THE POLITICAL ECONOMY OF HEALTH FINANCING REFORM: CASE OF KENYA

Countries globally committed to achieve universal health coverage (UHC) by 2030, as one of the targets of the Sustainable Development Goals (SDGs). Progress towards UHC requires concerted efforts to strengthen a country's health system, and health financing reforms are a critical part of that process.

Although health financing is an inherently political process, and there is broad consensus and growing literature on the political economy of health financing, there is still limited scholarship on the politics of health financing, and the political economy factors that contribute to the success or failure of health financing reforms, especially in low and middle-income country (LMIC) settings.

Like other countries globally - Kenya committed to achieving universal health coverage (UHC) by 2030, a commitment that saw the government implement a raft of health financing reforms over the years. However, the majority of scholarship on health financing reforms in Kenya has focused on the technical aspects, specifically on resource mobilisation, risk pooling, purchasing, and designing benefits package, often ignoring the important role that politics plays on the success or failure of such policy reforms. In fact, so far, no study exists on the political economy of health financing reforms in Kenya

This research will therefore seek to answer the question: How does politics affect the adoption and implementation of health financing reforms?

To answer this question, this research will follow an empirical approach based on qualitative research design. First, the researcher will conduct systematic review of published and grey literature, then will use Fox and Reich's (2015) theory-based framework (of Stages heuristics of the policy process (agenda setting, design, adoption, and implementation) and the 3I's (variables) Ideas and ideologies, interests, and institutions to organize the analysis. Next, the researcher will conduct between 20-30 key informant interviews with stakeholders drawn from government agencies, civil society, advocacy groups, international organisations, public and private health providers among others.

The findings of this research will contribute to the growing literature on political economy of health financing in LMICs. This research also hopes to make theoretical contribution, by theorising the political dimension (role of interest groups & other actors etc) in health financing reforms in LMICs. Finally, the research will provide empirical evidence of the effects of political variables on health reforms in Kenya and LMICs, providing lessons to policymakers and planners on the theoretical and empirical findings on the politics of health reform in LMICs