Research

This study is examining the level and determinants of the efficiency of county health systems in Kenya and explore the potential for efficiency gains. The study uses quantitative frontier methods to measure the level of technical efficiency of the 47 county governments in Kenya, and regression methods to examine determinants of efficiency. The study is using qualitative case study methods to understand the mechanisms by which a range of determinants (public finance management, human resources for health management, coordination, and corruption) influence health system efficiency. This project is funded by Wellcome Trust, FCDO, ESRC, and MRC under the Health Systems Research Initiative (HSRI) track.

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HERU is a core partner of the International Decision Support Initiative network (IDSI) , which aims to enhance the use of evidence to set healthcare priorities. Our IDSI work focuses on 1) generating evidence, 2) developing capacity, and 3) engaging policy makes to develop an institutionalized, evidence informed, transparent and systematic process for healthcare priority setting in Kenya, and the broader African Region. Under this work, we provided technical support to the Health Benefits Advisory Panel (HBAP) of the Kenyan MOH to develop a UHC health benefit package, and are supporting the Kenyan Ministry of Health to develop a framework and strategy to institutionalized health technology assessment in the Kenyan health sector. In collaboration with IDSI partners, work under this project includes capacity development and advocacy for HTA in Kenya and the broader African region, the development of process and methods infrastructure for HTA, HTA pilots to test the feasibility of the use of HTA in decision making, and conducting research to assess priority setting practices in the health sector. This work is funded by a Bill and Melinda Gates Foundation (BGMF).

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In partnership with, THINKWELL this is a BGMF funded project that aims to evaluate the impact of the Linda Mama free maternity programme in Kenya and conduct a process evaluation to examine the implementation experience of the programme. The study uses participatory action research approaches to co-produce research questions with policy makers and create feedback loops to implementers aimed at improving the programme’s implementations over multiple iterations of data collection, analysis, and feedback. Our work under this project has also included the assessment of public healthcare financing in Kenya, and the impact of COVID-19 on health financing reforms for UHC

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HERU is a technical partner for Strategic Purchasing Africa Resource Center (SPARC) , an initiative to strengthen strategic purchasing expertise and support to governments in sub-Saharan Africa. Under SPARC we have documented strategic purchasing reforms in Kenya and assessed progress on these reforms. We have reviewed literature on how(if) performance-based financing promotes strategic purchasing across Africa. As part of SPARC we will generate evidence on strategic purchasing in Kenya and across the African region and engage with decision makers at different levels on ways to improve strategic purchasing, leveraging evidence.

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This work is funded by a Wellcome Trust Fellowship and aims to explore informal payments (petty corruption) for healthcare services in Kenya and their effect on equitable access. Specifically, the study will investigate the level of informal healthcare payments in the Kenyan health system, examine demand and supply side factors associated with informal payments for healthcare in public health facilities in Kenya, and explore how gender and geographical location intersect with poverty to influence informal payments for healthcare in Kenya.

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This study aims to examine the implementation and effects of performance - based financing in the Kenyan health system. Specifically, the study will 1) examine the influence of context on the emergence, design, introduction, and implementation of performance based financing (PBF) in Kenya, 2) examine implementation fidelity and the factors (and how) that influence differences between PBF design and implementation at the national, county, and health facility level 3) examine the perceptions of national, county, and facility level stakeholders on the intended and unintended effects of PBF on the Kenyan health system, and 4) examine the changes over time of the PBF programme performance indicators.

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This study aims to estimate the economic burden of hypertension to households, and explore the experiences, pathways to care and coping strategies for patients with hypertension in Kenya.

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This study aims to elicit the preferences of NHIF members for the attributes of outpatient healthcare providers in Kenya and consider how these might inform provider identification and contractual arrangements to improve access, equity and quality of services.

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This project aims to assess

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This project is funded by the Global Alliance for Chronic Diseases (GACD) and aims to inform and support the scale up of a Primary Health Integrated Care model for chronic Conditions (hypertension, diabetes and breast and cervical cancers) in Kenya. The project will 1) examine the implementation process, 2) assess the experiences of patients, 3) assess the health benefits (on hypertension, diabetes and cancer control) and potential unintended consequences (on HIV viral suppression), and 4) evaluate the effectiveness of the NHIF chronic care benefit package in providing financial risk protection to people with hypertension, diabetes, breast and cervical cancers.

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Policy Briefs
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