West Pokot passes landmark stand-alone health bill

The law will allow county health facilities autonomy over the resources they generate.

In Summary

• It allows the county to increase spending on health care. 

• Amref says the law complements UHC's target of increasing health care expenditure. 

West Pokot county assembly in session
AUTONOMY OVER RESOURCES: West Pokot county assembly in session
Image: FILE

A law enacted by West Pokot legislators allows county health facilities to invest in service delivery opportunities like pharmaceutical and non-pharmaceutical supplies.  

The Facility Improvement Fund law is the first such legislation in Kenya and it is expected to increase investments in health and boost Universal Health Coverage.

West Pokot, with the support of Amref Kenya, is set to ring-fence revenues generated by health facilities for use in improving health infrastructure and other essential services.

The bill had been tabled in the county assembly in March and passed unanimously. It became law after Governor John Lonyangapuo gave his assent.

Amref's health director Meshack Ndirangu said the law aligns with the UHC's target of increasing health care expenditure.

“When facilities have autonomy over the resources they generate, they can increase investments in health care at the same time ensuring that spending is efficient and targeted for impact,” Ndirangu said.

Last week on Friday, First Lady Margaret Kenyatta launched the third medical safari under her Beyond Zero health project in Pokot.

Kenyatta commended the county leadership for pumping more resources to the health sector to help reduce referrals and deaths.

The Public Finance Management Act 2012 took away the freedom of health facilities to retain, bank and spend revenues collected from user fees.


Under the Act, revenue collected is submitted to the County Revenue Fund from where facilities request for funds.

Bureaucracies set in and quite often less funding than what was remitted is provided. The health facilities continue to experience delays in the procurement of essential supplies. Staff motivation is also reduced due to the inability of health facility management teams to afford a favourable working environment.

This reduced autonomy has also resulted in a decline in donor support for many facilities due to their limitations in dealing directly with donors.

But, as demonstrated by West Pokot, the landmark PFM Act also provides for county governments to develop laws that allow them to give financial autonomy to units such as health facilities.

The Act presents subcounty health units such as hospitals and health facilities the opportunity to have residual rights over the revenue they generate.