The KENYA INSTITUTE for PUBLIC POLICY RESEARCH and ANALYSIS No. 80/2019-2020 Eyes on Social Sector Budgets Children, Youth and Women Sensitive Planning and Budgeting in Kenya: Trans Nzoia County Brief, 2014/15-2017/18 County Government of Trans Nzoia KEY HIGHLIGHTS OF THE BRIEF This brief provides an analysis of how the County Government of Trans Nzoia plans and budgets for the needs of children, youth and women. The analysis focused on social sector (health, education, water and sanitation, social services, and nutrition) budgets for the period 2014/15-2017/18. The analysis was based on budget information collected from the Office of the Controller of Budget, county policy documents and face-to-face interviews with relevant county stakeholders. The key highlights from the analysis are summarized below: a). An estimated 52 per cent of the Gross County Product (GCP)1 of Trans Nzoia, which ranked 19th (1.7% contribution to GDP) of all the 47 counties in Kenya as of 2017, came from the services sector. The county should continue creating an enabling business environment to attract more investments in the services, manufacturing, industry and agricultural sectors, and investing in enhancing farmers’ capacities in modern agricultural methods, extension services, agribusiness and research. b) The county’s own source revenue increased from Ksh 0.3 billion in 2014/15 to Ksh 0.36 billion in 2015/16 and declined to Ksh 0.25 billion in 2017/18. The equitable share transfer increased from Ksh 4.1 billion to Ksh 5.6 billion during the same period while own source revenue as a share of total revenue fell from 6.9 per cent in 2014/15 to 3.7 per cent in 2017/18. To improve the share of its own source revenue, there is need for enhanced fiscal efforts to accelerate revenue mobilization from both local revenue and conditional grants. c) Maternal and child health outcomes improved, but the rates of skilled birth attendance and immunization remained below the national averages. The number of women with access to a skilled birth attendant during delivery increased from 28.2 per cent in 2014 to 40.3 per cent against the national average of 64.9 per cent in 2018. This improvement was largely influenced by introduction of free maternity services in 2013. However, the share of fully immunized children in the county (68.9%) remained below the national average of 77 per cent in 2018. To reverse this latter trend, the county should prioritize investments in child and maternal services. d) The Early Childhood Development Education (ECDE) budget in the county improved from Ksh 0.3 billion in 2014/15 to Ksh 0.6 billion in 2017/18. Partly because of increased spending on ECDE, gross ECDE enrolment rate in the county went up from 52.7 per cent in 2014 to 84.1 per cent in 2018 while net enrolment improved from 48.9 per cent to 52.9 per cent in the same period. Looking forward, the challenge for the county is to ensure equitable distribution and effective utilization of available resources. In addition, the county should ring-fence ECDE resources2 so that they are not used for other purposes such as provision of secondary and higher education bursaries. e) Total spending in water and sanitation improved from Ksh 0.2 billion in 2016/17 to Ksh 0.24 billion in 2017/18. However, 64 per cent of the county residents had no access to improved sanitation and sewerage coverage in 2018. The county needs to invest more in the sector’s infrastructure to gain from the sanitation utility revenue that will enhance sanitation service delivery and in meeting operations and maintenance costs. f) The county’s child protection, youth and women budget allocation as a share of total county budget allocation during the review period averaged 3.3 per cent. Spending on the sector was, on average, Ksh 0.2 billion. This was an under-investment given that this segment of the population is the most vulnerable. There is need to prioritize the sector during future allocations. KIPPRA Policy Brief No. 80/2019-2020 1 g) Considering 100 per cent nutrition sensitive (direct nutrition interventions) spending, the county did not finance the nutrition sector. There was no clear budgetary allocation for nutrition between the period 2014/15 and 2017/18. The county should ensure that direct nutrition interventions across several sectors such agriculture, education and health are budgeted for, with visible budget lines. Moreover, nutrition should be well articulated in the County Integrated Development Plans. h) The budget execution rate especially for child protection, youth and women was low. The absorption rates improved from 46 per cent in 2014/15 to 72 per cent in 2015/16 before declining to 34 per cent in 2017/18. The low budget execution rate was partly because approved budgets were not released on time by the National Treasury. Procurement and cash flow planning by the county was also weak. To improve budget utilization rates, there is need for the National Treasury to adhere to disbursement schedules by releasing resources on time. On its part, the county should strengthen procurement systems and improve cash flow forecasting. i) Due to limited disaggregation of data in expenditure reports, it was not possible to establish how much of the county government budget was spent on crucial social services such as child protection, youth development, disability and gender mainstreaming. By having standalone budget lines on the above, the county is better placed to effectively deliver the above-mentioned services, especially to women and girls. On child protection, for example, the county recorded an increase in number of reported cases of child neglect and abandonment from 23 in 2014 to 1,406 cases in 2018, yet there is no specific budget line for this. The same also applies to gender-based violence, which has increased in recent years. 