Unpacking the journey to self reliance (J2SR)

“As we listen to some of the most thoughtful voices around the world, over and over again we hear the need to be independent, the need to be self-reliant. That’s the spirit that has led USAID to craft a framework we call the Journey to self-reliance” Mark Green

Under the leadership of Administrator Mark Green, the United States Agency of International Development embarked on the journey to self-reliance (J2SR) with the aim of ending the need for foreign assistance and fostering self-reliant communities.

The self – reliance theory of change is anchored on two mutual factors – commitment and capacity. While commitment is the degree to which a country’s laws, policies, actions, and informal governance mechanisms (such as cultures and norms) support progress towards self-reliance; capacity is a country’s ability to manage its own development, across the dimensions of political, social, and economic development, including the ability to work across these sectors.

To achieve this, the USAID funded Afya Timiza project is incorporating this theory of change to enable target counties in Turkana and Samburu adapt this new shift and embrace the journey to self-reliance.

Since the beginning of devolution in Kenya, Turkana County Government has demonstrated commitment to improving health with increased budgetary allocations and improving maternal and child health indicators. Despite the increased allocation to health, the total resources allocated to the county have not been able to meet their needs putting an onus on the private sector and donors to fill the gap.

Turkana indicators at a glance:

Indicator	2013	2018
1.	Doctor Patient Ratio	1:70,000	1:20,000
2.	Nurse Population Ratio	1:5,200	1:232
3.	Immunisation Coverage	42.5%	84.2%
4.	Skilled Delivery	25.2%	65.1%
5.	Global Acute Malnutrition	24%	18/1%
6.	HIV Prevalence	6.9%	3.2%
7.	Contraceptive Prevalence	11	19.4%

Speaking during the unpacking of the J2SR strategy in Turkana County, the Director of Medical Services Dr Gilchrist Lokoel acknowledged that the county was committed to maintaining the dignity of its people but would largely rely on the support of donors to strengthen capacity beyond efficient management and investment of resources (such as petroleum) but also becoming a model for resilience in Kenya and African at large.

“Over the years, the counties’ budgetary allocations have been dwindling putting a crunch on the health budget. Since devolution, Turkana County has been receiving an average of Kshs 11 to 12 billion but in the financial year 2018/2019, the county received 8.9 billion,” explained Dr Gilchrist.

He reiterated that despite Turkana County’s commitment to improve health services in the county, the health workforce was increasing against drastically reducing funding.

Dr Gilchrist expressed his concern towards aligning the County’s development with the new shift because despite the County spreading every spectrum of expenditure to every line item conceivable in the County’s plans and budgets, it was an unfeasible feat because all allocations have been done against inadequate resources.

Using nutrition as an example, he explained that the County had allocated Kshs 2 million for the financial year 2018/2019 to meet the county’s nutrition needs which required hundreds of millions. He maintained that the way forward would be for all the investment plans to be reviewed and targets measured progressively for a period of time.

He was confident that Turkana County would achieve economic independence.

“To Mark Green and the USAID team, we are not requesting for consistent aid, we are requesting for technical assistance and support in petitioning the County Assembly because the county has the commitment of the management workforce, but needs the support of the Assembly to become self-reliant,” said Dr Gilchrist.

During his closing remarks, Dr Gilchrist expressed his excitement towards the new shift of programming because it was a noble way of empowering every citizen through innovation and integration.

The meeting was attended by Gilbert Wangalwa, Chief of Party, Afya Timiza and the project team, as well as representatives from the county and sub county health management teams. The meeting took place on November 19, 2019.