Project Notice |
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| PNR | 486 |
| Project Name | Development of the health sector |
| Project Detail | Despite strong economic growth and the reform efforts of the Kenyan Government, the country’s health system remains underdeveloped. The Kenyan Demographic and Health Survey of 2008/9 revealed mixed results for some performance-based indicators. Positive national trends are seen in child mortality, contraceptive use, immunisation and the use of mosquito nets. However, HIV prevalence remains unchanged at 6.3 % and there have been no significant gains in maternal health. There are also wide provincial disparities that are masked by improved national statistics. The problems result from weak institutional capacities for providing quality services, as well as persistent inequities in the delivery of services. Financing of the health sector is insufficient and unbalanced, and there are serious systemic weaknesses that hamper management of the supply-chain and support systems. These challenges were exacerbated when the Ministry of Health was split into two separate ministries. The majority of poor Kenyans are excluded from good health care, especially in rural areas where there are few facilities and not many people can afford to use them. The social security system is inadequate and health services are often of poor quality because there is a lack of trained and experienced health workers, and financial resources are insufficient and mismanaged. One area of particular concern was highlighted by the Demographic and Health Survey, which is particularly important for women’s wellbeing: reproductive health care. On average, poorer women become pregnant seven times, and around 80 % of them give birth without any medical supervision. Violence against women is also widespread, involving grave human rights violations with serious consequences for health. Objective Kenya’s poor — especially women and young people — have equal access to good, affordable health care, particularly in the area of reproductive health. Approach The health programme supports the Kenyan Government in carrying out the reform process initiated in 2004. This includes the introduction of a socially equitable financing system, the development and introduction of quality standards, and the mainstreaming of gender equality and human rights principles in the reform process. Ending gender-specific violence is an additional priority area of the programme. The programme operates at several levels. With advice and capacity building for policy makers it is influencing the formation of policies and strategies. This process involves close cooperation with public institutions, non-governmental and church-based organisations and networks, other donors and the private sector. The programme uses both advisory services and financial contributions to support the organisational development of its partner. It also works with private sector networks to encourage private involvement in development partnerships in order to increase diversity, quality and competition in the reforms. Such development partnerships are an important tool for improving the cooperation and coordination of all providers in the health sector. In some poorly resourced areas, GIZ provides advisory and financial inputs to help improve reproductive health services. Individual initiatives are supported with financial grants, while broader planning processes benefit from advisory services. The results and lessons learned from these interventions are fed back into programme activities at the national level. Results achieved so far Health care indicators appear to be improving as a result of the first reforms. For instance, for the first time in ten years the number of women taking advantage of family planning services, pregnancy screening and supervised delivery has increased. The advice provided by the programme has contributed much to the comprehensive process of reforming health financing, and to the ongoing development of a poverty-oriented financial strategy for the health sector. The dialogue between governmental and non-governmental health agencies has improved substantially as a result of the technical and financial support of the programme. At the same time, both sides are now participating in the sector-wide approaches for joint financing, supported by the international donors. Health ministries and non-governmental providers are currently formulating a policy to promote development partnerships with the private sector. The GIZ programme is responsible for coordinating and representing the donors that are involved in health financing, reproductive health and the private sector development partnerships. The cooperation between the donors has improved considerably. The programme did much to alleviate the effects of violence perpetrated against women during the post-election unrest in December 2007. Several thousand women and children were raped and physically abused at that time. Using development cooperation funds, medical treatment has been given to more than 1,700 poor women and children since the beginning of 2007, while 180,000 women and children benefited from psychosocial support to help them cope with their traumatic experiences. An array of youth-oriented health services has been established with programme support, and human rights principles and gender-equality are now firmly embedded in important national policies and strategies. In the regions where the programme is active, the incidence of female genital mutilation has fallen significantly. |
| Funded By | Other Funding Agencies |
| Sector | Health & Medical |
| Country | Ghana , Western Africa |
| Project Value | Plz Refer Document |
Contact Information |
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| Company Name | German Federal Ministry for Economic Cooperation and Development (BMZ) |
| Address | Postfach 12 03 22, 53045 Bonn, Germany, Tel: +49 / 228 / 9 95 35-0, Fax: +49 / 228 / 9 95 35-35 00. |
| Web Site | http://www.bmz.de/ |
