Systematic Review of Kenya’s Programmatic Progress towards Universal Coverage and Its Effect on Health Equity
Timothy Chrispinus Okech, PhD

Abstract
Over the years, the Government of Kenya with support from sectoral partners has continued to initiate and implement various policy reforms earmarked towards enhancing health equity. The purpose of this paper was to critically review the various initiatives that the government of Kenya has over the years initiated towards enhancement of universal coverage in terms of policy reforms including health care financing. For purposes of the analysis, data was largely collected through in-depth review of government policy documents including draft health care financing strategy, health policy framework, Ministry of Health strategic plans, Vision 2030, commissioned studies by the Ministry, among others. Notable findings include existence of multiple sources of revenue with government revenue showing an upward trend over the years in absolute terms though still lagging behind the Abuja Declaration of 2001, and existence of high levels of out-of-pocket spending which has continued to contribute towards catastrophic health expenditures. Other findings include existence of significant contribution by the development partners which is however, off-budget and skewed in favor of some regions notwithstanding its sustainability given the global trends. Similarly, though there exist a number of organizational entities that provide risk pooling options, the nature of resource pooling has limited cross-subsidization. Various recommendations have been suggested including sufficient funding for the health system through risk pooling mechanisms, earmarking some taxes for health care; improved revenue collection approaches, continued political commitment by government and development partners while enhancing efficiency in the management of health funds.

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