The countdown partnerships in Kenya is led by African Population and Health Research Center (APHRC) and the Kenya Medical Research Institute - Wellcome Trust Research Programme (KWTRP) as the lead research institution for the Kenya initiative. As the lead institution, KWTRP works closely with the Monitoring and Evaluation division in the Ministry of Health, and is supported by WorldPop at the University of Southampton on geospatial analysis to track RMNCAH+N. The partnership aims to enhance the availability of quality evidence through targeted analysis during national and subnational reviews of overall sector progress, as well as performance review of the country RMNCAH+N plan.
The Kenya Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) Investment Framework and the Kenya Health Sector Strategic Plan (KHSSP) have a strong focus on universal health coverage, which is anchored on primary health care. Both documents envision “a Kenya where there are no preventable deaths of women, newborns or children, and no preventable stillbirths; where every pregnancy is wanted, every birth is celebrated and accounted for and where women, babies, children, and adolescents are free of HIV/AIDS, survive, thrive and reach their full social and economic potential.”
The RMNCAH investment framework is focused on addressing (direct quote):
- Disparities in inequitable coverage, through investments in underserved counties and accelerated action for underserved and marginalized populations;
- Prioritized demand-side barriers to increased utilization, coverage, and affordability of RMNCAH services; and
- Prioritized supply-side bottlenecks in the health system to improve access to high impact interventions delivered efficiently and effectively while ensuring financial protection for the poor. (Page 9)
Implementation of the health sector strategic plan and the RMNCAH investment framework will help Kenya move towards achieving the targets set within the sustainable development goals, particularly on maternal and child health. Some of the targets set within the investment results framework include to increase; skilled deliveries, number of antenatal visits, full immunization coverage, contraceptive use by currently married women, and the percentage of pregnant women tested for HIV who receive results and post-test counseling among other indicators. It also targets reductions in stunting, teenage pregnancy and neonatal mortality.
Outputs, Products, Programs
Achievements for 2020-2022
The Kenya country collaboration undertook several projects during the period 2020 to 2022 and these have been summarized in the data uptake series brief.
The collaboration contributed to the following key areas during 2020-2022:
- Mid-Term Review (MTR) of the health sector strategic plan: The review relied on the DHIS2 and recent surveys as the main sources of data. The review was guided by the health sector’s monitoring and evaluation plan which outlines key indicators for the sector strategy with universal health care as the anchorage. The review focused on national and county progress; it was not feasible to do sub-county-level analyses which was also needed by Counties.
- County-level PHC Performance Initiative (PHC-PI) scorecards: This leverages the work conducted in collaboration with the Primary Healthcare Performance Initiative to develop county vital signs profiles (CVSPs). A process of review and updating the PHC performance was carried out using coverage data.
- Annual reviews report to contribute to the endline review report for RMNCAH+N: These reviews relied on the DHIS2 and the Demographic and Health Survey data, and focused on national and county progress, as well as sub-county level analyses.
- Policy briefs were developed on key areas of interest to the health sector; cancer, essential medicines, health governance, human resources, maternal newborn health, medical equipment and tuberculosis.
- Through the collaboration, Kenya participated in the Urban Health Project ; a study on maternal, newborn and child health in large cities in sub-Saharan Africa to understand the levels, trends, and inequalities in maternal, newborn and child health in major cities in sub-Saharan Africa, specifically Nairobi Kenya. This study aims to provide a comprehensive picture of levels and trends of risk factors, access, coverage and quality of health services of urban dwellers, comparing the poor and non- poor urban dwellers.
- The Kenyan collaboration team participated in and completed analysis for Countdown annual meetings in 2022 and 2023.
Planned Research for 2023-2025
- An end term review of the sector strategy has been planned to take stock of achievements during its implementation. This will adopt a scaled down approach consisting of an in-depth statistical review of the data as well as contextual review of the health system. The countdown partnership will support the statistical review process.
- Given the stagnation of impact indicators, gaps in quality of care are implied. A quality-of-care (QOC) survey is planned to investigate this; Through the partnership, some additional analysis of the QOC survey data will be done to assess equity in quality of services for Reproductive, Maternal, Newborn, Child and Adolescent Health.
- The partnership is supporting a Ministry of Health team member, Rose Muthee, as a Countdown fellow for the capacity strengthening fellowship program in 2023.