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