Mapping and tracking the complexity of financial flows through non-state non-profit (faith-based) health providers in Kenya

Kingangi, Lucy

Mapping and tracking the complexity of financial flows through non-state non-profit (faith-based) health providers in Kenya

Master Thesis

2018

Publisher

University of Cape Town

Department

Health Policy and Systems Division

Faculty

Faculty of Health Sciences

Abstract

In strengthening health systems, the World Health Report 2000 indicates that health system improvement strategies must also cover private (for-profit and non-profit) health care provision and financing if progress towards Universal Health Coverage is to be achieved. Yet very little is known about the financing of non-profit providers in Africa - especially not faith-based health providers, who have often historically remained elusive in terms of financial transparency. This thesis reports on a multiple case study conducted with two non-profit faith-based health providers in Kenya, namely the Africa Inland Church Kijabe Hospital; and Nyumbani-Children of God Relief Institute in Nairobi (Nyumbani) - and situates these within the broader context of health systems financing and public-private partnership in Kenya. Data was collected from multiples sources including: secondary literature; secondary analysis of existing data (such as the Kenya Health Information System); financial data on projects and annual reports; routine facility and service data; previous research on both organizations; archival data; and supplemented by 6 in-depth interviews with key stakeholders. The study reveals a highly complex funding environment for non-profit (and faith-based) health providers in Kenya, which is a result of historic health system configurations, and current funding policy and focus (such as the influx of HIV-related funding). The HIV program in AIC Kijabe Hospital is solely funded by USAID; while Nyumbani is also funded by USAID (70%), but has other private sources. In both cases, funding from various sources is structured differently with varied financial flows and requirements. Faith-based health providers in Kenya are highly dependent on complex donor-funding arrangements, and lack financial resilience as a result. Donors need to better understand the nuance of engagement with such providers.