This report presents Kenya’s Reproductive Maternal Neonatal Child and Adolescent Health (RMNCAH) Investment Framework for Kenya to realize the Vision 2030, the Constitution of 2010 and the Health Sector Strategic and Investment Plan 2014-18 and Sustainable Development Goals (SDGs).
Kenya has made remarkable progress in improving RMNCAH outcomes during the last decade. Child mortality has declined by over 20 percent since 2008 and the country achieved a total fertility rate (TFR) of less than four. Stunting, which remained stubbornly high over the past two decades, has started to decline. Six out of ten pregnant women now receive skilled care at childbirth and over half get postnatal care. However, in Kenya today, many women, neonates, children, and adolescents continue to suffer or die from conditions, which are preventable or treatable. Access to quality RMNCAH services still remains a challenge across all levels of care, while geographic, population sub-groups, and economic inequities persist due to supply and demand side barriers.
Improving coverage for RMNCAH services is a priority for the Government of Kenya. The Government has introduced new policies such as Free Maternity Services and Elimination of User Fee for Primary Care to address critical barriers and the First Lady is spearheading the nation- wide Beyond Zero campaign to ensure that no woman should die while giving life. Globally, there is renewed momentum and support for RMNCAH with the updated strategy for Women’s Children’s and Adolescent’s Health and the establishment of new partnerships and funding streams for acceleration such as the Global Financing Facility (GFF). Growing national and international commitments provide an opportune time to enhance both domestic and external support for RMNCAH in Kenya to ensure smart, scaled-up, and sustained financing with focus on results.
Kenya has introduced an ambitious devolution initiative, which could help to address the major demand and supply side challenges. With devolution, national and county levels now have clear roles and responsibilities. This national RMNCAH Investment Framework is relevant to all 47 counties and will serve as a guide for the development and implementation of county RMNCAH implementation plans, which will be an integral part of County Integrated Development Plans and aligned with the County Health Strategic and Investment Plans. Each county can use the framework to inform county implementation plans that specifically focus on how to improve services relevant for that county context.
Sustained and additional health care financing will be central to the success of this RMNCAH Investment Framework. Towards this, the Ministry of Health (MOH) is developing a roadmap for Universal Health Coverage and a health financing strategy that will seek to mobilize additional domestic resources and align support from development partners. Given the limited fiscal space, this investment framework recognizes that coverage and quality improvements will, to a large extent, depend initially on increased productivity and efficiency gains.