1

The Leader’s Role in Effective Policy Advocacy: Considerations for Increased Domestic Health
Financing in Kenya

Benter Owino

January 5, 2022

A full version of this paper was submitted as an assignment to the

School of Leadership, Business and Technology
Pan Africa Christian University
PhD Course: Public Policy and Advocacy, November 27, 2021
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Abstract
Leading public policy change is a multi-faceted and complex undertaking. There are power and
resource constraints to navigate, as well as several corporate and public sector stakeholder groups
advocating from different policy perspectives to either partner with or out-compete. Strategies for
leaders to practice effective policy advocacy are based on either direct or indirect approaches
targeted at government policy and legislation entities. Whereas no strategy is superior to the other, a
leader must be cognizant of the merits and demerits of each in order to adopt the most appropriate to
effectually activate the desired levers of change. This paper synthesizes perspectives from
implementation of policy cycle processes to demonstrate the role of a leader in policy through the
case study of public health financing in Kenya’s devolved governance setting.

The Leader’s Role in Effective Policy Advocacy: The Case for Increased Domestic Health
Financing in Kenya

Effective leadership of policy advocacy is instrumental in achieving required policy and

legislative change while creating various levels of awareness in societies. Leaders interact with
advocacy initiatives differently based on their sector and the stakeholders they engage with.
Regardless of sector or issue of interest, to be successful in policy advocacy calls for every leader to
have a rounded understanding of the theoretical basis for their strategic approaches they adopt.
Various forms of policy influence policy advocacy outcomes differently, hence leaders of advocacy
outfits are required to select appropriately to maximize impact while avoiding pitfalls of advocacy
actions.

Advocacy and Leadership

Leadership and advocacy are interconnected and can be employed effectively to accomplish
pertinent issues in community and globally. Leadership of advocacy actions is unique than
organizational management or other mainstream management practice. To structure and manage an
advocacy team requires a set of skills that enables the team to carve out a position of influence of
political and legislative processes on behalf of citizens. It also requires acknowledgement of the
realization that social and legal change processes can be slow and results may not accrue fast
enough.
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Policy Advocacy Strategies and Tactics

The form of policy advocacy strategy an organization employs is guided by its vision,
mission, nature of the policy issue of concern and interests of other participating stakeholders
seeking to influence a government entity leading the policy process. Several strategies have been
proposed for policy advocacy, most of which are drawn from other disciplines such as governance
and political science (Cullerton et al, 2018).

Gen & Wright (2018) note that nonprofits have used a number of models for policy advocacy
which describe organizations approaches using the three elements of inputs, activities and outcomes.
These models are faulted for lacking theoretical basis and empirical research back up despite being
based on real life practice. Other categorizations of advocacy activities consider targets of advocacy
so that we have administrative advocacy, legislative advocacy and media advocacy. There is also
categorization according to the actions such as research, public education, coalition building and
direct actions (Almog-Bar &Schmid, 2013; cited by Gen &Wright, 2018).

