Country
Kenya
Kenya_SDHNet_mappingreport_FINALDRAFT.pdf
SDH addressed in the document
The main policy goal has been provision of affordable and quality healthcare to all citizens through ensuring that all sectors deliver on their role in provision of health.
The discussion of Kenya SDH has been amplified through the National Health Policy Framework 2011-2030, (GoK, 2012) which has defined the key health related sectors in which SDH strategies are adoptable. The policy framework identifies the sectors as, economy and employment which is aimed at ensuring work and stable employment opportunities for all people across different socio economic groups; security and justice which deals with fair justice systems, particularly in managing access to food, water, housing, work opportunities, and other determinants of wellbeing; Education and early life with emphasis on support of education attainment of both women and men to promote abilities to address challenges relating to health; agriculture and food with considerations of health in food production, manufacturing, marketing and distribution; nutrition with objective of ensuring adequate nutrition for the whole population, through avoiding and managing over, or under nutrition; infrastructure, planning and transport which give guidelines on optimal planning of health impacts for roads, transport and housing investments, to facilitate efficient movements of people, goods and services relating to health; environments and its sustainability look at the influence of population consumption patterns of natural resources in a manner that minimizes their impact on health; housing with aim of promoting housing designs and infrastructure planning that take into account health and well being; land and culture with the purpose of strengthening access to land, and other culturally important resources by particularly women, and finally population which is targeting to manage population growth and address migrations and its health impact .
| Type of Institution | Institution Name | Institution role |
|---|---|---|
| Government | National Council of Science and Technology |
Research system coordination mechanisms between governing and coordinating institutions
The national oversight on research, science and technological innovation is expected to be mandated to a national institution. Science and technology provide the essential means for facilitating economic, social and cultural transformations at national and global levels. Success of national development policies will often largely depend on the extent of integration of modern science and technology in their implementation. In recognition of the importance of science and technology to national development processes the government of Kenya established National Council of Science and technology. The Council has over the years concentrated support on many scientific research initiatives and development research facilities especially in the country's agriculture and health sectors.
Research system coordination mechanisms between national research institutions and groups researching for SDH and health inequity
Research stakeholders work and pursue their health agenda as single entity with no effort for consolidation for convergence to address the goal of health improvement. No wonder it is in this line that the Ministry of Public Health and Sanitation has been exploring ways of strengthening inter-sectoral collaboration to attain its national goals. The new national health policy framework (2012-2030) clearly spells out the policy directions needed to implement this initiative. It was in this regard that the Ministry of Public Health and Sanitation organized a two days meeting in May 2012 with other government sectors to introduce the SDH concept and to explore possible opportunities for addressing existing health determinants and inequities.
Research system coordination mechanisms to promote partnerships and networks at different levels of the research systems (for sharing of resources collectively - skills, funds, data sharing, information sharing)
Kenya research system that deals with health related issues is spelt through key policy making or disseminating process. In this sub-system key ministries are involved. Example of ministries and organisations that deals with health policy issues includes Ministries of health, Ministry of finance, Ministry of planning and Kenya Institute of Public Policy Research and Analysis (KIPRA).
key national financers and funding: Government Funding
• Central government revenue
• Local/municipal government revenue
• National Social security funds
key international financers and funding: Funding through Bilateral Agreements
• Government of Australia
• Government of Austria
• Government of Belgium
• Government of Canada
• Government of Denmark
• Government of Finland
• Government of France
• Government of Germany
• Government of Greece
• Government of Ireland
• Government of Italy
• Government of Japan
• Government of Luxembourg
• Government of Netherlands
• Government of New Zealand
• Government of Norway
• Government of Portugal
• Government of Spain
• Government of Sweden
• Government of Switzerland
• Government of United Kingdom
• Government of United States
• Government of People's Republic of China
Regional Development Banks
• African Development Bank
• Asia Development Bank
• Latin America Development Bank
• Caribbean Development Bank
• Islamic Development Bank
United Nations Bodies and Agencies
• World Health Organization (WHO)
• Bureau of the Economic and Social Council (ECOSOC)
• Food and Agriculture Organization of the United Nations (FAO)
• International Labour Organization (ILO)
• International Organization for Migration (IOM)
• UNAIDS Secretariat
• United Nations Children's Fund (UNICEF)
• United Nations Development Fund for Women (UNIFEM)
• United Nations Development Programme (UNDP)
• United Nations Educational, Scientific and Cultural Organization (UNESCO)
• United Nations High Commissioner for Refugees (UNHCR)
• United Nations Human Settlements Programme (UN-HABITAT)
• United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA)
• United Nations Office on Drugs and Crime (UNODC)
• United Nations Population Fund (UNFPA)
Regional and multilateral bodies and Foundations
• European Commission
• The Global Fund to Fight AIDS, Tuberculosis and Malaria
• World Bank (WB)
• World Food Programme (WFP)
• International HIV/AIDS Alliance
• Action AID
• Aga Khan Foundation
• Association François-Xavier Bagnoud
• Bernard van Leer Foundation
• Bill and Melinda Gates Foundation
• Bristol-Myers Squibb Foundation
• Care International
• Caritas Internationalis/Catholic Relief Services
• Deutsche Stiftung Weltbevölkerung
• Diana Princess of Wales Memorial Fund
• Elizabeth Glaser Pediatric AIDS Foundation
• European Foundation Centre
• Family Health International
• Foundation Mérieux
• Health Alliance International
• Helen K. and Arthur E. Johnson Foundation
• International Federation of Red Cross and Red Crescent Societies, International
Committee of Red Cross and Red Crescent
• National Red Cross Societies
• King Baudouin Foundation
• Médecins sans Frontières
• Merck & Co., Inc
• Plan International
• Population Services International (PSI)
• SIDACTION
• The Clinton Foundation
• The Ford Foundation
• The Henry J. Kaiser Family Foundation
• The Nuffield Trust
• The Open Society Institute/Soros Foundation
• The Rockefeller Foundation
• United Nations Foundation
• Wellcome Trust
• World Vision
• International Planned Parenthood Federation
• Order of Malta
| Institution Name | Funding source | Amount to health | Amount to health research | Amount to SDH and health inequities | Amount to research in SDH and health inequities |
|---|
| Institution Name | Type of Institution | collaboration level | collaboration type | link to research on SDH |
|---|
| Institution Name | Type of Institution | Strategies considered in the institutional plan | Breakdown of percentage of researchers by specific disciplines | Breakdown of percentage of researchers by level of seniority | Proportion of researchers involved in research on SDH and health inequity | Trainings to build capacity in research in SDH and health inequities specific courses/ programmes |
|---|
Promoting research on SDH and health inequity:
Efforts should be put to enhance community involvement at all levels of planning and implementation for ownership of activities that will help improve health outcomes. An example of the success story of community involvement in Rwanda in environmental conservation was given.