1. COUNTY OVERVIEW Trans Nzoia occupies a land area of approximately 2,496 km2 and is divided into 5 sub-counties and 25 wards. The county’s population was 990,341 in 2019, which is 2.08 per cent of the national population. The total county population constituted of 489,107 males, 501,206 females and 28 intersex persons. In 2015/16, the overall poverty rate of the county was 34.0 per cent with 9.7 per cent living in extreme poverty, indicating that the overall poverty was slightly better than the overall national rate of 36.1 per cent. Extreme poverty in the county was higher than the national average of 8.6 per cent. Among children, four in every ten children were affected by monetary poverty or lack of financial means,3 while 24.7 per cent of youth and 34.1 per cent of women were also affected. Additionally, 43.4 per cent of children were living in multidimensional poverty; that is, deprived in several areas including nutrition, healthcare, education, housing and drinking water,4 while youth and women recorded 47.4 per cent and 65.6 per cent, respectively. Levels of monetary poverty remained lower than national averages for children, youth and women. However, the level of multidimensional poverty among women was above the national average and was highest in Table 1: Trans Nzoia county administrative, poverty and demographic profile Administrative Profile Latest Available Area (km2) 2,496 Number of sub-counties 5 Number of wards 25 Overall poverty (%) 34.0 Extreme poverty (%) 9.7 Population (2019) 990,341 Group Children National Children Youths National Youths Wo/men National Wo/men Monetary Poor Male (%) 37.4% 42.1% 24.1% 29.1% 30.2% 30.5% Female (%) 41.9% 41.0% 25.4% 28.8% 34.1% 34.1% Total (%) 39.6% 41.6% 24.7% 28.9% 30.7% 32.4% Population 503,582 20,742,290 297,688 13,443,268 161,569 7,847,350 Multidimensionally Poor Male (%) 43.7% 49.3% 42.8% 44.7% 59.0% 51.0% Female (%) 43.2% 47.1% 52.2% 49.4% 65.6% 60.8% Total (%) 43.4% 48.2% 47.4% 47.1% 61.4% 56.1% Population 503,582 20,742,290 297,688 13,443,268 161,569 7,847,350 Source: Kenya National Bureau of Statistics (2018) 2 KIPPRA Policy Brief No. 80/2019-2020 comparison to that of youth and children. The overall high rates of poverty, especially among women and youth, suggests that planning and budgeting processes should better consider human capital sectors so that the county can maximize on the productive and innovative potential of its future workforce to initiate a fast and sustainable growth trajectory (Table 1). 2. STATE OF COUNTY ECONOMY 2.1 Gross County Product Growth Trans Nzoia County accounted for 1.7 per cent of the national GDP in 2017. Its Gross County Product (GCP) per capita expanded from 2 per cent in 2014 to 2.8 per cent in 2015, contracted to negative 4.1 per cent in 2016 and later expanded to 1.3 per cent in 2017 (Figure 1a). The most recent downturn was largely attributed to decline in agricultural production due to fragmentation of land. It further affected earnings and overall contribution to the socio-economic well-being of the residents. The economy remained reliant on the services sector, which accounted for 52 per cent of the GCP and 0.8 per cent of the national GDP in 2017, ranking 19th among the 47 counties in terms of contribution to GDP (Figure 1b). Agriculture contributed 43 per cent of the GCP and 0.7 per cent of the national GDP in 2017. Other industries including, but not limited to, electricity supply, water supply and construction and manufacturing sub-sectors contributed 4 per cent and 1 per cent to the GCP. This trend calls for diversification to manufacturing and services sectors particularly for job creation. The county can thus seek to attract more investments in manufacturing, and services, for a balanced economy through collaboration with different sub-sectors, especially the private sector. To increase agricultural productivity and the participation of women and youth within the sector, the county should put in place mechanisms to reduce the cost of farming, enhance the marketing of agricultural produce and promote agricultural value chains. This can be done through developing infrastructure and enhancing farmers’ capacities in modern agricultural methods, extension services, agribusiness and research. Figure 1: Trans Nzoia County gross county product and economic structure, 2014-17 (a) GCP (per capita) growth trends, 2014-17 (%) (b) Structure of the economy, 2017 (% of GCP) 5.00 60 52 15.0 13.8 10.5 10.2 43 50 4.00 10.0 40 5.0 2.0 2.8 1.3 3.00 30 (2.1) - (4.1) 2.00 20 (5.0) 4 10 1 (10.0) 1.00 2014 2015 2016 2017 -0.80 0.01 0.06 0.67 Real GCP (per capita) growth Nominal GCP (per capita) growth - (10) Services Manufacturing Other Industries Agriculture Share of National GDP (LHS) Percent of GCP (RHS) Source: KNBS (2019) Statistics 2.2 Overall Budget Performance The county government annual spending in real terms grew from Ksh 3.6 billion to Ksh 5.5 billion between 2014/15 and 2016/17, before declining to Ksh 3.8 billion in 2017/18 (Figure 2a). The spending was heavily dependent on national government transfers accounting for 90.2 per cent. In nominal terms, own source revenue increased from Ksh 0.3 billion in 2014/15 to Ksh 0.36 billion in 2015/16 and decline to Ksh 0.25 billion in 2017/18. The equitable share transfer increased from Ksh 4.1 billion to Ksh 5.6 billion during the same period. The burden of the drop in the county government spending predominantly affects social sectors’ spending, which are recurrent in nature. The contribution of own source revenue and conditional grants was, on average, 9.8 per cent (Figure 2b). There is therefore the need for enhanced fiscal efforts to accelerate revenue mobilization from both local revenue and conditional grants. The share of actual development budget increased from 30 per cent in 2014/15 to 34 per cent in 2015/16 and declined to 26 per cent in 2017/18. The recurrent expenditure, constituting of personnel emoluments and operation and maintenance costs, accounted for about 71 per cent of the county government spending throughout the period. Wages alone accounted for about 40 per cent of all county government spending (Figure 3a). This indicates that the Public Finance Management (PFM) Act 2012 provision that ceils