NHA accelerates pro poor reforms in the health sector in Kenya
Estimation Year
2001/02
Intended Policy Goals
The Government of Kenya has written the second National Health Sector Strategic Plan labeling the document “Reversing the Trends.” This theme was brought about as a result of some of the key findings from the 2001/02 National Health Accounts estimation. Key findings of the NHA were the high OOP expenditures at 51%, low per capita utilization especially by the poor and that the poor sought care more in government rural health facilities. Systematic policies to address these issues had to be developed if Kenya were to improve any health indicators.
Actual Policy Use
Realizing that patients were issued with half filled prescriptions and had to buy the rest in private pharmacies, the government decided to overhaul the procurement of drugs and out-source distribution to the private sector who delivered drug kits to health facilities. This increased availability of medicines in public health facilities, with 81% of patients visiting dispensaries reporting receiving all the medicines. Secondly, to reduce OOP expenditures and increase access, user fees were reduced in primary level facilities in what is commonly known as 10/20 Policy. This resulted in over 50% increase in number of outpatient visits.
User fees accounted for 30% of funds allocated for operations and maintenance in health facilities. To further reduce the household’s OOP on providing funds for O&M, the Ministry of Health pilot tested a Health Facility Fund (HFF) in Coast province. The HFF entailed providing grants directly to health facilities thereby removing the long bureaucratic process of disbursing funds. The involvement of facility management committees enhanced governance on utilization of these funds and an evaluation on HFF reveals that there has been improvement in service delivery. In order to scale up the HFF to other provinces the Ministry of Health requested the Ministry of Finance to gazette the Health Sector Services Fund (HSSF) whose objective was to streamline the financing flow of resources in the health sector. The HSSF was gazetted in December 2007 and is expected to be the pillar for decentralization of health sector in Kenya.
Source
Ministry of Medical Services
