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Background of Health Financing in Kenya & Kirinyaga County

Financial Management Training for Facility In-Charges

24 February 2025

Dr. Esbon Gakuo

County Director of Health

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Outline

  • Provide a Timeline of Key Events in Health Financing in Kenya with a focus on Kirinyaga County

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Timeline of Key Events in Health Financing in Kenya and Kirinyaga

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Pre-Independence

Limited government-funded medical services for Africans

1965

Sessional Paper no. 10 on African Socialism

    • Provide social services on a large scale
    • Abolished Hospital User charges
    • Abolished Poll Tax

1966

NHIF starts operations covering employes earning >1000

1972

Voluntary NHIF contributions for those <1000 and the self-employed

Late 70’s-1989

Gradual re-introduction of user fees

1989

Formalization of Cost-Sharing Policy

1990

User Fees suspended

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Timeline of Key Events in Health Financing in Kenya and Kirinyaga

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1991-2003

Phased re-introduction of User fees (FIF)

2001

Kenya signs The Abuja Declaration

2004

User fees abolished in PHC facilities and introduction of 10/20 Policy

2004

Social Health Insurance Fund bill passed in Parliament but not assented

2007

Establishment of Health sector Support Fund (HSSF) through a Legal Notice

2009

Implementation of Economic Stimulus Programme

2009

HSSF Legal Notice amended to introduce Hospital Management Sector Fund (HMSF)

2010

Promulgation of Constitution of Kenya 2010

2010

DANIDA introduced

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Timeline of Key Events in Health Financing in Kenya and Kirinyaga

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2013

Implementation of Devolved system of government

2013

Abolishment of user fees in PHC and Maternity fees in all public health facilities - FMS

2016

Enactment of the Kirinyaga Health Services Act

2016

Kirinyaga FIF Regulations developed but not submitted to Assembly for adoption

2017

Linda Mama introduced

2018

Launch of Universal Health Coverage (UHC) Pilot Program

2018

Launch of EduAfya

2020

COVID-19 Pandemic Support

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Timeline of Key Events in Health Financing in Kenya and Kirinyaga

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2023

Direct Financial Support from US Gov to County Dept of Health – Wezesha Afya Project

2023

Enactment of the Primary Healthcare Act, Facility Improvement Financing Bill, and Social Health Insurance Act

2023

Enactment of the Kirinyaga FIF Act

2024

Enactment of the Kirinyaga FIF Regulations

2024

Implementation of Social Health Insurance Fund (SHIF) Begins

2025

Approval of the Kirinyaga FIF Board and Hospital Management Committees

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THANK YOU

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