The project goal is increased domestic financing for immunization and improved distribution of vaccines from national to county level. To facilitate prioritization of immunization budgeting in the county budgets, CHP continued several engagements with influencers at different levels. With the target of immunization expenditure, MoH and Finance officials at Narok County were given special engagement as it was noticed limited understanding of issues surrounding immunization lead to failure in prioritizing immunization in planning and budgeting. The information on immunization budget expenditure and other crucial information for evidence advocacy in Narok County were not available posing a great opportunity for engagement with the influencers. This is achieved through advocacy to ensure sustained increase in disbursement of the proportion of the budget allocated to immunization by the Narok county government. The project focused on ensuring that policy makers, organized interest groups gain knowledge and understanding on the need for domestic financing and become champions of domestic financing on Immunization. With the increased access to budget information, the interest groups place pressure on decision makers to increase domestic financing on immunization.
The interventions continued to be in the two main areas of Evidence gathering and stakeholder engagement with a focus on Champion-building and influencer’s engagement targeting Civil Society Organizations (CSOs) and Health facility Champions, Engagements with the Political leadership, Ministry of Health (MoH) and Finance Narok officials. Evidence gathering was mainstreamed in the project activities and culminated in a documentary on Immunization if the county
The focus was to strengthen the capacity of health facility champions and Civil Society organizations to participate and become key influencers in the budget making process with the aim of placing pressure on the county government to increase the budget allocation to immunization.
Thirty Health facility champions (27 Male and 3 Female) capacity to engage the county Government continued to be enhanced as evident in the community meetings and forums they held to discuss the County budgeting process and mobilization of community members to analyze the 2021/2022 Annual development Plan (ADP). The ADP was analyzed in 24 public participation forums led by the Health Facility immunization champions where 24 submissions were made to County government finance department on immunization financing. To achieve this, follow up meetings with Health Facility Immunization Champions and refresher capacity building was done by CHP in partnership with IPFK.
There is evident improvement in participation of CSOs in the Narok County budgeting process. For the first time since devolution of government to County government units, 14 Narok County Civil Society Organizations reviewed the County Annual Development Plan (ADP)for Financial Year 2021/2022 and did a joint submission to the County Executive Committee Member (CECM)-Finance, Economic Planning, CT and e-Government . The submission was based on the observations made on the draft ADP 2021/22 and also included the CSOs proposals as recommendations for consideration and adoption in the final plan.
The aim of reviewing and the ADP and making the submission were to generate empirical evidence for action by the County government and also increase visibility on gaps to be acted upon. In addition to sharing with CECM the document was shared among key stakeholders and decision makers. It is envisioned that the decision makers will refer to this document when making budgeting decisions for the year 2021/2022
This review and submission were made possible through the CSOs trainings, one on one meetings and boot camps done by Community Health Partners (CHP) in partnership with Institute of Public Finance Kenya (IPFK)
The finance sector and Division of Immunization are key to the development of supplementary budget and pre budget issues as they are consulted by both the executive and the county assembly teams. With the increased focus on immunization financing the project focused on engaging this team in ensuring they provide both the Executive and the county assembly with evidence-based advocacy for domestic financing of immunization. 4 meetings were held where 13 (11 male and 2 female) champions from the County Health Management Team (CHMT) and the county finance and economic planning team supported CHP in developing a gap analysis for immunization financing requested by H.E the Governor, Narok County after a meeting with CHP team on enhancing domestic financing for immunization. This document was also shared with the CEC health, CEC finance, health and budget committees for consideration as they develop or review the 2021/2022 county plans.
Engagement with high-level immunization champions on prioritization of immunization in the budget influenced the county government of Narok to focus on improving financing for immunization by committing to increase the budget allocation for immunization up from 15 million earlier approved to 30 million in the current financial year (2020/2021) in the supplementary budget planned for October. The politicians (Narok County Governor H.E Samuel Tunai, Members of the County Assembly (MCAs)), Ministry of health (CEC Health and 2 Chief Officers for Medical Services and public health) and finance department officers (CEC, the director and 3 county economists) continued to be engaged in discussions on domestic financing for immunization with a focus on addressing the gaps after International donors pull out funding or change strategy.
Two members of parliament from Narok County, Honorable Soipan Kudate (The Narok County Women Representative) and Honorable David Sankok (Nominated Member of Parliament) have been engaging other policy makers on the need to focus on strategies to improve domestic financing of immunization. This was as a result of gaining knowledge and understanding from CHP on the need for domestic financing and becoming champions through media and other forums both in the county and National government.
To enhance Evidence based immunization financing advocacy, an Immunization Tracking tool was developed so as to enable the team to collect real-time data on the status of immunization including efficiency on service delivery and extend of absorption of the immunization budget. The data collected will be used to develop fact sheets and policy briefs for elevation of immunization conversations with the key influencers. This tool was developed by IPFK and shared with 6 (3 Female and 3 Male) sub county public health nurses and 2 male members of Narok CHMT. The participants were able to interact with the new Immunization Tracking tool and gave their feedback for CHP and IPFK to incorporate before releases the final tool.
To advocate for domestic immunization financing in Narok County, the County Health Management Team (CHMT) and the county finance and economic planning team held a round table meeting where strategies on improving domestic financing of immunization were discussed
CHP has continued to build relationships with both the CHMT and the finance and economic planning teams in Narok County to mobilize financial and political good will towards financing for immunization. This team is key in the budgeting process they are entrusted to develop the budget for the county and are also key advisers to both the executive and the county assembly. In order to build this relationship several meetings were held between CHP and 5 (1 female and 4 male) Economic planning team members to discuss the County budgeting process, the 2021/2022 ADP, County Budget Review and Outlook Paper (CBROP) as crucial documents that can be used to strategically improve the Immunization budgeting.
Evidence for policy engagement was enhanced after development of a community documentary that was able to outline areas of engagement to increase domestic financing. The information in the documentary has shown the government commitment in taking up the cost of immunization as a government responsibility and not of the donors.
The six day filming managed to get views from 18 (3 female and 15 male) Facility immunizations Champions, 8 mothers who are the beneficiaries of immunization, 2 CHP staff, 2 of our recruited High level Champions, 2 CECs and 2 health care providers. It has given a sample that represents the community and the county government views.
