Independent Commission for Aid Impact publishes report on DFID’s Contribution to the Reduction of Child Mortality in Kenya

14 Mar 2014

The Independent Commission for Aid Impact (ICAI) has published today a report on the Department for International Development’s Contribution to the Reduction of Child Mortality in Kenya.

Reducing under-five child mortality is a global priority and has seen remarkable progress. Under-five mortality has fallen by 24% in Kenya since 1990 but this is less than global and regional averages and the level in Kenya remains high.

We found that DFID has played a significant leadership role globally, particularly on malaria. DFID’s work in Kenya is largely coherent; its bilateral programmes have achieved impact in a challenging context. Improved immunisation and the provision of bed nets have saved lives. There are, however, significant weaknesses and regional disparities in basic health systems. DFID should focus more on neonatal mortality, sustainability, health systems strengthening and hard-to-reach areas. As a result of these findings, we have given a rating of Green-Amber.

Graham Ward, ICAI Chief Commissioner, said: “DFID has been effective in reducing under-five mortality in Kenya through its wider influence in the international system and through its own bilateral work. It has implemented proven interventions, identified by global research and incorporating cross-country learning, particularly for malaria reduction.”

Lead Commissioner, Mark Foster, said, “Sustaining the gains of child mortality reduction is essential. This requires continued DFID funding in the short term and a clear plan for further engaging with – and transferring responsibility to – the Government of Kenya in the medium term. The core of sustainability lies in strengthening basic health systems. This is an area of DFID expertise and should be an increasing focus of its work.”

ICAI has made three recommendations to support DFID’s future work in reducing child mortality in Kenya:

Recommendation 1: DFID centrally should specify its policy on equity more clearly and DFID in Kenya should focus systematically on the quality of – and access to – maternal, neonatal and child health services for remote and hard-to-reach populations. DFID should routinely use beneficiary feedback in its programme design.  

Recommendation 2: DFID should develop a clear exit strategy for funding basic supplies in Kenya (such as bed nets) and focus instead on achieving a long-term and co-ordinated approach amongst development and financing agencies, including GAVI and the Global Fund, for health systems strengthening. DFID should develop criteria for resuming direct financing to the Government of Kenya.

Recommendation 3: DFID should engage with emerging county government structures in Kenya to mitigate the risks and to expand the opportunities of devolution for health outcomes and to help develop information systems and financial management tools that will rapidly identify and address any negative impacts.

The full report is available here: https://icai.independent.gov.uk/reports/dfids-contribution-reduction-child-mortality-kenya/