Assessing the Implementation and Effects of Direct Facility Funding in health centres and dispensaries in Kenyan coast

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Information about Assessing the Implementation and Effects of Direct Facility Funding in...

Published on July 28, 2009

Author: CREHS

Source: slideshare.net

Assessing the Implementation and Effects of Direct Facility Funding in health centres and dispensaries in Kenyan coast Antony Opwora, Margaret Kabare, Sassy Molyneux & Catherine GoodmanKEMRI/Wellcome Trust 1

Background Kenyan government reduced user fees in 2004 Concerns that the policy reduced facility level funds and health facility committee (HFC) activities Direct funding for facilities (DFF) piloted in Coast Province since 2005 with DANIDA funds, plans for nationwide rollout Funds transferred directly into facility accounts, and can cover operations and maintenance, refurbishment, casual staff, allowances (not drugs) HFCs prepare work plan of expenditure, approved by district management Communities empowered to monitor funds, eg accounts displayed on public notice boards We evaluated the way DFF was implemented and effects it had at health facility level 2

3 Conceptual Framework

Methodological Challenges No baseline data collected prior to pilot HMIS data incomplete & unreliable Challenges addressed through: Focus quantitative analysis on intermediate and process outcomes outlined in the conceptual framework Qualitative methods to explore perceived impact

Methods – Sampling 2 districtsSampling frameAll MOH health centres and dispensariesSelected All 9 health centres Random sample of 21 dispensaries

2 districts

Sampling frame

All MOH health centres and dispensaries

Selected

All 9 health centres

Random sample of 21 dispensaries

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