Community and facility-level engagement in planning and budgeting for the government health sector - A district perspective from Kenya

O'Meara, WP; Tsofa, B; Molyneux, S; Goodman, C; McKenzie, FE; (2011) Community and facility-level engagement in planning and budgeting for the government health sector - A district perspective from Kenya. Health policy (Amsterdam, Netherlands), 99 (3). pp. 234-243. ISSN 0168-8510 DOI:

[img] Text - Published Version

Download (241kB)


Health systems reform processes have increasingly recognized the essential contribution of communities to the success of health programs and development activities in general. Here we examine the experience from Kilifi district in Kenya of implementing annual health sector planning guidelines that included community participation in problem identification, priority setting, and planning. We describe challenges in the implementation of national planning guidelines, how these were met, and how they influenced final plans and budgets. The broad-based community engagement envisaged in the guidelines did not take place due to the delay in roll out of the Ministry of Health-trained community health workers. Instead, community engagement was conducted through facility management committees, though in a minority of facilities, even such committees were not involved. Some overlap was found in the priorities highlighted by facility staff, committee members and national indicators, but there were also many additional issues raised by committee members and not by other groups. The engagement of the community through committees influenced target and priority setting, but the emphasis on national health indicators left many local priorities unaddressed by the final work plans. Moreover, it appears that the final impact on budgets allocated at district and facility level was limited. The experience in Kilifi highlights the feasibility of engaging the community in the health planning process, and the challenges of ensuring that this engagement feeds into consolidated plans and future implementation. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Item Type: Article
Keywords: Health planning, Decentralization, Community participation, PARTICIPATION, DECENTRALIZATION, REFORM, TANZANIA, UGANDA
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
PubMed ID: 20888061
Web of Science ID: 287887500007


Download activity - last 12 months
Downloads since deposit
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item