Sustainability starts with spending: public financial management lessons from Kenya’s universal health care pilot

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dc.contributor.authorJackson, Debra
dc.contributor.authorAdjagba, Alex Olateju
dc.contributor.authorOguta, James Odhiambo
dc.date.accessioned2025-10-27T10:58:17Z
dc.date.available2025-10-27T10:58:17Z
dc.date.issued2025
dc.description.abstractBackground: Effective public financial management (PFM) is a foundational enabler of sustainable progress toward Universal Health Coverage (UHC). Achieving UHC requires not only increased funding for the health sector but also the efficient, equitable, and accountable use of resources. In 2019, Kenya piloted a UHC initiative across four counties to generate evidence to inform national scale-up. This study examines the PFM processes underpinning the pilot implementation, with a focus on how financial planning, budget execution, and accountability mechanisms influenced the delivery of UHC interventions at the county level. Methods: This study employed a qualitative research design to explore PFM processes during the implementation of Kenya’s UHC pilot in four counties. Data were collected through 51 in-depth interviews and five focus group discussions with key stakeholders, including healthcare workers, patient representatives, and senior members of the County Health Management Teams (CHMTs). An inductive thematic analysis approach was employed to identify patterns and themes that emerged from the data. The analysis was facilitated using Dedoose software (Version 9.0.17), which enabled systematic coding and organization of the qualitative data.
dc.identifier.citationAdjagba, A.O., Oguta, J.O., Akoth, C., Toweet, S.K., Okoth, P. and Jackson, D., 2025. Sustainability starts with spending: public financial management lessons from Kenya’s universal health care pilot. BMC Health Services Research, 25(1), p.1029.
dc.identifier.urihttps://doi.org/10.1186/s12913-025-13194-7
dc.identifier.urihttps://hdl.handle.net/10566/21173
dc.language.isoen
dc.publisherBioMed Central Ltd
dc.subjectDevolution
dc.subjectImmunization
dc.subjectKenya
dc.subjectSustainability
dc.subjectDecentralization
dc.titleSustainability starts with spending: public financial management lessons from Kenya’s universal health care pilot
dc.typeArticle

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