Cost sharing in health care in kenya pdf

In 2009, kenya developed a draft health financing strategy to guide the country toward universal health coverage. Kenyas healthcare system cannot meet the vast needs. The term costsharing refers to how health plan costs are shared between employers and employees. The impacts of cost sharing in health services in geita. Cost sharing in higher education is a policy that comes from the united states. The shared roles of enhanced insurance coverage alongside taxbased health spending need. What are the challenges facing the health sector in kenya. Available evidence reveals that direct out of pocket payments at the point of use are an impediment to access. This drop prompted the government to suspend the fees for approximately 20 months. The paper examines health sector reforms in kenya at the district level based on the government of kenyas health policy framework of 1994.

Answers i increased spread of cancer,diabetes,heart diseases,hiv and aids which claim many productive manpower and requires huge financial resources. During the period of cost sharing in public clinics, attendance dropped by about 50%. Based on the model we can calculate the total cost of health care services in kenya in the financial year 20062007 as 63 billion ksh which is equivalent to 690 million euros or 18. Poor peoples experiences of health services in tanzania. Nhif collections as a percentage of costsharing revenue in health. Task force health care has proposed a roadmap to the embassy. The effects are examined in public as well as in private health facilities. Our main office is in nairobi, and our main focus areas are western kenya, nairobi informal settlements and northern kenya arid and semi arid lands. Effects of costsharing on health care services provision in kenya. Its important to understand that the costsharing structure can have a big impact on the ultimate cost to you, the employer. Using a direct health care sharing model, our members have experienced a biblical and affordable option for. Results of a randomized experiment to promote maternal health care in kenya.

Costsharing health coverage guide by small business majority. The moral case for universal health care at its root, the lack of health care for all in america is fundamentally a moral issue. Terry gakuruh this chapter provides an overview of the health system in kenya as a context in which to view the findings of the 2004 kenya service provision assessment kspa 2004 survey. It is widely believed that costsharing charging a subsidized, positive price for a health product is necessary to avoid wasting resources on those who will not use or do not need the product. However, there is reason to believe that it will not accomplish as much reduction as needed. This study is set to match and compare results of the analysis of impacts of cost sharing on households with those on healthcare providers in two selected districts in tanzania. The united states is the only industrialized nation that does not have some form of universal health care defined as a basic guarantee of health care to all of its citizens. This draft was revised in 2015 and is moving toward finalization.

The impacts of cost sharing in health services in geita distrct, tanzania 182190 for dollar cost sharing or cost matching uw, 2007. Raising public commitments to kenyas health sector. The truth of the matter is that the majority of health care spending is on health care services and not monthly premiums. In 1989user fees introduced cost sharing or facility improvement fund 1n 20041020 rule in dispensaries and health centres. Focus on kenya health policies the kenya health policy 20122030 offers guidelines to ensure momentous improvement in the status of health in kenya, in line with the provision of the new constitution of kenya 2010, vision 2030, and other global commitments. User fees, or cost sharing as it commonly referred to in kenya, was not part of the policy discussion between 1963 and 1989. Cost sharing the share of costs covered by your insurance that you pay out of your own pocket. Using a direct health care sharing model, our members have experienced a biblical and affordable option for their health care needs since 1994. Thus the population will this year alone seek and pay for services in both public and private health facilities to the tune of kshs 4550 billion.

In kenya, the government introduced user fees at public health facilities like pumwani maternity hospital in 1989, as part of a world bank push for costsharing in public services. High cost of medical equipment, drugs and services. During the period of costsharing in public clinics, attendance dropped by about 50%. The country has begun implementing health financing reform in recent years. It is the community share of the cost of running any project. Indeed when the ministry of health waived maternity fees in its facilities and reduced cost sharing fees to kshs. The fall and rise of cost sharing in kenya semantic scholar.

