PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Overview
The Policy, Health Finance and Private Sector mechanism will address gaps that exist in health legislation, health care financing, and private sector engagement.
Comprehensive Goals and Objectives
This project will;
Support the review and harmonization of health legislation and regulatory framework.
Engage in the development and implementation of the new Health Policy Framework in line with the new constitution.
Contribute to the review, development and implementation of Health Care Financing strategies.
Contribute to increased private sector participation in policy formulation, planning and financing within the health sector
Background
In 1994, the Government of Kenya (GoK) through its Ministry of Health developed the Kenya Health Policy Framework (KHPF) 1994-2010, which formed the blue print for health sector development. The KHPF had, as its strategic theme 'Investing in health', and its overall stated goal was 'To promote and Improve the health of all Kenyans through deliberate restructuring of the health sector to make all health services more effective, accessible and affordable'. The National health strategic Plan (NHSSP 1), guided the first phase of the implementation of the policy objectives which resulted in downward trend of various key indicators and as a result stagnation of expected impact. The National Health Sector Strategic Plan II (2005 2010) was developed to address the reversing trend in key health indicators.
The KHPF was designed to end in 2010 and as a result the process of developing a policy framework in line with various changes that have taken place including the new constitution has been initiated within the health ministries. Various changes have taken place that include the development of the MDGs to which Kenya signed up to, the vision 2030 which is Kenya's long term vision strategy, shift to increased focus on scaling up universal access to cost effective interventions addressing key causes of ill health and death such as HIV, Malaria, TB, Immunization amongst others, addressing underlying determinants of health and strengthening the stewardship functions of both health ministries.
Additionally, the Kenya's health sector is also inadequately regulated. The Report on the Review of the Health Act is yet to be implemented, the implications of the new constitution in the health sector is also yet to be formulated and implemented. The existing regulatory agencies and medical professional associations do not also have adequate resources to enforce regulations.
Thirdly, the Ministry of Health constituted a Task Force composed of various stakeholders that embarked on the development of a Health Care Financing strategy in 2007. The task force focused on developing a long-term, fiscally sustainable, equitable and efficient approach to financing health services in Kenya. The lack of consensus among the various key stakeholders including GoK and other private sector in the development of the strategy has necessitated the government to respond with ad hoc financing arrangements prompting resistance from key stakeholders. The health sector therefore continues to be heavily dependent on Donors especially in key areas such as HIV/AIDS where donors account for 70% of total funding, Malaria, and Immunizations. A review of health sector financing for the next three years shows that donor funds are flattening posing a major challenge to the government in regard to financing the anticipated gap. The HCF strategy will attempt to develop innovative ways of financing health within the country's macro-economic framework.
In June 2010, USAID/Kenya carried out a health systems assessment which identified limited participation of the mainstream civil society organizations in the development of health policies and the planning process within the health sector. Sector policy development and planning was found to be mainly dominated by Ministry officials. The private sector and mainstream civil society organizations including citizens, communities, NGO's and the media have not claimed space to establish representation in the existing mechanisms and forums for developing the sector's plans and policies.
Key activities
USAID/Kenya through this mechanism proposes to support the review and harmonization of health legislations so that they are consistent with the new constitution and vision 2030 as well as continue supporting the regulatory bodies.
The mechanism will also support the review and development of the Kenya Health Policy Framework 2011 2030 in line with the new constitution. This will be done by providing various policy options for various stakeholders on review, development of the policy framework and development of a popular version for dissemination.
Under Health care financing, USAID/K will support the development of a comprehensive Health Care Financing Strategy (HCF) which will include innovative approaches in financing health care. The support for the development of the strategy will seek to address three key areas of health finance:
Mobilization of funds for health and reviewing the roles of the current key players - government, private sector and NHIF.
Enhancing efficiency in payment of services
Increasing product scope and quality by determining the roles of both private and public sector as well as engaging stakeholders in a consultative process to build consensus on the revised HCF strategy. The consultations will gauge stakeholders' views and acceptability on various health care financing options.
USAID/Kenya will support the development of a strategy for engaging the private sector; this involves sharing the health sector problems with the private sector both for profit and non profit and exploring opportunities for collaboration to increase private sector participation in the overall health sector.
Linkages to the Partnership Framework/GHI principles
This mechanism will contribute to the following principles:
Through the support of the development of country health policy frameworks and HCF strategy, it will increase impact through strategic coordination and integration by enhancing equity and increasing programmatic efficiency and effectiveness in turn this will impact positively on the overall health outcomes.
The principle of encouraging country ownership and investing in country-led plans by supporting and strengthening health policy, financing and private sector policy framework that will guide overall implementation in the sector.
Through the development of a strategy for private sector engagement, the mechanism will strengthen global health partnerships and private sector engagement.
It will also build sustainability by strengthening government stewardship.
Geographic coverage and target populations
The scope of the program is national and will target the total country's population.
Key contributions to health system strengthening
The focus of this mechanism is in systems strengthening on policy, health financing and private sector engagement and is expected to strengthen stewardship of the GoK in this three key health systems components.
Efficiency, Effectiveness, Equity and Sustainability
This mechanism is expected to enhance stewardship within the health ministries. The developed strategies will enhance efficiency within the sector in regard to policy development. The health care financing options will enhance equity, transparency, accountability, sustainability and overall quality of health services in the sector.
Monitoring and Evaluation plans
The USAID policies and guidelines will be applied in the monitoring and evaluation of the project. The mechanism will develop work plans with key process activity indicators that will include reports both narratives and financial, field visits, meetings, and regular updates on review workshops. Other Key monitoring and evaluation indicators will be developed. The expected key milestones/outputs will be;
Health Policy Framework that was developed through a very intensive consultative process.
Health Care Finance strategy (HCF) developed through also a very intensive consultative process with all the key stakeholders
Refined planning manuals compatible with the county planning and budgeting cycle Refined
Public Private Partnerships Strategy
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