development spending at a minimum of 30 per cent of the total budget was violated in between 2016/17 and 2017/18 while the Regulations 2015, which require that not more than 35 per cent of the county’s total revenue should go to payment of wages and salaries, was only observed in actual spending in 2015/16. KIPPRA Policy Brief No. 80/2019-2020 3 Percent share of GDP Percent of GCP Figure 2: Trans Nzoia county revenue and expenditure trends, 2014/15-2017/18 (a) County government spending, 2014/15-2017/18 5 (b) County revenue composition (%) (Ksh millions) 10,500 100 3 9,000 4 7 5 95 7,500 6 4 11 5 6,004 6,000 5,333 90 4,091 4,215 4 4,500 5,500 85 4,784 93 91 92 90 3,000 3,754 3,808 80 85 1,500 75 - 2014/15 2015/16 2016/17 2017/18 Average 2014/15 2015/16 2016/17 2017/18 Equitable share Own source revenue Conditional grants Nominal expenditure Real expenditure Source: Office of the Controller of Budget (Various) reports, 2014-2018 Figure 3: Trans Nzoia county spending priorities by economic and administrative classification, 2014/15- 2017/18 (a) County government spending by economic (b) County government spending by priorities, average classification, 2014/15-2017/18 2014/15-2017/18 100 90 30 34 28 26 Health Services 29.7 80 Public Works, Transport and Infrastructure 16.9 70 Governor/County Executive services 9.9 24 County Assembly 9.6 60 31 Agriculture, Livestock & Fisheries 7.0 35 50 32 Administration, Coordination & Public Service Board 6.8 Education and Vocational Training 6.8 40 Public Health, Environment, Water & Sanitation Services 5.4 30 Social Services,Culture,Youth,gender & special programmes 3.3 51 Land, Physical Planning, Urban Development & Other programmes. 2.8 20 39 35 36 County Treasury and Economic Planning 1.8 10 Commerce, Trade, Industry and Tourism - 0 - 5.0 10.0 15.0 20.0 25.0 30.0 35.0 2014/15 2015/16 2016/17 2017/18 Percent Personnel emoluments Operation and maintainance Development expenditure PFM 35 percent Source: Controller of Budget reports, 2014-2018 The county spent over 52.2 per cent of the total expenditure during the period under review on health, education, agriculture, nutrition, social protection, youth, gender, water and sanitation. These sectors are regarded as being more sensitive to the needs of children, youth and women. The effect of this expenditure on the various programmes and activities vary across sectors. 3. ANALYSIS OF SOCIAL SECTOR SPENDING 3.1 Health 3.1.1 Health Sector Priorities During the period under review, the county outlined key priorities that targeted children, youth, women and persons with disability. During this period, the sector’s priorities included: the establishment of a county teaching and referral hospital; upgrading of sub-county hospitals; establishment and strengthening of community health units through the community strategy; rehabilitation and expansion of tier 1 and tier 2 facilities (rural health facilities); revamping emergency healthcare services and emergency response protocols; sustainable supply of essential medicines and medical supplies; and the development of infrastructure at all hospitals and select health centres. The number of women who had access to a skilled birth attendant during delivery increased from 28.2 per cent in 2014 to 40.3 per cent in 2018 due to introduction of free maternity services in 2013. The proportion of children fully immunized improved during the review period, although it remained below the national average. The share of fully immunized children in the county improved from 55.4 per cent in 2014 to 68.9 per cent in 2018. Infant mortality and under 5 mortality rates were estimated at 63 deaths per 1,000 live births in 2016 slightly below the national average of 79 deaths per 1,000 live births. 4 KIPPRA Policy Brief No. 80/2019-2020 Ksh millions Percent Percent Table 2: Trans Nzoia county selected health sector performance indicators Selected Health Indicators 2014 2015 2016 2017 2018 County National County National County National County National County National U5MR (death per 1,000 live births) - - - - 63.0 79.0 - - - - 2016 Estimate MMR (death per 100,000 live - - - - 333.0 495.0 - - - - births) 2016 Estimate Skilled birth attendant coverage 28.2 53.5 38.0 56.9 38.3 59.3 25.4 53.0 40.3 64.9 (%) (source: DHIS2) Proportion of pregnant women 54.6 76.4 65.3 75.4 60.8 76.9 48.7 73.7 64.3 81.9 who attended at least one ANC visit during pregnancy (%) (Source: DHIS2) Proportion of pregnant women 17.0 35.9 23.6 39.7 24.3 39.8 13.1 32.6 28.6 48.7 who attended at least four ANC visit during pregnancy (%) (Source: DHIS2) Proportion of children under one 55.4 70.2 67.1 75.7 67.8 72.4 44.3 65.9 68.9 77.0 year who are fully immunized (%) (Source: DHIS2) DPT/Hep+HiB3 dropout rate (%) 10.0 6.8 8.6 7.2 10.3 6.6 14.6 10.1 4.4 4.0 (Source: DHIS2) Still Birth Rate (Source : DHIS2) 35.6 29.3 23.8 22.6 22.8 21.5 21.8 22.6 20.6 20.4 Source: Ministry of Health (2018), Demographic Health Information System (DHIS) 3.1.2 Health budget and expenditure The share of health budget as a proportion of total county budget allocation was 28 per cent in 2014/15 and 2015/16 before increasing to 33 per cent in 2017/18. Health actual expenditure expanded from about Ksh 1.2 billion in 2014/15 to Ksh 2.0 billion in 2016/17 and later declined to Ksh 1.6 billion. Spending on health comprised of, on average, 72 per cent recurrent expenditure and 28 per cent development expenditure (Figure 4a). The absorption rates increased from 85 per cent in 2014/15 to 95 per cent in 2015/16 before declining to 76 per cent in 2017/18. This is attributable to failure by the exchequer to release the full amount approved in the health budget. Figure 4: Trans Nzoia county health spending trends, 2014/15-2017/18 (a) Share of health budget and spending by economic (b) Health budget execution rate 2014/15-2017/18 classification, 2014/15-2017/18 100 2.5 100 27 28 29 27 28 80 95 94 2.0 85 80 76 60 73 72 71 73 72 1.5 60 40 1.0 2.1 2.0 2.2 40 31 33 28 28 30 1.5 1.7 1.6 1.6 1.2 20 0.5 20 - - - 2014/15 2015/16 2016/17 2017/18 