Turkana County Launches the Health Sector Strategic Plan 2018 – 2022

Since the establishment of devolved governments in Kenya in 2013, Turkana County department of health has been coordinating the county’s health sector to deliver the constitutional mandate guided by the principles of joint planning, monitoring and implementation.

The County aspires to be a healthy and productive county that is anchored on a progressive, responsive and sustainable technologically driven, evidence-based and client health-centered health system. This guiding principle fosters the vision statement for the county health sector and commitment to accelerate the achievement of Universal Health Coverage (UHC) and the strategic direction of the HSSP.

With support from the National Government and development partners, the County has had significant achievements especially in the infrastructural and human resources for health and improved health indicators including; an increase in percentage of fully immunized children from 36% to75%; deliveries conducted under skilled attendants increased from 18% to 45%; HIV prevalence reduced from 7.9% to 3.6%; TB treatment success rate increased to 69%.

On physical infrastructure, 159 new facilities have been constructed and rehabilitated, 10 sub-county hospitals were renovated, a satellite blood bank was established, an oxygen plant was installed at the county referral hospital, and a central drugs warehouse constructed amongst other infrastructural projects.

At the commencement of development of HSSP, a situational analysis of the health sector in Turkana County was undertaken taking into consideration the key health indicators and health systems strengthening building blocks. The results of the analysis indicated that Turkana County has a total of 382 healthcare services outlets including 158 functional community health Units and 224 health facilities against a requirement of 400 outlets; 232 CUs and 168 health facilities.

This shows an overall deficit of 20 health facilities with the largest deficit at level III (20) followed by level IV (9) and a deficit of 74 community health units. However, it has an excess of level II (78 dispensaries and clinics) with skewed distribution across the county hence need for new facilities in areas identified to be affected. Over 800 health workers and 2268 Community Health Volunteers were engaged to support service delivery across the county. The county department of health and sanitation is also embracing technology with 18 health facilities already undertaking digitization of medical records. Notably, the flow of funds to county health facilities has also improved. Despite these significant achievements, the health indicators for the counties are still below the national averages, and health challenges abound.

Although Turkana County has progressively increased its allocation to health services in absolute terms from KSHs 1.3 Billion in FY 16/17 to 1.7 Billion in FY 18/19; a significant proportion goes to capital formation to bridge the infrastructural gap existing in the county health system and thus enhance delivery. Health insurance coverage in Turkana County is also low (5%) compared to the national average of 22%. It is therefore paramount that health financing is addressed to support the move to universal health coverage and particularly alleviate the catastrophic health spending by households in the county, bearing in mind that households remain a significant financing agent at almost 35% of the spending.

During the five year period, the estimated resource requirements for the health sector is projected to grow significantly from 2.06B  in FY 2018/19 to 2.62B in FY 2022/23 representing a growth of approximately 27.1 percent in response to meeting the growing health needs within the County. The County estimates that implementation of the interventions proposed in the strategic plan will cost Kes.  11,932,565,861.

The County government anticipates that KShs 9,734,892,688 will be available to fund the health and sanitation interventions proposed in this plan, are based on experience and projections captured under its Medium Term Expenditure Framework (MTEF). These estimates are primarily based on on-budget support from the following sources- equitable share of national revenue, conditional grants from national government (including grants from development partners), user fees at the county level, and appropriation in aid. In comparison to the estimated resource requirements for the five year period, the estimated financing gap is KShs. 2,197,673,174.

The County intends to scale up its resource mobilization capacity as to bridge the financing gap anticipated in implementing this strategic plan through interventions such as: 

1. Prioritizing the health sector by increasing resource allocation from the current 1.7 to 2.3 Billion by the year 2022. The County Executive will lobby the County Assembly for approval of the increased allocations.
2. Reducing the burden on households’ out-of-pocket (OOP) spending from the current 35% to 25% in 2022.
3. Cultivating better links with the private sector and develop public-private partnerships to increase access and alternate financing of health services.
4. Mobilize  citizens for enrolment into the NHIF and other insurance schemes to expand coverage and benefits, and increase the flow of funds to county facilities
5. Lobby for an increase in allocation of resources from development and implementation partners, and ensure that these are evidence-based and that partnership engagement is strengthened.
6. Strategic purchasing of health services and prioritization of preventive healthcare as a more cost-effective way to manage ill-health.
7. Supporting initiatives to move towards universal health coverage and develop a health financing strategy that defines sustainable ways of raising revenues to finance healthcare and shield households from catastrophic health spending.

Speaking during the launch, the County Executive Commissioner for Health Hon, Jane Ajele lauded development partners including the USAID funded AFYA TIMIZA and Tupime County project, Ampath and PEPFAR for providing technical support in the development of the HSSP plan.

According to Isaac Ntwiga, the Afya Timiza Health Systems Strengthening Advisor, the HSSP highlights the investments required to strengthen County Health System building blocks through enhancing the capacity and commitment of the county government towards self –reliance and a resilient health sector.

Article by: USAID|AFYA TIMIZA Project