Experts expect Kenya to raise more local funds for health

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THE recent re-basing of Kenyan economy into a middle-level status means the country should now start to raise more domestic funds for health programmes.

Health experts say the coming years might see a dip in foreign grants in favour of a more sustainable domestic financing.

Donors financed at least 35 per cent of the total health spending in Kenya in 2011, according to the National Health Accounts that year.

The foreign donors, who include Global Fund, finance almost 90 per cent of drug costs for diseases like HIV, Malaria and TB.

According to Dr Carole Presern, the director of the Partnership for Maternal, Newborn & Child Health (PMNCH), developing countries must now prioritise domestic investment in health.

Dr Presern said most low income countries are soon going to be middle economies. “Even under the worst scenario we’ll only have 13 low income countries in 15 years and there’s a lot of resources in Africa and elsewhere for domestic financing,” she said. “Ultimately the trajectory is international finance will become less relevant in most countries.”

Dr Presern, a midwife and an anthropologist, worked most recently as managing director of the Global Alliance for Vaccine Initiative before joining the Partnership.

Increase of domestic resources for health programmes is noted as key for countries to achieve the Millennium Development Goals, which expire next year.

Kenya is not expected to achieve Goal 4 and Five on reducing child mortality and maternal mortality respectively by next year.

The two are, however, among the 17 new goals currently being considered to replace the MDGs.

Dr Presern was speaking to journalists from Africa, China and India after a breakfast meeting hosted by PMNCH in New York on the sidelines of the United Nations General Assembly last week.

She said future international finance is likely to be “very targeted”, aiming at areas that governments avoid due to cultural and religions constraints. “Reproductive and sexual health is a classic example. In some cultures, this is not prioritised and international donors might say, we will fund this issue, and that might put to light an issue like child marriage,” she said.

The PMNCH is an international alliance, started in 2005, uniting different partners to improve the health of women and children around the world. It is chaired by Graca Machel and hosted by the World Health Organisation in Geneva.

Dr Presern mentioned India as one developing country that is successfully raising domestic resources for health. India has also identified priority areas where donors are encouraged to invest in.

“If you go to India and I have, the Indian government will say these are our priorities and if you do not want, you go away. But of course some countries do not have the luxury to say this,” she said.

During the UN general assembly, President Uhuru Kenyatta also urged African countries to explore ways to raise domestic resources.

“We have depended on external help for health services, but we have to mobilise domestic resources to find our own solution instead of moving from one crisis to another,” President Uhuru said.

He made the keynote address at an event called “Domestic Financing for Health: Invest to Save.”

President Uhuru said Kenya is making plans raise local funds. He said the fruits of Africa’s economic growth would only be beneficial if proper investments were channelled towards health.

However, Kenya’s health spending still remains a paltry six per cent of the entire national budget, against the 15 per cent that the country commits itself to.

Lawrence Summers, professor and President Emeritus at Harvard University, who now chairs the Lancet Commission on Investing in Health,, was a panelist at the event.

He said: “Governments in low and middle income countries must invest in health. Just one percent of their economic growth over the next two decades would fund the grand convergence. The global community must support poorer countries and spearhead the search for new technologies.”

Earlier in the day, Dr Presern also advised countries to consider implementing the Global Framework On Women and Children’s Health, which gives innovative packages of interventions.

The Framework estimates that increasing health expenditure by just Sh490 (US$ 5) per person every year up to 2035 in 74 high-burden countries could yield up to nine times that value in economic and social benefits.

The framework draws on the work of the Study Group for the Global Investment Framework for Women’s Children’s Health, coordinated by PMNCH and the WHO.

“It also says things like investments in HIV, TB and Malaria. It also mentions progress on contraception. There’s also an epidemic of child marriages. It’s an epidemic because it’s children bearing children,” Dr Presern said.

She further called for increased training of midwives. “I used to be a midwife so I am always struck how little investment there is in people we need to run the system.”

The framework says returns from such investments include greater gross domestic product growth through improved productivity, and prevention of the deaths of 147 million children, 32 million stillbirths, and 5 million women by 2035.

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