MOU with Government
Kenya Government and Faith Based Health Service Providers sign MOU
A Memorandum of Understanding (MoU) to guide public-private-partnership has been signed between Government of Kenya and Faith Based Health Service providers represented by Christian Health Association of Kenya (CHAK), Kenya Episcopal Conference of the Catholic Church (KEC) and Supreme Council of Kenya Muslims (SUPKEM).
The historic signing ceremony was held at Afya House (MOH Headquarters) in Nairobi on July 9, 2009, and attended by religious leaders from CHAK, KEC and SUPKEM. The Government side was led by Prof. James Ole Kiyiapi, Permanent Secretary in the Ministry of Medical Services.
The signing of this partnership framework, marked the end of a long journey towards strengthening partnership and collaboration between Government and FBOs involved in health service delivery in Kenya. The journey started in July 2004.
Finalisation of the MOU
Religious leaders who signed the MoU include His Eminence John Cardinal Njue – Chairman of KEC, Rt. Rev. Michael Sande – Chairman of CHAK, Prof. Abdul-Ghafur El-Busaidy – Chairman of SUPKEM, Very Rev. Fr Vincent Wambugu – Secretary General of KEC, Dr Samuel Mwenda – General Secretary of CHAK and Abdulatiff Shaban – Director General of SUPKEM. Other leaders present to witness the occasion were Rt. Rev. Philip Sulumeti – Chairman of MEDS, Dr Robert Ayisi – Executive Secretary of Catholic Health Commission and Jonathan Kiliko from MEDS.
The Government delegation also included Dr Martin Awori – Government Medico-Legal Advisor, Dr David Kiima – Chairman of the MOH-FBHS-TWG, Elkana Onguti – Head of Planning Department, Chris Rakuom – Chief Nursing Officer and the Deputy Director of Medical Services.
Religious leaders from the three organizations who spoke on behalf of the Faith Based Health Services providers thanked the Government for facilitating the finalization of the MoU. They expressed their optimism that the formalized partnership framework would enhance engagement and collaboration with Government towards sustaining and scaling up quality health service delivery in Kenya.
HE Cardinal Njue said that the Church had a long-term commitment to serving the people of Kenya and therefore valued collaboration and support from Government. Dr Samuel Mwenda, the General Secretary of CHAK who has also served as the Secretary of the MOH-FBHS-TWG gave an overview of the journey the country had travelled to arrive at the MoU's development, consensus building and finalization.
The journey towards an MOU
The journey begun with meetings of church leaders from CHAK, KEC and MEDS held in July 2004 and February 2006 with the Minister for Health where the decision to develop a formal partnership framework was made. The Partnership Technical Working Group of Government and Faith Based Health Services providers named MOH-FBHS-TWG was established under the leadership of the Director of Medical Services and CHAK appointed as its Secretariat.
The TWG undertook an elaborate process of generating an evidence base to support the MoU's development following which it also facilitated a consultative consensus building process with key stakeholders. A comprehensive situational analysis study of the Faith Based Health Services vis-à-vis Government health services was conducted in 2007 covering all Government and Mission Hospitals in Kenya and all FBO and GoK health facilities in 11 districts that were randomly sampled from each of 7 provinces. This generated a study report with updated information on the prevailing status and potential of the Faith Based Health Services and the challenges they were facing.
A study tour was conducted by a joint team of MOH, FBOs and NGOs to five African countries in November 2007 to obtain lessons on public-private-partnerships from Ghana, Uganda, Tanzania, Malawi and Zambia. Consensus for the MoU was obtained at the National Church Leaders Health Partnership Forum held on July 30-31, 2008, and the MOH-FBHS-TWG Retreat held on October 12-14, 2008.
Prof Ole Kiyiapi expressed appreciation on behalf of Government for the important contribution FBOs were making in health and education. He acknowledged that FBO health facilities were the only source of health services in some remote parts of the country and observed that the MoU would create a formalized framework to strengthen collaboration between Government and Faith Based Health Service providers. He further indicated the Government's commitment to increase support to FBO health facilities in order to increase service coverage and improve access through affordable service pricing. He stressed that future support to Faith Based Health facilities would be provided within the framework of the MoU with FBO secretariats playing a key role in support allocation.
Categories of partnership
The framework has defined three categories of partnership with varied levels of support and subsequent variation in the level of Government involvement in the health facility governance structure. All Faith Based Health facilities should participate in the joint annual health sector planning and M&E. In order to qualify to be a part of this MoU, all FBO health facilities must be registered with the Medical Board to ensure that they meet the basic legal and quality standards and should be affiliated to CHAK, KEC or SUPKEM.
A criteria defined in the MoU would be applied in determining the classification of each FBO health facility according to the level of support; minimum support, partial support and maximum support. The Church or Mosque that owns the health facility should also accept to be bound by the conditions of the MoU. Financial accountability would be maintained and regular reports submitted through the secretariats. Human resource support through secondment of health workers would be better structured and managed. An effective and accountable Governance structure would be maintained in all health facilities.
The MOH-FBHS-TWG is mandated to coordinate and provide oversight to the implementation of the MoU. This new mandate and terms of reference are enshrined in the MoU. An M&E framework has also been elaborated to guide monitoring and evaluation of the partnership implementation.