation of their objective. Following this meeting, Mr Mutwiri scheduled a sitting between LACCSOF and the County Assembly Committee on Finance to discuss matters concerning the Laikipia County Annual Development Plan 2024–2025 and integrate their input on increasing allocation towards the health sector.


From Nyandarua to Taita Taveta, and from Laikipia to Tana River, CSOs are making significant strides in their advocacy efforts. By engaging stakeholders, leveraging data, and fostering meaningful inclusion, the groups are contributing to the realisation of health equity in Kenya. Undoubtably, by working hand in hand with county government officials and other stakeholders, CSOs are paving the way for a healthier and more equitable future for all Kenyans, thanks to SMART advocacy training by AFIDEP and PPD-ARO through the ADHF project.