Data gathering and verification survey on healthcare service delivery systems in Mombasa County, Kenya.

Kenya

Japan International Cooperation Agency（JICA)

December 2022 - March 2023

Position

Chief of project and hospital management

Type of Service

Investigation and resarch

SDGs

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 Under the national development plan, called Kenya Vision 2030, the Kenyan government aims for Universal Health Coverage (UHC) by 2030. However, since the decentralization in 2013, the central Ministry of Health has been responsible for policy-making, guideline development, and management of national referral hospitals, while each local government has been tasked with providing healthcare services. Consequently, regional disparities in health service delivery systems and access to services have emerged.

Mombasa County, situated on the southeast coast of Kenya, has a population of 1.2 million and is experiencing economic growth due to the influx of foreign companies, investments, people, and logistical resources. Alongside this dynamic growth, there has been a significant increase in healthcare demand. Therefore, improving the functioning of primary and secondary hospitals and strengthening the referral system have become major challenges.

In light of the aforementioned situation, this research project aims to identify service delivery issues in the Mombasa County health sector. Moreover, it aims to investigate the specific needs for improving hospital facilities and equipment. By doing so, this project will contribute to effective collaboration combining hardware support through grant aid and soft supports such as technical cooperation. This will help determine the direction of future cooperation. In particular, this research project serves as the groundwork for developing a concrete cooperation plan for Port Reyes Hospital, the primary medical facility in Changamwe Sub-County, which is served by the Mombasa Port and International Airport, as well as the Trans-African Highway.

Technical Advice on UHC monitoring and evaluation

Kenya

World Bank

December 2018 – July 2020

Position

Technical Advisor (Monitoring and Evaluation)

SDGs

・The Government of Kenya (GoK) is committed towards achieving universal health coverage (UHC) by 2022. In his inaugural speech, the President of the Republic of Kenya announced UHC as a key pillar that the government will deliver during his second term. The renewed political commitment presents a unique opportunity for Kenya to rapidly progress towards UHC.

・The GoK has introduced several initiatives to fast-track progress towards UHC, especially among the poor and vulnerable, but they have been fragmented and coverage remains low. These initiatives include removal of user fees in levels II and III facilities, free maternity programme in all public facilities and selected private facilities, health insurance subsidies for the poor (HISP) and health insurance for the elderly and people living with severe disability.

・In December 2018, the GoK launched the UHC pilot in four counties. Under the pilot, all health services in level IV and V facilities were declared free of charge. To compensate counties for revenue loss arising from user fees removal, the GoK committed to provide pharmaceutical and non-pharmaceutical supplies through the Kenya Medical Supplies Agency (KEMSA) and allocate money for health systems strengthening and operations and maintenance. The government plans to roll out UHC in the remaining 43 counties effective July 2019.

As the country fast tracks progress to UHC, it is important that rigorous monitoring and evaluation mechanisms are put in place. Without these, the country will not know what they have achieved, how much they still need to do, and/or whether they are getting value for money and accountability. The World Health Organization (WHO) and the World Bank have developed a framework to monitor progress towards UHC.

This consultancy supports the Ministry of Health (MoH) to monitor and evaluate progress to UHC in four pilot counties, highlight key challenges Kenya is facing and how these can be addressed in a timely manner. The selected consultant will work closely with the Ministry of Health and a team of Kenyan consultants contracted by the World Bank to conduct a series of M&E studies including household survey and process evaluations.

Scope of work

The consultant is expected to do the following:
・Drawing from the Japan experience, provide technical assistant and

advisory role to UHC department, MoH to finalize the M&E framework for the four counties, drawing from the broader M&E framework already developed

・Working closely with the MoH and the Bank, support UHC pilot counties to finalize and implement their M&E frameworks

Marketing of medical check-up and smartphone application for behaviour change to control NCDs

The Republic of Kenya

Africa Scan Inc.

March – April 2018

Position

Technical Adviser

SDGs

Through kiosk activities, the Africa Scan, has promoted lifestyle changes in order to control obesity since 2015. In 2017, the Feasibility Survey for Increasing the Uptake of Health Check-ups in Kenya, funded by JICA, was initiated to formulate ODA activity under the JICA PPP (Public-Private Partnership) program. At the same time, Africa Scan was seeking the opportunity to expand its marketing of behaviour change applications in the private sector. Given Kenya’s epidemiological transition to NCDs, it is highly important to promote behaviour change and encourage the practice of regular medical check-ups to control NCDs.