Kenya Investment Case

Developing an investment case for community health in Kenya

In 2017, Kenya’s Ministry of Health and Living Goods partnered to make the case for community health in Kenya. Using the UNICEF Costing Tool and the Lives Saved Tool (LiST) to estimate the benefits and costs of scaling up community health in Kenya, the study defined ROI as the difference between the economic benefit and cost of scaling up community health between 2017 and 2026. The study also used key informant interviews, focus group discussions, and stakeholder engagement meetings to assess the benefits of community health. Emerging data was instrumental in contextualizing the costs and benefits of community health in different settings—that is, rural/urban and county/national—identifying enabling and constraining factors for community health in Kenya, and documenting value not otherwise apparent from quantitative data.

The Return on Investment (ROI)

The joint study on community health in Kenya estimates a 1:9.4 economic return on investment in terms of lives saved and increased economic productivity for every shilling invested in community health.

Short-term benefits (five-year period)

With a focus on increased adoption of preventive health care, community health can help detect and address illness before more expensive and advanced interventions are required. For instance, averting advanced-stage HIV/AIDS, malaria, and tuberculosis (TB) is expected to save an estimated US$107.8 Million (KES10.8 Billion) over five years.

Long-term benefits (10-year period)

• Increased productivity: Estimates indicate that deploying community health nationwide could increase productivity in Kenya by US$24.5 billion (KES2.4 trillion) over a 10-year period from 2017-2026. It is expected these savings will exist through reduced hospital visits and shorter periods of illness, due to increased use of preventive health care measures, decreased maternal and child ailments, and averted cases of stunting.
• Insurance against future health crises: This refers to the value of community health in avoiding the high cost of global health crises, including pandemic preparedness and rapid response. The total economic value of a fully scaled community health system in preventing health crises in Kenya is as high as US$330 million (KES33 billion) in the long-term.
• Employment: This refers to the overall multiplier increase in employment as a result of government investment in community health. The total economic value is as high as US$2.5 billion (KES 250 billion) over 10 years.

Indirect benefits: impact of community health on the wider health system

Indirect benefits of health care interventions refer to gains that go beyond the immediate outcomes of community health interventions that positively influence the wider health care system. Investment in community health in Kenya is poised to generate several indirect benefits, among them:

• Improved data on community health and other health indicators since community health workers (CHWs) collect demographic and other data at the household level.
• Enhanced opportunities to provide a first-line crisis response for outbreaks such as cholera as well as for addressing emerging illnesses such as non-communicable diseases.
• Improved linkages providing an interface between communities and health facilities to ease referrals and delivery of health messages conveniently at the household level.

Broad-based benefits

Investing in community health will generate many broad-based benefits including:

• Increased data on indicators not necessarily linked to health such as economic development and sanitation.
• Youth and women empowerment, especially notable at the community level through the selection of CHWs.
• Community empowerment, especially among low-income populations.