Using CLA in Resource Mobilization for Afya Elimu Fund with Devolved Governance Units

The Afya Elimu Fund ( AEF) resource mobilization case study details use of CLA approach, specifically external collaboration, and leveraging on existing County relationships and networks to pitch for the fund. This is implemented by USAID|HRH Kenya Mechanism- Kenya (September 27, 2016 to September 26, 2021). AEF is a revolving loan product that provides low interest (4%) loans to prospective healthcare trainees in mid-level medical training colleges towards their medical training fees and targets needy students who cannot afford the high cost of medical training.

In 2010, Kenya ushered in a new constitution creating two levels of government, national and county. Health service provision including the management of the health workers was devolved to the county level. Whereas, devolution has led to a lot of development in the health sector, huge disparities still exist in the number and caliber of health workers needed to man essential health services with the devolved units experiencing huge staffing shortages. Moreover, the period immediate post-devolution saw a lot of staff movement across the country through transfers making the staffing gaps more acute, particularly in marginalized counties and those with high disease burden.

The demand for AEF has continued to grow, with the loan applications surpassing existing resources. HRH Kenya mechanism used a CLA approach, initiating external collaborations with the counties for resource mobilization. The graduating health workforce is largely employed by the county departments of health and this builds a sustainable approach, for counties to contribute to their own workforce.