GREAT LAKES UNIVERSITY OF KISUMU+

SCHOOL OF HEALTH SCIENCES.

DEPARTMENT OF CLINICAL MEDICINE
HEALTH ECONOMICS BCM 128 2023/2024 TRIMESTER TWO - LECTURE GUIDE

Lecturer: Prof. Willis Obura (PhD. Economics)

Purpose of the Course

This course is designed to introduce students to the principles of
health management and information in relation to the running of a
health facility

Expected Learning Outcome

At the end of the course the student should be able to
a) Describe the principles of public financial management
b) Outline features and processes in human resources management
in relation to the health field
c) Describe the basic concepts of health economics
d) Describe health management information system
e) Be familiar with the organisation of health services in Kenya

A. DEFINATIONS

1. Health Economics- Health economics is used to promote

healthy lifestyles and positive health outcomes through the
study of health care providers, hospitals and clinics, managed
care and public health promotion activities.

2. Management: Management can be defined as a process of

getting the work or the task done that is required for
achieving the goals of an organisation in an efficient and
effective manner. Process implies the functions of the
management. That is, planning, organising, staffing, directing
and controlling.
3. Planning: Planning is the fundamental management
function, which involves deciding beforehand, what is to be
done, when is it to be done, how it is to be done and who is
going to do it. It is an intellectual process which lays down
an organisation’s objectives and develops various courses of
action, by which the organisation can achieve those objectives.
It chalks out exactly, how to attain a specific goal.:

4. Implementation: Implementation is the execution or

practice of a plan, a method or any design, idea, model,
specification, standard or policy for doing something. As such,
implementation is the action that must follow any preliminary
thinking for something to actually happen.

In Social and Health Sciences Implementation is defined as a

specified set of activities designed to put into practice an
activity or program of known dimensions. According to this
definition, implementation processes are purposeful and are
described in sufficient detail such that independent
observers can detect the presence and strength of the
"specific set of activities" related to implementation. In
addition, the activity or program being implemented is
described in sufficient detail so that independent observers
can detect its presence and strength.

In computer science, implementation results in software, while

in social and health sciences, implementation science studies
how the software can be put into practice or routine use.

5. Evaluation: Evaluation refers to the systematic process of

assessing what you do and how you do it to arrive at a
judgement about the 'worth, merit or value' of something.

Essentially, evaluation involves taking a series of planned steps

in order to better understand a program or service.
It is the structured interpretation and giving of meaning to
predicted or actual impacts of proposals or results. It looks at
original objectives, and at what is either predicted or what was
accomplished and how it was accomplished.

(a)Types of Evaluation: Some of the types are:

(i) Formative evaluation ensures that a program or program

activity is feasible, appropriate, and acceptable before it is
fully implemented. It is usually conducted when a new
program or activity is being developed or when an existing
one is being adapted or modified.
(ii) Process/implementation evaluation determines whether
program activities have been implemented as intended.
(iii) Outcome/effectiveness evaluation measures program
effects in the target population by assessing the progress in
the outcomes or outcome objectives that the program is to
achieve.
(iv) Impact evaluation assesses program effectiveness in
achieving its ultimate goals.
(v) Process Evaluation determines whether program
activities have been implemented as intended and resulted
in certain outputs. You may conduct process evaluation
periodically throughout the life of your program and start
by reviewing the aactivities and output components of the
logic model (i.e., the left side).
(vi) Outcome Evaluation measures program effects in the
target population by assessing the progress in the
outcomes that the program is to address. To design an
outcome evaluation, begin with a review of the outcome
components of your logic model (i.e., the right side)

(b) Monitoring:
Monitoring is a continuous process of collecting and analysing
 information about a programme, and comparing actual against
planned results in order to judge how well the intervention is
being implemented. It uses the data generated by the
programme itself (characteristics of individual participants,
enrolment and attendance, end of programme situation of
beneficiaries and costs of the programme) and it makes
comparisons across individuals, types of programmes and
geographical locations. The existence of a reliable monitoring
system is essential for evaluation.
(c)Monitoring and Evaluation
Monitoring and evaluation are the processes that allow policy-
makers and programme managers to assess: how an intervention
evolves over time (monitoring); how effectively a programme was
implemented and whether there are gaps between the planned and
achieved results (evaluation); and whether the changes in well-
being are due to the programme and to the programme alone
(impact evaluation).

