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Integrated Service Delivery Case Study: Kenya. Erin E. Sullivan, Ph.D. Global Health Delivery Project Harvard School of Public Health July 16, 2010. Kileken ole-MoiYoi , Erin Sullivan, Nayana Dhavan, George Kimathi, Joseph Rhatigan, Ephantus Kabiru, Rebecca Weintraub. Data Collection.
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Integrated Service Delivery Case Study: Kenya Erin E. Sullivan, Ph.D. Global Health Delivery Project Harvard School of Public Health July 16, 2010
Kileken ole-MoiYoi, Erin Sullivan, Nayana Dhavan, George Kimathi, Joseph Rhatigan, Ephantus Kabiru, Rebecca Weintraub
Data Collection 50 key informants Well-defined roles in the country’s health system Represented: Government of Kenya Kenya-based NGOs Internationally-based NGOs Multilateral organizations Private sector
Kenya: Country Context Population: 38.5 million Life expectancy: 56 for females 53 for males UN Human Development Index: 147 out of 182 GDP per capita: US$ 1,590 (in PPP)
HIV Program Financing Office of the President NACC
Integration Challenges Global Fund model Limited infrastructure to support programs Poor M&E structures Conflicts of interest within the CCM Delays in funding
System-wide Effects Concerns about long-term sustainability Neglect of non-target diseases Parallel systems Human resource challenges
Conclusions Disease programs should improve integration with public health system A relatively strong health system maximizes Global Fund resources Investments in workforce, infrastructure and government capacity ensure sustainability Coordination and alignment between health system stakeholders is needed
Further Research Sustainability and governmental capacity Donor alignment and management
Integration • ‘integration’—a term loosely used to describe a variety of organizational arrangements for a range of programmes in different settings. • we define integration as the extent, pattern, and rate of adoption and eventual assimilation of health interventions into each of the critical functions of a health system which include, (i) governance, (ii) financing, (iii) planning, (iv) service delivery, (v) monitoring and evaluation (M&E), and (vi) demand generation.