MBA-HCM Theses and Dissertations (2018)
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Browsing MBA-HCM Theses and Dissertations (2018) by Subject "Communicable diseases"
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- ItemAssessing out of pocket costs and the incidence of catastrophic expenditures among chronic disease households in Kenya(Strathmore University, 2018) Ngolo, JulianUniversal Health Coverage (UHC) is among the global goals pursued by the Kenyan government. Currently, the country faces the burden of communicable diseases, chronic diseases and non-communicable diseases. To develop policies that ensure access to needed healthcare services and financial protection for all, examining out of pocket costs and the incidence of catastrophic health expenditures among households with chronic disease in Kenya is an important research and policy question. Descriptive analysis was done on secondary data from Kenya Household Expenditure and Utilization Survey (KHHEUS), 2013 consisting of 33,675 households. Out of these households, 8284 households reported having at least one member with a chronic disease. Catastrophic health expenditures was examined by obtaining the proportion of households that incurred out of pocket expenditures that exceeded 40% of a households’ non-food expenditure. The incidence of catastrophic health expenditures among chronic disease households was 8.1% and this increased to 13.5% when transport costs were considered. In addition, payments for outpatient services was the greatest driver of total out of pocket costs among chronic disease households and payment for drugs took the largest share of these costs. Variations in out of pocket costs incurred were noted with the richest quintiles and urban households incurring highest direct healthcare costs while the poorest quintiles and rural households incurred highest costs on transport. These results are important in policy making and designing health financing schemes
- ItemAn Assessment of the implementation of the East African pooled procurement mechanism among faith-based medicines supply organizations(Strathmore University, 2018) Jaguga, Collins Davies PamboThe East African region has a significant burden of communicable and noncommunicable diseases, yet patients have low access to essential medicines and medical supplies. Some of the barriers to accessing medicines are high prices and stock-outs. Pooled procurement of health products is an innovative approach to obtaining large volumes of products at competitive prices, thus promoting affordability and availability. A number of factors influence the success of pooled procurement mechanisms. These include sustainable financing, harmonization of processes and political support. The East African Pooled Procurement Mechanism had been in operation for over three years but significant benefits were not being realized. This study sought to understand how this pooled procurement intervention was implemented, challenges encountered and key strategies for the realization of intended outcomes. A census survey was conducted among members of the pooled procurement steering committee. Data was collected through questionnaires, a focus group discussion and individual interviews. Collected data was analyzed using content and thematic analysis approaches. The results revealed that implementation of the East African pooled procurement intervention involved, for the most part, elements of successful implementation of pooled procurement mechanisms. These were stakeholder engagement; situation analysis; consensus building and implementation planning; setting up of a central procurement agency and managing and organizing procurement. However, a myriad of challenges were faced in the implementation of this intervention. The major ones were conflicting legislations and regulations for health products across the East African countries and limited financial resources for procuring health products and meeting administrative costs. As a result, there were marginal cost savings and delays in delivering or non-delivery of health products to medicine supply organizations. In view of the major challenges, it is recommended that the initiative adopts the third or fourth model of pooled procurement, to navigate country legislations and regulations for health products; a revolving drug fund for sustainable financing is implemented for organizations that are not financially stable and a continuous quality improvement system through reporting, monitoring and evaluation system is established.