Lessons on Strategic Purchasing of Health Services in Kenya

55 Pages Posted: 3 Apr 2023

See all articles by Angela Kairu

Angela Kairu

Kenya Medical Research Institute (KEMRI) - Kemri-Wellcome Trust Research Programme

Stephen Mulupi

Liverpool School of Tropical Medicine - Department of International Public Health

Wenhui Mao

Duke University - Duke Global Health Institute

Ipchita Bharali

Duke University - Duke Global Health Institute

Gilbert Kokwaro

Strathmore University Business School

Kaci Kennedy McDade

Center for Policy Impact in Global Health, Duke University

Gavin Yamey

Duke Global Health Institute; Duke University - Duke Global Health Institute

Date Written: March 29, 2023

Abstract

Kenya has progressed towards implementing and institutionalizing strategic health purchasing (SHP) practices as a key strategy to achieving universal health coverage (UHC). However, multiple challenges are faced such as fragmentation of pooling arrangements, inadequate health funding, rigid public financial management requirements, lack of purchaser-provider split and lack of formal policies and laws to support SHP. Given these challenges, we conducted a mixed methods study to understand key lessons on the purchasing reforms in Kenya. We conducted a comprehensive literature review of policy documents, white papers, and published articles and reports, and interviewed 12 technical experts and key policy makers. Kenya has established structures for coordination of strategic purchasing for benefit packages designs, contracting of health providers and institutional arrangements. There has been good progress in reforming in the National Health Insurance Fund (NHIF), the main vehicle for the UHC scheme. Although policy and legal frameworks to support this coordination exists, the implementation remains fragmented and poor. Additional continued challenges include unclear regulatory frameworks for NHIF, gaps in monitoring outcomes and performance indicators, and limited data sharing between public and private sector health insurance schemes. There is a need to leverage existing coordinating mechanisms to ensure alignment of SHP to support UHC scale-up and implementation in Kenya.

Keywords: Strategic health purchasing, reforms, experiences and lessons, Kenya

Suggested Citation

Kairu, Angela and Mulupi, Stephen and Mao, Wenhui and Bharali, Ipchita and Kokwaro, Gilbert and McDade, Kaci Kennedy and Yamey, Gavin, Lessons on Strategic Purchasing of Health Services in Kenya (March 29, 2023). Duke Global Working Paper Series No. 51, Available at SSRN: https://ssrn.com/abstract=4406108 or http://dx.doi.org/10.2139/ssrn.4406108

Angela Kairu

Kenya Medical Research Institute (KEMRI) - Kemri-Wellcome Trust Research Programme ( email )

Kilifi
Kenya

Stephen Mulupi

Liverpool School of Tropical Medicine - Department of International Public Health ( email )

Liverpool
United Kingdom

Wenhui Mao

Duke University - Duke Global Health Institute ( email )

310 Trent Drive
Box 90519
Durham, NC 27710
United States

Ipchita Bharali (Contact Author)

Duke University - Duke Global Health Institute ( email )

310 Trent Drive
Box 90519
Durham, NC 27710
United States

HOME PAGE: http://centerforpolicyimpact.org

Gilbert Kokwaro

Strathmore University Business School ( email )

P.O. Box 3009
Nairobi, 00506
Kenya

Kaci Kennedy McDade

Center for Policy Impact in Global Health, Duke University ( email )

310 Trent Drive
Box 90519
Durham, NC 27710
United States

Gavin Yamey

Duke Global Health Institute ( email )

Trent Hall
310 Trent Drive
Durham, NC 27708
United States

Duke University - Duke Global Health Institute ( email )

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