A strong, well-functioning and sustainable health system – capable of efficiently delivering and managing health care services – is vital to improving the health status of Kenyans.  Health systems in Kenya are constrained by insufficient financial resources, a shortage and poor distribution of healthcare workers, weaknesses in legislation and information systems and a lack of management and other technical expertise.  Accessing quality health services is especially difficult for women and youth.

Strengthening the health system is at the core of the Government of Kenya’s reform agenda.  USAID supported the formulation of foundational health policies, laws, and guidelines stemming from the 2010 Constitution and is assisting the Health Ministries to transition to devolved county health governance systems.  As the process of devolution continues, USAID is also assisting counties to better plan, manage and finance quality health services to meet local needs.  

Leadership and Governance

The transfer of health service delivery to county governments requires new capacity building and technical support for county-level health leadership. USAID’s approach in leadership and governance is to assist the Government of Kenya to strengthen governance structures and functions; institutionalize management and budgeting procedures, create leadership and governance curricula; and improve access to management training courses to ensure county readiness to assume new devolved functions and responsibilities.

Human Resources for Health

The World Health Organization has characterized Kenya as facing an acute shortage of health workers.  Universities and training facilities are only producing 40 percent of the needed health workforce, and poor distribution and retention is a serious concern particularly in rural areas where the need is greatest.  USAID’s approach to human resources for health has helped to finance critical gaps in health workforce needs with the Ministry of Health taking over financing for these positions.  In 2010-2012, 1,850 workers whose salaries were formerly paid through USAID were absorbed by the government. USAID’s approach also includes actions to strengthen human resources information management, regulatory and professional bodies, and pre-service and in-service training.

Health Financing

The high cost of healthcare remains a major barrier to access, especially for the poor who spend a larger share of their household income to meet their healthcare needs.  Moreover, the transfer of national revenues to counties may impact health service delivery, as counties may not immediately be able to optimize use of devolved health resources.  A major focus for health financing is to ensure that existing funds are used efficiently and to reach poor and underserved populations.  USAID works with the Government of Kenya to develop health financing policies and strategies, especially for the financing of free primary health care and maternity services.  USAID supports innovative private health financing mechanisms that target increased coverage for the poor and those lacking access to care.  USAID also continues to strengthen the National Hospital Insurance Fund, including conducting a cost analysis for an outpatient primary health care benefit package.

Medical Products and Technologies

The Kenyan Government has prioritized efforts to strengthen management of medical products and technologies, with emphasis being placed on ensuring these commodities are accessible and affordable, meet defined standards for quality, efficacy and safety, and are appropriately utilized.  USAID has contributed to gains already made in this area and has assisted the Kenya Medical Supplies Agency for several years.  In 2012 USAID signed a direct funding agreement with the Kenya Medical Supplies Agency, paving the way for it to begin undertaking procurement and distribution of all health commodities, including U.S.-funded commodities currently managed under parallel programs.

Health Information Systems

USAID and other donors supported a groundbreaking effort to improve data quality and use through the development of district and community health information systems.  USAID has aligned its own reporting needs to Kenya’s performance management efforts, and continues to support the Kenyan Government’s district health information system.  Reporting rates in the District Health Information System are currently high but lack completeness and accuracy.  USAID has supported the development of national training materials for the District Health Information System entry and use, which are being rolled out in partnership with the Government of Kenya.  As county governments take leadership for local data collection and decision-making, USAID will continue to provide technical leadership in this area.  USAID also works to strengthen the Community Health Information System, improve reporting rates, and integrate it into the district health information system. This will enable the Government of Kenya and all other key stakeholders to access complete and accurate health information for community based programs including reproductive health and family planning, maternal and child health, nutrition, and HIV/AIDS.

For more information:

Karen Freeman
Mission Director
P.O. Box 629
00621 Nairobi
Tel: + 254 8622000

Barbara Hughes
Office of Population and Health USAID/Kenya
P.O. Box 629
00621 Nairobi
Tel: + 254 8622000

Updated September 2013

Last updated: September 12, 2013

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