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Amplifying Voices Towards Advocacy for Improved RMNCAH Outcomes

Impact Report

AMPLIFYING VOICES PROJECT

The RMNCAH Network, through its Seed Grant project, aimed to advocate for improved Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) outcomes in Bungoma County, Kenya. The project’s objectives were multifaceted, including advocating for increased budget allocations for RMNCAH, prioritization of Gender Transformative actions, finalization of key RMNCAH policies, enhancing coalition visibility, and advocating for increased NHIF claims to support Primary Health Care (PHC) services.

 

Key advocacy results achieved during the project period include successful advocacy efforts leading to a KES 47.5M allocation towards RMNCAH programs, albeit lower than the targeted percentage. The network also contributed to increased NHIF empanelled facilities and inclusion of RMNCAH priorities in the County Health Sector Work Plan. Additionally, partnerships with organizations like Jacaranda Health facilitated resource-saving opportunities for the network’s activities.

 

Despite these successes, challenges were encountered, including delayed processes within the Department of Health and limited project resources. These challenges affected the implementation of certain activities, such as the MPDSR processes, highlighting the need for better coordination and resource mobilization strategies. Looking ahead, the RMNCAH Network plans to capitalize on established partnerships and continue advocating for improved maternal services in Bungoma County. Tracking key commitments from stakeholders and enhancing visibility through documentation and resource mobilization efforts are among the network’s priorities for future advocacy endeavors within the RMNCAH space.

Achievement Timeline

MILESTONES

Health allocation to RMNCAH Program

Initially, there was zero allocation towards RMNCAH programs (According to the final approved itemized budget for Bungoma County, FY 2023/24). RMNCAH Network together with CHMT made submissions with recommendations to the Executive (Health and Finance counterparts) for adoption (May 2023)

 

The network’s efforts have seen an allocation of KES 47.5M of KES 4.8B total health allocation to RMNCAH Program which is lower compared to what we advocated for. RMNCAH division saw a drop in its allocation from 2.7% in the previous FY 2022/23 allocation to 0.9% allocation in the FY 2023/24.

 

RMNCAH Network has made submissions towards increased domestic allocation for RMNCAH programs. This was done during Annual Development Program (ADP) FY 2024/25 Review. The network, alongside other civil society organizations also made submissions during the County Integrated Budget Review Outlook Paper FY 204/25 review meeting for Bungoma County in October 2023.

RMNCAH Network actively engaged in the MPDSR processes within Bungoma County in three levels: County review, sub county and community level MPDSR. During the seed grant, the network gathered evidence on MPDSR actions that needed budgetary allocations to be included in the annual work plan FY 2023/2024.Six MPDSR Actions were identified, and Network advocated for Budget allocation for the actions in the AWP. All the actions were incorporated in the AWP and allocated budgets, 3 of the 6 actions have been allocated funds and some progress have been seen on their implementation(This is 50% of the total actions included in the AWP)

 

According to the Final copy of the AWP FY 2023/24, County quarterly MPDSR reviews the county allocated Kes 400,000 to facilitate the county quarterly MPDSR review meetings while Kes 500,000 was allocated towards the RMNCAH quarterly performance review meeting in the FY2023/24.In FY2023/24, Kes 16M was allocated towards the completion and equipment of the Satellite Blood Donor Centre. This was a significant increase in the proportion that the network was advocating for.

RMNCAH Network has had a series of consultative discussions with the department of health, particularly, the Division of Health Policy and Planning, to track the status of its priority policies; Referral Strategy and Community Health Strategy (CHS) Regulation.

The progress was somehow affected by the leadership transition in the Division, as the Head of the Policy and Planning was changed. H.E. Gov. Kenneth Lusaka, Governor Bungoma County, also appointed a Taskforce to review the Bungoma County Health Services Act 2019. The Network adjusted to the changes and made submissions and recommendations on Referral Strategy and CHS regulations to the Taskforce. RMNCAH Network was able to support Review meeting for the Referral Strategy through the Seed Grant from Options Consultancy limited.

 

One member of the Network, Phelgona Odipo, was among the taskforce that was appointed by the governor to review the CHS Act 2019, and this was a leverage for the network to be part of the review and give inputs towards key sections of the Act. The CHS Act is yet to be validated yet, therefore RMNCAH Network will wait for the release of the final Act to review its priority sections.

RMNCAH Network’s advocacy efforts towards strengthened Primary Health Care for Bungoma County has contributed to major successes in the department of health. During the Seed Grant project, the network has meaningfully taken part in reviews for NHIF claims for Primary Health Facilities. Through these reviews, the number of facilities claiming from NHIF has grown significantly from 148 to 151 facilities. A total of 163 facilities have been Accredited by NHIF, as Bungoma County Referral Hospital being upgraded from Level iv to level v, according to KEPHS Report.

 

RMNCAH Network was among key stakeholders lauded by the CECM, Health, Dr. Andrew Wamalwa, towards supporting the Department of health. This was during Universal Health Coverage Day, when the Dr. Andrew was giving an update about Bungoma County in terms of PHC to achieving UHC. (RMNCAH Network – YouTube Channel)

 

The Network also celebrates the Launch of Bungoma County Vital Signs Profile as measurement tool for Primary Health care performance. This launch was led by Governor Kenneth Lusaka, alongside other launches; Primary Health Care 2023, LusakaCare Caravan to offer health services to areas with no dispensaries.

 

RMNCAH Network received a request by the Department of Health towards launch of Community Health Promoters (CHPs) toolkits and other digital gadgets in February 2024.

 

The Network intends to hold consultative discussions towards implementation of the Community Health Strategy Regulation towards strengthening the roles of CHPs. It will also leverage on the links with the NHIF to follow-up with monthly reviews for facilities to enhance 100% claims by the facilities.

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