Busia County, strategically located on the Kenya-Uganda border, holds a significant position within the East African Community (EAC). This article delves into the multifaceted aspects of Busia County, exploring its historical context, economic dynamics, and the emerging tourism sector. It examines the challenges and opportunities that shape the region's development, with a particular focus on revenue collection, community health initiatives, and the potential for sustainable growth.
Map of Busia County, Kenya
A Historical Overview
Western Province (Swahili: Magharibi) was one of Kenya's seven administrative provinces outside Nairobi. It is inhabited mainly by the Luhya people. Quakerism is widely practised here. Kenya's second highest mountain, Mount Elgon is located in Bungoma District. The Kakamega Forest rainforest is part of the area. The province capital was Kakamega. After the 2013 general election, and the coming into effect of Kenya's new constitution, provinces became defunct and the country is currently divided into 47 counties. Each county has its own government and therefore there is no central regional capital. Kakamega is the seat of government for Kakamega County, Bungoma County has its seat in Bungoma town, Busia County has the Assembly in Busia, Vihiga County in Vihiga Town.
Economic Landscape: Challenges and Opportunities
Revenue generation is crucial for county government operations, as it provides the necessary resources for delivering public services and fostering economic development. In Kenya, devolved units depend on locally generated revenues to complement the funds received from the national government. For counties like Busia, which is strategically located at the border with Uganda, the potential for revenue collection is significant.
Despite this advantage, Busia has struggled to achieve its revenue targets (Busia County Government, 2023). The county’s location on the Kenya-Uganda border offers considerable opportunities for revenue generation through active cross-border trade, bustling local markets, and access to fishing resources in Lake Victoria. Nevertheless, Busia consistently falls short of its revenue goals.
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Several systemic and operational challenges have hindered revenue collection efforts in Busia. The county’s heavy dependence on cross-border trade makes it vulnerable to external economic shocks, such as fluctuations in Uganda’s economy, which directly affect trade volumes and customs revenue (UNCTAD, 2020). Moreover, informal trade, commonly referred to as “Magendo,” flourishes along porous borders, avoiding taxation and worsening revenue losses.
Key Challenges in Revenue Collection
- Dependence on Cross-Border Trade: Vulnerability to economic fluctuations in Uganda.
- Informal Trade ("Magendo"): Tax evasion due to porous borders.
- Infrastructure Problems: Poor roads, insufficient facilities, unreliable technology.
- Public Awareness and Trust: Residents view taxes as burdensome due to lack of visible benefits.
- Lack of Innovative Strategies: Untapped potential in tourism, sand mining, land rates, and fishing permits.
The county’s reliance on cross-border trade, coupled with political challenges, inadequate infrastructure, and tax evasion, creates a cycle of inefficiency and underperformance. These obstacles not only impede service delivery but also weaken the county’s capacity to invest in long-term development (World Bank, 2021).
Busia County faces significant challenges in revenue collection due to a mix of structural, operational, and policy-related issues. Key factors include a lack of political support, an over-dependence on a fragile cross-border economy, revenue leakages, and major infrastructural shortcomings. Furthermore, inefficiencies in policy execution and inadequate engagement with stakeholders worsen the situation, making it increasingly difficult to enhance revenue generation.
A major contributor to these problems is the revenue management system implemented by the county. Although this system was designed to modernize revenue collection and boost efficiency, it has encountered numerous challenges since its rollout. Technical issues, poor infrastructure, and insufficient training for county staff have all limited its effectiveness.
Political commitment is essential for effective revenue collection. In Busia, the lack of strong political support hampers policy enforcement and undermines necessary reforms. Politicians often focus on populist strategies, such as opposing tax hikes, to maintain voter loyalty. This reluctance to back unpopular yet essential revenue policies leaves the county struggling to ensure compliance and broaden its tax base.