A broad classification proposed by (Gen &Wright, 2018; citing walker, 1991) looks at how
organizations can use several activities as part of a bigger pathway to advocacy influence. Hence
advocacy strategies are grouped as either ‘inside strategy’, seeking to build close ties with public
officials or ‘outside’ strategy, to influence and mobilize the general public. Direct strategies are
routinely used by nonprofits to influence policy as was the case for the Kenya Health policy 2014-
2030. Indirect approaches would for example include the investing in relationships strategy and the
insider approach (Gen &Wright, 2018). Further work by Mosley (2011, cited by Gen &Wright,
2018) uses classification of insider and direct tactics which entail lobbying or engaging with
government through testimonial or contributing to commissions. Indirect tactics focus on changing
the policy advocacy environment by forging coalitions or educating the public.
The strategy of investing in relationships (Cullerton et al, 2018) seeks to first build trust and
use that to negotiate for a policy position. Cullerton et al (2018) assert even though lobbyists
routinely prepare detailed information to engage policy processes but as, that is not enough, they
must invest in relationships with government policy makers and other stakeholders in order to
successfully influence use of the information. Relationships with policy makers enhances trust and
credibility and can also enable coalitions and alliances with other stakeholders pursuing the same
cause. Some ways of building relationships are nonprofits technical assistance support for
government programs. Cullerton et al (2018) caution that relationships must be targeted to the most
influential government officials and stakeholders. The building relationships strategy is widely
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applied in Kenya’s health sector policy making process by the Development Partners in Health in
Kenya (DPHK).
A further way to categorize policy advocacy strategies is by the intended outcomes namely;
to protect rights of marginalized populations and public education for social good; influencing
government or media personalities; and to gain the attention of decision makers to promote the
organization’s advocacy goals (Gen & Wright, 2018). From these categorization activities can be
hypothesized to lead to policy change by indirect pressure or influencing decision makers via public
engagement, through legislation shaping policy implementation instead of its ratification and focus
on making policy processes democratic. Linking policy activities with outcomes can lead to better
clarity on the most workable tactics for every contest (Gen & Wright, 2018).
Policy advocacy contributes significantly to policy processes in governance. Key players,

especially nonprofits and civil society organizations need to appreciate the theoretical bases for the

approaches they adopt and endeavor to link their activities to the theories to ensure consistency.

Methods
This paper seeks to demonstrate a leader’s ability to effectively lead and engage in policy
advocacy and is guided by the following objectives;
1. Articulate the leaders’ role in effective advocacy and policy change
2. Design an advocacy plan for policy change on an issue of interest
3. Detail the process of execution of the plan, including an advocacy brief
4. Make recommendations for effective leadership of policy advocacy actions in general and in
health financing in specific.

Key Concerns with Public Health Financing in Kenya

Kenya shifted to a devolved system of the government in 2013, when the 47 newly-created
county governments were charged with overseeing delivery of health care services (Owino & Vilcu,
2020). Under the new dispensation, county governments obtain revenue from four sources: their
share of national revenue received as block grants from the National Government; their own revenue
including funds generated from public health facilities user fees; conditional grants from the National
Government for specific purposes; health insurance reimbursements especially from NHIF; and
conditional grants from donors.
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Kenya’s Universal Health Coverage agenda is one of the “Big Four” strategic pillars declared
by the presidency with an aspiration to ensure everyone has access to quality and affordable medical
coverage by 2022 through major policy and administrative reforms in the health sector (MOH, 2014;
NACC, September, 2018). According to the World Bank Group, the aspiration for UHC requires a
matching level of domestic financing of healthcare, to the level of the Abuja targets whereby African
governments committed to ensure to allocate 15% of their government budgets to health services
(Olalere & Gatome-Munyua, 2020). However, most African countries, Kenya included, have not
been able to achieve the targets. According to the Kenya Health Sector Strategic Plan (KHSSP)
2020, only 7-8% of national government budget was allocated to health (MOH, 2020) while the
figures vary among the counties. The Ministry of Health, through the KHSSP 2020 and the Health
Financing Policy proposed a raft of measures to increase domestic financing for health, including
improved revenue generation, a national social insurance scheme, and Facility Improvement Funds
retained at source of collection to improve quality of health facility services. The process of
developing these strategic directions and monitoring their implementation has been supported by
donor partners, nonprofits’ technical assistance and advocacy activities.
Several challenges arise out of low domestic financing for health services in Kenya. Citizens
experience a high rate of out of pocket expenditures to meet their healthcare needs. Out of pocket
health spending are payments households make for medical care from their own resources, and do
not receive any reimbursed by either a health insurance provider, employer or government
(Ravishankar &Gausman, 2016).
By 2020 only 17 % of Kenyan households had some form of health insurance while the
remainder of the population relies of out of pocket expenditures for health, donor support of
government spending. People’s ability to pay is constrained as the proportion of people living below
the poverty line is over 40% (NACC, 2020). Middle- and low-income families are constantly at risk
of engaging in catastrophic expenditures on health. Catastrophic health expenditures are out of
pocket health expenditure that are so high to the extent of posing financial risks to the households.
Against this backdrop, the Kenya government’s aspiration to provide essential health
services to all requires a major change in the financing and governance of public healthcare in the
country. Proponents of increased domestic funding for health services argue that it is morally wrong
for the poor to face disability, death and ill health because of their socio-economic status. In 2018 the
government undertook a pilot project to institute universal health care in 4 counties in a bid to
understand how a nationwide program would be run. The pilot was co-funded by international donor
partners, a matter that raised concerns about sustaining a locally-led universal health care (NACC,
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2018). The emergent question is how should financing be done to address the health financing
challenges in sustainable ways through domestic sources of funds.

