Resource Allocation to Health Sector at the County Level and Implications for Equity, a Case Study of Baringo County.

Abstract

According to Bigambo (2014), the issue of equitable resource allocation is one of the perennial problems which has not only defied all past attempts at permanent solution, but has also evoked high emotions on the part of all concerned. In many low income countries, budget allocation patterns ignore changes overtime in health care needs like population size and disease patterns restricting the ability of health care services to respond to these changes which are in turn heavily influenced by existing health service supply patterns. Due to this, geographical regions that have previously received large amounts of resources continue to benefit from these resources regardless of whether there is a need to justify their need. On the other hand, regions that may have required a low amount of resources in the past, and which may require a large amount of resources now due to changes in their demographics and disease patterns receive the same amount of resources which can‟t meet the current needs of the population. The overriding concern is that sections of the population in the same areas are prejudiced in their access to essential health care merely by virtue of their place of residence (McIntyre et al 1990). Therefore the main objective of the study is to evaluate the process of resource allocation to the health sector in Baringo County and its implication to equity. The study was conducted in Baringo County which is allocated in the North Rift, part of former Rift-Valley province, Kenya. It has six sub-counties namely: Baringo North, Baringo Central, Koibatek, Marigat, Mogotio and East Pokot. This is a descriptive study that employs both qualitative and quantitative research methods. Qualitative data includes: in-depth interviews of key officials in health and finance departments and Focused Group Discussion (FGD) for the health care providers. The target population for this study included: county/sub-county health department administrators, finance department administrators and health care providers. One chief health officer, one chief finance officer, one director of health services and six SCMOH or their representatives participated in the study while a total of twenty two health care providers (in-charges of dispensaries and health centres) participated in the FGD. Data was collected using semi-structured interview questions, audio recorder and notes. Quantitative data was analyzed using excel while qualitative data was analyzed manually and data presented using tables, pie-charts, bar graphs and verbatim quotes. Results and findings were: the average utilization rate of the health services in Baringo county was 1.30 per capita/year which was below the national average rate of 3.1 per capita/year; public finance act of 2012 was followed in the budget making process but there was no criteria or formula for financial resource allocation; there was skewed distribution of the human resources with some sub counties being „favoured” while others were “disadvantaged” and finally there was evident of political interference with the distribution of the health resources. In conclusion there was significant disparity on the allocation/distribution of the health resources across the sub-counties. This calls for immediate redistribution of the available health resources as a short term measure while formulating and using a need-based resources allocation formula as a medium term and a long term measure.