Presentation Outline

2. Presentation Outline • Rationale for Decentralized Advocacy • CSO engagement • Level of participation • Nature of Participation • Relating with Europe • Challenges in DA • Milestones of Change • Way Forward

3. Rationale for Decentralized Advocacy • What is Decentralized Advocacy? • Why do we need decentralized Advocacy? • How should we conduct decentralized Advocacy? • When do we consider decentralized Advocacy successful?

4. SRH Situation in Kenya • Effects of Budgets and Policies: • MMR, TFR, CPR • Abortion • Teenage pregnancies • Hospital deliveries • Skilled birth attendance • HCP capacities • Patient provider relationships • HIV among women • ANC visits • Malaria among expectant mothers and infants

5. Main European Donors in Kenya’s Health Sector • United Kingdom (43% of bilateral aid to Kenya) • Germany • Denmark • European Union • Italy • Ireland • Belgium • France • Spain • Finland • Sweden • Austria

6. European Aid Modalities • General Budget Support • MDG Contracting (EU) • Sectoral Budget Support • Sector Wide Approach (SWAp) • Global Fund against Malaria, HIV/AIDS and Tuberculosis (GFATM) • NGO programmes and projects

7. …Cont In million USD EU Donor Atlas 2011

8. Donor commitment -2011/12

9. Top European Donors in the Health Sector • United Kingdom: • More focus on the demand side • Supply side support include midwifery, TBAs and SBAs in Western, Nyanza and North Eastern • HIV prevention (condoms) • FP • Obstetric care in Nyanza • HIV/AIDS capacity building of NGOs • Contribution to UN agencies • Collaboration with GIZ in HF

10. …Cont • Germany • Gender-based violence • Health management • Health Financing including demand-side-financing (Output Based Approach, OBA) on RH services • Focus on RH • Denmark • Contribution to the Health Sector Service Fund (with Gok and WB) • Support to KEMSA reforms • SRH Rights • Efforts against GBV • Maternal health through AMREF :

11. CSO engagement: Level of participation • Strength in Numbers: Numerous CSOs implementing SRHR related activities • Single organizational approach: SRHR activities are interwoven with diverse projects such as income generating, capacity building, gender, governance etc • Working within CSO networks: HENNET, EARHN, SRHRA • Working with the government: NCAPD: a SAGA spearheading RH advocacy thro formulation and execution of population policies and research • Working with European Partners: advocacy for SRHR in collaboration with NGOs in the North e.g SRHRA • Working with Embassies : Alignment to consistent donor countries and providing technical input for SRHR funding decision

12. CSO engagement: Nature of Participation • Participation in DPHK • Representation through HENNET • CSO individual and collective efforts: • Accessing the European embassies (phone, email and physical visits) • Publications (Development of tips and tricks. Budget study/analyses) • CSO capacity building • Participation in functions and platforms organized by DPs – Rare and agenda is set by DPs • Advocacy influenced by International development Frameworks (MDGs, Paris, ICPD, Abuja)- mostly initiated by international NGOs • Collaboration with organizations in the north to do advocacy in the south • Participation in the health sector Coordination framework (JICC, HSCC, HSCCC-Scand ICCs)

13. CSO-related Challenges in DA • Limited advocacy capacity among SRHR CSOs • Inadequate opportunities for participation in policy development and implementation, • Inadequate capacity to form strong alliances for collective advocacy, • Resource constraints, • Cultural, political and religious practices which hamper realization of SRHR objectives

14. National Policy related challenges to DA • Execution of KJAS general principles does not provide sufficient participation of CSOs (space and clout) • Development Partnership Forum – Highest level of consultation of aid mechanisms. Meetings are held bi-annually and only invites government and DPs • The resource policy is not yet finalized: this means there is no guiding policy for engagement with development partners at country level.

15. European DPs and Partnership related challenges to DA • Lack of disclosure from donors: on commitments, disbursement and expenditures • Embassy vs Development Agency • Difficulty in meeting donors/embassy officials • Who is the strategic target of DA • Disjointed interventions from the North

16. Milestones in Kenya’s DA • EU MDGs initiative in Kenya • Integration Advocacy • Increased capacity of CSOs in the discussions related to PRSPs or CSP, • Donors priority policies and programming at capital and country level- EU, Netherlands. • Government led SRH advocacy • SRHR Chapter within HENNET • Observer position within DPHK • Open communication with specific embassies

17. Milestones Cont’d • EU10 million CfP for Kenya (SM), Gender call Brussels • Budget increase in Kenya from EU • Grants Clearing House at DSW • Increased RM towards the EU • Targeting Youth with OBA-KfW • Mainstreaming Population into GIZ thematic areas • ASRHR Alliance efforts with the Dutch government

18. Recommendations for CSOs’ DA • Budget advocacy: • Accountability to Paris declaration • Increased funding for preventive services • Increased funding for drugs and medical supplies for SRHR • Improved accountability (RH specific budget lines) • Prioritization of RH in policies and budgets

19. Way Forward • Role of Kenya Embassies abroad • AfroNGOs Vs EuroNGOs • North –South Vs South –South Coordination and capacity building • Policy Literacy (Country Level, Bilateral and Multilateral policies) • Budget Literacy • CSO embassy relationships

20. Dear Caroline, • There actually is much debate in our parliament about this issue right now since the government seems to be cutting the SRHR budget in 2012 with € 40 million. Even though it declared SRHR as one of its priorities!! As Socialist Party we are againts all cuts in ODA, including this one. The Ministry is saying that this cut will not affect SRHR spending but only HIV/Aids spending (as the expenditures are combined), but it's not yet clear whether this is true or not. We can file parliamentary questions next week about the 2012 budget and of course this question will be one of them. Supposedly the Dutch government is not spending any money on SRHR in Kenia bilaterally, but I can't say whether we do through multilateral donors. I could ask next week with the other questions I'm going to file in. Let me know if this will be helpfull for you. • i'm attaching a link about an event that took place last week about the future SRHR cuts. Ewout was handed over a golden stork by an NGO and Kathleen was also there. I spoke to her and she sends you her best wishes. The link is http://www.simavi.nl/simavi/webStdPages.do?pageid=609981 (unfortunately it's in Dutch) • Bye for now, • Riekje

21. Ha! Caro, is it enough to state that the Netherlands plans to support reproductive health in Kenya beginning next year. We have not been working in the sector. Nevertheless, we are concerned with the following analysis lifted from our Multi-Annual Strategic Plan (MASP) – not yet for publicization as it is still not approved; “Women’s rights and Sexual and Reproductive HealthOn issues related to women’s rights progress is being made. The new constitution provides stronger rights for women with regard to inheritance, political representation and maternal health, including provisions which will enable health professionals to end the practice of unsafe illegal abortion, which leads to high maternal death rates. Sexual reproductive health is a serious problem in Kenya. 30% of maternity deaths are caused by illegal abortion. The new constitution offers a legal framework to constructively work to end this undesirable practice. On sexual and reproductive health very few organizations are active. Adolescent sexual health does not get proper attention, resulting in many early pregnancies, STDs, stigma and sexual violence. There is also a substantial unmet need for family planning methods and FGM Is still widespread.” And in the sector, the estimate is to work with EUROS 1 million on interventions in the sector. Caro, it all one can say.

22. AHSANTENI SANA THANK YOU