1. MINISTERIAL MEETING UNDER THE THEME “DOMESTIC FINANCING FOR HEALTH: INVESTING TO SAVE”, ADDIS ABABA, ETHIOPIA, 11- 12 NOVEMBER, 2013

2. Presentation outline 1. Who finances health in Kenya 2. Health financing challenges 3. Domestic health financing initiatives

3. Source: National Health Accounts, GOK, 2001-02, 2005-06, 2009-10; WDI 2012 Health Financing: Who pays in Kenya?

4. Expenditure by Key Priority areas, 2009/10

5. Health financing Challenges  High out of pocket spending –denying poor Kenyans access to health care - 20% of sick can’t access health due to financial barrier  Inadequate funding from the Government - GoK allocations below the Abuja targets  Heavy reliance on donor funding – sustainability issues - Key priority programmes are over 70% financed by donors  Low population coverage by insurance - Only 10% of Kenyan population have access to a medical cover

6.  Restructuring of NHIF  Improve governance and increase coverage  Free deliveries at public facilities  Kshs. 3.1 billion allocate for deliveries  Increase access by the poor and reduce MMR  Abolition of user fees at lower level facilities  Kshs. 700m allocated to compensate facilities for lost revenue  Pro-poor initiative to reach communities in rural areas  Finalization of the Healthcare Financing Strategy  Define the Roadmap towards Universal Health Coverage Current Health Financing Initiatives

7.  Restructuring NHIF  To free huge amount currently used for administration to go towards payment of benefits  Bring more formal sector participation including employer contributions  Include reimbursement of ART and outpatient care for opportunistic infections within the NHIF cover  Efficient Improvement  Redirecting resources to lower level facilities (provide primary care at cheaper costs)  Introducing performance based financing (reduce wastage)  HIV Trust Fund  Earmark 1% of government revenue for the Trust Fund  Finance 74% of HIV/AIDS financing gap by 2020  Fund to be expanded to cover other priority areas including NCDs Proposed Means of mobilizing Domestic financing

8. Thank You