Determinants of equitable allocation of funds to public hospitals in Kenya
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Date
2013
Authors
Kihuba, Elesban
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
One of the key funding objectives is equity. A snapshot of the country's. health outcomes
indicates some disparities. Underlying this is the way funds are allocated. Provision of
medical services is carried out by health facilities. As is the case in other developing
countries, hospitals tend to dominate the health system. The government usually provides
financial support to all public hospitals which are meant to protect the catchment
population against social and economic consequence of ill health. Subsidiary legislation has
also been issued to govern management of hospital funds in the country. The focus of this
study was to determine if the public hospital resource allocation practice takes into
consideration the. differences in levels of need for different counties and also to describe
the preexisting political, economic and social conditions under which people engage in
procedure and benefit distribution. A cross sectional study design was used to address the
research objectives adequately. This was a descriptive study which aims to answer the
basic 'w" questions - Who Where, What, When, What, Why and so what? as contained in
the study's objectives. All the 47 Counties were targeted. The findings of this study indicate
that the current basis for allocation differs with what has been recommended under the
Commission on Revenue Allocation criteria. It's heavily dependent on utilisation data.
Comparison of share of a county hospital fund and the share of devolved funds indicated
that poor counties receive fewer hospital funds than their equity target. Regression
analysis showed that increase in funding over the last 4 years was mainly based on
utilisation data and hospital size. Most of the other determinants were ignored. The
qualitative findings also correlated these results. Respondents felt that HIV and rural
population groups should be prioritised as well as poverty and size of the hospital in
resource allocation. Inadequate resources were seen as the key obstacle in achieving an
equitable distribution of resources.
Description
A research project submitted to the school of humanities and social sciences in partial fulfilment of the requirements for the award of the degree of executive master of public policy and administration of Kenyatta University, 2013