Private health sector assessment in Kenya:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Washington, D.C.
World Bank
c2010
|
| Schriftenreihe: | World Bank working paper
no. 193 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | "Investment climate in health series"--P. iii. Includes bibliographical references (p. 162-164) |
| Beschreibung: | xx, 164 p. ill. 26 cm |
| ISBN: | 0821383590 9780821383599 |
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| 245 | 1 | 0 | |a Private health sector assessment in Kenya |c Jeff Barnes ... [et al.] |
| 264 | 1 | |a Washington, D.C. |b World Bank |c c2010 | |
| 300 | |a xx, 164 p. |b ill. |c 26 cm | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 490 | 0 | |a World Bank working paper |v no. 193 | |
| 500 | |a "Investment climate in health series"--P. iii. | ||
| 500 | |a Includes bibliographical references (p. 162-164) | ||
| 650 | 4 | |a Medical care |z Kenya | |
| 650 | 4 | |a Medical economics |z Kenya | |
| 650 | 4 | |a Health facilities, Proprietary |z Kenya | |
| 650 | 4 | |a Medical care surveys |z Kenya | |
| 650 | 4 | |a Health Services |z Kenya | |
| 650 | 4 | |a Private Sector |z Kenya | |
| 650 | 4 | |a Health Care Surveys |z Kenya | |
| 650 | 4 | |a Health Planning |z Kenya | |
| 650 | 4 | |a Quality Assurance, Health Care |z Kenya | |
| 700 | 1 | |a Barnes, Jeff |e Sonstige |4 oth | |
| 710 | 2 | |a World Bank |e Sonstige |4 oth | |
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| adam_text | Titel: Private health sector assessment in Kenya
Autor: Barnes, Jeff
Jahr: 2010
Contents
Acknowledgments....................................................................................................................x
Acronyms and Abbreviations................................................................................................xi
Executive Summary................................................................................................................xiv
Key Findings.....................................................................................................................xiv
Recommendations..........................................................................................................xvii
Areas for Future Study....................................................................................................xix
1. Introduction and Background.............................................................................................1
Introduction.........................................................................................................................1
2. Methodology..........................................................................................................................4
3. Assessment Findings and Issues........................................................................................6
Private Sector Size and Structure......................................................................................6
Kenyan Burden of Disease and the Private Health Markets.......................................11
Ensuring Delivery of Quality Services in the Private Health Sector..........................23
Health Financing and Insurance.....................................................................................29
The Business Environment for the Private Health Sector...........................................39
Private Sector Supply Chain............................................................................................46
Policy Reform Environment............................................................................................52
4. Recommendations...............................................................................................................63
Stewardship and Governance of the Private Health Sector........................................63
Health Financing and Social Health Insurance.............................................................64
Delivering Quality Services in the Private Health Sector............................................66
Delivering Quality Drugs through the Private Supply Chain....................................72
Bridging the Knowledge Gaps to Stimulate Investment and Inform Public-Private
Policy Dialogue..........................................................................................................74
5. Conclusions..........................................................................................................................76
Estimating the Impacts.....................................................................................................76
Other Market Opportunities...........................................................................................78
Appendixes...............................................................................................................................79
Appendix 1. Scope of Work...................................................................................................79
Background........................................................................................................................79
Objectives...........................................................................................................................80
Statement of Work............................................................................................................80
Suggested Methodology..................................................................................................83
Deliverables.......................................................................................................................84
Duration, Timing and Schedule......................................................................................85