B. ROLES OF A MANAGER

(i) providing leadership for the employees they oversee.

(ii) Managers are responsible for setting goals that align with
organizational objectives. To ensure their team
successfully reaches their goals, managers should do the
following:

 Clearly communicate the goal to employees.

 Select the right individuals for each task.
 Motivate employees to reach each objective.
 Set appropriate deadlines.
  Check in with employees to ensure they’re
making progress.
 Set key performance indicators to measure
success.
 Regularly review performance metrics.
 Make strategy adjustments as necessary.

(iii) Training and Development

(iv) Administrative tasks which among other include Financial
Management, HRM, Strategic Plans, Marketing etc.
(v) Motivating working environment
(vi) ETC

C. MANAGEMENT STRATEGIES
Strategic management involves developing and implementing plans
to help an organization achieve its goals and objectives. This
process can include formulating strategy, planning organizational
structure and resource allocation, leading change initiatives, and
controlling processes and resources.

Micro Management Strategies:

(a)Set Clear Goals and Targets: One of the easiest management
strategies to implement is setting clear goals and targets.
This applies to the business as a whole, an entire team, or a
specific employee. These goals should be related to each
other, with smaller targets contributing to larger ones.

(b) Prioritise Work Tasks: When you set targets, prioritise

work that will help staff meet the goals that have been set.
In some cases, this is making the tasks obvious so there’s no
confusion, but good management also helps staff learn and
develop. Sharing your knowledge, and how you made those
 decisions will make them feel more confident in the
direction the business is going.

(c)Implement Effective Time Management: Once targets are

set, and the tasks identified, consider how much time the
work should take. This varies for each employee, as skill
level, confidence, and motivation all play a part. Avoid
micromanaging as a management strategy, as while this
gives you complete insight into what’s going on, most staff
will react negatively to it and it will lower their productivity.

(d) Provide and Accept Feedback: Any of the management

strategies we implement might not work as intended. There
could be changes to the business, or altered workloads due
to staff changes. People themselves may change and need
adjustments or the goals could become outdated.

(e)Revise Processes when Needed: With this feedback, you

have the opportunity to maintain the status quo or make
changes that benefit everyone in your team. Good
management will see you do everything you can to help your
staff, allowing them to achieve their goals and you to meet
your targets.

Macro Management Strategies:

(a)Strategic Consideration: Key considerations in developing an
operational strategy involve focusing on employee retention
and career development to build a robust and skilled
workforce. It also includes assessing and improving the
company’s market positioning through operational excellence.
Optimizing production systems, leveraging technology
effectively, and managing resources efficiently are critical
components. These considerations ensure that the operational
strategy not only supports the business strategy but also adds
value to the company’s bottom line.

(b) Transformational Strategy: A transformational strategy is a

comprehensive plan aimed at guiding significant changes
within an organization. It’s typically employed in response to
major external challenges or internal needs for change. This
strategy is crucial for adapting to evolving market conditions,
technological advancements, or shifts in organizational goals.

The primary goals of a transformational strategy include

increasing the company’s earnings and expanding its market
share. It also aims to boost customer satisfaction by enhancing
the quality and efficiency of services or products. An essential
goal is to reduce operational costs through streamlined
processes and innovative solutions.

(c) Functional Strategy: A functional strategy is a targeted

approach designed to optimize the performance of individual
departments within a company, ensuring they contribute
effectively to the overall business objectives. This strategy
focuses on enhancing the efficiency and effectiveness of
specific functional areas, aligning them closely with the broader
goals of the organization.

