THE POLITICAL ECONOMY OF HEALTH FINANCING REFORM: CASE OF KENYA

卫生筹资改革的政治经济学：肯尼亚案例

• 批准号: 2750962
• 金额: --
• 依托单位: London School of Economics and Political Science
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2750962
• 关键词: POLITICAL; ECONOMY; HEALTH; FINANCING; REFORM

Countries globally committed to achieve universal health coverage (UHC) by 2030, as one of the targets of the Sustainable Development Goals (SDGs). Progress towards UHC requires concerted efforts to strengthen a country's health system, and health financing reforms are a critical part of that process. Although health financing is an inherently political process, and there is broad consensus and growing literature on the political economy of health financing, there is still limited scholarship on the politics of health financing, and the political economy factors that contribute to the success or failure of health financing reforms, especially in low and middle-income country (LMIC) settings.Like other countries globally - Kenya committed to achieving universal health coverage (UHC) by 2030, a commitment that saw the government implement a raft of health financing reforms over the years. However, the majority of scholarship on health financing reforms in Kenya has focused on the technical aspects, specifically on resource mobilisation, risk pooling, purchasing, and designing benefits package, often ignoring the important role that politics plays on the success or failure of such policy reforms. In fact, so far, no study exists on the political economy of health financing reforms in KenyaThis research will therefore seek to answer the question: How does politics affect the adoption and implementation of health financing reforms?To answer this question, this research will follow an empirical approach based on qualitative research design. First, the researcher will conduct systematic review of published and grey literature, then will use Fox and Reich's (2015) theory-based framework (of Stages heuristics of the policy process (agenda setting, design, adoption, and implementation) and the 3I's (variables) Ideas and ideologies, interests, and institutions to organize the analysis. Next, the researcher will conduct between 20-30 key informant interviews with stakeholders drawn from government agencies, civil society, advocacy groups, international organisations, public and private health providers among others.The findings of this research will contribute to the growing literature on political economy of health financing in LMICs. This research also hopes to make theoretical contribution, by theorising the political dimension (role of interest groups & other actors etc) in health financing reforms in LMICs. Finally, the research will provide empirical evidence of the effects of political variables on health reforms in Kenya and LMICs, providing lessons to policymakers and planners on the theoretical and empirical findings on the politics of health reform in LMICs

全球各国承诺到2030年实现全民健康覆盖，作为可持续发展目标的具体目标之一。在实现全民健康覆盖方面取得进展需要齐心协力加强国家卫生系统，卫生筹资改革是这一进程的关键部分。尽管卫生筹资本质上是一个政治过程，并且在卫生筹资的政治经济学方面存在广泛共识和越来越多的文献，但关于卫生筹资的政治以及影响卫生筹资改革成败的政治经济因素的学术研究仍然有限，特别是在低收入和中等收入国家（LMIC）环境中。与全球其他国家一样，肯尼亚承诺到2030年实现全民健康覆盖（UHC），这一承诺使政府多年来实施了大量卫生筹资改革。然而，关于肯尼亚卫生筹资改革的大多数学术研究都侧重于技术方面，特别是资源动员、风险分担、采购和福利方案设计，往往忽视了政治对此类政策改革的成败所起的重要作用。事实上，到目前为止，还没有关于肯尼亚卫生筹资改革的政治经济学的研究。因此，这项研究将寻求回答这个问题：政治如何影响卫生筹资改革的采用和实施？为了回答这个问题，本研究将遵循基于定性研究设计的实证方法。首先，研究人员将对已发表的文献和灰色文献进行系统回顾，然后将使用Fox和Reich（2015）基于理论的框架(政策过程的阶段启发式（议程设置、设计、采用和实施）和3I（变量）的思想和意识形态、利益和制度来组织分析。接下来，研究人员将与来自政府机构、民间社会、倡导团体、国际组织、公共和私人卫生服务提供者等的利益相关者进行20-30次关键信息提供者访谈。这项研究的结果将有助于越来越多的关于中低收入国家卫生筹资的政治经济学文献。本研究还希望通过将中低收入国家卫生筹资改革中的政治层面（利益集团和其他行为者的作用等）理论化，做出理论贡献。最后，本研究将提供政治变量对肯尼亚和中低收入国家卫生改革影响的实证证据，为政策制定者和规划者提供关于中低收入国家卫生改革政治的理论和实证研究结果的经验教训