Examining health sector application and utility of program-based budgeting: County level experiences in Kenya.

INTRODUCTION: In 2012, Kenya enacted a new Public Finance Management Act to guide the public-sector planning and budgeting process. This new law replaced the previous line item budgeting, with a new program-based budgeting (PBB) process. This study examined the experience of health sector PBB implementation at the county level in Kenya. METHODS: We carried out a review of the literature documenting the health sector application and utility of PBB in low- and middle-income countries. We then collected empirical data to examine the experience of health sector application of PBB at County Level in Kenya. RESULTS: In the financial year 2017/18, counties utilised the PBB approach for health sector planning. The PBB approach was perceived by key stakeholders; to have improved the alignment of technical priorities with budgetary allocation, and to have increased transparency, accountability and openness of the process. Its challenges included lack of clear tools and guidelines to support implementation, low capacity at county level, political interference and the organisation of the public sector electronic financial management system around line item budgeting system. CONCLUSION: PBB is potentially a useful tool for aligning health sector planning and budgeting and ensuring the Annual Work Plan is more result oriented. However, realisation of this goal would be enhanced by the developing clear tools and guidelines to support its implementation, building capacity for county health sector managers to better understand the PBB application, and reforming the public-sector budgetary management system to align it with the PBB approach.

Postharvest Storage Practices of Maize in Rift Valley and Lower Eastern Regions of Kenya: A Cross-Sectional Study.

An assessment of local farmers' knowledge, attitude, and practices on postharvest maize storage and management was carried out with a view of understanding its role in maize contamination with mycotoxins and postharvest losses in Rift Valley and Lower Eastern Regions of Kenya among 165 and 149 farmers, respectively. Differences between the two regions were analyzed using the Chi-square test, Fisher exact test, and two-sample t-test. The median quantity of maize harvested by farmers in the two regions after shelling was 585 kg. A median of 20 kg of maize was put aside as a result of rotting before shelling, and there was a significant mean difference in maize set aside as a result of rotting between the two regions (107.88 kg vs. 31.96 kg; t (306.25) = 5.707, P value <0.001). The quantity of discoloured and mouldy maize consumed ranged from 0 to 90 kg; 7 (2.2%) respondents consumed mouldy maize, 36 (11.5%) fed it to cows, and 19 (6.1%) fed it to poultry. A small percentage (3.5%) believed mouldy maize is safe for human consumption, 23.6% for animal consumption, while 15.0% considered it safe for brewing, with the differences between the two regions being statistically significant (P value <0.05). Nearly half of the respondents (48.4%) kept maize on cobs indoors, 47.1% left it in the field without covering, and 33.1% consumed and sold maize while still green, with more farmers from Lower Eastern practicing this. The results of the study suggest that there were poor postharvest practices and low awareness levels among maize farmers and that this can lead to postharvest losses due to Fusarium spp. infection and mycotoxin contamination that poses a threat to human and animal food safety. This calls for interventions on better postharvest practices.

One Health capacity building in sub-Saharan Africa.

BACKGROUND: Africa of late has been faced with challenges that require a multidisciplinary and multisectoral approach to address them, and academic and non-academic institutions have played a key role in training and conducting research that would promote the One Health approach. OBJECTIVES: The objective of this review was to document networks and organizations conducting One Health training, research, and outreach in Africa, as one of a series of articles around the world. METHODS: Data for this review were collected from organizations through key contacts of the authors and their knowledge of networks they have worked with. Web searches were conducted using One Health, training, and research as key words for work done in Africa. RESULTS: Africa has major networks involved in One Health training, research, and outreach, with participation of both academic and non-academic institutions. This review highlights an effort in Africa to form networks to conduct multidisciplinary training and research. The main networks include Afrique One, Southern African Centre for Infectious Disease Surveillance (SACIDS), and One Health Central and Eastern Africa (OHCEA). CONCLUSIONS: Both academic and non-academic institutions and organizations have shown an interest to conduct multidisciplinary training and research in Africa for managing challenges that Africa is facing currently, especially the outbreak of infectious diseases.