In 2020, the COVID-19 global pandemic illustrated like nothing else in recent history the importance of building resilient health systems. The diversion of health system resources to address COVID-19 care led to a disruption of essential health services which affected the vulnerable households the most and put them at risk of incurring catastrophic health expenditures from private providers. Health financing is a particularly urgent component of health systems in developing countries in the wake of COVID-19. For its part, Kenya has made universal health coverage (UHC) one of its signature development goals in recent years, but financing it, even before the pandemic, has been a challenge. Given the challenges of COVID-19, low income countries such as Kenya need increased political will and technical capacity on domestic resource mobilization in order to deliver high-quality health services for their citizens. This report uses two counties (Makueni and Nyeri) in Kenya as cases by which to examine the challenges and best practices in increasing resource allocation for health at the subnational level. The research unearthed effective health financing practices which may provide important lessons for development partners as well as local and national Kenyan policymakers. These include; local health systems must reflect local priorities and how global donors and county leaders can strengthen subnational health systems post COVID-19 and beyond.
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