Factors affecting provision of service quality in the public health sector. Mental illness is common but the specialist service is extremely sparse and primary care. Although most donor and development agency attention is focussed on communicable diseases in kenya, the importance of noncommunicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Dec 06, 2010 effects of costsharing on health care services provision in kenya. Evidence from highincome health care settings shows that cost accounting systems can be effectively integrated and structured for calculating. The financial burden of outofpocket expenses in the. One motivation has been to raise revenues to offset escalating health care expenditures, in both the public and private sectors. Satisfaction with delivery services offered under the free. However, in the late eighties, cost sharing would start to attract considerable policy attention. Kenya health system assessment 2010 republic of kenya.

Sixteen health clinics were randomly selected to receive itns at a subsidized rate. The dhcfs improved ability to monitor the costsharing system, together with the introduction of consequences for the mismanagement of funds. Cost sharing typically takes the form of inkind resources includes contributed project personnel effort, manpower and cash. Effects of costsharing on health care services provision. Various reasons have been cited for the use of cost sharing arrangements, some of them contradictory evans, barer and stoddart, 1995. Impact of cost sharing on utilization of primary health care. Quality of care measures, though in some respects improved with cost sharing, were in general somewhat mixed and inconsistent. As of december 31, 20, the refugee population in dadaab was 408,283 refugees. User charges in government health facilities in kenya.

The financial burden of outofpocket expenses in the united. Impact of cost sharing on utilization of primary health. The netherlands has a good reputation in kenya and is the only country in europe with which kenya has a positive trade balance mainly due to the flower. The policy advocates that costs of higher education should be shared between the government, parents, students andor donor organizations. Mental health policy in kenya an integrated approach to. This program targeted itn distribution to pregnant women who visited clinics for prenatal care. However, in the late eighties, costsharing would start to attract considerable policy attention. Factors affecting provision of service quality in the. Overview of the health system in kenya chapter 2 overview of the health system in kenya dr. We further analyse the costresponsiveness behaviour of health care costs in kenya. Proponents of the policy such as the world bank have over the years been advocating for its implementation in african countries. Jan 25, 2016 however, there is reason to believe that it will not accomplish as much reduction as needed.

Estimation of the costs and efficiency of public health care. With more than 19 million children under the age of 15 living in kenya, this lack of investment has serious implications for the countrys urgent health care problems. Market study report 4 top 10 reasons why kenya is interesting for the dutch health sector 1. It ensures establishment of efficient health service delivery system linkages across levels of care that ensure continuity of care, for effective management of health needs of the population in kenya existing definition as defined by policy. Impacts and implications of rising outofpocket health care costs 7 oop spending likely to change with health care coverage because this analysis uses 2012 data the most recent year available, it does not reflect anticipated changes from the expansion of coverage through marketplaces and medicaid that started in 2014. Costsharing mechanisms in health insurance schemes. We also look briefly at the impact of fees on revenue and service quality in government facilities. This fee goes to the cost sharing fund of each facility where it is used for service developments. The policy exhibits kenyas health sectors obligation, under the national.

Given this it is important to get a health plan that provides cost sharing that will result in maximum outofpocket savings over a policy period typically a calendar year under the aca. Cost sharing in kenya 53 mand for modern health care stemming from rapidly growing populations and epidemiological changes. Chapter 2 overview of the health system in kenya the dhs. In 1989user fees introduced cost sharing or facility. Health care sharing with samaritan ministries connects the body of christ throughout the nation to help each other with their health care costs.

