Evidence shows that health facilities in Kenya have an history of collecting, retaining and using funds at source. The Constitution of Kenya 2010, established 47 county governments with a mandate to deliver quality health care bestowed upon them. A key function for the national government is policy formulation and in 2023 key Universal Health Coverage (UHC) Laws were passed. One of these was the Facility Improvement Financing (FIF) Act of 2023.
The FIF Act 2023 broadly provided a legal framework for county governments to institutionalize collection, retention and use of revenue by health facilities. Specifically, article 29 of the Law highlights that;
‘A county government may enact legislation to give further effect to the provision of this Act in the respective county.’
Therefore, this provision sets the ball-rolling for county governments to use the FIF Act 2023 as the model law. The County Government of Nyandarua followed its county law making process where a FIF Bill was proposed to the County Assembly, passed and signed into Law.
With already an existing law, the leadership of the Department of Health led by the County Executive Committee Member (CEC-M) for Health, Chief Officers and Directors convened a sensitization meeting for health facility and hospital heads across the County. Implementation of this law would require all health facilities and hospitals to put in place key operational systems.
During the sensitization workshop, facilities in Nyandarua were required to have in place management teams as per their level of care and open a revenue collection and a revenue expenditure bank accounts with signatories as provided for by the County law.
USAID Health Equity and Resource Optimization (USAID HERO) project has been supporting the County Government of Nyandarua and other counties to develop a clear FIF roadmap. Collaborating with the Council of Governors, high-level sensitization meetings have been done with CEC-M Health drawn from all 10 supported counties. These meetings have also targeted Chief Officers and County Directors of Health.
Implementation of FIF will ensure counties mobilize and increase domestic resources for health. Further it will catalyze quality of care provided as it unlocks public health facility competitiveness and performance. In Nyandarua, the health department has committed to support health facility managers with the required training to build skills and capacity towards proper and effective management of the FIF funds.