Kenya has a population of roughly 40 million, a fifth of whom live on less than $1 a day. The nation is at a critical juncture for both global health and larger development issues. The country’s new constitution contains a more robust system of checks and balances to assure improved governance and fiscal accountability. These components will reduce corruption, boost business confidence, increase trade and investment, and support broad-based economic growth.
At this moment of change in Kenya’s social and political life HIV/AIDS, tuberculosis, malaria, respiratory disease, and diarrheal disease continue to present major health threats to Kenya’s people, with HIV/AIDS being the leading cause of death among Kenyans. Maternal mortality and child mortality rates are among the highest in sub-Saharan Africa. One in 19 babies will die before his/her first birthday this year. Struggling health systems are the principal obstacles for addressing Kenya’s health challenges and preventing premature mortality.
The Kenya GHI Strategy is the next step in the successful U.S. partnership with Kenya. The Strategy serves as a guide for how the U.S. will work with the Government of Kenya and other Kenyan partners to improve and save lives. The Kenya GHI Strategy builds on the success of the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI). The Strategy elevates efforts to strengthen health systems and improve the wellbeing of women and girls. The focus areas in Kenya’s GHI Strategy support the protection of women, infants, and children from preventable, treatable health conditions and the reduction of illness and death from neglected tropical diseases (NTDs). These areas represent opportunities for U.S. health programs in Kenya to work more collaboratively, effectively, and efficiently to attain greater value from U.S. investments. At the same time the U.S. will continue to support Kenya in achieving critical results in HIV/AIDS, tuberculosis, and malaria.
Country Leadership: National Health Plan Priorities and Challenges
Kenya’s GHI Strategy was based on Kenya’s National Health Sector Strategic Plan II, 2009-12. The Government of Kenya has provided a comprehensive output- and performance-oriented plan that defines Kenyan aspirations and priorities for the health sector over the next five years. The latest National Health Sector Strategic Plan moves from a focus on the burden of disease to placing emphasis on promotion of individual and community health. The vehicle for implementing this approach is the Government of Kenya’s Essential Package for Health which focuses on improving health outcomes through six different life stages, and outlines six critical service delivery points. These points range from rural outreach to urban hospitals. The Plan increases the role of community health workers, strengthens ownership and community oversight of the health system, and enhances the role of districts in service delivery. It also addresses financial and other barriers to care, enhances collaboration among private and public sectors, reinforces the Ministries of Health as the stewards of the health sector, and implements fast-track activities for Kenya to achieve the Millennium Development Goals.
GHI Kenya Strategy: Focus Areas
The overarching GHI country goals for Kenya are to reduce unacceptably high rates of (1) maternal, neonatal and child mortality and (2) morbidity and mortality from neglected tropical diseases. To achieve these goals, the Kenya GHI Strategy has identified three focus areas for guiding U.S. investments in Kenya: (1) strengthening health systems, (2) integrating services, and (3) increasing demand for and awareness of available services. The U.S. will work with Kenya to achieve these goals by ensuring more effective and efficient integration of health programs.
Improving Effectiveness and Efficiency through GHI Principles
The Kenya GHI Strategy outlines specific steps that will be taken to advance the GHI principles. These steps include:
GHI in Action: Getting Bednets to Women and Children At Risk of Malaria
Insecticide Treated Nets (ITNs) have been shown to reduce malaria deaths in children under five years of age by about 20 percent and malarial illness among children under five and pregnant women by up to 50 percent. The Government of Kenya aims to achieve universal coverage with ITNs by providing one net for every two people at risk of malaria.
USG-Kenya partnership support
On March 9, 2011, Kenya launched the free distribution of nearly 11 million LLINs, which will benefit 22 million people at risk of malaria living in various parts of the country. Under the Global Health Initiative, the USG-Kenya partnership is investing in the country’s universal ITN coverage plan, which includes the mass distribution campaign.
While supporting the mass distribution campaign, USG in Kenya is addressing the additional GHI principles by:
It is anticipated that due to increased USG efficiency under the Global Health Initiative, committed funding of approximately USD $20 million to Kenya’s mass ITN distribution campaign will help save millions of lives.
GHI: What Others Are Saying
“Meaningful work is being done in developing a new and more cohesive model of integrating U.S. government health programs and in prioritizing key approaches that could have significant public health impacts, but have been neglected in the past...Programs now focus more on improving integration, examining unit cost efficiencies, capturing impacts, collaborating with other donors, and leveraging higher commitments from the Kenyan government. These are all welcome and constructive changes that strengthen U.S. approaches to health and have broad applicability beyond Kenya.”
CSIS Report “On the Ground with the Global Health Initiative” March 2011