GARISSA SOCIAL SECTOR BUDGET BRIEF

GARISSA SOCIAL SECTOR BUDGET BRIEF (2013-14 to 2015-16) Highlights In 2015-2016, county spent Ksh 6.5 billion, out of which 41 per cent was spent on social sector. Efficient administrative practices has resulted in year-on-year improvement of budget execution which increased to 88 per cent in 2015-16. The wage bill constitutes 35 per cent of the total expenditure of 2015-16 and acts as a challenge in implementation of the budget. This study recommends that the county take measures for staff rationalization to achieve a sustainable wage bill. In the health sector, only 18 per cent of the total budget in 2015-16 was allocated to development activities which is below the mandated 30 per cent as per the PFM Act 2012. The county needs to amend its budget formulation and strive towards more balanced budgets in order to improve health service delivery. The county government has specific budget lines defined for HIV/AIDS which is highly appreciated. The county is recommended to ensure such transparency for other critical heads like nutrition, maternal and child health etc. From 2013-14 to 2015-16, the education sector budget and expenditure has steadily increased. However, execution of development budget was only 69 per cent. This needs to be monitored by the county government. The Gender Parity Index (GPI) at all levels of education is much lower than the national averages. So, the county government needs to focus on provision of equitable access to education by promoting girls education. In the water sector, despite increasing development expenditure, the county faces an acute water problem with low coverage and poor service delivery. This calls for immediate action towards improving access to safe water by increasing water supplies infrastructure as well as the number of water service providers. 1

GARISSA Introduction Garissa is one of the three counties in the north-eastern region of Kenya, covering an area of 44,174 km 2. The county is divided into 6 sub-counties and 23 wards. The estimated population of the county is around 786 thousand, consisting of 54 per cent male and 46 per cent female. The county s broad strategic priorities as per the county s fiscal strategy paper (2016) include creating a conducive business environment; investing in agricultural transformation and food security; provision of accessible and quality health services; investing in transport and infrastructure development; improving access to water and sanitation; and investing in accessible and affordable energy. Administrative and demographic profile Area (km 2 ) 44,174 Number of sub-counties 6 Number of wards 23 Total population (2015) 785,976 Male 422,444 Female 363,532 Under 5 year 139,451 Primary school age (6-13) 215,541 Secondary school age (14-17) 189,272 Source: CIDP (2013-17) Overall budget/expenditure In 2013-14, the first year of post devolution, the county budget estimate was only Ksh 4.8 billion (Figure 1). The county significantly increased the budget by 62 per cent to Ksh 7.9 billion in the next year, however it marginally declined to Ksh 7.4 billion in 2015-16. In 2015-16, 40 per cent was allocated to the social sector out of the overall budget of the county. As per the county budget review outlook paper (CBROP 2015-16), the budget was adjusted for the subsequent years as per the actual expenditure in the previous years and absorption capacity as per the availability of resource. In terms of actual expenditure, county spent Ksh 6.5 billion in 2015-16 which was slightly lower than actual expenditure in 2014-15 at Ksh 6.4 billion. In 2015-16, 41 per cent of the total expenditure was spent on social sector. Execution of overall budget has improved post devolution. In 2013-14, the overall budget absorption was 45 per cent, mainly due to low absorption of development budget at only 31 per cent. The key factors that led to low absorption rates were inadequate physical infrastructure/office space to accommodate staff, delay in establishment of internal audit committee, and low local revenue collection which affected funding of planned activities. Additionally, IFMIS and GPAY connectivity problems coupled with inadequate capacity of the users of IFMIS also affected budget execution. The county took several steps to address these issues (e.g. improvement in 100 80 60 40 20 0 8 6 4 2 0 Figure 1: County budget & Expenditure (Ksh billion) 4.8 7.9 Budget 7.4 2.2 6.6 Expenditure 6.5 2013-2014 2014-2015 2015-2016 51 45 Figure 2: County budget absorption rates (%) 31 96 84 88 72 96 79 2013-2014 2014-2015 2015-2016 Recurrent Development Total 1

