COVID-19 in Kenya: Indices on County Healthcare Capacity and Populations at Risk

The virus, COVID-19 is burdening an already strained healthcare system in Kenya. Under the 2010 Constitution and after the 2013 election, healthcare is one of the 14 functions that has been devolved to the newly formed 47 counties. County governments are now at the frontline of delivering services to address the COVID-19 pandemic. However, healthcare capacity in the 47 counties is varied. Historical inequalities across regions, and in the health sector, date back to colonial times and despite seven years of devolution (2013-2020), convergence towards a uniform healthcare system across counties is far from a reality. This report offers some empirical evidence on which of the 47 counties in Kenya are best and least-well situated to deal with the Covid-19 virus. The purpose here is to assist policy makers in determining where limited resources, financial, human, and medical, can best be employed and where additional support may be provided by the national government to augment local resources.

The report presents data on two critical dimensions of countries specific circumstances: their healthcare capacity to respond to the virus and the risk to their population of contracting the disease. The data are presented in the form of two indices, specifically a healthcare capacity index and a population risk index. As the objective is cross-county comparisons, these are both relative measures. Another measure on county population size is also provided since the absolute size of a county’s population may be a factor in how resources need to be deployed.

A Diagnosis of the Public Procurement System in Kenya

This paper traces the institutions and processes that govern the use of public resources within the public sector in order to identify whether the broad goals of the public procurement policy are being achieved. Following this detailed review and selected case studies, the study contends that while the quest to use public procurement to advance economic development is a legitimate policy goal, government procurement in Kenya unequivocally fails to do so. And this failure is regular and consistent throughout most state departments, ministries and agencies, suggesting that the incentives for a clean, transparent and effective public procurement in Kenya will remain a long-term challenge in Kenya’s development path.

The Day After Tomorrow: Africa’s Battle with Covid-19 and the Road Ahead

Our report in collaboration with Observer Research Foundation provides an account of Africa’s battle against COVID-19, maps a profile of the continent’s vulnerabilities that render it susceptible to systemic collapse, and analyses ways in which it can build resilience in the face of future crises. The report takes a systemic perspective, and provides analyses oriented around four axes: Health, Economic, Socio-political and Technological systems; and three key elements: Risk, Response and Resilience.

Leasing of Medical Equipment Project in Kenya: Value for Money Assessment

The Kenya Government’s commitment to provision of quality and affordable health care for all Kenyans from a constitutional, policy and even global perspective is not in doubt. As a critical component of economic development, Universal Health Coverage (UHC) is identified as one of the planks of the government’s “Big Four” Agenda.

Despite obvious successes in health outcomes, in part driven by Devolution, challenges especially of inadequate medical personnel, low specialized health infrastructure to deal with a rise in non- communicable diseases and cases of injuries remain. This has engendered increasing demand for health services, piling pressure on the government budget.

The leasing of medical equipment (Managed Equipment Services-MES) project was initiated in 2015 as an alternative health care financing option to scale up health infrastructure for provision of specialized medical care. The question of whether this was the most cost-effective intervention, especially as a public private partnership (PPP) project, is what this publication sought to investigate. Which then begs the question: four years down the line, is the public getting value for money from implementation of the project?

The Unintended Effect of Kenya’s Alcohol Regulation Policies

Kenya’s Public Debt

The study aims at providing the current state of  play on Kenya’s Public Debt and the assessement of its sustainability. Debt management  options, are also suggested to enhance prudence in resource utilization to achieve economic development.

Kenya’s Public Debt

Analysis of the Auditor General’s Reports on the Financial Statements of National Government

This publication examines the findings contained in the financial audit reports published by the Office of the Auditor General for the three consecutive financial years from 2013-2014 to 2015-2016. Guided by the fact that financial audits are conducted at the sector level, the scope of this study highlights the findings for the Ministries, Departments and Agencies (MDAs) in the agriculture, health, education and devolution sectors.

The findings reveal that MDAs are heterogeneous in the care and fidelity with respect to public expenditure management. Whereas public spending has grown for all four sectors, the audit opinions have varied covering the full spectrum from Clean Opinions to Adverse opinions. This confirms the claim that different departments of the government render accounts that show poor levels of accounting and expenditure management to others that adhere fully and pass the constitutional threshold of lawful and effective expenditure management.

A Political Economy Analysis of Devolution in Kenya

This paper explores the diverse viewpoints of stakeholders on devolution and examines the implications of these recent changes in the micro- and macro-workings of Kenya through a political economy analysis framework. In what follows, interview results, are grouped into four thematic areas:

1. Public service delivery and development outcomes;
2. Revenue allocation and inter-governmental relations;
3. Inclusion, public participation and role of civil society; and
4. Expectations for devolution and possible future scenarios.

Key recommendations include:

• Conducting a Kenya-wide but county-specific needs assessment to identify priorities for each region while ensuring a sense of ownership for projects and empowering citizens to increase government transparency, monitor project implementation and hold stakeholders accountable to their roles and responsibilities within devolution.
• Continue to strengthen partnership between and among counties and encourage forward-thinking leadership to foster an optimistic outlook on devolution.
• Clarify roles between the counties and national government to prevent overlaps/duplication in functions and inefficient use of revenues.
• Follow best practices in the implementation of revenue allocation and public participation mechanisms.

Kenya Urban Areas Performance Index Report 2017

This report shows performance of the six largest urban areas in Kenya based on three areas, namely: service delivery, conditions for investment and governance. Performance of these urban areas is assessed using the Urban Areas Performance Index, a composite Index comprising 67 indicators (questions) that scores, on a scale of 0 (least performance) to 100 (best performance) points and ranks these urban areas. Urban areas that ensure individuals’ free choice, create favourable business conditions, use public resources efficiently and ensure transparency of their activities are ranked higher.

Also, the report provides a rich source of data and information that can be used by different audiences including policy makers, civil society, researchers, students, the media and indeed the general public to inform debate and dialogue on urban governance and planning. For example, this report provides policy makers with impetus to initiate the process of establishing urban areas structures. Similarly, it provides key messages for other groups such as the media and civil society to advocate for the same.