National Taxpayer's Association - success story
Health Budget Advocacy
The National Taxpayers Association (NTA) aims to promote good governance in Kenya to ensure that our taxes are well spent. Kenyan taxpayers have increasingly contributed a great share of the Government of Kenya’s revenue and the budget has been on an upward trend since the recent reforms of the Kenya Revenue Authority. Read more about their experiences here.
Despite this, Kenya continues to spend a lower proportion of GDP on health compared to neighbouring countries, which has resulted in acute shortages of both human resources for health and medical supplies.
As the right to health is enshrined in our constitution, the National Taxpayer's Association (NTA) embarked on a project to improve the provision of quality healthcare services in public health centres through enhanced transparency and accountability. Their experience has shown that it’s important to engage at all levels of the government, including national, country and facility levels.
At the national level, the partnership was aimed at influencing policy in line with recommendations from citizens who are the consumers of these services. While the Ministry of Health has a very good framework for citizen engagement, it is not often implemented. NTA simply filled that gap by collecting the views of citizens and transmitting them to policy-makers.
At the county level, they aimed to influence the allocation of resources towards the priorities identified by citizens.
At the facility level, they worked with existing health facility management committees, which are meant to link the community to service providers. They also developed a simple community health scorecard so that people could compare their facility against the service charter on various dimensions, such as the provision of ambulance services, staffing level and complaints mechanisms.
What did they find out?
The results of the scorecards were shocking, particularly in the area of staffing. On average, facilities had staffing levels of just 48.5%, which essentially undermines key policies, such as free maternity services, an initiative of the Jubilee Government.
Once the scorecards were completed NTA held a national launch to engage leaders and distribute to the media, who have overwhelmingly reported on the research findings. This has certainly influenced decision makers to act more swiftly. Community members were also invited to discuss the findings in the scorecard to help them engage leaders at county level. There have been many positive results across different counties, including an increase in ambulance availability, more health centres offering maternity services, and improvements in water supply.
Empowering citizens can be a great catalyst for real change, as when they are provided with the right tools, they can effectively demand accountability from elected leaders. In the context of our project, they saw citizens’ advocacy for specific policy changes resulting in improved service delivery within a very short period.