local revenue collection by 264 per cent; improvement in staff capacity; and embracing the use of IFMIS to process financial transactions) and as a result absorption of budget significantly improved to 84 per cent in 2014-15. In 2015-16, the overall budget absorption rate further increased to 88 per cent, mainly due to an improvement in absorption rate the development budget viz. 72 per cent (See CBIRR 2013-14, 2014-15 and 2015-16). Health Services Garissa has 133 health facilities consisting of 8 primary care hospitals, 3 secondary care hospitals, 25 basic primary health care facilities, and 97 dispensaries. Good health care services are mostly in the urban areas. The average distance to the nearest health facility is 35 Km. The number of trained health personnel is very low with the doctor population ratio being currently 1:41,538 while the nurse population ratio is 1:2,453 (For further details see CIDP p 23). The county s health indicators have improved during the defined time period. Between 2013 and 2015, the coverage of 4+ ANC visits improved from 43 per cent to 59 per cent, and skilled delivery increased from 56 per cent to 71 per cent. Also, exclusive breastfeeding increased from 54 per cent to 74 per cent. In terms of nutrition indicators the county seems to be following a mixed trend. It has 11 per cent of wasted children and 13 per cent of underweight children compared to the national average of 4 per cent and 11 per cent respectively. While, at 16 per cent of stunted children, Garissa has the least number of stunted children amongst the 10 counties studied. In 2013-14, the county government allocated Ksh 952 million for health sector, representing 12 per cent of its total budget (Figure 3). Next year, the budget was increased by almost 52 per cent to Ksh 1.4 billion. This further increased to Ksh 1.5 billion in 2015-16 representing 20 per cent of the total budget. In terms of composition, development budget had a share of 23 per cent in the total health budget in 2013-14, which further decreased to 18 per cent in 2015-16 (Figure 4). The county needs to amend its budget formulation and strive towards more balanced budgets in order to improve health service delivery. In terms of economic classification, salary/wage bills amounted to Ksh 1 billion in 2013-14, representing 46 per cent of the total county expenditure. This figure went up to Ksh 1.5 billion in 2014-15 that accounted for 22 per cent of the total expenditure. In 2015-16, the salaries/wage bills at Ksh 2.3 billion represented an increase of 56.6 per cent from 2014-15. This increase is attributed to the growing workforce in the county. Select health indicators MCH service coverage (%) 1 2013 2015 4+ ANC visits 43 59.3 Skilled delivery 56.24 70.9 Exclusive breastfeeding 54.1 73.6 Fully immunized child 50.6 61.5 Nutrition status (%) 2 Garissa Kenya Stunted children 15.6 26 Wasted children 11.4 4 Underweight children 13.1 11 HIV (%) 3 HIV adult prevalence 2.1 6 ART adult coverage 48 79 ART children coverage 10 42 1 DHIS 2013 & 2015 2 KDHS 2014 3 Kenya HIV County Profiles 2014 2

Figure 5: Health Expenditure and Absorption Rates Source: Programmatic distribution of budget data from PBB 2015-16 The actual health spending by the county was Ksh 1.2 billion in 2014-15, and Ksh 1.4 billion in 2015-16, representing budget absorption rates of 86 per cent and 96 per cent respectively (Figure 5). During this period, the execution of recurrent budget remained constant at 97 per cent (Figure 5). While, utilization of development budget was 65 per cent in 2014-15 that significantly improved to 89 per cent in 2015-16. As for distribution by programmes, in 2015-16, at 66 per cent, administration and support services accounted for more than half of the total budget of the health sector (Figure 6). While the shares of curative services and preventive and promotive services accounted for 32 per cent and 2 per cent respectively. Under the preventive and promotive services programme, the county allocated budget for HIV, AIDS and cent and public health. In the absence of specific budget lines, this brief could not track the county s own budget and expenditure for nutrition. However, UNICEF and USAID provide funding support for nutrition. The health sector faces various challenges such as inadequate infrastructure, shortage of qualified health personnel, and on time delivery of medicines and medical supplies (See CSFP 2015-16, p 24). To improve health service delivery, the county government needs to allocate more development budget as well as follow the guidelines of the PFM Act (2012) that mandates a minimum recurrent development ratio of 70:30. 3

