The Council of Governors (CoG) has unveiled the County Financial Management and Procedures Manual for County Health Spending Units, a move aimed at improving efficiency and enhancing service delivery in county health facilities.
During the launch, CoG Chairperson Ahmed Abdullahi highlighted the manual’s role in positioning county health facilities as key drivers of the Universal Health Coverage (UHC) agenda under the Bottom-Up Economic Transformation Agenda on Health.
“The Facilities Improvement Financing (FIF) Act provides for full financial autonomy of health spending units, while the Social Health Insurance Act offers financing mechanisms for these units,” said Abdullahi.
The Constitution of Kenya mandates county governments to oversee quality health services at primary and secondary levels.
Abdullahi acknowledged that health services have historically been delivered outside defined governance structures, leading to inefficiencies and sustainability challenges.
“We are cognizant that hospitals are now being audited as independent spending units. This necessitates systems and capacity to manage resources effectively and deliver healthcare services,” he noted, adding that responsibility for healthcare delivery lies with facility in-charges.
The Chairperson emphasized the ongoing UHC reforms, which have redefined health service delivery and introduced radical changes. To support implementation, 43 of the 47 counties now allow health facilities to retain funds generated internally to pay for services.
“All 47 counties are providing complementary funding to health facilities, as FIF alone cannot fully meet their needs,” Abdullahi stated.
He also lauded the counties’ contribution to the Social Health Authority (SHA) initiative, which replaces the National Health Insurance Fund (NHIF).
So far, 5,300 public health facilities have been registered and empaneled under SHA, with 14.8 million members enrolled to access tax-funded primary healthcare at Level 2 and Level 3 hospitals.
The Council continues to engage Public Finance Management actors at both national and county levels to facilitate the autonomy of health facilities as envisioned in the FIF Act.
Abdullahi urged Kenyans to register with the SHA to benefit from enhanced healthcare access.
“This manual is a crucial step in ensuring that health facilities operate efficiently, sustainably, and within proper governance frameworks,” he concluded.
The launch marks a significant milestone in aligning county health systems with national UHC goals, aiming to improve the quality and accessibility of healthcare across Kenya.
