The Costs and Financing Needs of Delivering Kenya’s Primary Health Care Service Package

The Costs and Financing Needs of Delivering Kenya’s Primary Health Care Service Package

By: Agatha Olago, Christian Suharlim, Salim Hussein, David Njuguna, Stephen Macharia, Rodrigo Muñoz, Marjorie Opuni, Hector Castro, Clarisse Uzamukunda, Damian Walker, Sarah Birse, Elizabeth Wangia, Colin Gilmartin

Publication: Frontiers in Public Health; 12 October 2023. DOI: 10.3389/fpubh.2023.1226145


For many Kenyans, high-quality primary health care (PHC) services remain unavailable, inaccessible, or unaffordable. To address these challenges, the Government of Kenya has committed to strengthening the country’s PHC system by introducing a comprehensive package of PHC services and promoting the efficient use of existing resources through its primary care network approach. The authors of the study estimated the costs of delivering PHC services in public sector facilities in seven sub-counties, comparing actual costs to normative costs of delivering Kenya’s PHC package and determining the corresponding financial resource gap to achieving universal coverage.

The authors collected primary data from a sample of 71 facilities, including dispensaries, health centers, and sub-county hospitals. Data on facility-level recurrent costs were collected retrospectively for 1 year (2018-2019) to estimate economic costs from the public sector perspective. Total actual costs from the sampled facilities were extrapolated using service utilization data from the Kenya Health Information System for the universe of facilities to obtain sub-county and national PHC cost estimates. Normative costs were estimated based on standard treatment protocols and the populations in need of PHC in each sub-county. (Related project: PHC Costing, Analysis, and Planning (PHC-CAP) Tool)