Enhancing sexual and reproductive health is one of the most vital investments for personal and societal development.
It promotes gender equality, limits the spread of diseases, and improves lives by reducing poverty.
Despite the significant benefits of providing reproductive healthcare services, Kenya is yet to devote the necessary resources to this aspect of healthcare, and more broadly to the health system.
The Ministry of Health (MoH) has not been receiving adequate resources to finance its operations.
This is better illustrated by the budget for the 2023/24 financial year where the government allocated Sh 141.2 billion towards the healthcare sector, representing 11 percent of the national budget.
In the budget, the government fell short of its commitment to the 2001 Abuja Declaration to allocate 15 percent to health.
With healthcare being a devolved function in Kenya, the ripple effect of inadequate resources at the subnational level has left a trail of poverty, loss of lives and untold suffering among Kenyans.
For a long time, the sector has witnessed healthcare workers boycotting work and hospitals lacking pharmaceutical products.
Underspending of the limited allotted resources is also another challenge in Kenya’s health system.
In the 2019/20 fiscal year, 91 percent of the health budget was spent at the subnational level and 70 percent at the national level.
It's a situation brought about by the untimely disbursement of healthcare funds by the national government and poor coordination between the national government and subnational units.
And in relation to sexual and reproductive healthcare, on average, data shared by the Ministry of Health indicates that Kenya spends 13 percent of the health budget on reproductive health, 12 percent on maternal health, and 2.1 percent on family planning.
Women and girls, especially those living in slums and rural parts of the country have always borne the brunt of the inefficiencies in the healthcare sector.
Many are impacted by their inability to go to school or participate in socio-economic and political activities due to a lack of access to sexual and reproductive health services.
The economic inflation brought on by the global COVID-19 pandemic and the ongoing conflict between Ukraine and Russia has exacerbated the situation.
As a result of the high poverty levels in the country, the majority of young women and girls are unable to pay out-of-pocket for services in private health facilities.
Vulnerable groups have occasionally been forced to use coping mechanisms like a heavy reliance on credit and participation in transactional sexual activities, hence putting their lives at risk.
The data and evidence synthesised by the African Institute for Development Policy (AFIDEP) reveal glaring gaps in the health sector that if filled, can enable Kenya to be on the right path towards efficient health expenditure and better SRHR services for women and girls.
The challenges of the Treasury's delayed delivery of money, lengthy and complex procurement processes, and the health sector's limited understanding and participation in Public Finance Management (PFM) processes can be addressed by streamlining the country’s procurement systems.
The value of investing in sexual and reproductive health services has been underestimated. Its wide range of benefits has equally been unrecognised in Kenya.
The creation of tax-based health finance schemes ensuring that everyone, regardless of social or economic standing, receives high-quality healthcare cannot be overemphasized.
Expanding health insurance coverage and implementing innovative public-private partnerships for health funding can go a long way in improving the provision of healthcare services for most of the population who are not able to acquire private insurance.
World Health Organisation in a report dubbed Health Systems Financing, the path to Universal Health Coverage (2010), suggests the need to provide subsidies and tax exemptions or reduce the cost of SRHR commodities to enable vulnerable women and girls (like the refugees and those living in urban poor areas) to afford reproductive healthcare services.
The country has no option but to adequately fund and address inefficiencies in budget expenditure to boost the provision of sexual and reproductive health services to achieve sustainable development goals.
Derick Ngaira is a Communications Officer, at AFIDEP. [email protected]