Government Contracting

Living Goods believes true success in financing community health systems will be achieved when governments own and pay for their own community health program. As such, we work closely with governments to facilitate a shift in this direction, recognizing that even small wins are significant.

We’re working to better understand the current flow of government funds for primary health care (and community health, more specifically); advocate for increased investment in community health; build governments’ capacities to spend, direct, and attract funds towards community health; and pioneer new contracting mechanisms for community health with the support of local governments ranging from co-financing agreements with governments, to results-based financing mechanisms.  

At the end of 2018, Isiolo County in Kenya became the first government to directly contract Living Goods through a co-financing arrangement, to manage all of their community health services for the next four years, covering 720 CHWs across Isiolo, Merti, and Garbatulla sub-counties for the next four years. Starting with an equal cost-share, the county government will shoulder an increasingly larger share of the price tag for community health throughout the life of the partnership. And, to ensure that community health has the long-term dedicated funding needed to enable government ownership, we will concurrently support the government to draft and implement supportive policies for community health. 

Given Kenya’s devolved system of governance, it has not been an easy task to figure out the nuances of how to structure the finances and operationalize a new way of funding community health led by an international organization like Living Goods. The Kenyan Senate became involved after exercising its oversight role to hear a number of petitions, and ultimately gave the partnership, its blessing.

We believe that changing new paradigms and working in partnership with governments is essential for ensuring true sustainability for community health and the Isiolo County Government has been fully engaged in this learning journey. We will document and share our learnings so that we can support future government partnerships involving contracting.

Our work in Isiolo will provide residents with universal health coverage (UHC) through the Kenyan government’s pilot initiative in four counties.  The county’s vision for strengthening its community health systems as an enabler for delivering sustainable UHC is extremely strategic, and we are grateful for the support and leadership of Isiolo’s Governor, Dr. Mohammed Kuti, for leading the way.

We began training the first 360 CHWs in Isiolo in May 2019 and held a prominent graduation ceremony on July 11, 2019. 

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