1. Key Highlights of the MDG Needs Assessment Study Elkana Onguti Ministry of Planning and National Development 28 th November 2005

2. 2 The MDG Needs Assessment Study Objective is to put the country on an MDG-based long term planning path by: Identifying interventions and investments needed to meet MDGs by 2015 Identifying the resources required to support a scale-up of interventions through to 2015 Outlining a financing strategy to achieve MDGs Provide a well researched & analysed long term plan as a basis for policy interventions Provide a framework for M&E and policy dialogue

3. 3 Outputs from the Study Comprehensive Kenya MDG Needs Assessment Report Needs Assessment Report to inform long term MDG-based Plan Subsequently, the long term plan to form the basis for the rolling medium term strategies and sectoral plans

4. 4 The Needs Assessment Report The Needs Assessment process took place from June 2004 – July 2005. The Needs Assessment Report was launched in August 2005 The following are the highlights of the report:

5. 5 Goal 1: Eradicate Poverty and Hunger Targets: (between 1990 and 2015) 1. Halve the proportion of people whose income is less than one dollar per day 2. Halve the proportion of people who suffer from hunger

6. 6 Poverty and Hunger - Situation Analysis - Chronic under-nourishment, severe hunger and micro nutrient deficiency Major causes: poverty, under and un- employment, landlessness, vagaries of weather, low education Vulnerable groups: small scale farmers, rural landless, urban poor, paternalists, fishers Categories at risk: pregnant & lactating women, children under-5, poor single mothers & widows, the elderly, the unemployed, the sick, AIDS orphans

7. 7 Poverty and Hunger - Intervention Costs - InterventionsMDG COSTING (Kshs) Total Cost (2005- 2015) Proposed Annual Expenditure Agricultural ProductivityKshs 240 BKshs 21.82 B Rural Income GenerationKshs 160.7 BKshs 14.6 B Nutrition ProgrammeKshs 204 BKshs 18.6 B Capacity BuildingKshs 33.8 BKshs 3.075 B MDG TOTALKshs 639 BKshs 64 B Actual MoA MTEF spending 2002/03-2003/04 Kshs 2.8 B ERS Required Spending 2004/05-2006/07 Kshs 6.8 B

8. 8 Goal 2: Achieve Universal Primary Education Target: (By 2015) 3.Ensure that children everywhere, boys and girls alike, will be able to complete a full course of primary schooling

9. 9 Education - Situation Analysis - Near-gender parity in the primary education cycle but not at post primary level Regional/gender disparity in primary school enrolment rates (low among girls in ASALs) Pressure to expand secondary enrolment Low enrolment in special education Limited places available in Technical, Industrial, Vocational and Entrepreneurship Training Low secondary-university transition rate (12%) Adult illiteracy (4.2M, 1999)

10. 10 Education - Interventions - Expand Early Childhood Development and Education(ECDE) by 2010 Ensure all children, especially girls, have access to quality primary education Achieve 50% improvement in adult literacy, especially for women Eliminate gender disparities in primary and secondary education Improve education quality Ensure access to and completion of primary ed. for vulnerable areas/groups Promote ICT and Science and Technology education

11. 11 Universal Primary Education - Intervention Costs - Category MDG COSTING (Kshs) Total Cost (2005-2015) Proposed Annual Expenditure ECDE2.7 B0.24 B Primary Education and Mobile Schools 90 B8.1 B Secondary Education42.4 B3.85 B Adult Basic Education3.5 B0.322 B HIV/AIDS24 B2.18 B Special Education6 B0.555 B Capacity Building7.1 B0.65 B

12. 12 Universal Primary Education – Intervention Costs (cont) - Category MDG COSTING (Kshs) Total Cost (2005-2015) Proposed Annual Expenditure Quality Assurance & Standards4.8 B0.44 B Non-formal Schools0.3 B0.03 B School feeding, Health & Nutrition 15.4 B1.4 B Monitoring & Evaluation0.075 B0.007 B Administrative + Teachers101 B9.1 B MDG TOTALKshs 297 BKshs 27 B Annual MOEST MTEF Spending 2002/03-2003/04 Kshs 15.5 B ERS Required Spending 2004/05-2006/07 Kshs 39.2 B

