How prepared is Kenya as GAVI plans exit?

Tuesday August 24 2021
A health worker vaccinates a child.

A health worker vaccinates a child. PHOTO | FILE | NMG


Kenya risks sinking into a health disaster if the government fails to allocate enough funding for immunization before the exit of the Global Alliance for Vaccines and Immunization (GAVI) by 2027. This is according to the Health Non-Governmental Organisations Network (HENNET). 

GAVI, the main donor for vaccines and immunization programmes in the country, is set to exit the region.

In a recent interview with Daily Nation, HENNET policy engagement and advocacy manager, Ms Elizabeth Muchoki, said a majority of children from hard to reach areas and those in informal settlements in urban towns will be severely affected.

Ms Muchoki is of the view that while 80 percent of the children in the country get the required basic immunization, the remaining 20 percent is still a big number. Yet despite the transition period issued by GAVI before it exists, the country, she says, is doing little to ensure the sustainability of immunization programmes. “The risk is disastrous and we will be going back to the era of diseases,” she warns.

“We knew way back that GAVI gave a plan in 2015 on how we will fund immunization and we have been talking about the issue since 2012. There were expectations that the government would come up with plans on how to take care of its children and the community,” she says, adding that it is expensive to vaccinate a child and that the whole process needs proper financial planning. In 2018-2019, HENNET established that it costs Ksh3,500 to immunize a child per year.

Ms Muchoki says there are possibilities the demand for vaccines in the country will increase due to the rapid growth in population. “Many children are being born every day and even with the Covid-19 pandemic, people are still giving birth. This will have a financial implication,” Ms Muchoki argues. HENNET is supporting counties to come up with a costed implementation plan (CIP) to call for domestic funding.


Kilifi County Head of the Division, Family Health Services, Mrs Jesca Deche, is urging the National Government and county governments, and also relevant non-state actors, to allocate enough funds for immunization programmes. “Many partners have interests in maternal programmes but not immunization. The support for immunization is low,” she says.

Mrs Deche notes that with the high poverty levels in Kilifi County, many families struggle to treat diseases. Therefore, the government should prioritise disease prevention.

Mrs Deche stresses that Kilifi County badly needs an immunization exercise. As per 2020 data, some 22 percent of the children in the county had missed immunization. Magarini and Rabai sub-counties showed the highest cases of children who had not been immunized, compared to Kilifi North Sub-County and the other four. Mrs Deche cites the vastness of the area, lack of enough health facilities, poor electricity coverage and limited road networks as the major challenges hampering immunization in Magarini.

“Magarini Sub-County is like a half of Kilifi County. If we were to reach the furthest area in Bombi village, it requires a lot of resources, including very strong vehicles. There are 50 hospitals and not all are offering immunization services,” she says. Lack of storage facilities has also contributed to poor uptake of vaccination.

“The gap is not good for the county. Of the 22 percent of children who have not been immunized in Kilifi, half of them are from Magarini. If we are to use solar power, then it must be reliable. We have old fridges that need to be replaced. Moving vaccines interferes with service delivery because of the wide area. Many mothers will not access the immunization centres as they are far apart,” Mrs Deche explains. 

“Outreach programmes would work better to reach communities in remote areas where the population is also scattered. This will work with proper planning and funding,” she argues.

County budget allocation to the health department, according to her, is a drop in the ocean. In each of the 2018/2019 and 2021/2022 financial years, immunization programmes were allocated only Ksh1.2 million, she says. 

“This money is not enough. We always don’t feel the weight when the donor is funding, but in immunization, we are talking of billions of money,” says Mrs Deche, urging the county government to prioritise immunization awareness and its importance to the public.

Kilifi County Executive Officer for Health, Mr Charles Dadu, calls for diversification in immunization. He says this will help counties to address the challenges of storage, electricity and physical accessibility in remote areas. 

The CEC says Kilifi County Government initiated a solar connectivity programme with the support of UNICEF to supply power in health facilities in Magarini Sub-County.

He adds that the county is set to enter into an agreement with Malindi Solar Company to roll out the solar power connections in remote areas of the county. “The sustainability in the journey of self-reliance calls for multi-stakeholder involvement. We need to have intergovernmental engagements to see how county governments can complement one another,” he adds.

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