A Tree Bearing Fruit: Seven Years of Health Policy Plus in Kenya for Catalyzing Sustainable Finance for Healthcare

Kenyans from national and county government, donor organizations, and stakeholders gathered in Nairobi and online May 24 to reflect on a journey to build self-reliance in a country that heretofore has relied chiefly on donor funds to support healthcare for strategic health programs. The occasion was a celebration ending seven years of work by Health Policy Plus (HP+), funded by the U.S. Agency for International Development (USAID).

The event marked the tangible results of the project in HIV and malaria response, family planning, maternal health, capacity building at the national and county levels, and sustaining work throughout the COVID-19 pandemic. Several speakers noted that HP+ helped Kenya adapt to the 2010 mandate that healthcare services and governance would shift from the national government to Kenya’s 47 county governments. “Today is a cocktail mixed with excitement as well as soberness,” said David Khaoya, country director for HP+ in Kenya. He moderated the session that included invited dignitaries from USAID Kenya, the Ministry of Health, the Council of Governors, and the leadership of the County Executive Committee (CEC) health caucus.

The future of the work done by HP+ was clearly on the minds of many in the room. “I’m excited at what we’ve achieved and [have] sorrow for its end,” Khaoya said, “but if you see me leaving on this side you can see me coming from the other side. Our focus is not on what we achieved but on how we achieved it so others can replicate it elsewhere in the country.”

HP+ has worked since April 2016 in Kenya. Dr. Suneeta Sharma, the HP+ global director, who traveled from Washington, DC, said she felt pride in the project’s high-level results in policies adopted and operationalized, domestic resources mobilized, efficiencies improved, governance structures created, and evidence-informed decisions made while following the priorities of local teams and their partners.

Nzoya Munguti, a health financing specialist and USAID Kenya’s activity manager for the project, noted: “Our perspective is to support countries to finance their own self-reliance and better engage private sector solutions…over the last seven years, USAID has supported HP+ in working toward sustainable financing for health [in Kenya], which is a big project with remarkable achievements.”

Dr. Richard Muga, the chair of the CEC health caucus had his eye on continued work: “The achievements of your efforts are beginning to bear fruits, but the work is not complete. Although you called us to end-term [in this meeting], we are looking forward to a meeting for the beginning of a new term.” His colleague, Dr. Mahamud Eda, the vice chair of the CEC health caucus from Mandera County, where HP+ has not worked, spoke of his desire for a future that included HP+ work in his county.

Any fruit that is ripe has got two functions. The first function is to nourish the person next to it. USAID has grown HP+, which through their assistance has nourished county governments. So we thank you. The second role of any fruit that is ripe is to make sure that the seed that is in it germinates to grow another tree. So I wish to advocate that any partners that have been funding HP+, please make sure that you keep funding them so that they germinate and grow more trees.
Dr. Mahamud Eda

The event also featured a panel on mobilizing domestic resources for health, a Q&A to name the most pressing health challenge preventing Kenya from attaining universal health coverage, and an “open mic” session for sharing stories of work with HP+.

Kisumu County assistant director of medical services, Dr. Kennedy Otieno, told how HP+ strengthened their capacity to analyze data to the extent that Treasury counterparts began requesting county guidance on financial analysis. “I really appreciate HP+ and the funders for this program, for democratizing esoteric information for so many technical officers…This reversal of roles has really enabled the county departments, especially Kisumu, to realize the potential of planning, especially financial planning, for service delivery.”