Kenya has made steady progress in improving reproductive, maternal and child health outcomes in the last decade. Child mortality has declined by over 20 percent since 2008 and the country achieved a total fertility rate of less than four. Stunting, which has remained stubbornly high over the past two decades, has started to decline. Six out of 10 pregnant women now receive skilled care at childbirth and over half receive postnatal care. However, considerable geographic and socioeconomic disparities remain a challenge across all levels of care.
Drawing on the Kenya Health Sector Strategic and Investment Plan 2014–2018, the RMNCAH-N Investment Framework aims to address these disparities by aligning key stakeholders around prioritized investments, with a focus on 20 counties with poor maternal and child health outcomes and low coverage rates for essential health services. It aims to address key demand-side barriers through strategic behavior change communication to improve health-seeking behaviors of individuals, families, and communities.
Priorities identified in the investment plan include:
- Address disparities and increase equitable coverage through prioritized investments in underserved counties and accelerate action for underserved and marginalized populations.
Address prioritized demand-side barriers to increase access, utilization, coverage, and affordability of RMNCAH-N services, and ensure financial protection for the poor:
- Expand community health services networks and access to preventive and promotive interventions
- Expand universal health coverage through subsidized insurance cover for essential primary healthcare services
Address prioritized supply side health system bottlenecks to improve access to efficient, effective, high quality service delivery for high-impact interventions:
- Maternal and newborn health services: basic emergency obstetric and newborn care (BEmONC), comprehensive emergency obstetric and newborn care (CEmONC), and functional referral systems
- Family planning: availability, accessibility, acceptability and quality of FP services
- Child health: access to preventive services, primary health care, and emergency care
- Nutrition: focus on nutrition for early childhood development
- Adolescent health: Scale-up availability of cross-sectoral adolescent sexual and reproductive health services.
How the GFF partnership works in Kenya
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. To support these endeavors, a multi-donor trust fund for RMNCAH technical assistance was established in Kenya.
The GFF partnership co-financed Transforming Health Systems for Universal Care Project aims to improve domestic resource mobilization, requiring each county to allocate a minimum of 20 percent of county funds to receive a county performance allocation. The Kenya RMNCAH Technical Assistance Multi-Donor Trust Fund plays a complementary role by working to strengthen public financial management capacity at the county level with a focus on planning and budgeting.
The World Bank is also providing analytical and advisory services with financial support from the GFF Trust Fund; Gavi, the Vaccine Alliance; and the Bill and Melinda Gates Foundation toward an in-depth analysis of the major causes of inefficiency at the county level using the case study approach.
Financing Kenya’s priority investments
Partners that contribute to financing Kenya’s priorities outlined in the investment case include Bill & Melinda Gates Foundation, Children’s Investment Fund Foundation, Clinton Health Access Initiative, and the governments of Canada, Denmark, Germany (KfW, GIZ), Japan (JICA), Netherlands, South Korea (KOICA), United Kingdom (DFID), and the United States (CDC, USAID).