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Busia’s location near Uganda makes cross-border trade a vital economic activity. However, this reliance carries risks, particularly when Uganda’s economy experiences downturns. A decline in cross-border transactions directly impacts the revenue collected at customs and other border points.
Revenue collection is often hindered by discrepancies between national policies and county regulations. For instance, trade agreements within the East African Community sometimes clash with Busia’s local revenue collection strategies. These policy misalignments create confusion for both taxpayers and enforcement agencies, leading to inefficiencies.
Leakages happen when funds collected fail to reach county accounts due to issues like corruption, mismanagement, or inefficiencies. In Busia, inadequate monitoring systems enable revenue officers to misappropriate funds or underreport collections, which weakens the county’s capacity to finance essential projects.
Collusion between law enforcement officers and traders facilitates tax evasion. Locally referred to as “Magendo,” this practice involves smuggling goods across the border without paying taxes. This not only diminishes revenue but also fosters unfair competition, discouraging compliance from honest taxpayers.
Busia County has not fully tapped into its available revenue streams. For example, markets, parking fees, and land rates are not being collected effectively due to inadequate enforcement and outdated systems. The county also lacks creative strategies to broaden its revenue sources.
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The automated revenue system decreased inconsistencies by 15%, yet issues such as unreliable internet and insufficient training continued to be a problem. Informal trade made up 40% of untaxed transactions, and 65% of traders indicated that they felt politically encouraged to evade taxes. Public trust was still lacking, with 58% expressing dissatisfaction with how tax funds were allocated. Furthermore, 43% of revenue officers encountered challenges in tax collection due to inadequate infrastructure.
Suggested solutions include aligning county laws with national policies, enhancing automation of revenue streams, and investing in staff capacity building. The study emphasizes the importance of exploring new revenue sources, including eco-tourism, improved management of border markets, and tapping into informal sectors like bodaboda operations. It also suggests decentralizing revenue collection to local municipalities and building public trust through transparent service delivery.
By tackling these systemic issues, Busia County can enhance its revenue capabilities, lessen its reliance on national funding, and promote sustainable economic development. The recommended reforms aim to establish a transparent, fair, and efficient revenue collection system that caters to the needs of its varied population.
For example, in the 2023/2024 financial year, the county collected Ksh.22.7 million, Ksh.30.3 million, and Ksh.14 million for the months of August, September, and October respectively. In 2024/2025, the county has only been able to collect Ksh.18.6 million, Ksh.17.1 million, and Ksh.22.1 million for the same period of time indicating a significant drop in revenue generation over the same period.
Table 1: Socio-Demographic Differences Between Nambale and Teso South Sub Counties
| Characteristic | Nambale | Teso South | P-value |
|---|---|---|---|
| Households in Lowest Wealth Quintile | 15.2% | 24.5% | 0.008 |
| Caregivers Lacking Formal Education | 1.6% | 4.2% | 0.007 |
| Roman Catholic Affiliation | 25.7% | 33.2% | 0.028 |
| Farming Occupation | 49.7% | 60.5% | N/A |
| Self-Employment | 21.7% | 17.1% | 0.043 |
| Household Income Sources | Small Businesses | Farming and Produce Sales | <0.001 |
Community Health Initiatives: iCCM Intervention in Busia County
Sub-Saharan Africa (SSA) continues to experience high mortality among children under five, primarily due to preventable diseases such as diarrhea, malaria, and pneumonia, with malnutrition as an underlying factor (1). In Kenya, under-five mortality has declined by 50% from 102 per 1,000 live births in 1999 to 53 per 1,000 in 2022 (2).
Kenya introduced the Integrated Management of Childhood Illnesses (IMCI) strategy in 1999; however, inadequate coverage, poor access, underutilization of guidelines, and lack of funding undermined its effectiveness, particularly the community component (4). The iCCM framework launched in 2015 under Kenya’s Community Health Strategy (CHS) targets common child illnesses through CHWs, especially in hard-to-reach areas (5). The framework is a platform for community management of childhood diarrhea, malaria, pneumonia, neonatal illness, and malnutrition (6).
