Budget credibility refers to the extent to which government budgets are implemented by comparing actual revenues and expenditures with approved budget estimates. In low- to middle-income countries, health budgets are typically under-executed by 14 percent, on average. Recent research has shown that Kenya’s national health budget was underspent by 18 percent between fiscal years 2015 and 2017. Research for this brief, which uses country-level budget execution data, uncovered a similar pattern. In fiscal years 2018, 2019, and 2020, for example, 17 of Kenya’s 47 counties spent less than 85 percent of their health budgets, on average, while only 13 counties spent within five percent of their approved budgets.
This study will look into the causes of health budget deviations and the effects of poor budget execution on health care delivery in Nakuru and Kakamega counties. The insights gathered will inform policy actions that county and national governments can implement to ensure timely availability of funding and enhance budget performance rates.