2014/15 2015/16 2016/17 2017/18 Average Approved Budget Actual Expenditure Execution Rate (RHS) Recurrent expenditure (%) Development expenditure (%) Source: Office of the Controller of Budget (Various) reports, 2014-2018 3.1.3 Health sector medium term expectations The county aims to rehabilitate, expand and equip existing health facilities; complete and operationalize the county teaching and referral hospital; revamp the originally mapped 198 health units; provide adequate resources to procure medicines in adequate quantities; install an ICT drug management system to track the movement of medicines and medical supplies from the county storage unit to the various health facilities; develop a customized county community strategy policy document to direct community strategy activities within the county; recruit more healthcare workers to ensure adequate service delivery; and address regular labour unrest and industrial disputes in the sector that have occasionally hampered healthcare provision and emergency response. KIPPRA Policy Brief No. 80/2019-2020 5 Percent Ksh billions Percent 3.2 Education and Vocational Training 3.2.1 Education sector priorities County governments are responsible for Early Childhood Development Education (ECDE) and youth polytechnics, which are part of Technical Vocational Education and Training (TVETs) as per Schedule IV of the Constitution of Kenya 2010. During the plan period 2013-2017, the county education sector focus was to: development ECDE infrastructure; supervise and assure quality; establish ECDE health and nutrition program; employ ECDE teachers and polytechnic instructors; procure and distribute tools, equipment, learning and instructional materials; establish a model vocational training centre; employ staff; develop infrastructure in VTCs; establish resource data centres/ICT villages; provide internet connectivity to all county public institutions; integrate ICT in education delivery and construct laboratories; train teachers; and establish a modern library and technical institute. Gross ECDE enrolment rate increased from 52.7 per cent in 2014 to 84.1 per cent in 2018 while net enrolment rate (NER) increased from 48.9 per cent to 52.9 per cent during the same period. This was generally lower than national averages of (94.4% and 63.5%, respectively), indicating that few children joined ECDE than before with the implementation of devolution. More girls were enrolled in ECDE than boys in Trans Nzoia county. Gross primary and secondary school enrolment rates were 116.7 per cent and 63.4 per cent in 2018, respectively. Net enrolment rate (NER) improved by 0.1 per cent for primary school and decreased from 42.3 per cent to 29.1 per cent for secondary school during the same period. There was inequality in access to primary education between male and female school-going children in favour of girls as shown in Table 3. However, more boys than girls enrolled in secondary school. In 2018, there were 30 accredited vocational centres in the county, enrolling 2,432 learners. Table 3: Trans Nzoia county selected education sector performance indicators Pre-primary School 2014-County 2014-National 2018-County 2018-National Gross enrolment ratio (%) 52.7 73.6 84.1 94.4 Net enrolment ratio (%) 48.9 71.8 52.9 63.5 Male (%) 49.3 73.4 47.8 62.5 Female (%) 48.5 70.2 56.4 65.0 School size (Public) (Pupils) (Average) 75.0 75.0 116.0 85.0 Gender parity index (value) 1.0 1.0 - - Pupil-teacher ratio (No.) (Public) 38.0 31.0 40.0 31.0 Proportion of enrolment in private schools (%) 33.7 31.5 32.0 33.0 Primary School 2014-County 2014-National 2018-County 2018-National Gross enrolment ratio (%) 99.3 104.0 116.7 107.2 Net enrolment ratio (%) 85.0 88.0 85.1 82.4 Male (%) 87.6 86.0 84.8 81.7 Female (%) 82.3 90.0 85.4 83.0 School size (Public) Average No. of pupils 505.0 338.0 624.0 375.0 Gender parity index (Value) 1.0 1.0 - - Pupil-teacher ratio (No.) 48.0 42.0 49.0 40.0 Proportion of enrolment in private schools (%) 14.0 16.0 14.0 16.0 Secondary School 2014-County 2014-National 2018-County 2018-National Gross enrolment ratio (%) 52.9 58.7 63.4 66.2 Net enrolment ratio (%) 42.3 47.4 29.1 37.5 Male (%) 44.4 49.6 31.9 35.4 Female (%) 40.2 45.2 25.3 39.8 School size (Public) - - 388.1 392.0 Gender parity index (value) 0.9 0.9 - - Pupil-teacher ratio (No.) (TSC) 45.0 30.0 40.0 32.0 Pupil-teacher ratio (No.) (TSC and BOM) 21.0 20.2 22.0 20.0 Proportion of enrolment in private schools (%) 31.9 30.7 1.9 5.8 Source: Ministry of Education (Various), Education statistical booklets, 2013-2018 3.2.2 Education and vocational training budget and expenditure The share of ECDE spending in the county increased from Ksh 0.3 billion in 2014/15 to Ksh 0.6 billion in subsequent years. The share of ECDE spending as a proportion of total education spending was, on average, 7.5 per cent during the 6 KIPPRA Policy Brief No. 80/2019-2020 Figure 5: Trans Nzoia county overall education spending trends, 2014-18 (a) National and county education allocation, 2014/15- (b) Share of education spending by level, 2014/15- 2017/18 2017/18 8.0 100.0 7.0 80.0 37.2 38.3 38.7 33.6 36.9 6.0 2.3 5.0 2.3 60.0 4.0 1.7 2.0 40.0 3.0 56.6 54.7 52.7 58.1 55.5 3.9 2.0 2.7 2.8 3.1 20.0 1.0 0.3 0.4 0.5 0.6 6.2 7.0 8.6 8.2 7.5 - - 2014/15 2015/16 2016/17 2017/18 Average 2014/15 2015/16 2016/17 2017/18 Pre-Primary Primary Secondary Pre-Primary Primary Secondary Source: National Treasury (Various), IFMIS Figure 6: Trans Nzoia county ECDE spending trends, 2014/15-2017/18 (a) Share of ECDE budget and spending by economic (b) ECDE budget execution rate 2014/15-2017/18 classification, 2014/15-2017/18 100 0.60 100 90 27 28 80 0.50 87 52 47 75 80 70 0.40 67 68 60 6079 0.30 50 73 72 40 40 48 53 0.20 0.39 0.38 30 0.31 20 20 7 10 11 0.10 0.19 5 8 0.29 0.36 0.51 0.55 10 - - 21 - 2014/15 2015/16 2016/17 2017/18 2014/15 2015/16 2016/17 2017/18 Average Approved Budget Actual Expenditure Execution Rate (RHS) Recurrent expenditure (%) Development expenditure (%) Share of budget Source: Office of the Controller of Budget (Various) reports, 2014-2018 period. Spending on primary and secondary education increased from Ksh 2.7 billion in 2014/15 to Ksh 3.9 billion in 2017/18 and Ksh 1.7 billion in 2014/15 to Ksh 2.3 billion in 2017/18 respectively (Figure 5a). The share of ECDE budget in the total county budget allocation averaged 8 per cent over the review period, comprising of 47 per cent development and 53 per cent recurrent expenditure (Figure 6a). The absorption rate increased from 67 per cent in 2014/15 to 87 per cent in 2015/16 before declining to 68 per cent in 2017/18 (Figure 6b). Like the health sector, the years with high exchequer releases compared to approved ECDE budget had higher absorption rates. 