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The Danida Model for Support to primary health care facilities 2014-2016

Following devolution in 2013 it was politically not viable to continue with the HSSF and the fund was closed down. Danida continued the support from 2014 by engaging directly with the 47 counties and the National Treasury, channelling funds through the national systems using the national Integrated Financial Management Information System (IFMIS). This modality proved at the time to be the only viable way of supporting health facilities with conditional grants and Danida was the only donor supporting this transition of devolution in Kenya.

Compared to the previous central fund the new modality had a number of challenges. The flow of funds were slower, fiduciary risks higher and the quality of reporting from the county level remained weak. This was especially the case due to a lacking central coordinating entity – as was the case previously – as well as the newly established counties’ relatively weak administrative capacities. Nevertheless, improvements over the period were experienced, and the Danida grants were still the only donor funds flowing to all counties through the national systems. It was a prerequisite for receiving Danida funds that counties operated the funds in the national financial management systems (IFMIS).

The grants for the primary health care facilities had the exact same purpose as during the HSSF. It was only the modality of transferring the funds from central level to the facilities that was changed to make full use of country systems.

It is widely recognised that Danida was spearheading and piloting Development Partner (DP) use of national systems for on-budget development assistance thus strengthening the alignment agenda as well as paving the road for additional Development Partners, who today are pursuing the same path.

Despite the above challenges, the Danida grants to primary health care facilities have played an instrumental role in the running of primary health care facilities countrywide especially during the challenging time of transition following devolution. There are numerous examples of the Danida grants being the only reliable operational funding available to primary health care facilities. The Danida support - often referred to as 'The Danida model' - was highly valued by government because of its wider effects on both health and public financial management systems.