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WHO’s Country Connector on Private Sector in Health

From Governance to Stewardship: Helping governments champion and sustain the process of change in fragile health settings

Government engagement is crucial to effective and scalable implementation of health programming in public and private health systems. Yet, too often, organizations fail to harness the potential of these partnerships to ensure the sustainability of critical services.

In many low-resourced settings like Kenya, there is a rapidly growing landscape of health innovations, but few have been sustainably integrated within constrained government health agendas and budgets. Unless governments are made financial and operational stewards of these innovations, they remain short-term, low-impact answers to persistent gaps in their health systems.

The Kuboresha Afya Mitaani (KAM): Urban Maternal Newborn Child Health Project was a three year USAID-funded implementation research project taking place in two Nairobi informal settlements, Kawangware and Mathare, where the maternal mortality rate is almost twice the national average.

This resource, published in the WHO’s Country Connector on Private Sector in Health, offers the following learnings to other implementers:

  1. Multi-stakeholder engagement (early and often) helps identify systemic barriers, and build a collective accountability to action.
  2. Continuous data sharing empowers governments to direct limited resources to priority health system gaps and build a case for investment.
  3. Integrating into annual budget cycles builds government ownership of and support for private sector solutions.
  4. Implementation-based partnerships can drive stronger government stewardship of outcomes.

Kuboresha Afya Mitaani was set up to consider a sustainable transition to government right from the beginning, not simply at the end of the project, as is often the case with donor-funded initiatives.

The ‘early-and-often’ approach to government engagement, development of a multi-stakeholder environment, ‘baking in’ government cost share expectations and support, and setting up of MOUs were all designed for this transition – and the coalition have been pleased to see this come to fruition through the continued buy-in, ownership, and investment from our Nairobi county government partners.

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