August 18, 2015
Hideo Eguchi, Chief Representative, JICA Kenya Office and Henry Rotich, Cabinet Secretary, Ministry of Finance shake hands after signing.
On August 17, the Japan International Cooperation Agency (JICA) signed a loan agreement with the Government of the Republic of Kenya to provide a Japanese ODA loan of up to 4 billion yen for the Health Sector Policy Loan for Attainment of the Universal Health Coverage.
This is the first Japanese ODA loan for Africa with the objective of achieving universal health coverage (UHC), under which all people receive appropriate preventative, curative, rehabilitation, health promotion and other necessary health care services at affordable costs.
Although Kenya has made great strides toward achieving Millennium Development Goals (MDGs) such as HIV, malaria, and the infant and under-five mortality rates, little progress has been made in the maternal mortality ratio, which has decreased only to 400 cases per 100,000 births in 2013 from 490 cases in 1990. As the country also has large disparities according to region and economic standard, improving the regional disparities and expanding the coverage of health services particularly among the poor are priorities.
This loan is a policy-based program loan provided in the form of general budget support upon the achievement of high-priority policy actions which are necessary for the Government of Kenya to attain UHC by 2030. The policy actions for this loan are: (i) drafting UHC-related policy documents, (ii) preparing manuals for UHC programs* and securing the national budget for the Free Maternity Services(FMS), and (iii) strengthening the health system with county governments as service providers.
By supporting these policy actions, this loan aims to expand essential health services throughout the country and thereby stabilize the economy and promote social development in Kenya. It is especially expected that pregnant and nursing women and infants will benefit from expansion of service coverage and quality improvements in health services. The implementation of the UHC programs will be coordinated with the Global Financing Facility, a new international financing mechanism focused on improving maternal and child health, which was launched at the Conference on Financing for Development held in Addis Ababa in July 2015.
The Government of Japan formulated Japan’s Strategy on Global Health Diplomacy in May 2013 and announced at the Fifth Tokyo International Conference on African Development (TICAD V) in June 2013 that it will promote and strengthen support for UHC.
In addition to this loan, JICA has supported policy formulation in the field of UHC in Kenya since 2013 through dispatching experts to the Ministry of Health. To expand the provision of prevention efforts and basic services at the community level that are critical for achieving UHC, JICA supported the Project for Strengthening Community Health Strategy (2011-2014) and has also supported the Organizational Capacity Development Project for the Management of Devolved Health Systems in Kenya (2014-2019). By linking this loan and this technical cooperation, JICA is providing comprehensive support to the efforts of the Government of Kenya to achieve UHC during this transitional decentralization stage.
* The UHC programs consist of Free Maternity Services (FMS), Health Insurance Subsidy Program (HISP), which promotes health insurance enrollment among the poor, and Result-Based Financing (RBF) for primary care facilities.
1. Terms and Amount of Loan
|Annual interest rate (%)||Repayment
|Health Sector Policy Loan for Attainment of the Universal Health Coverage||4,000||0.25||—||40||10||General untied|
2. Executing Agency
Ministry of Health, Kenya
Address: Afya House, Cathedral Road
P.O. Box 30016–00100, Nairobi, Kenya
3. Planned Implementation Schedule
(1) Completion of the Program: January 2016 (with completion of loan disbursement)
(2) Consulting services: No hiring of consultants is planned.
(3) Tender announcement of initial procurement package for international competitive bidding on program construction: N. A.