Feature Story

Four years of Kenya’s partnership with the GFF: Interview with Ruth Kagia, Senior Advisor in the Office of the President of Kenya

This April, the GFF Investors Group held its eighth meeting in Washington DC. We used this opportunity to speak to Ruth Kagia, Senior Advisor to the President of Kenya and a country representative on the GFF Investors Group about the progress made and lessons learned from GFF work in Kenya. One of the first countries to join the GFF, Kenya has made steady progress in improving reproductive, maternal and child health outcomes in the last decade. The GFF partnership is working with national and county governments to improve health planning and budgeting at the county level and to provide technical assistance for resource mapping and capacity building activities. With GFF support, Kenya is working on addressing geographical and socio-economic disparities, health system bottlenecks, and barriers to accessing affordable reproductive, maternal, child and adolescent health services.

Could you describe the progress that Kenya has made over these four years with GFF support?

It's been quite a journey. and it's a journey that Kenya and the GFF have walked and grown together. In the initial stages, the GFF was critical to helping sharpen the investment case and prioritize the reproductive health of women and children and foster thought leadership. As we moved forward, GFF became very important for shifting the focus of the entire health agenda to the needs of women, children and adolescents--hence to primary health care issues--which at the end of the day are the fundamentals of a good health care system. Finally, the GFF and the World Bank project are based on results. This means that provision of additional funds for health providers and county governments is tied to increasing their own resources for health and efficiently using resources that they receive with focus on reproductive, maternal and child health.

What are some specific contributions that the GFF has provided to Kenya’s work?

First, linking results to resource allocation. We often throw resources at problems, but then we do not focus on the impact we are having. For me, the focus on results is critical. If we can maintain that incentive framework, we will see a transformation of the health sector.

Second, shifting focus on women’s and children’s health. These “silent issues” don't have as many advocates as cancer or diabetes. It's so easy for them to get drowned out in the huge health agenda. So again, giving that sharp focus matters.

Nine new countries have recently joined the GFF. What lessons could Kenya’s experience provide to these new countries?

Establish a very strong baseline and identify the pressure points. Have a mechanism to monitor progress from the early stages. This will be critical to measuring progress and results. It is very important to establish a very strong database. And last, always follow the money and make sure that the funds are flowing to the pressure points.

Looking forward to 2030 and the Sustainable Development Goal targets, what are your hopes, where will Kenya be with the support of the GFF?

Kenya has set very ambitious targets. We want to have achieved universal health coverage not by 2030, but by 2022—and we are pulling all the stops to make sure that we do that. And even if we don't have everybody getting the quality and coverage that they deserve, we want to transform the entire health sector, to the point where no one is unable to get medical care because they cannot afford it. This means reducing the out-of-pocket expenses to a minimum. Kenya also aims to improve the quality of public health care, so that patients do not have to seek health care services in private hospitals in order to get quality care. We want to make sure we raise the overall quality and affordability of healthcare to everyone.

We are making very good progress because we're starting from those who need health care most: people who don't even seek medical care because they can't afford it. We're starting with those who are most vulnerable and then working our way up.