This document summarizes a presentation on domestic health financing initiatives in Kenya. It finds that individuals pay the majority of health costs through out-of-pocket expenses, denying many Kenyans access to care. Government funding is below targets and donor funding is not sustainable. Current initiatives include restructuring the National Hospital Insurance Fund to increase coverage, providing free deliveries, and abolishing fees at lower facilities. Proposed means to increase domestic financing include further NHIF reforms, improving efficiency, and establishing an HIV Trust Fund financed by 1% of government revenue to address priority programs like HIV/AIDS and non-communicable diseases.

1. MINISTERIAL MEETING UNDER
THE THEME “DOMESTIC
FINANCING FOR HEALTH:
INVESTING TO SAVE”, ADDIS
ABABA, ETHIOPIA, 11- 12
NOVEMBER, 2013

2. Presentation outline
1. Who finances health in Kenya
2. Health financing challenges
3. Domestic health financing
initiatives

3. Health Financing: Who pays in
Kenya?
•
Source: National Health Accounts, GOK, 2001-02, 2005-06, 2009-10; WDI 2012

4. Expenditure by Key Priority areas,
2009/10
HIV/AIDS
25%
Other health
services
35%
Reproductive
health
14%
Tubeculosis
1%
Malaria
25%

5. 
Health financing
High out of pocket spending –denying poor Kenyans access to health
Challenges
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

6. 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

7. 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


8. Thank You