Investment case for primary health care in low- and middle-income countries: A case study of Kenya

被引:4
|
作者
Mwai, Daniel [1 ,2 ,3 ]
Hussein, Salim [4 ]
Olago, Agatha [4 ]
Kimani, Maureen [5 ]
Njuguna, David [6 ]
Njiraini, Rose [7 ]
Wangia, Elizabeth [8 ]
Olwanda, Easter [2 ]
Mwaura, Lilian [2 ]
Rotich, Wesley [2 ,3 ]
机构
[1] Univ Nairobi, Econ Dept, Nairobi, Kenya
[2] Futures Hlth Econ & Metr Ltd, Dept Res & Knowledge Management, Nairobi, Kenya
[3] Futures Hlth Econ & Metr Ltd, Dept Informat Technol & Data, Nairobi, Kenya
[4] Kenya Minist Hlth, Dept Primary Hlth Care, Nairobi, Kenya
[5] Kenya Minist Hlth, Dept Community Hlth, Nairobi, Kenya
[6] Kenya Minist Hlth, Dept Planning & Hlth Financing, Nairobi, Kenya
[7] United Nations Childrens Fund, Kenya Country Off, Nairobi, x, Kenya
[8] UHC Secretariat, Kenya Minist Hlth, Nairobi, Kenya
来源
PLOS ONE | 2023年 / 18卷 / 03期
关键词
COMMISSION;
D O I
10.1371/journal.pone.0283156
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
BackgroundPrimary healthcare (PHC) systems attain improved health outcomes and fairness and are affordable. However, the proportion of PHC spending to Total Current Health Expenditure in Kenya reduced from 63.4% in 2016/17 to 53.9% in 2020/21 while external funding reduced from 28.3% (Ksh 69.4 billion) to 23.9% (Ksh 68.2 billion) over the same period. This reduction in PHC spending negatively affects PHC performance and the overall health system goals. MethodsWe conducted a cost-benefit analysis and computed costs against the economic benefits of a PHC scale-up. Activity-Based Costing (ABC) on the provider perspective was employed to estimate the incremental costs. The OneHealth Tool was used to estimate the health impact of operationalizing PHC over five years. Finally, we quantified Return on Investment (ROI) by estimating monetized DALYs based on a constant value per statistical life year (VSLY) derived from a VSL estimate. ResultsThe total projected cost of PHC interventions in the Kenya was Ksh 1.65 trillion (USD 15,581.91 billion). Human resource was the main cost driver accounting for 75% of the total cost. PHC investments avert 64,430,316 Disability Adjusted Life-Years (DALYs) and generate cost savings of Ksh. 21.5 trillion (USD 204.4 Billion) over five years. Shifting services from high-level facilities to PHC facilities generates Ksh 198.2 billion (USD 1.9 billion) and yields a benefit-cost ratio of 16:1 in 5 years. Thus, every $1 invested in PHC interventions saves up to $16 in spending on conditions like stunting, NCDs, anaemia, TB, Malaria, and maternal and child health morbidity. ConclusionsEvidence of the economic benefits of continued prioritization of funding for PHC can strengthen the advocacy argument for increased domestic and external financing of PHC in Kenya. A well-resourced and functional PHC system translates to substantial health benefits with positive economic benefits. Therefore, governments and stakeholders should increase investments in PHC to accelerate economic growth.
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页数:10
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