The key goals of a functional strategy include aligning the

operations and initiatives of each department with the overall
success of the business. It aims to improve the quality and
effectiveness of products or services offered by the company
and enhance the efficiency and productivity of each
department.
D. ROLE OF ACCOUNTING IN FINANCIAL MANAGEMENT
1. Meaning: Accounting is the process of recording financial
transactions pertaining to a business. The accounting process
includes summarizing, analyzing, and reporting these transactions to
oversight agencies, regulators, and tax collection entities.
In otherwise, it is the process of recording, classifying and
summarizing financial transactions. It provides a clear picture of the
financial health of your organization and its performance, which can
serve as a catalyst for resource management and strategic growth.

Accounting is a term that describes the process of consolidating

financial information to make it clear and understandable for all
stakeholders and shareholders. The main goal of accounting is
to record and report a company’s financial transactions, financial
performance, and cash flows.

2. Types of Accounting: There are three main Types:

(a) Financial Accounting: The primary function of financial
accounting is to track, record, and recap all daily transactions into
monthly, quarterly, and yearly financial statements.
In short, financial accounting provides a general look at business
performance over a period of time in the form of financial
statements – the Balance Sheet, Income Statement, and Statement
of Cash Flows, and "financial reporting" to your description would
make it more comprehensive.
Finance bookkeeping involves recording financial transactions and
maintaining financial records, while financial reporting involves
preparing financial statements and other reports for external
stakeholders.
(b) Managerial Accounting: Managerial accounting can be easily
mistaken for financial accounting, but actually, they are two different
aspects.
Managerial accounting is the process of organizing financial data and
reporting financial status to managers. Thereby helping business
managers make optimal operating decisions and grasp the issues as
soon as possible if there are any.
Management accounting information is especially important in
operating an enterprise, and at the same time serves to control and
evaluate that business.
While financial accounting can be publicly shared with stakeholders,
management accounting information is shared exclusively with
others in an organization due to the sensitive nature of the
information.

(c) Cost Accounting: Costing accounting is a specialty field that

looks closely at the actual cost related to the accomplishment of a
business goal. Cost accounting plays an important role in optimizing
production processes in order to reduce costs for businesses and bring
higher profits for individual product sales.

The costs of producing a product for a business can be categorized as

fixed and variable costs.

Fixed costs: The type of costs that do not change with the amount of
product that is manufactured.

Fixed costs remain the same regardless of whether goods or services

are produced or not. Thus, a company cannot avoid fixed costs. The
most common examples of fixed costs include lease and rent
payments, utilities, insurance, and interest payments.

Variable costs: The costs that change with the production quantity of
products made or the performance of services. Common examples of
variable costs include costs of goods sold (COGS), raw materials,
packaging, commissions, and certain utilities such as gas or
electricity.
In brief Role of Accounting in Financial Management are to store
and analyze financial information and oversee monetary
transactions. Accounting is used to prepare financial statements for
a company's employees, leaders, and investors. Accounting also
functions to ensure the payment of funds into and out of a company.

E. BUDGETTING
(a) Meaning: A budget is a plan you write down to decide how you
will spend your money each month. A budget helps you make sure
you will have enough money every month. Without a budget, you
might run out of money before your next paycheck.

A budget is simply a spending plan that takes into account estimated

current and future income and expenses for a specified future time
period, usually a year.

Having a budget keeps your spending in check and makes sure that
your savings are on track for the future.

Budgeting can help you set long-term financial goals, keep you from
overspending, help shut down risky spending habits, and more.

(b) Business Budget: Budgeting is the process of preparing and

overseeing a financial document that estimates income and expenses
for a period. For business owners, executives, and managers,
budgeting is a key skill for ensuring organizations and teams have the
resources to execute initiatives and reach goals.

A basic budget consists of projected income and expenses for a given

period (for instance, the upcoming quarter or year). After expenses are
subtracted from projected income, the leftover money can be allocated
to projects and initiatives, ensuring you’re not planning to overspend.

