Digitizing and Contracting Private Practices to Sustain Family Planning: Lessons from Kenya

Private providers in Kenya, including numerous small and medium practices, have the potential to attract and retain clients, increase revenues, operate more efficiently, and contribute to universal health coverage by digitizing operations and participating in health financing programs. Both actions aim to sustain scaled-up provision of health services, including family planning, in the private health sector while reducing financial barriers for clients. This brief focuses on the transition from paper, cash-based operations and limited individual contracts with payers, to digital solutions that enable more efficient contracts between multiple providers and payers. The Sustaining Health Outcomes through the Private Sector Plus project examined effects from two reinforcing interventions in which an intermediary supported a network of 33 practices to (1) install and build use of a digital clinic management system, and (2) contract with health financing programs such as the National Hospital Insurance Fund (NHIF), individually and as a network. The COVID-19 pandemic affected implementation of both interventions, as did learning that the NHIF requires legal reform before it can contract with an intermediary that represents multiple private providers. The intermediary succeeded in contracting the network with a private health insurance scheme for low-income households, and digitized the clinical and administrative operations of 10 new network members. Looking ahead, donors can support governments, in collaboration with private stakeholders, to enact reforms that enable contracting between programs like the NHIF with intermediaries representing multiple practices. Donors can also assist intermediaries to develop and deliver a sustainable value proposition. Done right, these efforts can enable private practices, especially smaller ones, to sustainably increase access to family planning and other essential health services.