13. 13 Goal 3: Promote Gender Equality & Empower Women Target: 4.Eliminate gender disparity in primary and secondary education preferably by 2005 and to all levels of education no later than 2015

14. 14 Gender - Situation Analysis - Gender imbalances and inequalities across sectors and society Low access to employment for women; poor working conditions and control of trade & market forces Under-representation of women in leadership and decision making positions Violence against women; health related indicators – HIV/AIDS, reproductive illness

15. 15 Gender - Interventions - Increase awareness and provide education on women s reproductive health and rights Preventing practices that are harmful to women s sexual and reproductive health and promoting rights through legislation Effective monitoring and implementation of laws protecting women s human rights

16. 16 Gender - Intervention Costs - InterventionsMDG COSTING (Kshs) Total Cost (2005/2015) Proposed Annual Expenditure MobilizationKshs 15.225 BKshs 1.38 B Institutional StrengtheningKshs 43.125 BKshs 3.92 B Lobbying and AdvocacyKshs 19.875 BKshs 1.8 B Build Coalitions and Mobilize Support Kshs 51.525 BKshs 4.6 B Research, Information and Monitoring Kshs 21.525 BKshs 1.9 B MDG TOTALKshs 151.275 BKshs 13.7B Actual MTEF Spending 2002/03 - 2003/04 Kshs 0.186 B ERS Required Spending 2004/05- 2006/07 Kshs 1.14 B

17. 17 Goal 4 & 5: Reduce Child and Maternal Mortality Targets: (between 1990 and 2015) 5.Reduce by two-thirds the under-five mortality rate 6.Reduce by three-quarters the maternal mortality ratio

18. 18 Child and Maternal Mortality - Situation Analysis - Decrease in child mortality in the 1970s and 80s and an increase in the 1990s Decline in the level of child immunization Only 42% of mothers assisted by skilled health personnel in 2003 (51% in 1989) 15% of health facilities able to provide basic obstetric care, and only 9% have comprehensive essential obstetric care Only 63% of the total demand for family planning is satisfied

19. 19 Child and Maternal Mortality - Intervention Areas - Increase access to skilled delivery care Provide prompt post-partum care, counseling, and family planning Improve post-abortion care Strengthen health promotion activities Strengthen reproductive health and family planning policies and improve planning management and resource allocation; Scale up IMCI package; and Increase access to high quality ante-natal care

20. 20 Child and Maternal Mortality - Health Systems Interventions - Strengthen the human resources Improve infrastructure Systems management Monitoring and evaluation and quality assurance Build capacity for research and development Access to essential services

21. 21 Goal 6: Combat HIV/AIDS, Malaria Targets: (by 2015) 7.Have halted and begun to reverse the spread of HIV/AIDS 8.Have halted and begun to reverse the incidence of malaria and other major diseases

22. 22 HIV/AIDS - Situation Analysis - 3 million people currently infected 2 million have died Millions of children living with sick parents 60% infected live in rural areas 50% hospital beds occupied by HIV patients Many are unable to access health care 200,000 urgently need ARVs Disease is costing Kenya Kshs 200 million daily

23. 23 HIV/AIDS - Interventions - Prevention Behavioral change programme STD control Voluntary counseling and testing Harm reduction for injecting drug users Prevention of mother to child transmission Blood safety intervention

24. 24 HIV/AIDS - Interventions - Care and Treatment Palliative care – to those nearing death Treatment – for opportunistic diseases Diagnostic HIV testing Prophylaxis – in ARV treatment Orphans care- to minimize impact of AIDS

25. 25 Malaria SITUATION ANALYSIS 6,000 expecting mothers suffer from malaria each year 4,000 children are born with low birth weight due maternal anaemia 34,000 children, <5 die of malaria p.a 120 million working days are lost due to malaria PROPOSED INTERVENTIONS Provision of ITN Treatment of complicated malaria Treatment of uncomplicated malaria