(c) Types of Budgeting: There are several budgeting types that each
prioritize different factors when approaching a financial plan. These
include:
 1. Zero-based budgeting, which sets each item at zero dollars at
the start of periods before reallocating
2. Static budgeting or incremental-based budgeting, which uses
historical data to add or subtract a percentage from the previous
period to create the upcoming period’s budget
3. Performance-based budgeting, which emphasizes the cash
flow per unit of product or service
4. Activity-based budgeting, which starts with the company’s
goals and works backward to determine the cost of attaining
them
5. Value proposition budgeting, which assumes no line item
should be included in the budget unless it directly provides
value to the organization

(b) Kenya Government Budgeting Process: The Budget

Making Process is anchored in the Constitution of Kenya, 2010,
and the Public Finance Management Act. Article 220 of the
Constitution and Sections 35(e) and 36 of the Public Finance
Management Act, 2012, requires this process to commence not
later than 30th August of the preceding financial year

There are four stages of the Process:

1. Formulation: Done by the executive arms of both national and

county governments. The formulation stage entails medium-term and
long-term planning, determining the financial and economic priorities,
preparation of the overall as well as budget estimates. At this stage we
cannot underscore enough the needs for meaningful public
participation by the public. The key budget documents at the
formulation stage include:
At the national level:

 Budget Circular
 Budget Review and Outlook Paper
 Budget Policy Statement – contains estimates national
government revenue and expenditure.
 The Budget Estimates
At the County level:

 Budget Circular
 The Annual development Plan
 County Budget Review and Outlook Paper
 The County Fiscal Strategy Paper - contains estimates national
government revenue and expenditure.
 Budget Policy Statement
 The Budget Estimates

2. Approval Stage: Done by Parliament the national level and County

Assembly at the county levels with each level having the Budget
Policy Statements and County Fiscal Strategy paper adopted
respectively. Amendments and approval of the estimates by
Parliament and County Assemblies takes places at this stage followed
by the enactment of the Appropriation bills that allows expenditures.

Key documents under this include the Finance Bill and

Appropriation Bills.

3. Implementation Stage: This stage entails execution the approved

budget proposals by the executive of the national and county
governments. Parliament and County Assemblies will exercise
oversight over the implementation.

Key budget documents here entail quarterly budget implementation

review reports by Controller of Budget as well as quarterly budgets
implementation reports by the national and county governments.

4. The Audit and Evaluation Stage: The Offices of the Auditor

General and the Controller of the Budget are in charge of the audit
and evaluation stages respectively. Audit reports look to confirming
whether public funds were expended prudently by both the national
and county governments. The Audit reports are tabled before
Parliament’s and County assemblies for debate and consideration
after which they should take appropriate action. Debate and
consideration s of the reports should be done within three months of
tabling of the report by the Office of the Auditor General. The
Controller of Budgets on the other hand reviews the budget estimates
of the previous financial years and tables a quarterly budget report to
the Parliament and County Assemblies

Key budget documents include: the Auditor General’s reports for

both levels of government and a review of the Budget Review and
Outlook Paper (BROP and CBROP) which forms the basis for
evaluation by the COB.

F. FACILITY IMPROVEMENT FUND.

1. Meaning: The Facility Improvement Fund is revenue collected at

public health facilities as user fees paid. to defray the costs of
running these facilities. This fund is usually vital in enabling
facilities to manage. their day-to-day expenses and manage situations
where emergency supplies have to be acquired.

2. Facility Improvement Fund Operation Manual: This manual is

designed to help manage the Government of Kenya's Facility
Improvement Fund successfully in local health centres. Experience in
the health centres has shown that implementation of the policies and
procedures described in the manual will improve the collection and
use of funds, and enhance patient and staff satisfaction with services.

The Manual addresses the following Governance issues among

others:

Section 1: Policy

Staff support: Make sure that all health, administrative and support
staff are aware of policies through meetings and circulars.

Section 2: Managing for Success

Performance targets: Use your service statistics and fee levels to set
targets so that you know how much you should be collecting and
waiving.
Set priorities: See which departments have the greatest revenue
potential and focus on improving performance in such departments.

Spend money to make money: Motivate staff to improve

performance by spending a percentage of the department's revenue on
improving services in that department.

Monitor collection performance: Compare actual collections with

targets each month to detect good and bad performance.

Section 3: Organization and Management

County supervision: Let your DHMT members know what is

happening, and help them to use supervisory visits to encourage staff
support for cost sharing revenue.

