PITCHBOOK
The PPP Journey in Kenya:Past, Current and Future Opportunities
East Africa Healthcare Federation Conference May 2012
Engagement Process
PPP-Health Kenya’s contribution
Challenge
Achievements
Moving foward
Presentation Overview
Engagement Process in Kenya
Step 1. Assess private health sector and policy environment
Step 2. Dialogue to create shared vision and identify potential areas of collaboration
Step 3. Agree on PPPs to carry out together
Step 4. Take actions to implement PPPs together
Step One: Private Sector Assessment
Conducted assessment in early 2009 …..
Created better understanding of private health sector (size, scope, activities)
Provided evidence for dialogue process
Measured political will to engage private health sector
Created “focusing event” for stakeholders to meet and start dialogue process
World Bank/IFC and USAID facilitated assessment and engagement process helping play role as “honest broker”
Step Two: Public Private Dialogue
“Piggy-backed” dialogue process on to multiple policy forums on private sector
Vision 2030, NHSSP II, Prime Ministers' Roundtable, Multi-stakeholder Forum, Ministerial Stakeholders Forum
Conducted three high-level meetings in less than 6 months to create momentum
Naivasha Meeting (April, 2009)Holiday Inn Meeting (June, 2009)Sarova Stanley Meeting (September, 2009)
Formed PPP Committee to lead process
PPP Committee held regular, joint debriefings with the both MOHs’ Permanent Secretaries
Step Two: Policy Dialogue
High-level decision-makers from all sectors present
Equal numbers between different sectors involved
All sectors had “space” to express own perspective
Frame issues and creates shared vision of purpose of PPPs
Create a public record of agreements and decisions (Meeting reports, PS debriefings, PPT presentations, public statements, etc)
Meetings are critical because they….. Ensure balanced and equal representation
Step Three: Reach Agreement
Shaped vision on PPPs
“Public and private sectors working together to ensure improved access to quality health care for all Kenyans”
Navaisha Declaration, 2009
Step Three: Reach Agreement
On PPP Road Map
Navaisha Declaration, 2009
PPP Framework Proposed Prioritizations
P1 - Policy dialogue
to engage the private sector
Institutionalize the PPP HK into a formal entity representing key groups in all policy health forums
Strengthen government’s stewardship capacity to engage and interact with the private sector
P2 - Policy reforms to
create an enabling environment for PPPs
Accelerate the review of the National Health Policy framework to integrate a PPP perspective
Review, harmonize and consolidate key Health Acts
P3 - Partnerships to
improve availability and accessibility of healthcare
Establish a PPP Framework to guide PPP initiatives
Analyze the healthcare gaps to id 2 to 3 PPPs
Integrate private sector into NHIF pilots in financing out-patient services and introduce low-cost insurance products
Step 3: Reach Agreements
MOMSMOPHSMOF
Catholic SecretariatCHAKHENNETSUPKEM
KHF KEPSA PHP Consortium
On Leadership and ProcessMandate: A public-private initiative bringing
together health state and non-state actors to foster dialogue on key and emerging issues linked to health PPPs
Rules of engagement: Common purpose Shared leadership and decision-
making Balanced representation Accountability to each other
Membership:
Step Four: Take Action
Actively participated in policy reforms to integrate PPP perspectiveSupporting MOHs’ initiatives to review and update Kenya Health Policy Framework, General Health Law and Health Acts
Monitoring process to ensure private sector participation and timely completion of policy reform process
Implement PPPs togetherCreating inventory of existing PPPs
Building MOH capacity to broker PPPs
Identifying and promoting easy (low hanging fruit) types of PPPs
Coordinating donor initiatives to identify and implement PPPs
The Long and Windy Road to PPPs
Health PPPs
Challenges Facing Engagement Process
Securing high-level support and political commitment from both Ministries
Lack of understanding and/or resistance to PPP concept Maintaining momentum and active participation by all Ensuring balance and consensus between the three sectors Staying focused on PPP priorities and not getting bogged
down in the policy process Identifying PPPs that can be quickly implemented to
demonstrate “quick wins” Donor interference with MOH efforts to work with private
sector Donor support for process disappeared for 18 months
Successes in the Engagement Process
Dialogue process between sectors institutionalized Growing political support for PPPs in health and for
PPP-Health Kenya PPP Unit’s TORs approved and staff assigned from
both ministries Built growing trust and spirit of collaboration between
all sectors Secured active and high-level participation from all
sectors in dialogue process
Mobilized private sector groups to participate in dialogue process
Facilitated regular and frequent communication between sectors (e.g. regular meetings, invitations to each other’s events)
Kept lines of communication open – particularly during difficult moments in process
Dispelled misperceptions about each other, building trust
Encouraged and motivated each other to continue moving forward
Demonstrated to everyone – GoK, other private sector groups, donor partners – that the public and private sector can work together !
PPP-Health Kenya! Critical Role
Moving forward: Unfinished Business
Create enabling environment NHSSP III (include 5 Yr PPP Strategy), PPP Health Policy,
PPP Guidelines Private sector integrated into General Health Law, HCF
Strategy
Strengthen MOH capacity Fully staff and fund PPP Unit Build operating systems Train MOH staff in new skill areas
Strengthen sector-wide capacity to engage Institutional PPP-Health Kenya! Fund PPP-Health Kenya’s activities
Implement PPPs!
On-going policy process to engage private sector – Vision 2030
Key Events Shaping Policy Landscape
Prime Ministers' Roundtable, Multi-stakeholder Forum, Ministerial Stakeholders Forum
Private Sector Assessment – “snap shot” of private health scope and size
YR?2008
2009
Naivasha Workshop on PPPs – 1st ever meeting with both sectors> > formed PPP Steering Committee
Holiday Inn Meeting - Building a Roadmap for PPPs
Sarova Meeting - Mapping a Consultative Process
Fairview Meeting - PPP-Health Kenya
2009
Design of PPP Unit
Thank You
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