The costs and financing needs of delivering Kenya’s primary health care service package

Frontiers in Public Health

Public Health

Marjorie Opuni¹  Elizabeth Wangia²  Salim Hussein³  Agatha Olago³  Stephen Macharia⁴  David Njuguna⁵  Clarisse Uzamukunda⁶  Hector Castro⁷  Sarah Birse⁷  Colin Gilmartin⁷  Damian Walker⁷  Christian Suharlim⁷  Rodrigo Muñoz⁸ 

[1] Independent Consultant, Lausanne, Switzerland;Kenya Ministry of Health, Department of Health Financing, Nairobi, Kenya;Kenya Ministry of Health, Department of Primary Health Care, Nairobi, Kenya;Kenya Ministry of Health, Director of Planning, Chief Economist and Head of Planning, Nairobi, Kenya;Kenya Ministry of Health, Health Economist, Nairobi, Kenya;Management Sciences for Health, Medford, MA, United States;Independent Consultant, Kigali, Rwanda;Management Sciences for Health, Medford, MA, United States;Management Sciences for Health, Health Economics and Financing, Arlington, VA, United States;Sistemas Integrales, Santiago, Chile;

关键词: actual cost;    normative cost;    primary health care;    universal health coverage;    Kenya;   

DOI  :  10.3389/fpubh.2023.1226163

 received in 2023-05-20, accepted in 2023-09-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionFor many Kenyans, high-quality primary health care (PHC) services remain unavailable, inaccessible, or unaffordable. To address these challenges, the Government of Kenya has committed to strengthening the country’s PHC system by introducing a comprehensive package of PHC services and promoting the efficient use of existing resources through its primary care network approach. Our study estimated the costs of delivering PHC services in public sector facilities in seven sub-counties, comparing actual costs to normative costs of delivering Kenya’s PHC package and determining the corresponding financial resource gap to achieving universal coverage.MethodsWe collected primary data from a sample of 71 facilities, including dispensaries, health centers, and sub-county hospitals. Data on facility-level recurrent costs were collected retrospectively for 1 year (2018–2019) to estimate economic costs from the public sector perspective. Total actual costs from the sampled facilities were extrapolated using service utilization data from the Kenya Health Information System for the universe of facilities to obtain sub-county and national PHC cost estimates. Normative costs were estimated based on standard treatment protocols and the populations in need of PHC in each sub-county.Results and discussionThe average actual PHC cost per capita ranged from US$ 9.3 in Ganze sub-county to US$ 47.2 in Mukurweini while the normative cost per capita ranged from US$ 31.8 in Ganze to US$ 42.4 in Kibwezi West. With the exception of Mukurweini (where there was no financial resource gap), closing the resource gap would require significant increases in PHC expenditures and/or improvements to increase the efficiency of PHC service delivery such as improved staff distribution, increased demand for services and patient loads per clinical staff, and reduced bypass to higher level facilities. This study offers valuable evidence on sub-national cost variations and resource requirements to guide the implementation of the government’s PHC reforms and resource mobilization efforts.

【 授权许可】

Unknown   
Copyright © 2023 Olago, Suharlim, Hussein, Njuguna, Macharia, Muñoz, Opuni, Castro, Uzamukunda, Walker, Birse, Wangia and Gilmartin.