Challenges in the area of stewardship and governance Information gap on basic data on the private health sector, business environment and consumer preferences Little or no dialogue between sectors No mechanism for all sectors to participate in health policy and planning In response, have created
Ehuf conference pesentation
The PPP Journey in Kenya: Past, Current and Future Opportunities East Africa Healthcare Federation ConferencePITCHBOOK May 2012
Engagement Process in Kenya Step 4. Take actions to implement PPPs together Step 3. Agree on PPPs to carry out together Step 2. Dialogue to create shared vision and identify potential areas of collaborationStep 1. Assess private health sector and policy environment
Step One: Private Sector Assessmentonducted assessment in early 2009 …..Created better understanding of private health sector (size, scope, activities) Provided evidence for dialogue process Measured political will to engage private health sector Created “focusing event” for stakeholders to meet and start dialogue process World Bank/IFC and USAID facilitated assessment and engagement process helping play role as “honest broker”
Step Two: Public Private Dialogue “Piggy-backed” dialogue process on to multiple policy forums on private sector Vision 2030, NHSSP II, Prime Ministers Roundtable, Multi-stakeholder Forum, Ministerial Stakeholders Forum Conducted three high-level meetings in less than 6 months to create momentum Naivasha Meeting (April, 2009) Holiday Inn Meeting (June, 2009) Sarova Stanley Meeting (September, 2009) Formed PPP Committee to lead process PPP Committee held regular, joint debriefings with the both MOHs’ Permanent Secretaries
Step Two: Policy DialogueMeetings are critical because they….. Ensure balanced and equal representation High-level decision-makers from all sectors present Equal numbers between different sectors involved All sectors had “space” to express own perspective Frame issues and creates shared vision of purpose of PPPs Create a public record of agreements and decisions (Meeting reports, PS debriefings, PPT presentations, public statements, etc)
Step Three: Reach Agreementhaped vision on PPPsPublic and private sectors workingtogether to ensure improved access toquality health care for all Kenyans” avaisha Declaration, 2009
Step Three: Reach Agreementn PPP Road MapPPP Framework Proposed Prioritizations Institutionalize the PPP HK into a formal entityP1 - Policy dialogue representing key groups in all policy health forumsto engage the private Strengthen government’s stewardship capacity tosector engage and interact with the private sector Accelerate the review of the National Health PolicyP2 - Policy reforms to framework to integrate a PPP perspectivecreate an enabling Review, harmonize and consolidate key Health Actsenvironment for PPPs Establish a PPP Framework to guide PPP initiativesP3 - Partnerships toimprove availability and Analyze the healthcare gaps to id 2 to 3 PPPsaccessibility of Integrate private sector into NHIF pilots in financinghealthcare out-patient services and introduce low-cost insurance products
Step 3: Reach AgreementsOn Leadership and ProcessMandate: A public-private initiative bringing together health state and non-state Membership: actors to foster dialogue on key and emerging issues linked to MOMS health PPPs MOPHSRules of engagement: MOF Common purpose Shared leadership and decision- making Balanced representation KHF Catholic Secretariat KEPSA CHAK Accountability to each other PHP Consortium HENNET SUPKEM
Step Four: Take ActionActively participated in policy reforms to integrate PPPperspectiveSupporting MOHs’ initiatives to review and update Kenya HealthPolicy Framework, General Health Law and Health ActsMonitoring process to ensure private sector participation andtimely completion of policy reform processImplement PPPs togetherCreating inventory of existing PPPsBuilding MOH capacity to broker PPPsIdentifying and promoting easy (low hanging fruit) types of PPPsCoordinating donor initiatives to identify and implement PPPs
Challenges Facing Engagement Process Securing high-level support and political commitment from both Ministries Lack of understanding and/or resistance to PPP concept Maintaining momentum and active participation by all Ensuring balance and consensus between the three sectors Staying focused on PPP priorities and not getting bogged down in the policy process Identifying PPPs that can be quickly implemented to demonstrate “quick wins” Donor interference with MOH efforts to work with private sector Donor support for process disappeared for 18 months
Successes in the Engagement Process Dialogue process between sectors institutionalized Growing political support for PPPs in health and for PPP-Health Kenya PPP Unit’s TORs approved and staff assigned from both ministries Built growing trust and spirit of collaboration between all sectors Secured active and high-level participation from all sectors in dialogue process
PPP-Health Kenya! Critical Role Mobilized private sector groups to participate in dialogue process Facilitated regular and frequent communication between sectors (e.g. regular meetings, invitations to each other’s events) Kept lines of communication open – particularly during difficult moments in process Dispelled misperceptions about each other, building trust Encouraged and motivated each other to continue moving forward Demonstrated to everyone – GoK, other private sector groups, donor partners – that the public and private sector can work together !
Moving forward: Unfinished BusinessCreate enabling environment NHSSP III (include 5 Yr PPP Strategy), PPP Health Policy, PPP Guidelines Private sector integrated into General Health Law, HCF StrategyStrengthen MOH capacity Fully staff and fund PPP Unit Build operating systems Train MOH staff in new skill areasStrengthen sector-wide capacity to engage Institutional PPP-Health Kenya! Fund PPP-Health Kenya’s activitiesImplement PPPs!
Key Events Shaping Policy LandscapeOn-going policy process to engage private sector –Vision 2030 Prime Ministers Roundtable, Multi-stakeholder Forum, Ministerial Stakeholders Forum 2009 Private Sector Assessment – “snap shot” of private health scope and size Design of PPP Unit Naivasha Workshop on PPPs – 1st ever meeting with both sectors > > formed PPP Steering Committee Fairview Meeting - PPP-Health Kenya Holiday Inn Meeting - Building 2009 a Roadmap for PPPs Sarova Meeting - Mapping 2008 a Consultative ProcessYR?