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TITLE OF PROPOSAL

FOCUS COUNTRIES OF THE RESEARCH
ABSTRACT (350 words)
RESEARCH QUESTION (100 words)
RATIONALE FOR THE COMPARATIVE CROSS-COUNTRY APPROACH (300 words)
DATA AND METHODOLOGY (400 words)
CHALLENGES AND RISK MITIGATION (200 words)
STRATEGIC RELEVANCE FOR THE INSTITUTION (200 words)
COMPOSITION OF THE TEAM (200 words)
DISSEMINATION STRATEGY (200 words)

TITLE OF PROPOSAL

The Road to Universal Health Coverage: A Comparative Study of Kenya and Ghana health
insurance on the poor households.

FOCUS COUNTRIES OF THE RESEARCH
Kenya and Ghana
ABSTRACT (350 words)
The attainment of Universal Health Coverage is anchored under the overall Sustainable
Development Goal on health. Efforts by governments to implement Universal Health Coverage
has been faced with numerous controversies due to allegations of corruption and financial
sustainability. Despite this allegations developing countries continue to make strides in order
provide everyone with affordable access to health services. However, these efforts are usually
made difficult by the fact that the poor and the vulnerable are often excluded or limited in their
ability to access to health services. Furthermore, governments are also faced with inefficient
funds to extend free coverage to these groups. Other challenges include lack of training and
organization, insufficient standards and quality monitoring, and high out-of-pocket expenditures.
To tackle these problems, various donor organizations have funded various governments through
various programs. To tackle the problem high out-of-pocket expenditures among the poor and the
vulnerable, donor organization have introduced various health subsidy programs with an aim of
promoting the attainment of Universal Health Coverage (UHC) for all.

the Health Insurance Subsidy Programme (HISP) for the poor was initiated as a pilot in 2014 among beneficiaries of the Orphans and Vulnerable Children Cash Transfers (CT-OVC). it has morphed into a state corporation with the mandate of providing accessible. It has coverage of 18% of the population. among them. and are therefore ideal candidates. across countries and donors? How does donor aid influence the success of health insurance subsidies for the poor and vulnerable? RATIONALE FOR THE COMPARATIVE CROSS-COUNTRY APPROACH (300 words) The provision of health insurance in Kenya is primarily through the National Health Insurance Fund (NHIF) which was established in 1966 under the Ministry of Health. but was unsustainable. for the same sector? What is the administrative burden of managing aid in a specific sector. As such. However. the corporation faces a big challenge in that the only source of revenue comes from members’ contributions. Over the years. RESEARCH QUESTION (100 words) The main question is the following “What is the impact of health insurance on the marginalized poor households health care in Kenya and Ghana?” The specific questions will be the following. These programmes primarily targets beneficiaries of Cash Transfer Programmes and is based on the correct assumption that these beneficiaries are already selected due to their poverty and vulnerability status. and how? How do recipient countries organize the administration of aid coming from different donors. With many studies focusing on measures of aid effectiveness. As such. as opposed to the 2% coverage by private insurance providers. In Ghana. across a growing range of donors. or why. little literature focuses on the channels. this too had limited success due to various reasons. This then gave rise to the .In Kenya this attempt is attained through. In Ghana. the Africa Health Markets for Equity (AHME) consortium is also running in the country.     Do the way donors implement aid make a difference. However. This inadvertently limits the participation of the country’s majority poor. In a bid to tackle this. user fees were introduced but with vulnerable groups being exempted. affordable. inadequate funding. modalities work and which don’t. the Health Insurance Subsidy Programme (HISP) funded by World Bank Group and the Rockefeller Foundation and through the Africa Health Markets for Equity (AHME) consortium funded by Bill and Melinda Gates Foundation and the UK Department for International Development. the free healthcare model was initially adopted. a similar arrangement is in place whereby beneficiaries of the Livelihood Empowerment Against Poverty beneficiaries are able to access free health insurance in addition. instruments. sustainable and quality social health insurance. it is best suited to deliver UHC in Kenya. This research will seek to fill this gap by examining health insurance subsidy programs and its impact on the poor households in Kenya and Ghana.

