Health System and EPI Program
In 2008, the Ministry of Health and Sanitation was split in two: The Ministry of Medical Services and the Ministry of Public Health and Sanitation. A Health Sector Coordinating Committee is alternately chaired by the permanent secretaries of the MoMS and MoPHS.
The National Health Sector Strategic Plan II (2005-2012) defines six levels of health care. Level 1 is the community. On Level 2 are dispensaries. On Level 3 are health centres. Levels 4-6 are hospitals. The health sector is developing a decentralized governance structure. It includes provincial and district stakeholders fora and health facility and community health committees. Among other functions, the provincial and district fora will monitor, supervise and evaluate health program performance.
In 2010, the Health Sector Services Fund began disbursing recurrent cost funds directly to Level 1,2 and 3 health facilities. The funds and managed by Health Facility Management Committees and support delivery of the Kenyan Essential Package for Health, which includes immunization. Provincial and district health management teams provide oversight and district-level accountants report how the funds are used.
The Kenyan Expanded Program on Immunization is located in the Immunization Division, Department of Family Health, MoPHS. Specific targets for immunization and other health priority programs are set out in the National Health Sector Strategic Plan (2005-2012). Annual plans prepared by Level 2 and 3 facilities are consolidated into district (148) and provincial (8) plans. Vaccine coverage is one of the core health sector indicators.
External partners and the government jointly oversee the Kenyan Expanded Program on Immunization through an Inter-agency Coordinating Committee.
Over the period 2006-2011, Gross National Income (GNI) in Kenya increased from $570 to $820 per capita. According to WHO/UNICEF-Joint Reporting Form (JRF) Database, the Kenyan government spent an average of $5 per infant throughout this six-year reporting period. The highest reported government expenditure was in 2007, when $10 million was spent on routine immunization. In 2008, government expenditures decreased 3.3 million, spending $5 per infant. Expenditures have not been reported for 2009. In 2010 and 2011, government contributions to the Program’s overall cost ranged from 85% to 88%.
Kenya has a unicameral Parliament. The president is elected separately from Parliament. The president names cabinet members without parliamentary approval. All government ministers must be members of parliament, however, the president can name ministers who then become ex officio MPs. President may dismiss cabinet and may dissolve parliament.
Kenya's Parliament follows the Westminster model wherein parliament cannot substantively alter the government's budget.
Particularly relevant to immunization are the National Assembly’s standing Public Accounts Committee and the Committee on Health, Housing, Labour & Social Welfare.
The Kenyan Public Health Act (Chapter 242) outlines smallpox vaccination requirements, identifies vaccination as a requirement for school entry, gives the Minister of Health the power of regulating immunization and empowers the government to assure vaccine quality. No other vaccination-related provisions exist, however, in 2011 the Health Committee of the National Assembly drafted a bill covering vaccines and vaccination activities. In its 2012 session, parliament considered five major health bills. Health Committee members are considering which bill should incorporate new vaccine-related provisions. In January 2012, following the approval of the new constitution, the Ministry of Health began a review of all existing health legislation. The Parliamentary Health Committee and Ministry will coordinate their legislative work on vaccine-related provisions. The aim is to complete the legislative update before the session ends and national elections are held in late 2012.
- February 2012: Program Director McQuestion and SPO Kizza attend a third parliamentary briefing in Nairobi.
- June 2012: Peer exchangers from the Kenyan Parliament and MoH attended a legislative briefing and workshop organized jointly by the Ugandan Parliament and Sabin to discuss legislative strategies and draft immunization laws for SIF East African countries.