There is need to address the mindset of road users in Kenya to mitigate the morbidity and mortality cases on our highways. Kenyan licensed drivers also need to be tested on their driving skills on a regular basis as a measure of reducing the number of illegal drivers and incidences of accidents due to the increased number of drivers who break driving rules on a daily basis.
There is need to explore the best mechanisms for inter-sectoral collaboration based on the existing evidence in the country on the country's health indicators in relation to various sectors performance factors. More research on the best mechanism was advocated to achieve this goal.
There is a lot being done in the Ministry in relation to social determinants of health but due to weak monitoring and surveillance vital information gets lost within the system. The health sector in collaboration with other sectors needs to use research to enable the development of indicators that can be used to measure progress in SDH in the country.
SDH needs to be mainstreamed into the health workforce by integrating it into the health curriculums of tertiary learning institutions involved in training health officers.
Through the project's support in collaboration with other programs the establishment of an SDH research programme in the School of Public Health, University of Nairobi will be carried out.
Synergy of the SDH activities occurring in the Ministries on Health, University of Nairobi and World Health Organization- Kenya should be carried out. This will maximize on the utilization of existing SDH resources existing in the mentioned institutions.
Attracting partners & resources:
The renaming of the social determinants of health to human well being will make the concept more attractive to the other non-health sectors and this will encourage them to buy in to the idea. It appeared the term social determinant was still a new concept. Majority of the sectors need to be sensitized on the concept. Accountability of our actions as individuals is needed to enhance more safety and well being on the Kenyan population.
Bridging the gap between researchers and policy/decision makers:
There is need for advocacy and capacity building in the policy, planning and budgeting for the purposes of mainstreaming the social determinants of health in all the sectors.
Informing and influencing national priorities and policies:
The contributors to the wellbeing of the Kenyan populations need to debate of the leadership of the social determinants of health implementation agenda. Some of the suggestions tabled were that SDH should be housed at the National Economic and Social Council under the office of the President and the National Environmental Council.
There is need to identify documents that we can work with to strengthen inter-sectoral approach in the management of the social determinants of health e.g. the national annual plans and vision 2030.
There is need for policy direction on the utilization and prioritization of resources directed to the health sector. The role of health sector is to ensure the Kenyan citizens have good health which could be achieved better through increased provision of preventive services yet our budgetary allocations are biased towards curative services. The effects of preventive services need to be documented in order to help in paradigm shift from curative to preventive health care services.
In future a meeting to inform more senior policy maker in government on the social determinants of health and evidence on how these determinants have influenced our health outcomes should be carried out. This then calls for a more vigorous policy oriented research on SDH.
Direct taxation is based on income thus has an element of fairness. Indirect taxation is not fair as both the rich and poor pay the same taxation, but if reduces it will limit incentive to the trade and industry sectors. The most resent increments in fuel prices in the country saw the highest increment go to the taxation of paraffin yet it's the most utilized fuel product by the poorer in society. This was seen as a clear indicator of social injustice. Research needs to be carried out to inform on where this indirect taxes can be applied in a fairer way.
Informing national research agenda:
The research agenda in health needs to look at the actors, needs, capacities, gaps and sustainability issues. It also needs to find mechanisms through which all this issues can be looked at together.
| Institution Name | Type of Institution | Details |
|---|
Key research groups involved in research on SDH and health inequity:
Most of the SDH related research has been conducted by academic institution and other research organizations that has a strong bearing in health research like CDC and KEMRI. This suggests that though a lot of research has been done in health, few have been reported as having concentration on SDH in Kenya.
Key research areas in SDH and health inequity:
Most of the health research relating to SDH have been conducted in the field of economy and employment in Kenya. It is also notable that substantial work has also been done in the areas of agriculture, food and nutrition, environmental and sustainability, and education and lifestyle. Culture as it relates to health has also attracted quite a significant percentage.
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