3.2.3 Education Sector Medium Term Expectation The county government with support from stakeholders aims to; construct and equip 3 ECDE classrooms in every public ECDE Centre; construct specialized toilets for the ECDEs; expand existing 25 VTCs; establish special Needs Vocational Training Centre; establish a capitation fund for VTCs; purchase and distribute modern equipment and instructional materials; construct administration blocks and twin workshops; establish boarding facilities in VTCs; integrate ICT in vocational training centers; establish the Trans Nzoia Education Trust; and promote the establishment of a public university in the County. 3.3 Water and Sanitation 3.3.1 Water and sanitation Sector Priorities The County Integrated Development Plan (CIDP) 2013-2017 outlined key priorities for both the water and sanitation sub-sectors. For the water sub-sector, the county sought to: rehabilitate and protect Mt Elgon and Cherang’any hills water towers; augment water schemes; connect Ts and extend Kabolet water supply; rehabilitate and drill boreholes and wells; protect springs; establish a central garbage disposal and recycling centre; expand sewerage systems and increase drainage systems; conduct county environmental clean ups; and construct public toilets. Access to improved water and sanitation was recorded at 80 per cent and 36 per cent, respectively. The population living within the service areas of water service providers decreased from 38 per cent to 21 per cent between 2014 and 2018. The proportion of population covered or served by the utility improved from 63 per cent in 2014 to 84 per cent in 2018. KIPPRA Policy Brief No. 80/2019-2020 7 Percent Ksh billions Ksh billions Percent Percent Besides, 64 per cent of the residents were not covered by the sewerage system. The sector experienced the problem of non- revenue water, 6 which was 41 per cent in 2018; a worsening from 40 per cent in 2014. High non-revenue water denies the water utility revenue to enhance water service delivery and in meeting water operations and maintenance costs. Table 4: Trans Nzoia county selected WASH sector performance indicators Indicators 2014-County 2014-National 2018-County 2018-National County population within service areas of WSPs (%) 38 * 21 * Water coverage by utilities (%) 63 53 84 * Non-revenue water (NRW) (%) 40 42 41 * Sanitation coverage within utility area (%) 60 69 - * Sewerage coverage (%) 36 * 34 * Access to improved water (%) 80 * 80 * Access to improved sanitation (%) 36 * 36 59 No toilet facility – Potential open defecation county-wide (%) 2 * 2 8 Source: Kenya National Bureau of Statistics (2014), KDHS 2014; County Integrated Development Plan (CIDP) 2018 3.3.2 Water and sanitation budget and expenditure The total budget allocation to the sector as a share of total county budget allocation during the review period was, on average, 5 per cent. Total spending on the sector increased from Ksh 0.21 billion in 2014/15 to Ksh 0.24 billion in 2015/16 and declined to Ksh 0.2 billion in 2016/17 but improved to Ksh 0.24 billion in 2017/18. Spending consisted of, on average, 20 per cent recurrent and 80 per cent development expenditure. The approved budget allocation to the sector decreased from Ksh 0.36 billion in 2014/15 to Ksh 0.26 billion in 2017/18. However, the absorption rate increased from 58 per cent in 2014/15 to 68 per cent in 2015/16 before declining to 60 per cent in 2016/17, after which the rate improved to 94 per cent in 2017/18. The fluctuation is attributed to failure by the exchequer to release the entire approved budget amount on time, and capacity constraints. Figure 7: Trans Nzoia county water and sanitation spending trends, 2014/15-2017/18 (a) Share of WASH budget and spending by economic (b) WASH budget execution rate, 2014/15-2017/18 classification, 2014/15-2017/18 0.5 100 100 94 90 0.4 80 80 70 68 0.3 60 58 60 60 81 87 78 72 80 50 0.2 40 0.4 0.3 400.3 30 0.2 0.2 0.3 0.2 0.2 20 0.1 2019 13 22 28 20 10 7 6 5 4 5 - - - 2014/15 2015/16 2016/17 2017/18 Average 2014/15 2015/16 2016/17 2017/18 Approved Budget Actual Expenditure Execution Rate (RHS) Recurrent expenditure (%) Development expenditure (%) Share of budget Source: Office of the Controller of Budget (Various) reports, 2014-2018 3.3.3 Water and Sanitation Medium Term Expectation In the plan period of 2018-2022, the county aims to: increase access to safe drinking water from the current 35 per cent to over 50 per cent; increase pipeline extensions by a further 250km under the gravity water schemes; source for funds for Sosio–Teldet Gravity Scheme; expand the sewerage system to cover 70 per cent of the urban population; drill a minimum of 20 bore holes per year and support the sinking and installation of manual water pumps on 150 new hand dug wells; de-silt and rehabilitate 25 water dams; procure 1 skip loader, 2 side loaders and refuse containers for efficient solid waste management; establish a new solid waste management site away from town; and construct 50 exhaustible public toilets to cover all market centres. 