Relationship between public spending by local government and health status in Kenya
Mohammed, Abdikeir Meimuna
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Public spending by Kenyan government in the health sector has been dogged by misallocation of resources, untimely disbursement of funds, under-spending, many medical facilities constructed and not in use and medical supplies purchase being damaged and expired. As a result a child's chance of survival is as low as 73 children dying before their 5th birthday in Kenya. 28,000 children died in 2012 of either pneumonia or diarrhoea which are diseases with both preventive and curative solutions. This study evaluated whether a relationship exists between public spending in health by Kenya's local government and health status. Further, it establishes factors that affect public spending ability to improve health status. Using regression analysis this study modeled the relationship between aggregate annual public spending in health by local government and annual child mortality rate which is the number of children that die after their first birthday and before their fifth birthday per 1000 live births between 1978 and 2008. The study analysed a similar relationship between aggregate annual development spending in health by local government and annual child mortality between 2003 and 2008 across the 175 local authorities. The results of this study reveal that a significant and positive relationship exists between public spending in health by local government and national health status. However there is an insignificant and small relationship between development spending by local government in health and sub national health status. Local governments have constructed frequently health facilities near the population and have spent more in curative primary health care. These two factors strength ability of public spending improve health status. However rarely are capital expenditures matched to future running cost of facilities, spending is significantly below the budgeted in the health sector and spending in nonbudgeted items is a common phenomenon. To accelerate the achievement of Kenya's goal in improving health status, this study recommended increased spending by county government in the areas where previously spent on by local government. Additionally practice of the fundamental principles of public spending would improve the ability of public spending in improving health status further accelerating the achievement of improved health status in Kenya. Key words: effectiveness, public spending, health status, good planning, expenditure control, untimely disbursement, unbiased projection , appropriate policy.