County support: Work closely with your CMOH and County

Accountant to ensure that you always have adequate supplies of
essential receipts, medical stationery and record books.

Staff responsibilities: Make sure that all staff members know what
they are supposed to do with regard to cost sharing revenue.

Section 4: Fee Structure, Exemptions and Waivers

Fees and exemptions: Make sure that fee-level and exemption

posters are prominently displayed and that all staff are familiar with
them.

Access to the poor: Make sure that staff are familiar with waiver
procedures so that patients who cannot afford to pay are not turned
away. Open a waiver register and record all waivers granted.

Section 5: Fees Collection

Fees collection: Minimize queuing and movement between

departments to ensure that patients are not inconvenienced.

Cash boxes: Make sure that the Revenue Clerk uses a proper cash
box for security and demonstration of accountability to patients.
Departmental registers: Make sure that each department enters
information on fees in their service registers and prepares monthly
summaries.

Inpatient Summary Form: Use the new Inpatient Summary Form to

ensure that all inpatient fees are correctly charged.

Section 6: Expenditure Planning and Management

Expenditure Planning: Submit annual expenditure plans and

quarterly AIE requests on time to make sure that there are no delays
in spending funds.

Expenditure monitoring: Keep track of goods and services provided

from your 75% funds through the DMOH's office.

Section 7: Quality of Care and Local Public Information

Quality of care: Make sure that funds are used to visibly improve
patient services and that other aspects of patient care such as courtesy
and cleanliness are observed.

Patient and public information: Tell patients how cost sharing

revenue is being used and keep the community informed.

Section 8: Accounting

Cash Analysis Book: Make sure that the collections section of the
Cash Analysis Book is properly maintained and that the original page
is submitted to the CMOH by the 10th of the following month.

Section 9: Performance Review

Monitor performance: Prepare and use the monthly Revenue

Summary Report and Collections Tracking Sheet to see where there is
poor performance and take corrective action.
Reporting: Submit the monthly collection report to the DMOH by
the 10th of the following month and the monthly Workload Report to
the DMOH by the 15th of the following month.

G. AUDITING AND REPORTING

1. Meaning: AuditingAuditing is defined as the on-site verification

activity, such as inspection or examination, of a process or quality
system, to ensure compliance to requirements. An audit can apply
to an entire organization or might be specific to a function, process, or
production step.

An audit is an "independent examination of financial information of

any entity, whether profit oriented or not, irrespective of its size or
legal form when such an examination is conducted with a view to
express an opinion thereon.

2. Purpose: Auditing also attempts to ensure that the books of

accounts are properly maintained by the concern as required by law.

 Audits provide third-party assurance to various stakeholders

that the subject matter is free from material misstatement.

 Other commonly audited areas include: secretarial and
compliance, internal controls, quality management, project
management, water management, and energy conservation.
 As a result of an audit, stakeholders may evaluate and improve
the effectiveness of risk management, control, and governance
over the subject matter.
 Due to strong incentives (including taxation, mis-selling and
other forms of fraud) to misstate financial information,
auditing has become a legal requirement for many entities who
have the power to exploit financial information for personal
gain.
 Financial audits are performed to ascertain the validity and
reliability of information, as well as to provide an assessment
 of a system's internal control. As a result, a third party can
express an opinion of the person / organization / system (etc.)
in question. The opinion given on financial statements will
depend on the audit evidence obtained.

3. Integrated Audit: This is where auditors, in addition to an opinion

on the financial statements, must also express an opinion on the
effectiveness of a company's internal control over financial reporting.

4. Assessments: The purpose of an assessment is to measure

something or calculate a value for it. An auditor's objective is to
determine whether financial statements are presented fairly, in all
material respects, and are free of material misstatement.

5. Auditors: There are substantial types of Auditors of which the

most common are Internal and External Auditors:

(a) Internal Auditor: They are employed by the organizations

they audit. They work for government agencies (federal, state
and local); for publicly traded companies; and for non-profit
companies across all industries.

