In February 2018, Kenya, along with teams from the World Bank and the Center for Global Development, hosted two JLN learning exchanges in Nairobi as part of the network’s Revisiting Health Financing technical initiative.
The learning exchanges on Fiscal Policy for Public Health and Leveraging Existing Resources for Efficiency (the collaborative’s third in-person session) gathered participants from ten countries for in-depth learning and discussion – including Bangladesh, Ethiopia, Ghana, Indonesia, Kenya, Malaysia, Mongolia, Nigeria, the Philippines and Sudan.
Hosting the JLN learning exchanges in Kenya provided Kenya’s government with a platform for globally sharing and highlighting the country’s commitment and intensified efforts to achieving universal health coverage (UHC). The events also provided an opportunity for wider participation of stakeholders from the Kenya health sector, including the Ministry of Health, Kenya Revenue Authority, county governments and non-governmental health organizations.
The events in Nairobi kicked off with a specially convened meeting: the World Bank JLN team joined the JLN Kenya Country Core Group (CCG) representatives for a discussion of their 2018 plan to support the country’s UHC efforts and the resources needed to actualize the plan.
The meeting continued with a session featuring two senior management members from the Kenya Ministry of Health: Dr. Isaq Odongo, head of curative and rehabilitation health services and Dr. David Kariuki, head of policy planning and financing.
Dr. Kariuki shared details of Kenya’s national UHC agenda, spurred by the recent presidential declaration of 100 percent UHC by 2022, and touched on existing challenges and the plan to realize the UHC goal in collaboration with the Ministry of Finance, partners and the private sector.
Dr. Somil Nagpal of the World Bank introduced the JLN and its mandate, and shared insights from "Going Universal: How 24 Developing Countries are Implementing Universal Health Coverage Reforms from the Bottom Up,” a study that sheds light on countries’ UHC journeys (including Kenya’s) based on a systematic data collection effort.
Dr. Odongo appreciated the timely insights given Kenya’s UHC efforts that lie ahead and noted that with the work done by JLN, rather than reinventing the wheel, the Kenyan government could leverage the JLN’s existing information and resources.
Leveraging Taxation as Fiscal Policy for Public Health
The learning exchange on Fiscal Policy for Public Health provided a platform to share country experiences and evidence on implementing taxes and other fiscal mechanisms to improve public health.
Country representatives from Kenya, Malaysia, the United Kingdom, Ukraine and the United States shared their experiences of implementing tobacco, alcohol and sugary drinks tax policies in the context of both improving health and mobilizing resources for the public health sector.
The participants engaged in discussions on the challenges and the need to contextualize efforts and success, with a special spotlight on Kenya. The session ended with a discussion on the feasibility of adopting fiscal policies for health and next steps for the learning exchange.
Challenges and Learning around Increasing Efficiency
The Efficiency collaborative was graced by several senior Kenyan government representatives, including H.E. Dr. Mohammed Kuti, Governor of Isiolo County and the Chair of the Health Committee of the Council of Governors; Dr. Ahmed Omar, Ministry of Health; Dr. David Kariuki, Ministry of Health; Dr. Isaq Odongo, Ministry of Health; Dr. Anne Wamae, Head of Standards and Quality Assurance and Regulations, Ministry of Health; Mr. Muteti, National Treasury; Dr. Gandham N.V. Ramana, Program Leader, World Bank; and Dr. Jane Chuma, Health Economist, World Bank.
The speakers elucidated on Kenya’s UHC efforts, challenges and plans and how their work could benefit from the discussions taking place in the JLN Revisiting Health Financing technical initiative.
Dr. Kuti explained the positive impact that Kenya’s decentralized health system has had on ensuring equity, quality and efficiency while highlighting the challenges it has posed on increasing efficiency, such as dual practice in both the private and public sectors and an inefficient cold-chain and drug distribution process that could negatively affect the quality of health commodities and vaccines.
Representatives from the National Treasury discussed the government’s financial realignment to realize the country’s new UHC goals by increasing the health budget by 15 percent and setting policies that encourage private sector participation and expansion of health services.
The Efficiency collaborative participants convened for setting priorities and discussing the collaborative’s work plan with a focus on the co-development of a future priority-setting guide for countries. Scope of work for the guide, content flow and joint development of an initial listing of chapters were discussed.
Further, focusing on the sub-topic of measurement and information, representatives from Kenya and the Philippines presented the results of a recent pilot they conducted on implementing the 20 efficiency indicators prioritized in the previous meeting of the Efficiency collaborative. Learning from the two pilot presentations, JLN countries discussed how they could undertake “self-pilots” to similarly implement key efficiency indicators.
Notes on the Authors: Dr. Kenneth Munge, Health Economist, KEMRI Wellcome Trust; Joseph Githinji, UHC Consultant; and Esther Wabuge, JLN Kenya CCG Coordinator