Government response through Policy and Legislative Reforms

Government response to the need for better financing for health has elicited varying response.
Overall, there is positive commitment articulated in the country’s vision 2030 strategy, the Kenya
Health Sector Strategic Plan 2020, the Health Financing Strategy and the NHIF Amendment Bill
2021 and the Health Laws Amendment Bill 2021 (Parliament of Kenya, 2021) which are now at the
second reading stage in Parliament.
Government efforts to institute amendments to health financing are supported by bilateral
partners such as the World Bank Group, the UK and US government agencies as well as private
foundations such as the Bill and Melinda Gates Foundation. For example, the World Bank Group has
played a role in reforming and repositioning the national Health Insurance Fund (NHIF) as the
primary purchaser of health services in Kenya. The goal is to ensure that NHIF is able to provide
insurance and reimbursements to the scale required for universal health coverage (World Bank, n.d.).

Issues for advocacy for Increased Domestic Public Health Financing in Kenya
The health funding shortfalls and finding ways to bridge the gap have received the attention
of local and international stakeholders who have adopted varying advocacy strategies to influence
the government to increase domestic funding for health at national and county levels. Some donors
have transitioned their financial support after devolution to align support with the county’s mandate
to provide health services. For example, the Danish Government supports level 2 and level 3
facilities through conditional grants. The World Bank and Global Financing Facility support county
governments which then decide how the money flows down. Other partners are engaged in various
forms of policy advocacy for greater financing for the sector. Henceforth this paper proposes an
advocacy plan to address the issue, from the perspective of a nonprofit engaged in policy advocacy
in Kenya.
These considerations follow the steps to effective policy advocacy (Sonke Gender Justice
Network, 2013) to advance the case for increased government funding for health services using
insider and indirect strategies for policy influence (Gen &Wright, 2018).

Goal: The Kenya government through the Ministry of Health articulates relevant policy and
legislation to ensure Abuja targets for healthcare financing are met by 2023.
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Policy under review: Kenya Health Policy 2012 -2030, with focus on health financing.

The problem: The policy does not make sufficient provision to maximize local revenue sources to
fund health service delivery. The options of increased insurance coverage, accountability for
revenues and streamlined purchasing arrangements are key considerations for shore up domestic
finances for health.

Action options: Produce and disseminate Health Financing Policy advocacy briefs. The policy
briefs would target the Ministry of Health Division of Health Financing as the key policy custodian;
and shared with donors, nonprofits and other stakeholders and partners with interest and influence in
health financing space.

Policy briefs would be useful in the following ways to influence policy.

i. Meetings with the Ministry of Health Directors. Actors would partner with other partner
organizations that advocate for Health financing reforms to discussions with senior MOH
officials to share analysis synthesized in the briefs. The goal is to raise awareness of the
gaps and recommend policy options for adoption.
ii. Participation in government policy development processes. The Ufanisi Collaborative
will second staff to work with MOH staff to be part of the policy writing process. They
will be highly skilled and adept at analytics to enable strategic thinking as the policy
review happens.
iii. Issue press articles with current information on the issue to influence public
understanding of the benefits of the proposed policy reforms.
iv. Participate in media forums on the issue. Organizational staff will either participate in the
media forums or support MOH staff to participate by providing support in preparation of
relevant content.

