DFID’s contribution to the reduction of child mortality in Kenya

Review

The Department for International Development (DFID) has played a significant leadership role globally and its work in Kenya is largely coherent, however DFID should focus more on neonatal mortality, sustainability, health systems strengthening and hard-to-reach areas. We awarded a rating of green-amber and made three recommendations.

Findings

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.

Recommendations

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. 
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.
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.