Findings from Health Economics Research Unit Broaden Understanding of Science (A Critical Analysis of Purchasing Arrangements in Kenya: The Case of…

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Findings from Health Economics Research Unit Broaden Understanding of Science (A Critical Analysis of Purchasing Arrangements in Kenya: The Case of the National Hospital Insurance Fund)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Investigators publish new report on Science. According to news originating from Nairobi, Kenya, by VerticalNews correspondents, research stated, "Purchasing refers to the process by which pooled funds are paid to providers in order to deliver a set of health care interventions. Very little is known about purchasing arrangements in low-and middle-income countries (LMICs), and certainly not in Kenya."

Our news journalists obtained a quote from the research from Health Economics Research Unit, "This study aimed to critically analyse purchasing arrangements in Kenya, using the National Hospital Insurance Fund (NHIF) as a case study. We applied a principal-agent relationship framework, which identifies three pairs of principal-agent relationships (government-purchaser, purchaser-provider, and citizen-purchaser) and specific actions required within them to achieve strategic purchasing. A qualitative case study approach was applied. Data were collected through document reviews (statutes, policy and regulatory documents) and in-depth interviews (n=62) with key informants including NHIF officials, Ministry of Health (MoH) officials, insurance industry actors, and health service providers. Documents were summarised using standardised forms. Interviews were recorded, transcribed verbatim, and analysed using a thematic framework approach. The regulatory and policy framework for strategic purchasing in Kenya was weak and there was no clear accountability mechanism between the NHIF and the MoH. Accountability mechanisms within the NHIF have developed over time, but these emphasized financial performance over other aspects of purchasing. The processes for contracting, monitoring, and paying providers do not promote equity, quality, and efficiency. This was partly due to geographical distribution of providers, but also due to limited capacity within the NHIF. There are some mechanisms for assessing needs, preferences, and values to inform design of the benefit package, and while channels to engage beneficiaries exist, they do not always function appropriately and awareness of these channels to the beneficiaries is limited. Addressing the gaps in the NHIF's purchasing performance requires a number of approaches. Critically, there is a need for the government through the MoH to embrace its stewardship role in health, while recognizing the multiplicity of actors given Kenya's devolved context."

According to the news editors, the research concluded: "Relatively recent decentralisation reforms present an opportunity that should be grasped to rewrite the contract between the government, the NHIF and Kenyans in the pursuit of universal health coverage (UHC)."

For more information on this research see: A Critical Analysis of Purchasing Arrangements in Kenya: The Case of the National Hospital Insurance Fund. International Journal of Health Policy and Management, 2017;7(3):244-254.

The news correspondents report that additional information may be obtained from K. Munge, Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya. Additional authors for this research include S. Mulupi, E.W. Barasa and J. Chuma.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.15171/ijhpm.2017.81. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Keywords for this news article include: Kenya, Africa, Nairobi, Science, Hospitals.