The World Bank has approved a $41 million (Sh3.5 billion) grant to go towards devolution of health services, which is at the centre of a raging dispute between the government, governors and medical workers. The money will also support other reforms in the sector aimed at taking health services closer to the people in order to meet universal health goals. " Kenya has been implementing extensive reforms in its health sector. The new funds will be used to help manage these changes and to ensure that poor people benefit from the reforms," a statement from the bank said. World Bank Country Director for Kenya Diarietou Gaye said reforms should ensure decent health services for all citizens. Kenya has also received another $20 million (Sh1.7 billion) from the Health Results Innovation Trust Fund to roll out incentives for better services in health centres. Under the initiative, health facilities will be paid based on the standards of health and nutrition services provided. "The project will scale up an approach known as Results-Based Financing which pays frontline health facilities based on the quality and quantity of services they provide," read the World Bank statement. The programme was first piloted in Samburu and will be extended to 20 other counties for three years. The United Kingdom and Norway are key sponsors of the programme. The pay-for-performance approach led to increased demand for health services in countries like Honduras and Mexico where it is practised. "As Kenya's counties adjust to the decentralised way of working, the project will build their capacity to identify and manage key priorities," World Bank lead health specialist Ramana Gandham said. Doctors staged a two-week strike last month agitating for the shelving of decentralisation of health services until a new law is enacted binding counties to standard remuneration and other terms of service. Paralysed The strike paralysed health services with newborns among those who died for lack of appropriate attention. The government promised to present a Bill in Parliament by next month to guide devolution of health services. The medics resumed duty in a face-saving gesture after a court ruled that devolution could not be pushed back because it was a requirement of the Constitution. A case seeking to have the referral hospital structure remain intact is pending at the High Court . Achieving universal healthcare in Kenya is a big challenge because most individual and family health budgets are met off-pocket with only three million of the 40 million plus Kenyans under the National Health Insurance Fund . This means that people forego medical consultation and treatment for lack of money. The result-based financing scheme seeks to help the poor by easing out of pocket health expenses through insurance subsidy which the programme will offer.
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