Justification
This advocacy activity will address short to long-term goals of educating and supporting
government policy makers, implementers and selected citizen representatives.
Regulations to increase government funding for health care in Kenya will have far -reaching effects
in the country’s policy landscape and service delivery in the public sector. The policy elements on
financing for Health needs amendment because there are major gaps. According the Kenya Health
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Sector Strategic plan (2020), the current level of state funding for healthcare stands at only 7.5 per
cent of total national budget, which is below the International Abuja targets of 15 percent by 2022.
The Ufanisi Collaborative represents a constituency of nonprofits advocates for increased
domestic health financing in Kenya. Nonprofits and other civil society groups act on behalf of
citizens who depend on government to meet basic health care needs are affected by the policy issue,
and which is likely to benefit from this legislation.
This plan touches on the 4 elements of policy advocacy proposed by O’Connell (n.d.) as
represented in Figure 1 below.
Figure 1 – The Four Elements of Policy Advocacy

Source: O’Connell (n.d.)

Assessment of organizational priorities and risks

A situation analysis will be conducted jointly with the MOH by reviewing existing literature
and interviewing key stakeholders in health policy and health financing to establish the status. The
Ufanisi Collaborative will develop tools to facilitate assessment of policies and related legislation
related to health financing that are negatively affecting or hindering actualization of the Abuja
targets. Analysis of the information will guide identification of priority actions to undertake as well
as gauge risks that must be mitigated for project effectiveness. The assessment will also address the
financial and human resources requirements necessary to carry out the proposed policy advocacy
action.
The situation assessment report will be a useful resource throughout the design and
implementation of the project. Since the MOH and key stakeholders will be involved in the situation
analysis, it is expected that the relationships built and trust gained during the process will open
avenues for engagement through implementation of the activities. The situation analysis will involve
community representatives who will also be involved during later stages of the project through
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public participation activities. Information from the citizens will be used to support engagements
with government policy makers.

Advocacy Project Structure

Besides an internal team comprising of a Director, there will be an advocacy and
communications specialist, media liaison, government and partnerships liaison, research and
analytics specialist, finance, human resources and administration team. This staffing component will
be supported by partnering with other nonprofits addressing the same issue through national
technical working groups and community level civil society groupings. Institutional partnerships
with other nonprofits enable greater visibility of the work and is one of the key strategies for policy
advocacy ((Bond, 2005, Sonke 2013; Gen & Wright, 2018).
Advocacy committees have long been used by policy influencing organizations to act as
reference groups when tabling issues to government policy makers. The project will create an
advocacy committee on public health financing reforms. The committee will bring together
government, private sector, other nonprofits and community representatives. The committee will be
chaired by a government official and will convene as necessary depending on the issues at hand.

Implementation Plan
Engaging the Ministry of Health
The policy issues on health financing necessitate engagement with senior Ministry of Health
officials to influence change, namely; Division of Health financing and universal health care, Senate
Health Committee, National Assembly Health Committee and National Treasury where necessary.
The project will work closely with the NHIF since the policy reforms being proposed will affect their
policy and operations. Participation in technical working groups will provide an opportunity to
inform about the issues and also employ the alliances strategy (Gen & Wright, 2018) to build
support.

Stakeholder and civil society engagement

In applying the institutional partnerships strategy (Gen &Wright, 2018) of policy advocacy, the
Ufanisi Collaborative will work with other non-profits and civil society groups advancing the case
for increased domestic funding for health services. There has been significant progress with
amendments to aspects of health financing laws and policies with the support of donors and
nonprofits. Some of these partners will be invited to collaborate in influencing proposed
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amendments. Selection of partners will be targeted to reduce common policy advocacy

inefficiencies (Cullerton et al, 2018). Advocacy relationships must be targeted to the most influential
government officials and stakeholders. The building relationships strategy is widely applied in
Kenya’s health sector policy making process by the Development Partners in Health in Kenya
(DPHK). In the stakeholder engagements representation of key population groups will be considered
such as people with chronic diseases who spend more on health care, vulnerable and marginalized
populations and youth from various counties.