26. 26 Tuberculosis - Situation Analysis - Situation Analysis 106,000 TB cases notified in 2004 compared with 96,000 cases in 2003 and 82,000 in 2002 (NLTP 2003,4) It is currently estimated that over 60% of TB patients are also HIV+

27. 27 Tuberculosis - Interventions - Additional human resources Infrastructure and equipment Trainings Commodities and products Drugs Planning and administration Monitoring and Evaluation

28. 28 Maternal Child Health & Health Systems, HIV/AIDS, Malaria and other Diseases - Intervention Costs - Interventions MDG COSTING (Kshs) Total Cost (2005/2015) Proposed Annual Expenditure Maternal Health Care4.8 B0.44 B Child Health (intervention, treatment and personnel costs) 20.6 B1.8 B Care and Treatment of HIV/AIDS417.5 B37.9 B HIV/AIDS Prevention169.1 B15.3 B Malaria Treatment, Prevention & Administration31.1 B2.8 B TB (Treatment, Prevention, Facilities & Administration) 4.4 B0.4 B MDG TOTALKshs 647.8 BKshs 58.8 B Actual MoH MTEF Spending 2002/03 -2003/04Kshs 39.05 B ERS Required Spending 2004/05-2006/07Kshs 126.3 B

29. 29 Goal 7: Ensure Environmental Sustainability Environment Target : 8.Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources

30. 30 Environment - Situation Analysis - The greatest threat to our environment is posed by poverty High levels of poverty negatively impact on the environment through agricultural land degradation Since 1930, Kenya has lost about 65% of its originally standing wood volume The area under industrial plantations has declined from 165,000Ha in 1988 to less than 80,000Ha in 2003 The total forest area under protection stands at 1.7M Ha (1.7%) against the recommended forest cover level of 10%

31. 31 Environment - Interventions - Effective policy framework for environmental conservation and management Measures to increase and protect forest cover Strategic and long-term environmental strategy Environmental education, public awareness and participation in pursuit of sustainable development

32. 32 Environment - Intervention Costs - Interventions MDG COSTING (Kshs) Total Cost (2005/2015) Proposed Annual Expenditure National environment framework1.3 B0.12 B Fisheries and other aquatic ecosystems2.1 B0.19 B Community initiatives in land degradation28.8 B2.62 B Forests and other terrestrial ecosystems29.4 B2.67 B Wildlife management and conservation8.9 B0.8 B MDG TOTALKshs 70.7 BKshs 6.4 B Actual MoENR MTEF Spending 2002/03-03/04 (Environmental mgmt, Project environmental screening) Kshs 2.5 B ERS Required Spending 2004/05-2006/07Kshs 5.9 B

33. 33 Goal 7: Water and Sanitation Target: (By 2015) 10.Halve the proportion of people without sustainable access to safe drinking water

34. 34 Water and Sanitation - Situation Analysis - Access to safe water stands at 89.7% in urban areas and 43.5% in rural areas, The national average is 57% 81% of total population has access to safe sanitary means Water coverage is 49% & 86% for sanitation Total water coverage requirements to meet MDGs is 80% Total coverage for improved sanitation is 96%

35. 35 Water & Sanitation Costs to 2015 (Excluding costs not in the MDG model) InterventionsMDG COSTING (Kshs) Total Cost (2005/2015) Proposed Annual Expenditure Provision of Rural water12.4 B1.1 B Provision of urban water28.2 B2.5 B Provision of rural sanitation3.6 B0.3 M Provision of urban sanitation14.2 B1.2 B Waste water treatment1.4 B0.12 B Hygiene Education1.2 B0.1 B MDG TOTAL61.2 BKshs 5.5 B Actual MoW & I MTEF Spending 2002/03-04 Kshs 2.4 B ERS Required Spending 2004/05- 2006/07 Kshs 13.4 B

