Using policy to protect funding for a lifesaving program
Example: the Kakamega County Maternal Child Health and Family Planning Act 2017
The Kakamega County Maternal Child Health and Family Planning Act 2017 is an innovative use of legislation to safeguard funding outside of the normal budget cycle. The policy enshrines a lifesaving government program into law and ringfences funding to ensure its stability, regardless of future government priorities.
The need
In 2013, recognizing the increasing need to protect the lives of mothers and children in the county, the Kakamega County government launched Imarisha Afya ya Mama na Mtotoa community-focused social cash transfer program that provides funds to mothers in need after they access certain recommended health care services. Although wildly successful, the program was malleable to changes in political will. PATH advocates and partners acted to solidify the program into law, and in July 2017, Kakamega county’s governor enshrined the lifesaving cash transfer ensuring the longevity of the program though the Kakamega County Maternal Child Health and Family Planning Act 2017.
The policy solution
In 2013, recognizing the increasing need to protect the lives of mothers and children in the county, the Kakamega County government launched Imarisha Afya ya Mama na Mtoto, a community-focused social cash transfer program that provides funds to mothers in need after they access certain recommended health care services. Although wildly successful, the program was malleable to changes in political will. PATH advocates and partners acted to solidify the program into law, and in July 2017, Kakamega county’s governor enshrined the lifesaving cash transfer ensuring the longevity of the law though the Kakamega County Maternal Child Health and Family Planning Act 2017.
Traditionally, when wanting to influence finance, advocates follow the budgetary cycle and work to influence specific budget line items. The Kakamega County Maternal Child Health and Family Planning Act 2017 took a different approach, solidifying the Imarisha Afya ya Mama na Mtoto program into law to ensure protection of its funding.
The policy
Designed with four specific objectives in mind, the Kakamega County Maternal Child Health and Family Planning Act 2017 is aimed at increasing skilled delivery rates in Kakamega county; reducing mother and child mortality; reducing mother-to-child transmission of HIV; and improving nutrition status of children under two years of age.
Specifically, the legislation sets aside resources for the program by requiring the county to dedicate 3 percent of its health budget for the cash transfers allocated by the Department of Health Services, while using another 1.5 percent to provide stipends for important community health volunteers that provide essential health care services. In addition, some of the funds go toward postnatal family planning and HIV/AIDS prevention services, an attempt to help decrease fertility rates and better educate women about maternal and child health.
The impact
Because of the bill, the futures of 40,000 mothers are now more secure, and the Kakamega County government has a springboard from which they can continue strengthening MNCH efforts.
The Kakamega County Maternal Child Health and Family Planning Act not only helps to expand access to lifesaving services to mothers in need, but also serves as a bold and effective policy model that other counties can adopt at the local level to strengthen their health systems and the health systems of the nation overall. The bill’s success sets an example for other counties and the Kenyan national government to observe, which will hopefully drive future support in creating similar initiatives.
Considerations for application
The Kakamega County Maternal Child Health and Family Planning Act is an innovative way to put the force of legislation behind a government program and ensure its safety from any changes in political priorities. The method of ringfencing funding for a specific health issue can be applied to different settings or types of services and/or basic commodities.
Policy text
More resources