Health Managers’ Utilization of Evidence to Inform Annual Health Sector Planning and Budgeting Process in Bungoma County, Kenya

Abstract

Evidence-based planning and budgeting within the health sector are essential in strengthening the health system building blocks. Decentralization has presented opportunities for collecting local and reliable data to facilitate evidence-based planning and budgeting. Despite the increasing availability of routine health information at all levels of the health system, its effective utilization among health managers in lower and middle-income countries remains inadequate. This study, therefore, aimed to assess the health managers’ utilization of evidence to inform the annual planning and budgeting process. The study utilized a descriptive cross-sectional design, incorporating quantitative and qualitative research methods. Quantitative data were collected from 170 health managers, while qualitative data were gathered from three county department of health executives and 83 community health committee members across eight functional community health units. Statistical Package for the Social Sciences (SPSS v. 29.0) was employed for analyzing the quantitative data, while thematic analysis was used for the qualitative data. Only 42.4% of health managers received training in planning, budgeting, and annual performance reviews (APRs). Among the 45.9% who conduct APRs, only 47.4% use the findings to inform the process. A significant association was found between training and conducting of APRs, χ2 (1, N = 170) = 21.73, p < .001, and between training and the utilization of APR findings in decision-making, χ2 (1, N = 78) = 14.72, p < .001. Although 75% of health managers acknowledged the availability of health information, 71% disagreed that they have skills in data use for planning and budgeting and 54% disagreed regarding the reliability of the available data. The health managers who were trained in health sector planning, budgeting, and APRs were more likely to use findings to inform the process. To improve evidence-based planning and budgeting, the county health department should allocate additional funding towards conducting APRs as a critical first step in guiding the identification of priorities. Additionally, there is a need to implement capacity-building initiatives targeting health managers across all tiers of the county health system, focusing on data management and its effective utilization in planning and budgeting.