Contents
Appendix 2. Stakeholders Interviewed...............................................................................86
Appendix 3. Focus Group Discussion Analysis.................................................................89
Understanding the Private Health Sector in Kenya: An Analysis of Focus Group
Discussions with Private Health Providers...........................................................89
Contributions of Private Providers to Public Health...................................................89
Constraints Preventing Private Providers from Providing More Services...............90
Potential Strategies for Improving the Health Care Provided by the Private Sector91
Appendix 4. Donor Investment Opportunities..................................................................93
Opportunity One: Creating a Legal Structure for Innovation and Security in Health
Insurance....................................................................................................................93
Opportunity Two: An Integrated Licensing and Enforcement Structure for Health
Facilities......................................................................................................................94
Opportunity Three: Linking Gold Star, Insurance, and Affordable ART Supply.... 95
Opportunity Four: Accreditation and Quality Assurance for Laboratories.............96
Opportunity Five: Rural Retail Drug Network.............................................................97
Opportunity Six: Expand Access to Finance.................................................................99
Opportunity Seven: Develop Local Training Capacity in Health Management and
Finance........................................................................................................................99
Opportunity Eight: Support for the Policy Reform Process......................................101
Appendix 5. Case Studies....................................................................................................104
Case Study #1: The Gold Star Network.......................................................................104
Case Study #2: Sustainable Healthcare Foundation/CFW Shops.............................106
Case Study #3: Low-end Insurance Product............................................................... 109
Appendix 6. Selected Data on Key Health Markets........................................................112
1. National Health Accounts......................................................................................... 112
2. Women s Health (Delivery, Antenatal, and Family Planning Services)..............113
3. Treatment of Childhood Diarrhea............................................................................ 121
4. HIV/AIDS.....................................................................................................................124
Appendix 7. Naivasha Workshop Report.........................................................................126
Antecedents..................................................................................................................... 126
Workshop Overview......................................................................................................126
Addressing Misperceptions, Building Trust............................................................... 128
Challenges to Partnership in the Kenyan Health Sector............................................130
Closing Remarks............................................................................................................133
Annex A: List of Naivasha Workshop participants...................................................134
Annex B: Implementation Framework for Social Health Protection Strategy........136
Annex C: Naivasha Declaration....................................................................................I37
Annex D: The Naivasha Workshop Recommendations-April 2009......................139
Contents vii
Appendix 8. Second PPP Workshop: Building a Roadmap for Health PPPs in
Kenya (follow-up to Naivasha workshop)................................................................142
1.0. Introduction Workshop Overview........................................................................142
2.0. Background...............................................................................................................143
3.0. Highlights from Opening Speech by Permanent Secretary, Mr. Mark Bor......144
4.0. Prioritization of Naivasha Workshop Recommendations..................................145
5.0. Aureus Capital.........................................................................................................154
6.0. Next Steps and Road Map......................................................................................155
Annex A: Agenda for June 25 and 26 Workshop at Holiday Inn, Nairobi..............157
Annex B: Participant List...............................................................................................158
Annex C: Summary of Board/Council Activities to Update Their Respective Health
Act.............................................................................................................................159
Annex D: Private Health Sector Work Plan DRAFT..................................................160
References...............................................................................................................................162
Tables
Table 3.1. Number of Health Facilities by Type and Ownership, Kenya, 1999.................8
Table 3.2. Distribution of Health Facilities in Kenya by Type and Ownership, 2006.......8