Education Under devolution, the county has targeted three key areas for the education sector vis-à-vis infrastructure expansion and improvement, learning support and access to education for bright and needy students. At present, the county runs 213 early childhood development and education (ECDE) centres and 3 youth polytechnics. In addition, there are 131 primary and 18 secondary schools that are funded and managed by the national government. The number of teachers currently providing basic education is 1,351 consisting of 380 ECDE, 728 primary, and 243 secondary school teachers. The county seems to be performing better in provision of access to education at the pre-primary in comparison to the primary level and secondary level. As of 2015, gross enrolment ratio (GER) is 77 per cent at pre-primary level compared to the national average of 76.5 per cent. While the GER of 73.4 per cent at primary level is significantly lower than the national average of 103.6 percent, and at secondary level it is 21.2 per cent compared to the national average of 63.3 per cent. Similarly, with net enrolment ratio (NER) of 58.6 per cent at primary level and 14.4 per cent at secondary level, the county has recorded little progress in provision of higher education vis-à-vis the national average of 88.4 per cent and 47.8 per cent respectively. The pre-primary level NER in the county is comparatively higher at 76.2 per cent. The county is facing challenges in provision and promotion of secondary education as that has not yet been devolved. At present, gender parity index (GPI) values of the county at ECDE, primary, and secondary education level stand at 0.68, 0.58, and 0.43 respectively. The values indicate that a larger proportion of boys are accessing education in comparison to the girls. The GPI is much lower than the national average at all the levels of basic education, which indicates a lower-than-national performance in providing equitable access to education. There is a need of the county government to align its focus on providing equitable access at all levels of education by promoting girls education. Select education indicators (2015) Pre-primary education Garissa Kenya Gross enrolment ratio (%) 77.2 76.5 Net enrolment ratio (%) 76.2 74.6 Gender parity index (value) 0.68 0.96 Pupil teacher ratio* (no.) 52.3 31.9 Primary education Gross enrolment ratio (%) 73.4 103.6 Net enrolment ratio (%) 58.6 88.4 Gender parity index (value) 0.58 0.96 Pupil teacher ratio* (no.) 54.6 35.2 Secondary (%) education Gross enrolment ratio (%) 21.2 63.3 Net enrolment ratio (%) 14.4 47.8 Gender parity index (value) 0.43 0.89 Pupil teacher ratio* (no.) 23.1 20.7 * The figures pertain to public schools Source: State Department of Education, Nairobi 4

The county s budget allocation for education was 3.5 per cent, 3.8 per cent and 6.6 per cent of the total budget in 2013-14, 2014-15, and 2015-16 respectively (Figure 7). In absolute terms, the budget steadily increased by around 50 per cent from Ksh 169 million in 2013-14 to Ksh 300 million in 2014-15 and further to Ksh 489 million in 2015-16. Over the same period, there was a complete shift in the recurrent and development budget ratio from 70:30 in 2013-14 to 29:71 in 2015-16 creating more fiscal space for development activities (Figure 8). Figure 9: Education expenditure and absorption rates Source: Programmatic distribution of budget data from PBB 2015-16 From 2014-15 to 2015-16, overall absorption of education budget marginally fell from 77 per cent to 76 per cent (Figure 9). Also with an increase in development budget over the years, actual spending had improved. The absorption rates increased from 44 per cent in 2014-15 to 69 per cent in 2015-16. However, this is not satisfactory and some of the factors that adversely affected execution of development budget were inadequate infrastructure and staffing, slow pace of enrolment and lack of an ECD training college in the county (For further details see CIDP 2015-16, p 25). In line with its development plans, the county had spent on various development projects, like construction of ECDE centres, primary schools, secondary schools and classrooms in polytechnics. To reduce teaching staff shortage, the county hired more ECDE teachers. The county government also implemented a county scholarship programme in 2014-15 (For further details see The Promise of Devolution 2015, p 29). Among the programmes, ECD programme had received highest budget allocation of 70 per cent in 2015-16. Also, budget allocations for administration and support services and public services were 18 per cent and 12 per cent respectively (Figure 10). Due to lack of disaggregated expenditure data, the scale of execution of these programmes weren t tracked. 5