8 KIPPRA Policy Brief No. 80/2019-2020 Percent Ksh billions Percent 3.4 Child Protection, Youth and Women 3.4.1 Child protection, youth and women sector priorities The County Integrated Development Plan (CIDP) 2013-2017 highlighted key priorities for the sector. The county sought to: establish Trans Nzoia County Youth and Women Development Fund; establish a social protection fund (for the orphaned and vulnerable children, the elderly and severely disabled persons; construct and operationalize a youth empowerment centre; establish a rehabilitation/vocational centre for street children and drug addicts; establish and operationalize a child rescue/GBV centre and remand home; secure, develop preserve and market cultural heritage sites, shrines, monuments and caves; establish botanical sites; capacity build and empower youth and women, music, sports and performing arts groups; establish youth sports academies; rehabilitate sports facilities; establish high altitude sports training centres and sports stadia; facilitate regular sports tournaments, meetings and exchange programmes; develop Trans Nzoia county tourism profile; establish tourism information office; and protect and preserve community tourism products. Specifically, on child protection, the county recorded an increase in number of reported cases of child neglect and abandonment from 23 cases in 2014 to 1,406 cases in 2018. Similarly, child trafficking, abduction and kidnapping increased from 2 in 2014 to 52 in 2018. However, cases of child sexual abuse declined significantly while cases of child labour increased from 6 in 2014 to 32 in 2018. Child physical and emotional abuse increased during the period (Table 5). The county reported two cases of FGM in 2018. The low/non-reporting of the female genital mutilation (FGM) to government institutions can be attributed to either the intensive campaigns and initiatives to protect the girl child, or fear by the population to report such cases, and culture that approves such practices. Table 5: Trans Nzoia county selected child protection performance indicators (No. of reported cases) Indicators 2014-County 2014-National 2018-County 2018-National Child Neglect and Abandonment 23 767 1,406 73245 Child Sexual Abuse 12 636 1 172 Child Trafficking, Abduction and Kidnapping 2 32 52 1022 Child Labour 6 168 32 378 Child Emotional Abuse - 58 13 853 Child Physical Abuse 17 583 20 2031 Female Genital Mutilation 1 9 2 40 Source: Kenya National Bureau of Statistics (2014), KDHS 2014; County Integrated Development Plan (CIDP) 2018 3.4.2 Child protection, youth and women budget and expenditure The sector’s budget allocation as a share of total county budget allocation during the review period averaged 3.3 per cent. Spending on the sector was, on average, Ksh 0.2. billion and constituted 45 per cent recurrent and 55 per cent development expenditure. The share of recurrent expenditure was highest in 2017/18 at 64 per cent of total expenditure and lowest in 2014/15 and 2015/16 accounting for 31 per cent of total expenditure. The absorption rates improved from 46 per cent in 2014/15 to 72 per cent in 2015/16 before declining to 34 per cent in 2017/18 due to prolonged election period and failure by the county exchequer to release the entire approved budget amount (Figure 8a). Figure 8: Trans Nzoia county social protection, youth and women spending trends, 2014-18 (a) Social protection, youth and women budget (b) Share of social protection, youth and women budget execution rate, 2014/15-2017/18 and spending by economic classification, 2014/15- 2017/18 0.25 100 90 100 90 0.20 80 80 45 36 55 72 70 0.15 0.20 0.23 0.22 70 60 60 69 69 50 50 0.10 46 43 40 40 0.17 55 64 34 30 30 0.12 31 31 45 20 0.05 0.09 0.10 200.07 3.8 2.8 3.3 3.3 3.3 10 10 - - - 2014/15 2015/16 2016/17 2017/18 Average 2014/15 2015/16 2016/17 2017/18 Recurrent expenditure (%) Development expenditure (%) Share of budget Approved Budget Exchequers Release Execution Rate (RHS) Source: Office of the Controller of Budget (Various) reports, 2014-2018 KIPPRA Policy Brief No. 80/2019-2020 9 Ksh billions Percent Percent 3.4.3 Child protection, youth and women medium term expectations Between the plan period 2018 and 2022, the county aims to: rehabilitate and expand the Kenyatta Stadium to a modern stadium; operationalize Bahati Children Rescue Centre, Youth Empowerment Centre (Elgon Hub) for business incubation, technology acceleration and talent development; establish a high altitude training centre; organize sports tournaments across the county to encourage talent discovery and empower young people to participate in national leagues; organize, train and provide start up grants to SACCOs for youth and special groups; enhance the youth and women revolving kitty; sponsor community cultural activities; support the elderly and vulnerable members of the community; and establish a drug and substance abuse rehabilitation centre. 3.5 Nutrition 3.5.1 Nutrition priorities Promotion of nutrition education and improvement of nutritional status of households to eliminate malnutrition cases was the focus for the county, according to the County Integrated Development Plan for the period 2013-2017. For children, the county nutrition indicators were generally higher than national averages, according to 2014 data. Stunting was 29 per cent of the population while wasting and underweight children were 4 per cent and 15 per cent, respectively (Table 6). Furthermore, the proportion of households consuming adequately iodized salt in the county was 6 per cent below the national figure, with the proportion being lower than the target proportion of 100 per cent. Vitamin A supplementation among children aged 6 to 59 months was 10 per cent, being below the target proportion of 80 per cent and far below the national coverage of 24 per cent in 2014. The proportion of overweight or obese women in the county was 29 per cent, the same as the national average. The average Body Mass Index (BMI) 7 of women in the county was also equal to the national average of 23. Table 6: Selected nutrition performance indicators Indicators 2014-County 2014-National Stunted children (%) 29.2 26.0 Wasted children (%) 3.9 4.0 Underweight children (%) 15.3 11.0 Vitamin A supplements coverage 7.6 24.0 Proportion of children aged 6 to 59 months- Received Vitamin A supplement 70.2 71.4 Proportion of children consuming adequately iodized salt. 100.0 99.1 Proportion of households consuming adequately iodized salt. 99.7 99.2 Household salt iodization (50 – 80 mg/Kg KIO3) 41.0 57.0 (% samples) Number of Women (BMI) 23.0 23.2 Overweight or obesity among women aged 15 to 49 years. 