Table 3.3. Out Visits to Providers by Provinces and Sector, 2007 (in %)............................9
Table 3.4. Estimates of Health Personnel in the Public and Private Sectors, 2007,
2008....................................................................................................................................10
Table 3.5. NHA HIV Subaccount Analysis..........................................................................16
Table 3.6. Source of ANC in Kenya, Most Recent Birth.....................................................21
Table 3.7. Source of ANC by Wealth Quintile, Most Recent Birth....................................21
Table 3.8. Treatment Source for Child s Cough or Fever, Limited to Most Recent
Birth, by Geographic Region..........................................................................................22
Table 3.9. Private Sector Source of Care for Child s Cough or Fever, Limited to
Most Recent Birth, by Geographic Region....................................................................22
Table 3.10. Output of Kenyan Training Institutions, Selected Health Worker
Cadres, 2002 and 2005.....................................................................................................30
Table 3.11. Kenya s Pharmaceutical Trade Balance, 2003-2008 (US$ million).................49
Table 5.1. Potential Impacts of Assessment Recommendations........................................77
Table 5.2. Health Market Opportunities in Kenya..............................................................78
Table A4.1. Leadership and Management Skills...............................................................102
TableA 4.2. Technical Assistance to Establish PPP in Health..........................................103
Table 7A.1. Strengths and Weaknesses by Sector.............................................................129
Table 7A.2. Challenges in partnering with the private sector.........................................130
Table A8.1: PPP Priorities.....................................................................................................146
Table A8.2: Comparison between PPP Council and PPP Units within MOH/MOF .... 150
Table A8.3: DRAFT Private Health Sector Road Map......................................................156
Figures
Figure 3.1. Private Health Care Providers..............................................................................7
Figure 3.2. Distribution of Total Health Expenditures in the Kenyan Private
Sector, 2005/06 (100% = 20.7 billion ksh).........................................................................7
Figure 3.3. Current Health Care Coverage...........................................................................12
Figure 3.4. Health Care Coverage with Market Segmentation..........................................12
Figure 3.5. Contraceptive Prevalence by Source of Supply (CPR for Modern
methods)...........................................................................................................................19
Figure 3.6. Key FBO Umbrella Organizations in Kenya....................................................54
Figure 3.7. Health Sector Stakeholders and Relationships.................................................60
Figure 5.1. Breakdown of Total Health Expenditure by Provider, 2005/06.....................76
Figure 6A.1. Total Health Expenditures by Source, 2001/02...........................................112
Figure 6A.2. Total Health Expenditures by Source, 2005/06...........................................112
Figure 6A.3. OOP Spending by Provider, 2005/06............................................................113
Figure 6A.4. OOP Spending by Provider, 2001/02............................................................113
Figure 6A.5. Total Health Expenditures for Women s Health Services (2005/06)........113
Figure 6A.6. THE in Women s Health by Sector, 2005/06................................................114
Figure 6A.7. THE in Women s Health by Private Providers, 2005/06............................114
Figure 6A.8. Antenatal Services by Source........................................................................115
Figure 6A.9. Source of Antenatal Services by Sector in Urban Areas............................115
Figure 6A10. Range of Private Sector Providers Offering Antenatal Services in
Urban Areas....................................................................................................................115
Figure 6A.11. Source of Antenatal Services by Sector in Rural Areas...........................116
Figure 6A.12. Range of Private Sector Providers Offering Antenatal Services in
Rural Areas.....................................................................................................................116
Figure 6A.13. Source of Antenatal Services by Income Group.......................................116
Figure 6A.14. Antenatal Services by Wealth Quintiles and Private Service Sector......117
Figure 6A.15. Delivery Services by Source (DHS 2003)....................................................117
Figure 6A.16. Source of Delivery Services by Sector in Urban Areas.............................118
Figure 6A.17. Range of Private Sector Providers Offering Delivery Services in
Urban Areas....................................................................................................................118
Figure 6A.18. Source of Delivery Services by Sector in Rural Areas..............................118
Figure 6A.19. Range of Sector Providers Offering Delivery Services in Rural Areas.. 118
Figure 6A.20. Delivery Services by Wealth Quintiles and Service.................................119
Figure 6A.21. Delivery Services by Wealth Quintiles and Private Service Sector........119
Figure 6A.22. Family Planning Services by Source (DHS 2003)......................................120