The framework is anchored in the CHS (7) and the Child Survival and Development Strategy (8), which address key areas including policy, management of cases and the commodity supply chain, and supervision. Within the national iCCM implementation framework, guidelines exist on training for CHWs to treat children aged below 5 years with diarrhea using oral rehydration salts (ORS) and zinc, to diagnose malaria with a malaria rapid diagnostic test (mRDT) and treat it with artemisinin combination therapy (ACT), and to refer suspected pneumonia, mild to moderate malnutrition, and sick newborn to a health facility (MoH, iCCM participants manual). This is in line with the components of iCCM as recommended by WHO and UNICEF. It also includes referrals of the newborn delivered at home and any newborn or mother with danger signs (9).
This strategy aimed at training, supporting, and equipping CHWs to deliver diagnostic, treatment, and referral services for three major childhood illnesses: malaria, pneumonia, and diarrhea. The CHWs were digitalized with mobile phones that had a digital health information application that not only facilitates reporting of the services delivered but also drives greater quality health care to the community. This reporting facilitated clear visibility of the coverage and timeliness of service delivery from the CHWs’ end but also enabling real-time monitoring from the supervisor’s application thereby facilitating evidence-based performance management.
Living Goods has partnered with Kenya’s Ministry of Health and county governments to strengthen community-based primary healthcare and advance universal health coverage. In Busia County, they implement the DESC approach-Digitally enabled, Equipped, Supervised, and Compensated-to deliver high-quality, cost-effective community health services. This model empowers community health workers (CHWs) with digital tools, supplies, supervision, and fair compensation, enhancing their performance and strengthening community health systems.
This study presents findings from the implementation of the integrated community case management (iCCM) intervention in Busia County, Kenya. It examines the impact on care seeking, treatment, and coverage for malaria, pneumonia, and diarrhea among children under five, at community level by CHWs.
In the intervention site, Nambale, CHWs known as Community Health Promoters (CHPs) delivered iCCM using a mobile smart health application. This application aligned with guidelines from the (11). The tool guided CHPs through standardized assessment protocols based on presenting symptoms such as cough, fever, or diarrhea. It helped identify iCCM entry points, supported illness classification, and enabled appropriate treatment and/or referral.
The application promoted protocol-driven decisions by prompting critical tasks such as timed breath counts and providing feedback to guide diagnosis based on the child’s age. It also included structured assessments for malaria and diarrhea, and embedded checks for danger signs to reduce the risk of missed referrals. In addition to digital case management, CHPs were supported through real time dashboards that allowed supervisors to track performance and offer timely coaching.
In contrast, CHPs in the comparison site, Teso South, followed the same national guidelines but used paper tools for assessments. They mainly focused on community case management hence assessing and managing Malaria cases alone and referring all diarrhea and Pneumonia cases identified in the community. Further, they lacked access to digital guidance or real time performance monitoring, which may have affected the accuracy, timeliness, and consistency of illness classification and referrals.
The study was conducted in two locations within Busia County. Nambale sub-county served as the site for the integrated Community Case Management (iCCM) intervention, while Teso South sub-county acted as the comparison site. The population of Nambale sub county was 111,636, while that of Teso South sub county was 113,097 (15). Living Goods has been implementing iCCM in Nambale sub county since 2017 with the Busia County health department. On the other hand, the comparison site was selected since it has no iCCM interventions. Additionally, it has comparable socioeconomic and demographic profile to the intervention site.
Despite comparable malaria prevalence (~25%) in both intervention (n = 382) and comparison (n = 380) sites, the intervention, centered on Community Health Workers (CHWs), significantly reshaped care-seeking and treatment access. While overall treatment seeking was similar (80.0% vs. 71.6%), the source differed markedly.
