Financing of health care is important globally. In Kenya, health financing has been high on the agenda of government, development partners and other stakeholders for a long time. This is because of health financing challenges that the country experiences- high out of pocket expenditure, limited funding of health care, unsustainable funding from development partners and inefficiency in utilisation of health care resources. Kenya is developing a health financing strategy that seeks to address these challenges. The Strategy proposes a financing system which guarantees access to quality health care for all Kenyans especially the poor. Pilot introduction of the Strategy has been proposed. The pilots aim to remove user fees and provide social health insurance in selected districts. GTZ Health Sector Programme through complementary funding from DFID is supporting the implementation of the pilots. The pilot project is referred to as “Health for All Kenyans through Innovations (HAKI)”. The implementation of the pilots will provide important lessons for national scaling up of the Strategy. The design of the pilot project has been completed.The Project has been recently presented to the Health Financing ICC that positively evaluated the concept and recommended a follow-up stakeholders meeting to discuss details of design and implementation.

Following this recommendation the GTZ Health Sector Programme convened a meeting with health care financing stakeholders- Ministries of Health, private sector, development partners in health, civil society/faith based organisations- to discuss the design of the health financing pilots. The key messages of the meeting were as follows:

• Design measures to guarantee sustainability. Some of the measures include; aligning to government structures and initiatives such as the NHIF, design of clear exit strategy in consultation with government, link to on-going reforms in the health sector, securing of political commitment;
• Link to other health financing initiatives such as the Output Based Approach;
• Design clear implementation structures for the pilots;
• Improve the quality of health care services;
• Enhance efficiency in utilisation of health care resources. Encouraging competition and strengthening of claims mechanisms are some of the ways;
• Stakeholders piloting health financing initiatives should hold a forum to share information on their initiatives for lesson learning;
• Government has to play a leadership role in the implementation of all pilots;
• Undertake an analysis of how different pilots fit in together. Development partners may consider supporting this analysis.

In essence, there was no objection to the technical design of the HAKI pilot project. It was agreed that the input from the meeting would be used to improve the pilot design. There was also agreement that the Health Financing ICC should establish a working group that deals with all health financing pilots in Kenya. There is need to exchange information on instruments, best practices, sustainability provisions and other topics.

See attached presentations and report- HAKI Documents, Health Financing Pilots 1,Participant list-1