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      Analysis of Universal Health Coverage and Equity on Health Care in Kenya

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          Abstract

          Kenya has made progress towards universal health coverage as evidenced in the various policy initiatives and reforms that have been implemented in the country since independence. The purpose of this analysis was to critically review the various initiatives that the government of Kenya has over the years initiated towards the realization of Universal Health Care (UHC) and how this has impacted on health equity. The paper relied heavly on secondary sources of information although primary data data was collected. Whereas secondary data was largely collected through critical review of policy documents and commissioned studies by the Ministry of Health and development partners, primary data was collected through interviews with various stakeholders involved in UHC including policy makers, implementers, researchers and health service providers. Key findings include commitment towards UHC; minimal solidarity in health care financing; cases of dysfunctionalilty of health care system; minimal opportunities for continuous medical training; quality concerns in terms of stock-outs of drugs and other medical supplies, dilapidated health infrastructure and inadequqte number of health workers. Other findings include governance concerns at NHIF coupled with, high operational costs, low capitation, fraud at facility levels, low pay out ratio, accreditation of facilities, and narrowness of the benefit package, among others. In lieu of these, various recommendations have been suggested. Among these include promotion of solidarty in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, engagement of various stakeholders at both county and national government in fast tracking the enactment of Health Act; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources, enhanced awareness amongst members, enhanced benefit package among other recommendations.

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          Most cited references19

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          Communities of practice: the missing link for knowledge management on implementation issues in low-income countries?

          The implementation of policies remains a huge challenge in many low-income countries. Several factors play a role in this, but improper management of existing knowledge is no doubt a major issue. In this article, we argue that new platforms should be created that gather all stakeholders who hold pieces of relevant knowledge for successful policies. To build our case, we capitalize on our experience in our domain of practice, health care financing in sub-Saharan Africa. We recently adopted a community of practice strategy in the region. More in general, we consider these platforms as the way forward for knowledge management of implementation issues. © 2011 Blackwell Publishing Ltd.
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            Health Systems Financing: The Path to Universal Coverage.

            (2010)
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              The Constitution

              (2010)
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                Author and article information

                Journal
                Glob J Health Sci
                Glob J Health Sci
                Global Journal of Health Science
                Canadian Center of Science and Education (Canada )
                1916-9736
                1916-9744
                July 2016
                16 December 2015
                : 8
                : 7
                : 218-227
                Affiliations
                [1 ]Associate Professor of Economics, United States International University, Africa
                [2 ]University of Nairobi, Nairobi, Kenya
                Author notes
                Correspondence: Timothy Chrisipinus Okech, United States International University- Africa P.O Box 14634, 00800, Nairobi, Kenya. Tel: 254-20-360-6000. E-mail: tcokech@ 123456usiu.ac.ke
                Article
                GJHS-8-218
                10.5539/gjhs.v8n7p218
                4965667
                26925910
                dc674e4f-fb47-4b79-a253-7ce83894757d
                Copyright: © Canadian Center of Science and Education

                This is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                Categories
                Article

                health equity,health infrastructure,human resources for health,solidarity

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