(b) External Auditors/Statutory Auditor: is an independent

firm engaged by the client subject to the audit to express an
opinion on whether the company's financial statements are
free of material misstatements, whether due to fraud or error.
For publicly traded companies, external auditors may also be
required to express an opinion on the effectiveness of internal
controls over financial reporting. External auditors may also be
engaged to perform other agreed-upon procedures, related or
unrelated to financial statements. Most importantly, external
auditors, though engaged and paid by the company being
audited, should be regarded as independent and remain third
party.

6. Performance Audit: refers to an independent examination of a

program, function, operation or the management systems and
procedures of a governmental or non-profit entity to assess whether
the entity is achieving economy, efficiency and effectiveness in the
employment of available resources.

Safety, security, information systems performance, and

environmental concerns are increasingly the subject of audits.

There are now audit professionals who specialize in security audits

and information systems audits. With nonprofit organizations and
government agencies, there has been an increasing need for
performance audits, examining their success in satisfying mission
objectives.

6. Quality Audits: Are performed to verify conformance to

standards through review of objective evidence.

A system of quality audits may verify the effectiveness of a

quality management system. This is part of certifications such
as ISO 9001.

Quality audits are essential to verify the existence of objective

evidence showing conformance to required processes, to
assess how successfully processes have been implemented, and
to judge the effectiveness of achieving any defined target
levels.

Quality audits are also necessary to provide evidence

concerning reduction and elimination of problem areas, and
they are a hands-on management tool for achieving continual
improvement in an organization.

7. Project Audit: A project audit provides an opportunity to

uncover issues, concerns and challenges encountered during
the project lifecycle.

Conducted midway through the project, an audit affords the

project manager, project sponsor and project team an interim
 view of what has gone well, as well as what needs to be
improved to successfully complete the project.

If done at the close of a project, the audit can be used to

develop success criteria for future projects by providing a
forensic review.

This review identifies which elements of the project were

successfully managed and which ones presented challenges.

As a result, the review will help the organization identify what it

needs to do to avoid repeating the same mistakes on future
projects

8. Operations Audit: An operations audit is an examination of the

operations of the client's business. In this audit, the auditor
thoroughly examines the efficiency, effectiveness and economy
of the operations with which the management of the entity
(client) is achieving its objective.

The operational audit goes beyond the internal controls issues

since management does not achieve its objectives merely by
compliance of satisfactory system of internal controls.

Operational audits cover any matters which may be

commercially unsound. The objective of operational audit is to
examine Three E's, namely:[] Effectiveness – doing the right
things with least wastage of resources. Efficiency – performing
work in least possible time. Economy – balance between
benefits and costs to run the operations

9. Forensic Audit: Refer to forensic accountancy, forensic

accountant or forensic accounting.

It refers to an investigative audit in which accountants with

specialized on both accounting and investigation seek to
uncover frauds, missing money and negligence:
 Reporting: The act by a company of giving an official report, for
example about its accounts or activities:
 quarterly/annual reporting
 corporate/company reporting
 a reporting deadline/requirement

ALSO

The way that the managers and their teams are organized in a
company:
It is important to establish clear lines of reporting.
She was not invited to the meeting as she was not in the chain of
reporting.

2. Auditing Reporting: An audit report expresses an auditor's

opinion on a company's financial performance and compliance
with generally accepted accounting principles (GAAP). These
principles set by the Financial Accounting Standings Board provide
clarity on the auditing process so that auditors can make their
opinions objectively.

The report summarizes the company’s assets and liabilities to

ascertain whether it is free of material misstatement. From there,
companies can identify areas to improve or determine what to look for
in prospective investors.

While the document is prepared for the company, auditors may

release the report to the public where any interested parties like
investors can see it. It is from such reports that investors make the
decision to invest in the company or not.

H. ORGANIZATION OF HEALTH SERVICES IN KENYA

1. Background: Thus one of the important activities of the

government is to look after the health of the people. The government
carries out this activity through the Ministry of Health. The Ministry
of Health is the main provider of health services to all the citizens of
this country.

