Health financing in Kenya: Domestic financing

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MINISTERIAL MEETING UNDER THE
THEME “DOMESTIC FINANCING FOR
HEALTH: INVESTING TO SAVE”, ADDIS
ABABA, ETHIOPIA, 11- 12 NOVEMBER,
2013
Presentation outline
1. Who finances health in Kenya
2. Health financing challenges
3. Domestic health financing
initiatives
Health Financing: Who pays in Kenya?
Shares (%) in Total Health Expenditures, by NHA round
100
90
Govt. health expenditure as % of
total govt. expenditure
80
70
10.5
60
7.6
8.3
50
7.1
5.9
40
30
20
10
1999
0
2001-02
2005-06
GOK
•
Households
2009-10
Donors
Source: National Health Accounts, GOK, 2001-02, 2005-06, 2009-10; WDI 2012
2002
2005
2008
2011
Expenditure by Key Priority areas,
2009/10
HIV/AIDS
25%
Other health
services
35%
Reproductive
health
14%
Tubeculosis
1%
Malaria
25%
Health financing Challenges
 High out of pocket spending –denying poor Kenyans access to health
care
- 20% of sick can’t access health due to financial barrier
 Inadequate funding from the Government
- GoK allocations below the Abuja targets
 Heavy reliance on donor funding – sustainability issues
- Key priority programmes are over 70% financed by donors
 Low population coverage by insurance
- Only 10% of Kenyan population have access to a medical cover
Current Health Financing
Initiatives
 Restructuring of NHIF
 Improve governance and increase coverage
 Free deliveries at public facilities
 Kshs. 3.1 billion allocate for deliveries
 Increase access by the poor and reduce MMR
 Abolition of user fees at lower level facilities
 Kshs. 700m allocated to compensate facilities for lost revenue
 Pro-poor initiative to reach communities in rural areas
 Finalization of the Healthcare Financing Strategy
 Define the Roadmap towards Universal Health Coverage
Proposed Means of mobilizing
Domestic financing
 Restructuring NHIF
To free huge amount currently used for administration to go towards payment
of benefits
 Bring more formal sector participation including employer contributions
 Include reimbursement of ART and outpatient care for opportunistic infections
within the NHIF cover

 Efficient Improvement
Redirecting resources to lower level facilities (provide primary care at cheaper
costs)
 Introducing performance based financing (reduce wastage)

 HIV Trust Fund
Earmark 1% of government revenue for the Trust Fund
 Finance 74% of HIV/AIDS financing gap by 2020
 Fund to be expanded to cover other priority areas including NCDs

Thank You
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