The sdg3, where uhc falls, is driven by the need for improved access to quality health services for all and protection of the population from catastrophic and impoverishing health care costs. Increased cost sharing for brand name drugs in certain lowincome populations may lead to nonadherence rather than generic substitution, perpetuating socioeconomic health disparities. We explore this argument in the context of a field experiment in kenya, in which we randomized the price at which pregnant women could buy long. Highlight the challenges facing the health sector in kenya. In 1970 gok established a comprehensive rural health service system in which health centers became the crucial points for preventive, promotive and limited curative services. Based on the analysis of kenyas gdp and national budgets from 20 to 2016. Factors affecting provision of service quality in the public. Universal health coverage uhc is a priority policy agenda worldwide and is one of the sustainable development goals sdgs. This term generally includes deductibles, coinsurance, and copayments, or similar charges, but it doesnt include premiums, balance billing amounts for nonnetwork providers, or the cost of noncovered services. However, by the early 1990s, the strain of providing free health care for all became evident in the face of rising health care costs and a struggling economy. Utilization, management and access muiya, bernard on. The 1989 outpatient registration fee led to an average reduction in utilization of 27% at provincial hospitals, 45% at district hospitals, and 33% at health centres. Effects of costsharing on health care services provision in. Unaffordable health services globally are a result of inadequate health financing care models which often result in catastrophic expenditures throughout pocket payments for health services 1016.

Others have argued that charges represent a useful supplementary source of. Next steps this market study report marks an important step to further strengthen the bilateral healthcare relation between kenya and the netherlands. Sessional paper on national social health insurance in kenya. Health care utilization in the kenyan health system. Moreover, in the absence of effective measures to reduce the cost of health care in the united states, shifting away from cost sharing and toward a greater reliance on insurance could help, but only at a cost of increasing insurance premiums and taxes. This is an indication that health finacing in kenya has faced numerous challenges. Despite significant gains in promoting awareness of health and wellness in kenya, preventable diseases remain a serious issue. In kenya, health services are provided through a network of over 4,700 health facilities countrywide, with the public sector system accounting for about 51 percent of these facilities. The need to provide quality and equitable health services and protect populations from impoverishing health care costs has pushed universal health coverage uhc to the top of global health policy agenda. User fees, or costsharing as it commonly referred to in kenya, was not part of the policy discussion between 1963 and 1989. Over the past two decades, the gok has pursued a policy of cost sharing to. This is an indication that health finacing in kenya has faced numerous challenges, including inadequte funding deolitte, 2011.

Christian health care sharing samaritan ministries. This study is set to match and compare results of the analysis of impacts of cost sharing on households with those on health care providers in two selected districts in tanzania. The setting is intended to establish and compare concurrently the impact. Evidence from a malaria prevention experiment in kenya. Care is also lead partner of the global fund in kenya and partners with cdc for a major health program.

Estimation of the costs and efficiency of public health. Hie financing reforms stipulated by the sectoral policy document is fourfold, namely. Pip this analysis follows the evolution of kenyas health financing policy reform program from 1989 to 1994 and judges the impact of the costsharing program on. Healthcare financing policy brief ministry of health. A lot can be won by innovative investments in this area. A country of approximately 37 million people, kenya has struggled to build a health system that can effectively deliver quality health services to its population. Early 1990s the government adopted health sector reforms that changed the financing system from free services to mixed financing mechanisms including cost sharing policies. The 1989 outpatient registration fee led to an average reduction in utilization of 27% at provincial hospitals, 45%. Our perspective on these issues is essentially an economic one.

Theory and evidence on cost sharing in health care. Access to health care varies widely throughout the country and is determined on numerous. As part of health sector reforms, cost sharing in public health facili ties was meant to improve the provision of quality health care services. This paper explores the kenyan health system and the two major factors that prevent individuals from seeking carecost and accessand also addresses the existence of other social and. Objectives by the end of the unit, the participant will be able. In many developing countries where the majority of the population works in the informal sector, there are critical debates over the best financing mechanisms to. In kenya, cost of maternal and child health services has also been cited as one of the obstacles to service utilization 8, 9. Mental health policy in kenya an integrated approach to scaling up equitable care for poor populations. In response, some governments have begun to develop. We further analyse the cost responsiveness behaviour of health care costs in kenya. I the specific reform objective, as it related to the costs and efficiency of the public health sector, i.