Preliminary evaluation of the WHO Special Programme on Primary Health Care: Kenya case study

EVALUATIONOFFICE MAY2024 PreliminaryevaluationoftheWHOSpecialProgrammeonPrimaryHealthCare KenyaCaseStudy Credit:WHO/BillyMiaron WHO/DGO/EVL/2024.6 ©WorldHealthOrganization,2024 Somerightsreserved.ThisworkisavailableundertheCreativeCommonsAtribution-NonCommercial-ShareAlike3.0IGOlicence(CCBY-NC-SA3.0IGO;htps://creativecommons.org/licenses/by-nc-sa/3.0/igo). Underthetermsofthislicence,youmaycopy,redistributeandadapttheworkfornon-commercialpurposes,providedtheworkisappropriatelycited,asindicatedbelow.Inanyuseofthiswork,thereshouldbenosuggestionthattheWHOendorsesanyspecificorganization,productsorservices.TheuseoftheWHOlogoisnotpermited.Ifyouadaptthework,thenyoumustlicenseyourworkunderthesameorequivalentCreativeCommonslicence.Ifyoucreateatranslationofthiswork,youshouldaddthefollowingdisclaimeralongwiththesuggestedcitation:“ThistranslationwasnotcreatedbytheWorldHealthOrganization(WHO).WHOisnotresponsibleforthecontentoraccuracyofthistranslation.TheoriginalEnglisheditionshallbethebindingandauthenticedition”. AnymediationrelatingtodisputesarisingunderthelicenceshallbeconductedinaccordancewiththemediationrulesoftheWorldIntellectualPropertyOrganization(htp://www.wipo.int/amc/en/mediation/rules/). Suggestedcitation.PreliminaryevaluationoftheWHOSpecialProgrammeonPrimaryHealthCare:Kenyacasestudy.Geneva:WorldHealthOrganization;2024.Licence:CCBY-NC-SA3.0IGO. Cataloguing-in-Publication(CIP)data.CIPdataareavailableathtp://iris.who.int. Sales,rightsandlicensing.TopurchaseWHOpublications,seehtps://www.who.int/publications/book-orders.Tosubmitrequestsforcommercialuseandqueriesonrightsandlicensing,seehtps://www.who.int/copyright. Third-partymaterials.Ifyouwishtoreusematerialfromthisworkthatisatributedtoathirdparty,suchastables,figuresorimages,itisyourresponsibilitytodeterminewhetherpermissionisneededforthatreuseandtoobtainpermissionfromthecopyrightholder.Theriskofclaimsresultingfrominfringementofanythird-party-ownedcomponentintheworkrestssolelywiththeuser. Generaldisclaimers.ThedesignationsemployedandthepresentationofthematerialinthispublicationdonotimplytheexpressionofanyopinionwhatsoeveronthepartofWHOconcerningthelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dotedanddashedlinesonmapsrepresentapproximateborderlinesforwhichtheremaynotyetbefullagreement. Thementionofspecificcompaniesorofcertainmanufacturers’productsdoesnotimplythattheyareendorsedorrecommendedbyWHOinpreferencetoothersofasimilarnaturethatarenotmentioned.Errorsandomissionsexcepted,thenamesofproprietaryproductsaredistinguishedbyinitialcapitalleters. AllreasonableprecautionshavebeentakenbyWHOtoverifytheinformationcontainedinthispublication.However,thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswiththereader.InnoeventshallWHObeliablefordamagesarisingfromitsuse.ThispublicationcontainsanindependentevaluationreportbytheWHOEvaluationOffice.ItdoesnotreflecttheviewsorpoliciesofWHO. Contents AbbreviationsandAcronyms 4 1.Purposeofthecasestudy 3 2.Methodsandapproach 3 3.Background 4 4.Keyfindings 11 DesignoftheSP-PHC–Relevanceandcoherence 11 Implementation–EfficiencyandeffectivenessoftheSP-PHC 15 Gender,equityandhumanrightsconsiderations 21 LessonslearnedandbestpracticesinadvancingselectedPHCleversinKenya 22 5.ConclusionsandopportunitiesforfutureSP-PHCsupporttoKenya 25 Annex1:Bibliography 29 Annex2:Discussionguidesforinterviewsandfocusgroups 31 ListoftablesTable1:PerformanceimpactindicatorsofKenya’shealthsystem 5 Table2:Keyhealthfinancingindicators 7 Table3OverviewofSP-PHCsupporttoKenyafrom2020-2023 11 ListoffiguresFigure1:TimelinefordevelopmentofkeynationalPHCpoliciesandstrategies(2) 5 Figure2:Primarycarenetworkmodel(18) 8 Figure3StructureofWHOKenya 10 AbbreviationsandAcronyms CHU communityhealthunit CRVS civilregistrationandvitalstatistics GAP GlobalActionPlan GPW GeneralProgrammeofWork HH households HPA healthpolicyadvisor HRH humanresourcesforhealth KI(I) keyinformant(interview) MoH MinistryofHealth MoI MinistryofInteriorandNationalAdministration PCN primaryhealthcarenetwork PHC primaryhealthcare PHCMFI PHCmeasurementframeworkandindicators SDG SustainableDevelopmentGoal SDG3GAP GlobalActionPlanforHealthyLivesandWell-being SP-PHC SpecialProgrammeonPrimaryHealthCare UHC universalhealthcoverage UHC-CN UHCcommunicableandnoncommunicablediseases UHC-LC UHClifecourse UHC-P UHCpartnership UNAIDS JointUnitedNationsProgrammeonHIV/AIDS UNICEF UnitedNationsChildren’sFund USAID UnitedStatesAgencyforInternationalDevelopment VSP vitalsignsprofile WHO WorldHealthOrganization 1.Purposeofthecasestudy Threecountrycasestudies(inChile,KenyaandTajikistan)wereconductedaspartofthepreliminaryevaluationoftheWHOSpecialProgrammeonPrimaryHealthCare(SP-PHC). Theoverallpurposeofthecasestudieswastwofold: 1.togenerateevidencefortheevaluationquestions,includingopportunitiestostrengthentheSP-PHCsupporttocountriesinachievingtheobjec