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Previous support

History of the Danida support to primary health care facilities

Danida has supported the health sector in Kenya for many years with a key focus on primary health care and reaching the poorest of the population. What today is the support to Universal Health Care in the newest phase of Danida support (from January 2017) was started in the 00's as an innovative scheme in Coast Province. In the pilot scheme, the primary health care facilities received a small grant to fund electricity, water, minor repairs, casual workers etc. to keep the facility running. At that time operational costs of the primary health care facilities was financed by cost-sharing, but as this was first drastically reduced and later fully abolished the grants from Danida secured that the facilities could stay operational.

Comparison of the three different modalities of Danida support to primary health care facilities

 

Health Sector Services Fund

2010 – 2013

'The Danida Model'

2014 – 2016

Universal Health Care

2017 -

Modality

  • Parallel direct funding mechanism
  • Central Secretariat to coordinate support
  • Support to approximately 3,300 primary health care facilities
  • Use of country systems (IFMIS)
  • Direct engagement with 47 counties
  • No central secretariat or coordinating mechanism 
  • Support to approximately 3,300 primary health care facilities
  • Use of country systems (IFMIS) and country framework for conditional grants (improved version of 'The Danida Model')
  • Direct engagement with 47 counties
  • Newly established central coordination entity jointly at MoH and CoG
  • Support to all government, gazetted primary health care facilities (4,000+)

Main challenges

  • Parallel modality not using and hence improving country administrative systems
  • Weak administrative capacity at decentral level

 

 

  • Newly established counties administratively immature
  • Flow of funds to facilities slower than previous modality
  • No central entity to support operationalisation of the support
  • Making full use of national systems requires early commitments in order to reflect funds in the budget

 

  • Counties still relatively weak in terms of administrative capacity
  • Making full use of national systems requires early commitments in order to reflect funds in the budget

 

Main results / impact

  • Strong and positive impact on health facilities and increased access to primary health care
  • Improved the reported quality of care
  • Improved staff motivation and patient satisfaction
  • Strengthened accountability by active community involvement

 

  • Strong and positive impact on health facilities and increased access to primary health care
  • Improved the reported quality of care
  • Improved staff motivation and patient satisfaction

    strengthened accountability by active community involvement

  • Fully aligned to national systems – highly supportive of devolution
  • Danida spearheading has paved the way for further DP involvement
  • Positive impact on improving PFM systems by piloting modality

 

  • Strong and positive impact on health facilities and increased access to primary health care
  • Improved the reported quality of care
  • Improved staff motivation and patient satisfaction
  • Strengthened accountability by active community involvement
  • Fully aligned to national systems – highly supportive of devolution
  • Expected faster funds flow than first phase with introduction of PMT and Special Purpose Account
  • Support fully harmonised with WB
  • Inclusion of more health facilities