A qualitative evaluation of priority-setting by the Health Benefits Package Advisory Panel in Kenya

Bibliographic Data

ID16763172
AuthorsRahab Mbau (0000-0001-6705-049X, Department of Global Health and Development, London School of Hygiene and Tropical Medicine , Keppel Street, London WC1E 7HT, UK, corresponding author), Kathryn Oliver (0000-0002-4326-5258, Department of Public Health Environment and Society, London School of Hygiene and Tropical Medicine , Keppel Street, London WC1E 7HT, UK), Anna Vassall (0000-0002-2911-1375, Department of Global Health and Development, London School of Hygiene and Tropical Medicine , Keppel Street, London WC1E 7HT, UK), Lucy Gilson (0000-0002-2775-7703, Department of Global Health and Development, London School of Hygiene and Tropical Medicine , Keppel Street, London WC1E 7HT, UK), Edwine Barasa (0000-0001-5793-7177, Health Economics Research Unit, KEMRI Wellcome Trust Research Programme , P.O. BOX 43640-00100, 197 Lenana Place, Nairobi Kenya)
Year2023
Volume38
Issue1
Pages49-60
Publication date2023-01-06
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czac099
PMID36373870
OpenAlexW4308956012
LanguageEN
Citations received1
References cited32

Kenya’s Ministry of Health established the Health Benefits Package Advisory Panel (HBPAP) in 2018 to develop a benefits package for universal health coverage. This study evaluated HBPAP’s process for developing the benefits package against the normative procedural (acceptable way of doing things) and outcome (acceptable consequences) conditions of an ideal healthcare priority-setting process as outlined in the study’s conceptual framework. We conducted a qualitative case study using in-depth interviews with national-level respondents (n = 20) and document reviews. Data were analysed using a thematic approach. HBPAP’s process partially fulfilled the procedural and outcome conditions of the study’s evaluative framework. Concerning the procedural conditions, transparency and publicity were partially met and were limited by the lack of publication of HBPAP’s report. While HBPAP used explicit and evidence-based priority-setting criteria, challenges included lack of primary data and local cost-effectiveness threshold, weak health information systems, short timelines and political interference. While a wide range of stakeholders were engaged, this was limited by short timelines and inadequate financial resources. Empowerment of non-HBPAP members was limited by their inadequate technical knowledge and experience in priority-setting. Finally, appeals and revisions were limited by short timelines and lack of implementation of the proposed benefits package. Concerning the outcome conditions, stakeholder understanding was limited by the technical nature of the process and short timelines, while stakeholder acceptance and satisfaction were limited by lack of transparency. HBPAP’s benefits package was not implemented due to stakeholder interests and opposition. Priority-setting processes for benefits package development in Kenya could be improved by publicizing the outcome of the process, allocating adequate time and financial resources, strengthening health information systems, generating local evidence and enhancing stakeholder awareness and engagement to increase their empowerment, understanding and acceptance of the process. Managing politics and stakeholder interests is key in enhancing the success of priority-setting processes

Business · Political science · Process management · Public relations · Stakeholder · Stakeholder analysis · Stakeholder engagement · Timeline · Transparency (behavior) · Computer Science · Global Maternal and Child Health · Health Systems, Economic Evaluations, Quality of Life · Healthcare Systems and Reforms · Medicine