A new report by IDinsight, in collaboration with the Bill and Melinda Gates Foundation, has revealed substantial gaps in the integration of financial and non-financial data within Kenya’s health sector.
According to the report, Kenya’s health financing decisions are based almost exclusively on financial data, while critical non-financial data, such as health service delivery metrics and patient outcomes, are largely overlooked.
The disconnect, the study suggests, is contributing to inefficiencies in the sector and limiting the country’s ability to achieve optimal health outcomes.
Speaking during the report dissemination event in Nairobi, Dr Frida Njogu Ndongwe, IDinsight’s Regional Director for Eastern and Southern Africa, emphasized the importance of integrating both financial and non-financial data for more effective budget decision-making.
“We are only looking at the financial data but not looking at health outcomes and health service utilization. The two need to speak to each other so that decisions are made to improve the quality-of-service delivery and health outcomes to influence financing decisions,” said Dr. Ndongwe.
Kenya’s health system, while backed by robust financial and non-financial data systems, suffers from a lack of interoperability between these two data streams.
According to the study financial data which is reported through the Integrated Financial Management Information System (IFMIS), is disconnected from non-financial health data, which is tracked via the Kenya Health Information System (KHIS).
“The KHIS tracks health indicators like mortality rates and disease prevalence across different levels, from local communities to the national Ministry of Health. However, the absence of integration between IFMIS and KHIS platforms makes it challenging to link resource allocation with health outcomes.”
“National and County governments should integrate financial and non-financial health indicators for use to create trends that asses’ outcomes, efficiency and cost effectiveness of health delivery in Kenya and influence budget allocations to priority health programs.”
The report also notes that while Kenya has increased its health expenditure, the spending is not traceably linked to improved health outcomes.
For example, according to the study maternal mortality rates in the year 2018-2020 were at 365 deaths per 100,000 live births compared to 355 deaths per 1000,00 live births in the year 2021-2022, while neonatal mortality rates in 2018-2019 were at 22 deaths per 1,000 live births compared to 2019-2020 which were at 21 deaths per 1000 live births.
According to the study the financial and non-financial data disconnect limits the ability to ensure that health resources are allocated effectively to priority programs, reducing the potential for accountability within the sector.
The study calls for urgent reforms to ensure that health sector financing is informed by a more holistic view of the system, factoring in both expenditures and the effectiveness of services provided to Kenyans.
“The integrations can lead to improved accountability and better use of public health funds, ultimately benefiting Kenya’s healthcare system,” Dr Ndongwe said.
The report recommends that to improve accountability, there is a need to strengthen governance structures related to program-based budgeting (PBB), enhancing the monitoring and evaluation frameworks for county and facility-level health management, and empowering decentralized accountability mechanisms.
It also advocates for cross-sectoral collaboration, involving health policymakers, public budget officials, and external partners to foster better data integration.
Kenya’s health sector, the report adds, can learn from the education sector, where School Boards of Management play a critical role in accountability something that is largely absents in the health facilities. By improving these structures and leveraging emerging technologies, such as AI and integrating public data platforms, the country can drive better integration of financial and non-financial data for decision making therefore improving health outcomes.
