Improving maternal health and universal health coverage in Kenya

February 20, 2020

KENYA — Kakamega County, Kenya, hosted its first Public-Private Sector Engagement Co-creation Workshop on Feb. 19–20, 2020. The two-day workshop convened 31 representatives from: county leadership and the County Health Management Team (CHMT); sub-county representatives including medical officers of health and reproductive health focal points; private sector representatives from large faith-based facilities, large private for-profit hospitals, small sole proprietorships and small faith-based facilities; and representation from the National Ministry of Health, Kenya Healthcare Federation, and development partners.

The workshop aimed to:

  • Increase engagement and community building between and amongst Kakamega County public and private health sectors
  • Co-prioritize key maternal health and health system issues and related public-private sector engagement challenges
  • Co-produce action plans for improving the prioritized challenges and identification of technical assistance needed to succeed

The workshop was supported by generous funding from MSD for Mothers and in partnership with the SDG Partnership Platform in Kenya with technical assistance and support led by Results for Development and Insight Health Advisors.

Dr. Ayub Misiani, County Director of Medical Services opened the meeting, noting that this workshop is one of the first opportunities to integrate the private sector in county planning for improving health outcomes. Throughout the workshop facilitators fostered cross-sector dialogue and discussion.

On the first day, participants developed a shared vision for improving maternal health and achieving UHC in the county. They validated common maternal health and UHC challenges discussed in prior sector specific meetings, shared and discussed challenges in engaging across public and private sectors, and worked to understand the root causes of these challenges through a problem tree analysis. These challenges included: delays in reimbursements from the National Hospital Insurance Fund (NHIF) to public and private facilities; lack of standardized supportive supervision across public and private facilities and quality of care in the private sector; and high staff turnover and lack of adequate skilled staff across public and private facilities.

On the second day, participants worked together to generate solutions to some of the root causes identified on the first day and began detailing action plans for working together to implement these solutions. Some of these solutions included creation of a platform for structured and formal dialogue and engagement, building the capacity of public and private sector facilities to negotiate with NHIF, increasing private sector representation in annual county work planning, and improving on-the-job training and standardizing supportive supervision among others.

One private sector representative noted that “through this workshop, I have developed trust from the public sector and I have seen their goodwill to engage us further.” Additionally, a public sector representative noted “this meeting is the first of its kind to work together [across public and private sectors] to improve the quality of life for Kakamega residents. I hope this happens in other counties.”

Moving forward the county leadership and the private health sector will develop and sign a communique confirming their commitment to work together to improve maternal and child health and progress towards the achievement of UHC goals. Implementation of the co-creation workshop action plans will be the starting point of this collaboration. The county participants will also work together to revise and operationalize their action plans and align these action plans with the ongoing County Annual Workplan Process (AWP).

A small group of public and private stakeholders have agreed to act as an interim working group to hold the group accountable for the agreed actions. Through funding from MSD for Mothers, Results for Development and Insight Health Advisors will continue to provide technical and facilitation support to help county representatives operationalize their activities.

The technical partners will also be gathering evidence to learn from this work to help improve the engagements as they proceed in Kakamega County and to share these lessons across other counties in Kenya and globally. This work is envisioned to contribute as well to the development of the Health PPP strategy and toolkit currently under development under the leadership of the Ministry of Health with support of the Council of Governors, SDG Partnership Platform, Kenya Healthcare Federation, World Bank / GFF, WHO, and others.

With support of the SDG Partnership Platform, other collaborating development/implementing partners will also be brought on board where relevant to better address county needs for support.

This program is supported by funding from MSD, through MSD for Mothers, the company’s $500 million initiative to help create a world where no woman dies giving life. MSD for Mothers is an initiative of Merck & Co., Inc., Kenilworth, NJ, U.S.A.

Contributors to this announcement include: Drs. Nelson Gitonga, Walter Obita, and Lyndon Marani, Insight Health Advisors; Maureen Kangee and Peris Njibu, SDG Partnership Platform; and Cicely Thomas, Keith Mangam, Courtney Tolmie,and Chloe Lanzara, Results for Development.

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About Results for Development
Results for Development (R4D) is a leading non-profit global development partner. We collaborate with change agents around the world — government officials, civil society leaders and social innovators — to create strong systems that support healthy, educated people. We help our partners move from knowing their goal to knowing how to reach it. We combine global expertise in health, education and nutrition with analytic rigor, practical support for decision-making and implementation and access to peer problem-solving networks. Together with our partners, we build self-sustaining systems that serve everyone and deliver lasting results. Then we share what we learn so others can achieve results for development, too. For more information, visit our website at: www.r4d.org.

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