The document summarizes Kenya's process of engaging the private sector in public-private partnerships (PPPs) for healthcare over the past decade. It outlines a 4-step process: 1) assessing the private health sector, 2) holding public-private dialogues to develop a shared vision, 3) reaching agreements on a PPP framework and roadmap, and 4) taking actions to implement PPPs. Key achievements include institutionalizing ongoing dialogue, growing political support, and establishing a PPP unit in the Ministries of Health. Moving forward, priorities are creating an enabling environment for PPPs through policies and guidelines, strengthening ministry capacity to manage PPPs, and implementing initial partnership projects.

1. The PPP Journey in Kenya:
Past, Current and Future Opportunities
East Africa Healthcare Federation Conference
PITCHBOOK May 2012

2. Presentation Overview
 Engagement Process
 PPP-Health Kenya’s contribution
 Challenge
 Achievements
 Moving foward

3. Engagement Process in Kenya
Step 4. Take actions to implement PPPs together
Step 3. Agree on PPPs to carry out together
Step 2. Dialogue to create shared vision and identify
potential areas of collaboration
Step 1. Assess private health sector and policy environment

4. Step One: Private Sector Assessment
onducted 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”

5. 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

6. Step Two: Policy Dialogue
Meetings are critical because they…..
 Ensure balanced and equal representation
 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)

7. Step Three: Reach Agreement
haped vision on PPPs
Public and private sectors working
together to ensure improved access to
quality health care for all Kenyans”
avaisha Declaration, 2009

8. Step Three: Reach Agreement
n PPP Road Map
PPP Framework Proposed Prioritizations
 Institutionalize the PPP HK into a formal entity
P1 - Policy dialogue
representing key groups in all policy health forums
to engage the private
 Strengthen government’s stewardship capacity to
sector
engage and interact with the private sector
 Accelerate the review of the National Health Policy
P2 - Policy reforms to
framework to integrate a PPP perspective
create an enabling
 Review, harmonize and consolidate key Health Acts
environment for PPPs
 Establish a PPP Framework to guide PPP initiatives
P3 - Partnerships to
improve availability and  Analyze the healthcare gaps to id 2 to 3 PPPs
accessibility of  Integrate private sector into NHIF pilots in financing
healthcare out-patient services and introduce low-cost
insurance products

9. Step 3: Reach Agreements
On Leadership and Process
Mandate:
 A public-private initiative bringing
together health state and non-state Membership:
actors to foster dialogue on key
and emerging issues linked to MOMS
health PPPs MOPHS
Rules of engagement: MOF
 Common purpose
 Shared leadership and decision-
making
 Balanced representation KHF Catholic Secretariat
KEPSA CHAK
 Accountability to each other
PHP Consortium HENNET
SUPKEM

10. Step Four: Take Action
Actively participated in policy reforms to integrate PPP
perspective
Supporting 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 together
Creating 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

11. The Long and Windy Road to PPPs
Health PPPs

12. 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

13. 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

14. PPP-Health Kenya! Critical Role
 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 !

15. 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!

16. Key Events Shaping Policy Landscape
On-going policy process to engage private sector –
Vision 2030
Prime Ministers' Roundtable, Multi-stakeholder
Forum, Ministerial Stakeholders Forum 2009
Private Sector Assessment – “snap shot”
of private health scope and size Design of
PPP Unit
Naivasha Workshop on PPPs – 1st
ever meeting with both sectors
> > formed PPP Steering Committee Fairview Meeting -
PPP-Health Kenya
Holiday Inn Meeting - Building
2009 a Roadmap for PPPs
Sarova Meeting - Mapping
2008 a Consultative Process
YR?

17. Thank You