Water Services Garissa has one permanent river (River Tana), 25 shallow wells, 65 boreholes, 177 water pans and one dam. Approximately only 23.8 per cent of the population have access to safe water. Access to piped water is also limited to the sub-county headquarters where approximately 27,725 households have connection. The main source of water in the county is River Tana and seasonal Laghas. The average distance to the nearest water point is 25 km. (See CIDP p 23; CBROP 20150-16, p 15). The performance of the water sector has been deteriorating over time. Between 2013 and 2016, the county population within service areas of WSPs decreased from 21 per cent to 20 per cent, while water coverage declined significantly from 81 per cent to 62 per cent. Also, the non-revenue water increased from 50 per cent to 55 per cent in the same period. In 2013-14, the county government allocated Ksh 393 million for water services, representing 5 per cent of its total budget. Next year, the budget increased manifold times to Ksh 961 million, but declined by 5 per cent to Ksh 916 million in 2015-16. The share of water services in the budget for 2014-15 and 2015-16 remained constant at around 12 per cent (Figure 11). Considering the scarcity of water in the county, it is necessary for the government to allocate a higher share of budget towards water services. In terms of composition, development budget had a share of 51 per cent in the total water services budget in 2013-14, which steadily improved to 80 per cent in 2014-15 and further to 86 per cent in 2015-16 (Figure 12). Select water indicators County population within service areas of WSPs (%) 2013 2016 21 20 Water coverage (%) 81 62 Non-Revenue Water (NRW) (%) 52 55 Source: Report on performance review of Kenya s Water services sector 2013 and 2016 Figure 13: Water services expenditure and absorption rates 6

The actual expenditure incurred by the water services sector faced an improvement of 14 per cent from Ksh 757 million to Ksh 864 million from 2014-15 to 2015-16 (Figure 13). Simultaneously, the overall absorption of water budget increased from 79 per cent to 94 per cent, mainly due to improvement in execution of development budget to 94 per cent in 2015-16. Also, absorption of recurrent budget improved from 96 per cent to 97 per cent during the same period (Figure 13). Source: Programmatic distribution of budget data from PBB 2015-16 In 2015-16, on the basis of distribution of the budget into different programmes, water infrastructure development received highest budget allocation of 74 per cent. While the shares of administration and support services, and water resource management were 17 per cent and 9 per cent respectively (Figure 14). As per the CBROP (2015-16) report, the water budget was utilized on projects that included excavation of new water pans, construction of boreholes, extension of water supplies and emergency water provision through water trucking. Despite increasing development expenditure, the county faces an acute water problem with low coverage and poor service delivery. Hence, the county government needs to take immediate action towards improving access to safe water by increasing water supplies infrastructure through construction of more dams, borewells, pipelines etc., as well as increasing the number of service providers. 7

Technical Note The social sector analysis is based on the financial data of the following three departments, viz. (a) Health; (b) Education; (c) Water. The budget and expenditure data has been sourced from County Budget Implementation Review Report (CBIRR) of 2014-15 and 2015-16. The programme wise budget bifurcation for 2015-16 has been taken from Programme Based Budget Report (PBB) of 2015-16. Social services was a part of the culture department, but no county specific data on social protection/ social services was available as a clear component and hence hasn t been mentioned in the budget brief. Due to absence of specific budget lines, the study could not track and comment on allocation/ expenditure for sanitation and nutrition related activities. 8