The research team respected a set of ethical codes in conducting the fieldwork. A properly designed impact evaluation can answer the question of whether the program is working or not. The qualitative information will focus on the design and implementation of the program for each country which is will provide vital context. to attain universal health coverage and subsequent targeting beneficiaries of cash transfer programs as recipients of the health insurance subsidies in addition. This will be followed by qualitative data collection based on sampling methods which will be used to determine the impact of the health insurance program on the poor households in the Ghana and Kenya. Better still if different data sets and approaches can be used and come to broadly the same conclusion. We want to know why and how a program works. Qualifying employees do not register for the subsidy as members in a timely manner. not just if it does. not only meetings with donors. Evaluation findings are strengthened when several pieces of evidence point in the same direction. and hence assist in decisions. These two countries have been selected for comparative studies due to their similarities in terms of. In order to be able to do this the study will use econometrics. Where a rigorous approach has not been possible then triangulation is all the more necessary to build a case based on plausible association. both countries run AHME consortium. Qualitative information can also reinforce findings and add depth to them. so far. The NHIS receives funding from a budgetary allocation from the Ministry of Finance and the Ministry of Finance resources for exempted persons. The country is also a beneficiary of the AHME consortium which is also running in Kenya. a health insurance scheme targeting the most vulnerable. METHODOLOGY AND DATA (400) The study will use mixed methods for evaluations and will involve both qualitative and qualitative data collections. ministries and project officials and the beneficiaries involved. Impact evaluation can also answer questions about program design: which bits work and which bits don’t. This method is important for robust findings especially when we have quantitative methods. This involved a transparent explanation of the project and the purpose of collecting the data. To do this the study will get a treatment and comparison groups are drawn from the same population then a single difference estimate is in principle valid. CHALLENGES AND RISK MITIGATION Risks expected during the study include:   Stakeholders do not buy-into the health subsidy programs. and so provide policyrelevant information for redesign and the design of future programs.National Health Insurance Scheme (NHIS). It is very desirable to get such exposure very early on in the study so it can help inform the evaluation design. Return trips are also advisable to help elucidate the findings. The research team wills ensure that the data is kept confidential. the challenge. Often a single data set will allow a variety of impact assessments to be made. All the beneficiaries of the Livelihood Empowerment Against Poverty (LEAP) have access to free health insurance unlike in Kenya. . Field experience is.

The two are associates in IRED. The team is highly experienced in conducting various research programs both locally and internationally. STRATEGIC RELEVANCE FOR THE INSTITUTION The Institute of Research on Economic Development (IRED) is devoted to the advancement of research on socio economic development. The team works on projects related to trade and finance in developing countries. In addition. Non-existent members (i. Diaspora and Economic Development in Kenya. Are cash transfers complementing social health protection policies in Ghana and Kenya?” This project is WOTRO Science and Global Development. IFPRI. not supported through approved forms) are added to the member’s master data Insurance subsidy cards are generated for non-qualifying or invalid members Member master data is not up-to date. is impertinent and is inaccurate Inaccurate information about the Fund. WOTRO. or feel uncomfortable with. products and services is publicized thus denting its image and reputation Fake documents such as IDs. The teams diverse experience makes them suitable in successfully implementing the set project.      Incomplete member details are captured. AERC. They work on different organizations such as UNCTAD. a draft version of the report will be sent to different stakeholders to check whether there are any issues mentioned that they do not agree with. COMPOSITION OF THE TEAM The team will consist of Dr. Innovations in developing countries. Implementation of The Road to Universal Health Coverage. the research team will cross check the data retrieved with data from OVC AND program documents to ensure accurate data is collected and analyzed. Bethuel Kinyanjui and Dr Wangari Wang’ombe. financial inclusion and inequality in Kenya and Cash transfer programs on Kenya and Ghana. DISSEMINATION STRATEGY . The team is currently working on impact of trade and labor markets in economic development. birth certificates and NHIF receipts may be used to support claims and such claims may be paid out by Health subsidy program Risk Mitigation Measures In order to ensure accurate collection data. innovative and meaningful applied research to solve social and economic problems by applying state-of-the-art methods and technologies consistent with local culture and traditions. In particular the team is working on the “Breaking the Vicious Circle between Poverty and Ill-Health. implementing the project will enable the organization to contribute to literature with regard to managing aid effectively and hopefully facilitate change and practice of management of aid in Sub Saharan Africa. A Comparative Study of Kenya and Ghana will enable the institution to pursue its paths to undertake relevant. Swiss Development Agency and IOM in different projects. its business.e. Before publication.

.     2 interactive workshops in both countries to inform on implementation of good practice guidelines. Thus. the following dissemination strategy has been developed using evidence for translating knowledge into practice. this proactive dissemination strategy offers the breadth to reach out to multiple audiences and the depth to conduct more in-depth interactive work with key audiences.To ensure that the outputs from the research informs policy and practice and thereby maximises the benefit to OVC beneficiaries and recipient countries. Development of links with key organizations such as Ministry of Health and National insurance fund to contribute to and capitalize on their networks Use of electronic media such as websites and blogs to disseminate the projects findings. Executive Summary and Plain English summary reports of the research. Publications including Full.