36. 36 Goal 7: Slum Improvement & Future Deterrent Target: 11.By 2020, to have achieved a significant improvement in the lives of slum dwellers

37. 37 Slums - Situation Analysis - Slum Improvement & Deterring future Development There are 533,000 informal households in Nairobi, Kisumu and Mombassa projected to increase to 885,000 by 2015 There are 710,721 informal households in the rest of the country, projected to be 1,074,524 by 2015 Critical issues are: (a)Access to tenure dwelling unit; (b)Housing conditions (c)Access to clean water (d)Household access to sanitation (e)Land requirement

38. 38 Slum Improvement - Interventions - Creation of enabling policy environment and regulatory framework (land; housing, slums,urban planning); Review of regulatory frameworks (regulations, standards, processes and procedures) Land tenure (access, market intervention, land rights, relocation/resettlement, etc) Planning (participatory planning, city/regional approach, country-wide information system)

39. 39 Slum Improvement - Interventions - Integrated urban and rural planning Physical Infrastructure (roads, street lights, drainage, water supply, maintenance) Social Infrastructure (refuse collection, fire protection, schools, health centres, community facilities) Increasing Household incomes (micro-finance, skills enhancement, Jua Kali sheds, kiosks and hawking systems, mixed land use and market centres) Social mobilization and communication (participation of residents of slums in the upgrading)

40. 40 Slum Improvement - Intervention Costs - Interventions MDG COSTING (Kshs) Total Cost (2005/2015) Proposed Annual Expenditure Enabling environment for accessing land & secure tenure 0.93 B0.082 M Upgrading and deterring new formations 736 B66.9 B Integrated urban planning5.6 B0.5 B Capacity building for stakeholder participation 4.1 B0.3 B Integrated communication framework0.9 B0.082 B MDG TOTALKshs 748 BKshs 68 B Actual MoL & Housing MTEF Spending 2002/03-04 Kshs 0.18 B ERS Required Spending 2004/05- 2006/07 Kshs 2.2 B

41. 41 Energy - Interventions - (1)Biomass – Sustainable supply of fuel wood (2)Charcoal Conservation – Energy saving stoves (3)Petroleum Products – Exploration, efficient use and better distribution systems (4)Electricity – Private sector participation; rural electrification; import cheaper power and manage water catchments (5)Others – Solar, mini-hydros and wind energy (6)Institutional strengthening for sustainability

42. 42 Energy - Interventions Costs - InterventionsMDG COSTING (Kshs) Total Cost (2005/2015) Proposed Annual Expenditure Administrative Strategies80.2 B7.2 B Fuelwood Supply Strategies23.6 B2.1 B Charcoal Conservation Strategies14.6 B1.3 B Petroleum Products168.2 B15.2 B Electricity224.1 B20.3 B New and Renewable Energy212.4 B19.3 B MDG TOTALKshs 723.3 BKshs 65.7 B Actual MoE MTEF Spending 2002/03- 03/04 (Rural electrification only) Kshs 2.5 B ERS Required Spending 2004/05- 2006/07 Kshs 9.1 B

43. 43 COST SUMMARY (Kshs) GOALMDG Cost 2005-2015 Annual Cost Actual MTEF Spending 2002/03- 2004/05 ERS Required Spending 2004/05- 2006/07 1. Poverty and Hunger639 B64 B2.8 B6.8 B 2. Universal Primary Education 297 B27 B15.5 B39.2 B 3. Gender151.2 B13.7 B0.186 B1.14 B 4,5, 6. Child & Maternal Mortality, HIV/AIDS, Malaria and other Diseases 647.8 B58.8 B39.05 B126.3 B 7a. Environment70.7 B6.4 B2.5 B5.9 B b. Water and Sanitation61.2 B5.5 B2.4 B13.4 B c. Slums Improvement748 B68 B0.18 B2.2 B d. Energy723.3 B65.7 B2.5 B9.1 B TOTAL3, 338.2 B309.1 B65.11 B204.04 B

44. 44 Thank You