Increasing health insurance coverage is critical to Kenya achieving universal health coverage (UHC) and reducing financial barriers to accessing healthcare and catastrophic out-of-pocket payments, which expose families to poverty and undermine savings for economic development. To achieve UHC, the Kenyan government is taking a multi-pronged approach, including replacing its National Health Insurance Fund with three new mechanisms: a social health insurance scheme and two funds, one to cover primary healthcare and one focused on chronic diseases.

PROPEL Health is supporting these sweeping health sector reforms in multiple ways. The project is working with the government to develop critical evidence to inform the regulations required to implement Kenya’s social health insurance bills, which were enacted into law in mid-October. PROPEL Health also assisted the Kenyan government to establish comprehensive costs for primary health services provided at its public health facilities to inform the structure and cost of its new Primary Healthcare Fund. In coordination with the Ministry of Health and the Office of the President, PROPEL Health developed a roadmap to guide a costing exercise and provided financial and technical support to convene Kenya’s Costing Technical Working Group, which developed process maps and completed the costing exercise. The results of the exercise are being used to inform strategic purchasing decisions and determine the costs of primary healthcare services and Kenya’s essential benefits package for UHC.

A statement issued by the Ministry of Health and shared via national news outlets, asserted that the new social health insurance scheme and UHC launch, “places a significant emphasis on the central role of primary health care in achieving UHC, particularly focusing on promotive and preventative services, as well as community-centered care.” The overall effort represents an important milestone as the country seeks to extend financial protections and advance universal health coverage. The adoption of social health insurance alone is expected to expand health insurance coverage from 20 percent of the population in fiscal year 2018/19, to 80 percent in 2025, and 100 percent in 2035, per the Ministry of Health’s 2020-2030 Universal Health Coverage Policy.