Figure 6A.23. Use of Private Providers in Urban Areas by Method...............................120
Figure 6A.24. Use of Private Providers in Rural Areas by Method................................121
Figure 6A.25. Treatment Source for Child s Diarrhea by Sector in Urban Areas............122
Figure 6A.26. Range of Private Sector Providers Offering Child Diarrheal
Treatment Services in Urban Areas.............................................................................122
Figure 6A.27. Treatment Source for Child s Diarrhea by Sector in Rural Areas...........122
Figure 6A.28. Range of Private Sector Providers Offering Child Diarrheal
Treatment Services in Rural Areas..............................................................................122
Figure 6A.29. Treatment Source for Child s Diarrhea by Wealth Quintiles and
Service Sector..................................................................................................................123
Contents
Figure 6A.30. Treatment Source for Child s Diarrhea by Wealth Quintiles and
Private Service Sector Source.......................................................................................124
Figure 6A.31. THE for HIV/AIDS by Sector, 2005/06.......................................................125
Figure 6A.32. THE by HIV/AIDS Provider, 2005/06.........................................................125
Figure 6A.33. Private Sector OOP Spending by Private Provider, 2005/06...................125
Figure 7A.1. Distribution of Workshop Participants by Sector.......................................128
Diagram A8.1: PPP Health Council Composition.............................................................147
Diagram A8.2: PPP Health Council Structure...................................................................148
Diagram A8.3: PPP Health Council Relationships............................................................149
Diagram A8.4: Parallel Policy Review Process..................................................................152
Boxes
Box 3.1. Did You Know?...........................................................................................................6
Box 3.2.Shalom Community Hospital Was Only Able To Access Financing After It
Became More Established...............................................................................................38
Box 3.3. Interest Rates Discourage Provider from Seeking Financing.............................45
Box 7A1. Other Benefits of Partnerships............................................................................130
Box A8.1. KEPSA Response.................................................................................................144
Box A8.2. MOPHS proposals for PPPs...............................................................................145
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| id | DE-604.BV037286133 |
| illustrated | Illustrated |
| indexdate | 2024-07-09T22:55:17Z |
| institution | BVB |
| isbn | 0821383590 9780821383599 |
| language | English |
| lccn | 2010016465 |
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| physical | xx, 164 p. ill. 26 cm |
| publishDate | 2010 |
| publishDateSearch | 2010 |
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| publisher | World Bank |
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| series2 | World Bank working paper |
| spelling | Private health sector assessment in Kenya Jeff Barnes ... [et al.] Washington, D.C. World Bank c2010 xx, 164 p. ill. 26 cm txt rdacontent n rdamedia nc rdacarrier World Bank working paper no. 193 "Investment climate in health series"--P. iii. Includes bibliographical references (p. 162-164) Medical care Kenya Medical economics Kenya Health facilities, Proprietary Kenya Medical care surveys Kenya Health Services Kenya Private Sector Kenya Health Care Surveys Kenya Health Planning Kenya Quality Assurance, Health Care Kenya Barnes, Jeff Sonstige oth World Bank Sonstige oth Erscheint auch als Online-Ausgabe 0-8213-8363-9 Erscheint auch als Online-Ausgabe 978-0-8213-8363-6 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=021198810&sequence=000004&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Private health sector assessment in Kenya Medical care Kenya Medical economics Kenya Health facilities, Proprietary Kenya Medical care surveys Kenya Health Services Kenya Private Sector Kenya Health Care Surveys Kenya Health Planning Kenya Quality Assurance, Health Care Kenya |
| title | Private health sector assessment in Kenya |
| title_auth | Private health sector assessment in Kenya |
| title_exact_search | Private health sector assessment in Kenya |
| title_full | Private health sector assessment in Kenya Jeff Barnes ... [et al.] |
| title_fullStr | Private health sector assessment in Kenya Jeff Barnes ... [et al.] |
| title_full_unstemmed | Private health sector assessment in Kenya Jeff Barnes ... [et al.] |
| title_short | Private health sector assessment in Kenya |
| title_sort | private health sector assessment in kenya |
| topic | Medical care Kenya Medical economics Kenya Health facilities, Proprietary Kenya Medical care surveys Kenya Health Services Kenya Private Sector Kenya Health Care Surveys Kenya Health Planning Kenya Quality Assurance, Health Care Kenya |
| topic_facet | Medical care Kenya Medical economics Kenya Health facilities, Proprietary Kenya Medical care surveys Kenya Health Services Kenya Private Sector Kenya Health Care Surveys Kenya Health Planning Kenya Quality Assurance, Health Care Kenya |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=021198810&sequence=000004&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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