Alternative Sustainable Financing of Public Health Care in Kenya
Timothy C. Okech, Jane W. Gitahi

Abstract
The pursuit of quality health care has been the concern of Kenya government in collaboration with key stakeholders including donors, NGOs, CBOs among others. To realize this, government has continued to develop and implement various national health policies and strategies necessary for enhancing financing of a well-functioning health system. Due to the economic reforms and performance experienced in the 1980s, the Kenyan government forced to cut down on public expenditure contributing towards the abolition of free and subsidized public goods including healthcare. In the process, the government introduced user charges, which has however contributed to limited utilization of health services as well as deterioration in quality of care and catastrophe in household expenditure. Similarly, government budgetary allocation as well as donor support has been dwindling over years. In order to enhance access to quality health care in the country, various suggestions are made to facilitate financing of health care. Among these include prioritization of healthcare financing as a target for fundamental reforms through enhanced allocation by the government in line with Abuja Declaration. Other supportive reforms that are necessary and particularly urgent include strengthening health infrastructure and human resources; increased autonomy for public health facilities to allow them to manage their resources in the best possible way while enhancing their capacities at all levels. Alternative financing mechanisms are equally suggested including dedicated taxes, risk-pooling mechanisms and infrastructure bond amongst others. Finally, necessary policies need to be put in place to enhance joint financing agreements as well as the sector-wide approaches to minimize duplication of effort and skeweness in implementation of health projects meant to enhance access to quality care.

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