CHW utilization for treatment was significantly higher in the intervention area (37.9% vs. 16.8%, p = 0.002), contrasting with a greater reliance on private facilities in the comparison group (10.5% vs. 3.2%, p = NS). Moreover, the study noted consistently lower proportion of patients having their first point of care at the health facilities at 47% in the intervention group compared to 59% in the comparison group with 41% being treated at the health facilities in the intervention group while 69% of the malaria patients received treatment at the health facilities.
Although overall mRDT testing was equal (74.7%), CHWs facilitated significantly more home-based testing in the intervention area (45.1% vs. 16.9%, p < 0.001), while government facility testing was slightly higher in the comparison group (71.8% vs.
The qualitative findings highlight the improvements in access to care for sick children as a contribution of CHWs implementing iCCM. Caregivers felt that CHWs were closer home, always available, and reliable. When a child was sick, caregivers cited how care could be accessed at any time of the day or night, and prompt. This is because CHWs were available and closer to them, especially when they did not have transport to hospital and during the night.
Besides being closer, access to care was more reliable than services offered at formal health facilities since CHWs were always available, unlike in health centers, which might be closed due to limited operational hours, or have medicine stock-outs. “…everyone in our village has her number.
The intervention also significantly improved access to appropriate treatment and follow-up. A higher proportion in the intervention area received ACTs (84.2% vs. 68.4%, p = 0.027), with CHWs being a major source (35.0% vs. 15.4%, p = 0.008), while private hospitals were a more significant treatment source in the comparison area (15.4% vs. 1.3%, p = 0.002).
Furthermore, CHWs in the intervention area contributed significantly more to follow-up care (35.8% vs. 16.8%, p = 0.002) and the provision of malaria prevention advice (35.9% vs. 17.9%, p = 0.001).
The iCCM intervention in Nambale led to a significant decrease in pneumonia prevalence, dropping to 15.4% in the intervention site compared to 27.6% in the control site (p < 0.001). This reduction was accompanied by a notable change in initial care-seeking behavior, with a substantially higher proportion of caregivers in the intervention area first seeking care or advice from CHWs (18.5%) compared to the control area (3.7%, p = 0.035). Consequently, a significantly larger percentage of individuals in the intervention group sought care on the same day of symptom onset (55.8%) compared to the control group (35.2%, p = 0.031), indicating improved timeliness of care.
Tourism Potential in Busia Town
Tourism in Busia Town, Kenya, is an emerging sector with significant potential for growth. In conclusion, tourism in Busia Town, Kenya, is an emerging sector with unique offerings centered around its border town status, cultural heritage, and proximity to natural attractions. The town’s position as a cross-border hub adds a distinctive element to its tourism appeal.
Step into Idokho, a tranquil settlement in Kenya’s Busia County. Experience its rich cultural heritage, diverse ecosystems, and the warm community spirit that defines this hidden Kenyan gem.Idokho is a charming settlement located in the heart of Busia County, Kenya. With its tranquil environment and rich cultural backdrop, Idokho offers a unique perspective on rural life in Kenya, away from the hustle and bustle of urban centers.
Nestled in the western part of Kenya, Idokho is characterized by its lush landscapes, fertile soils, and a climate conducive to agriculture and natural biodiversity. The area’s geography is marked by rolling hills, scattered woodlands, and numerous streams, which contribute to its serene ambiance and agricultural potential.
The community in Idokho is a vibrant mix of ethnic groups, primarily the Luhya and Teso, who coexist harmoniously, sharing traditions and customs. The settlement is a hub of cultural activities, including traditional dances, music, and local craftsmanship, reflecting the diverse heritage of its inhabitants.
Idokho’s unspoiled natural beauty and cultural richness offer significant opportunities for eco-tourism and cultural tourism. Initiatives to promote sustainable tourism can help preserve the area’s ecological and cultural assets while providing economic benefits to the local population.
Idokho stands as a testament to the enduring allure of rural Kenya, offering insights into the traditional lifestyle and cultural wealth of Busia County.
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