28.7 28.9 Source: Kenya National Bureau of Statistics (2014), KDHS 2014 3.5.2 Nutrition budget and expenditure Considering 100 per cent nutrition sensitive (direct nutrition interventions) spending, the county did not finance the nutrition sector. There was no clear budgetary allocation for nutrition between the period 2014/15 and 2017/18. 3.5.3 Medium term expectations In the period 2018-2022, the county plans to promote nutrition education and strengthen the community units to offer broad-based services to eliminate malnutrition cases. To realize the objective, the county will need to increase the share of nutrition sensitive spending, which has been inconsistent. 10 KIPPRA Policy Brief No. 80/2019-2020 3.6 Other Initiatives for Special Interest Groups Box 1: Key highlights on children, youth, women and PWDs’ initiatives a) AGPO During the period under review, the county reported compliance to the 30 per cent Access to Government Procurement Opportunities (AGPO) reserved for women, youth and Persons with Disabilities (PWDs). b) Children The county constructed 200 ECDE classrooms; modern sanitation facilities in schools and hired 766 caregivers for the ECDE centres. The county further constructed a rescue center for children and managed to rescue 260 street children. c) Youth The county established information centres at the county and sub-county levels (I-Hubs); engaged in sports promotion through sponsorship of teams, rehabilitation of stadia and procurement of equipment; implemented the governments Ajira programme, which is an online platform that links job seekers with employment opportunities; provides start up capital loans to the youth; and supported performing artists with equipment and grants. d) Women The county incorporated the County First Lady and MCA First Ladies in PMTC activities; provides sanitary towels to women of school going age; established a youth and women development fund Act; and trained 1,500 registered youth and women groups on utilization, management and general entrepreneurship skills. e) PWDs The county has a Disability Bill in place and actively budgets for PWD programmes, providing financial and material support to 2,535 PWDs. The county also formed a PWDs County Board to assist in disability mainstreaming in county programmes. In addition, 138 groups of PWDs were supported through grants worth Ksh 10,640,000. The County assisted 100 individuals (PWDs) with wheelchairs and other assistive devices with the aim of improving their livelihoods. 4. RECOMMENDATIONS AND IMPLICATIONS FOR POLICY A summary of implications for policy and responsible actors is presented in Table 7. Table 7: Recommendations and responsible actors Sector Finding Recommendation Responsibility Gross County An estimated 52 per cent of the Gross County The county should continue creating an enabling County Treasury and Product Product of Trans Nzoia, which ranked 19th (1.7% business environment to attract more investments in Planning/ County contribution to GDP) of all the 47 counties in the services, manufacturing, industry and agricultural Executive/Department of Kenya as of 2017 came from the services sector sectors, and invest in enhancing farmers’ capacities Trade, Industry & Tourism in modern agricultural methods, extension services, and Agriculture agribusiness and research Revenue The county’s own source revenue increased To improve the share of its own source revenue, there is County Treasury and from Ksh 0.3 billion in 2014/15 to Ksh 0.36 billion need for enhanced fiscal efforts to accelerate revenue Planning/Directorate of in 2015/16 and declined to Ksh 0.25 billion in mobilization from both local revenue and conditional Revenue 2017/18 grants Expenditures The budget execution rate, especially for the child To improve budget utilization rates, there is need for the All sectors/County protection, youth and women was low National Treasury to adhere to disbursement schedules Treasury and Planning/ by releasing resources on time. On its part, the county County Executive should strengthen procurement systems and improve cash flow forecasting Health Maternal and child health outcomes improved, To reverse this latter trend, the county should prioritize County Treasury and but the rates of skilled birth attendance and investments in child and maternal services Planning/County immunization remained below the national Department of Health averages Nutrition Considering 100 per cent nutrition sensitive (direct The county should ensure that direct nutrition County Treasury and nutrition interventions) spending, the county did interventions, across several sectors such agriculture, Planning/County not finance the nutrition sector education and health are budgeted for, with visible Department of Health and budget lines. Moreover, nutrition should be well all other sectors; namely articulated in the County Integrated Development Plans education, agriculture, social protection and WASH. Education The Early Childhood Development Education The county could ensure equitable distribution and County Treasury and (ECDE) budget in the county improved from Ksh effective utilization of available resources. In addition, Planning/County 0.3 billion in 2014/15 to Ksh 0.6 billion in 2017/18. the county could ring-fence ECDE resources so that Department of Education they are not used for other purposes There is inequality in access across the levels of schooling The county ought to ensure fair access of schooling and transition for all gender among school going children KIPPRA Policy Brief No. 80/2019-2020 11 WASH Total spending in water and sanitation improved The county needs to invest more in the sector’s County Treasury and from Ksh 0.2 billion in 2016/17 to Ksh 0.24 billion