Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya

Edwine Barasa, Susan Cleary, Sassy Molyneux, Mike English , 2016
KEMRI Wellcome Trust Research Programme

This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. Researchers at the Kemri Wellcome Trust research programme used a qualitative case study approach to examine processes in two public hospitals in Kenya.

The research showed that the budgeting and planning process in the case study hospitals was characterised by: lack of alignment, inadequate role clarity and use of informal priority-setting criteria. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included.

“It is clear that to improve priority-setting practices, decision makers in charge of these hospitals will need to focus their attention not only on the content and outcomes of priority setting but also - equally important - on the process.”

Public hospitals in Kenya could improve their budgeting and planning processes by:

  • aligning budgeting and planning practices

  • clarifying composition and roles of decision-making structures

  • using explicit and formal priority-setting criteria

  • incorporating both efficiency and equity in decision making

  • following deliberative democratic principles such as stakeholder engagement and empowerment, transparency, use of evidence and incorporating community values

Read more in this blog by Edwine Barasa.

Journal publication | Governance