2. Organization Structure: The Ministry of Health is the main provider

of health services to all the citizens of this country. The functions of
the Ministry include:

 Planning (for the delivery of health care services)

 Maintaining effective health information systems
 Manpower training, recruitment and development
 Promotive and preventive services
 Curative services
 Health care financing
 Registration and licensing of health facilities
 Health care policy development
 Health care quality assurance

The Ministry of Health operates at four main levels, which are based
on our country's administrative setup. The four levels are:
I. KENYA GOVERNMENT HEALTH POLICY AND
PLANNING PROCESS 2014-2030

POLICY AGENDA

The Constitution of Kenya guarantees all citizens the right to

quality healthcare. This includes reproductive health of the highest
attainable standards and access to emergen- cy medical treatment
amongst other rights.

The Kenya Health Policy, 2014–2030 gives directions to ensure

significant improvement in overall status of health in Kenya in line
with the Constitution of Kenya 2010, the country’s long-term
development agenda, Vision 2030 and global commitments. It
demonstrates the health sector’s commitment, under the government’s
stewardship, to ensuring that the country attains the highest possible
standards of health , in a manner responsive to the needs of the
population.

1. Principles Guiding the Kenya Health Policy

Articles 10 and 232, together with Chapters 6 and 12 of the

Constitution provide

guidance on the values and principles that all State organs and officers
are

expected to uphold in the delivery of services. In the implementation

of this

policy, the health sector will embrace the following principles: Equity
in

distribution of health services and interventions;

i. Public participation, in which a people-centred approach and social

accountability in planning and implementation shall be encouraged, in

addition to the multisectoral approach in the overall development

planning;

ii. Efficiency in application of health technologies; and

iii. Mutual consultation and cooperation between the national and

county

governments and among county governments.

2. Policy Pillars

(i) Ensure equitable allocation of government resources to

reduce disparities in health status

(ii) People cantered approach to health and Health interventions

(iii) Participatory approach to delivery of interventions;

 (iv) Multisectoral approach to realising health goals

(v) Efficiency in the application of health technology

(vi) Social accountability

(vii) Increase in cost – effectiveness and cost efficiency of

resource allocation and use
(viii) Continue to manage population growth.

3. Policy Objectives:

(i) Eliminate communicable conditions eg…

(ii) Halt and reverse the rising burden of non-communicable

conditions and mental disorders;

(iii) Reduce the burdens of violence and injuries;

(iv) Provide healthcare

(v) Minimise exposure to exposure to health risk factors

(vi) Strengthen collaboration with private and other sectors that

have an impact on health

PLANNING PROCESS

Health planning involves assessing health care needs of a defined

population, setting priorities, then developing, implementing,m
and evaluating programs that address priority needs.

The Planning Cycle has eight steps, as outlined below.

 Analyze Your Situation. First, clarify what you need to do.

 Identify the Aim of Your Plan.
 Explore Your Options.
  Select the Best Option. ...
 Detailed Planning.
 Evaluate the Plan and Its Impact.
 Implement Change.
 Close the Plan and Review.

J. HEALTH SECTOR REFORMS AND FINANCING.

(a) Key Reforms

Key reforms that Kenya has already undertaken towards achieving

Universal Health Care include;

 Free maternity services in all public health facilities since 2013;

 Free primary health care in all public primary healthcare
facilities – about 3,300 facilities;
 Major programme to equip major public hospitals across the
country with modern diagnostic equipment (94 facilities) where
contracts have already been signed up with suppliers;
 A National Referral Strategy has been developed and piloted;
 Health insurance subsidies through NHIF targeting
disadvantaged groups continues to be implemented;
 Provision of infrastructure and equipment to health facilities
across county governments (new wards, ambulances, additional
health workers); among other initiatives.

(b) Financing Health Sector.

The health sector in Kenya relies on several sources of funding:

public (government), private firms, households and donors
(including faith based organizations and NGOs) as well as health
insurance schemes.

There are however challenges- inadequate human resource for

health, inadequate budgetary allocations to healthcare, and
poor leadership and management in healthcare.
THIS IS THE END OF THE LECTURE FOR BCM 128. HOPE
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