infrastructure to gain from the sanitation utility revenue Planning/County in 2017/18. However, 64 per cent of the county that will enhance sanitation service delivery and in Department of Water and residents had no access to improved sanitation meeting operations and maintenance costs Sanitation/ NZOWASCO and sewerage coverage in 2018 Child There is significant duplication of social services, Align the county government social services County Treasury and protection, youth, gender and culture services between programmes with national government programmes Planning/County youth and the two levels of government. High cases of to avoid duplication of activities while ensuring that Department of Culture women child neglect and abandonment were reported the available resources are focused to the relevant and Social Services between 2014 and 2018 beneficiaries The county’s child protection, youth and women Prioritize the sector in future allocations budget allocation as a share of total county budget allocation during the review period averaged 3.3 per cent Budget The budget execution rate especially for child The National Treasury should adhere to disbursement County Treasury and Execution protection, youth and women was low. The schedules by releasing resources on time. On its part, Planning; All County absorption rates improved from 46 per cent in the county should strengthen procurement systems departments; National 2014/15 to 72 per cent in 2015/16 before declining and improve cash flow forecasting Treasury to 34 per cent in 2017/18. Disaggregated Due to limited disaggregation of data in By having standalone budget lines on the listed sectors, County Planning, Statistics Data expenditure reports, it was not possible to the county is better placed to effectively deliver the and M&E Unit/ and Social/ establish how much of the county government above-mentioned services, especially to women and Gender Departments budget was spent on crucial social services such girls as child protection, youth development, disability and gender mainstreaming (endnotes) 1 Gross county product is conceptually equivalent to the county share of GDP. Gross domestic product is a measure of newly created value through production by resident economic agents (in this case individuals, households, businesses, establishments, and enterprises resident in Kenya). 2 See, for example, UNICEF (2017), Early Moments Matter, New York: UNICEF. 3 Monetary poverty measures the lack of financial means of households to provide its members with basic goods and services deemed necessary for their survival and development. Extreme poverty refers to an income below the food poverty line. Households whose adult equivalent food consumption expenditure per person per month fell below Ksh 1,954 in rural areas and Ksh 2,551 in urban areas were deemed to be food poor. Similarly, households whose overall consumption expenditure fell below Ksh 3,252 in rural areas and Ksh 5,995 in urban areas, per person per month were con- sidered to be overall poor. 4 Multidimensional poverty, unlike monetary poverty, captures different deprivations experienced by an individual. In measuring child poverty in Kenya, these dimensions included: health care, nutrition/ adequate food, drinking water, sanitation and hygiene, education, knowledge of health and nutrition, housing and standard of living, and access to information. In the analysis, dimensions are measured as binary variables with “1” denoting deprived and “0“non-deprived. 5 Base year 2013. 6 Non-revenue water (NRW) is water that has been produced and is “lost” before it reaches the customer. Losses can be real losses (through leaks, sometimes also referred to as physical losses) or ap- parent losses (for example through theft or metering inaccuracies). 7 Body Mass Index (BMI) is a value derived from the mass (weight) and height of a person. It is expressed in units of Kg/M². Broadly, a person is categorized as underweight if BMI is below 18.5 Kg/M²; normal weight: between 18.5 Kg/M² and 25 Kg/M²; and overweight: 25 Kg/M² to 30 Kg/M² and obese: over 30 Kg/M². Acknowledgements We are grateful to Maniza Zaman (UNICEF KCO Representative) for the overall leadership and enabling coordination with UN-Women and UNDP. The preparation of this County Budget Brief was funded and supported by The UNICEF core team composed of Ousmane Niang, Dr Robert Simiyu, UNICEF (KCO) in collaboration with UN-Women (KCO) and UNDP (KCO). The Godfrey Ndeng’e, Sicily Matu, Nancy Angwenyi, and Patrick Chege (UNICEF brief was prepared under the leadership of The National Treasury, Kenya. KCO). The process also benefited immensely from Matthew Cummins and The entire process of preparing the brief was guided by Dr Rose Ngugi Bob Muchabaiwa (UNICEF ESARO) for providing technical guidance. (Executive Director, KIPPRA). The KIPPRA technical team composed of Dr We are grateful to the UN-Women team composed of Lucy Mathenge, Eldah Onsomu, Victor Mose, Samantha Luseno, Lawrence Kinuthia, Stella Angela Gichohi, Sebastian Gatimu, Joshua Musyimi and Maureen Gitonga Mutuku, Teresa Bosibori, Boaz Munga, James Ochieng’, Phares Mugo, Rose (UN Women KCO) and the UNDP team of Mary Njoroge, Faith Ogola and Ngara-Muraya. anasdfd James Ochieng. Tim Colby for their technical contribution. The contribution from the following government institutions in the For more information, contact production of this brief was instrumental: Council of Governors; County Kenya Institute for Public Policy Research and Analysis Governments; Controller of Budget; Commission on Revenue Allocation; Bishops Road, Bishops Garden Towers P.O. Box 56445-00200, Nairobi National Gender and Equality Commission; Ministry of Health - Division Tel: 2719933/4 ; Cell: 0736712724, 0724256078 of Nutrition and Dietetics; Ministry of Education; Ministry of Water and Email:admin@kippra.or.ke Irrigation; Ministry of Public Service, Youth and Gender; and the Kenya Website: http://www.kippra.org School of Government. Twitter: @kipprakenya 12 KIPPRA Policy Brief No. 80/2019-2020