The following are key advocacy and lobbying activities that will be carried out.
i. Media engagement
Media advocacy is noted to be an effective channel for influencing knowledge increase and
register support around causes (Gen & Wright, 2018; Sonke, 2013). The Ufanisi Collaborative will
work with government to produce targeted media briefs to demonstrate progress made in the health
financing. Research work will be packaged for opinion-piece newspaper articles and blog posts. The
project will explore participating in TV and radio panel discussions on the issue to inform the public.
ii. Monitoring and evaluation of activities
Baumgartner et al (2009) mentioned the need for lobbyists to keep monitoring
implementation of legislation or policies they support to bring into effect. The project will develop
and monitoring and evaluation plan to enable tracking of progress markers that determine where the
activities are effective. A database will be developed to facilitate reporting on the program areas.
Besides the situation analysis conducted at the onset, data will be regularly collected and analyzed to
inform engagements with the parties involved in the project. Ultimately the evidence collected
should inform the Ufanisi Collaborative to know whether it has been effective in its advocacy
actions.
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iii. Sample Statement to the Ministry of Health

Ufanisi Statement to Ministry of Health on Domestic Funding to Facilitate Universal Health

Coverage
We write to you as a nonprofit organization in the health sector with interest in supporting
Kenya’s citizens to access the best health services that assures universal health for all. We write to
strongly encourage members of the Parliament of Kenya and the Ministry of Health to pass robust budget
allocations for health care in keeping with the 2001 Abuja Declaration. African Heads of State committed
to allocating a minimum of 15 per cent of their government funds to the health sector to address the huge
burden of ill-health encountered in the continent, especially due to the increasing burden of HIV, AIDS,
TB and malaria.
A major challenge for health service delivery for Kenyans is the glaring inadequate resource
allocation to the sector. Out of pocket expenditures on health care have been on the increase since the
introduction of user fees in public health facilities. In addition, since devolution in 2013 out of pocket
expenditures have continued, leading the poorest households to engage in catastrophic expenditure that
puts their families at risk of impoverishment.
To address these barriers, this statement calls for the Kenya Government through the Ministry of
Health to:
i. Amend the Health Financing Policy to enable attainment of the 15 percent of total budgets to
Abuja targets for allocations health Pass relevant.
ii. Take the early opportunity to prioritize allocations and investments in health care delivery to
prioritize investments in health, particularly primary health services for a healthy citizenry.
Individuals with chronic conditions need protection from financially catastrophic events by
capping annual out of pocket expenses and ending lifetime limits for people with conditions.
iii. Institute financial protection to individuals and lessen the burden of out-of-pocket spending on
health by the most-poor households by availing other options for financing such as improved
social health insurance, subsidization and voucher systems.
iv. Forge partnerships with the private sector to bridge gaps and to lessen the burden on the public
sector especially among the population segments that can pay higher premiums.
v. We are keen to support the necessary policy amendments to pave way for these needed reforms
and call on the Ministry of health to make bold actions.
Sincerely,
Benter Owino
Country Director, The Ufanisi Collaborative
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Increasing Domestic Public Health Financing in Kenya

Benter Owino
The Ufanisi Collaborative

Executive Statement
Attainment of Universal Health Coverage in Kenya is possible and essential. It requires commitments by the
government to expand domestic resources. These government efforts can be augmented with targeted development
partners support, quality and equitable health services and measures to amplified financial protection for the 13%
most poor members of society who do not seek health care due to prohibitive costs.

Key Issues Call to action

The level of government budget allocations for To address these barriers, this statement calls for the Kenya
public health in Kenya remains too low to
Government through the Ministry of Health to:
facilitate achievement of the aspirations for
universal health coverage by the year 2022. vi. Amend the Health Financing Policy to enable attainment of the 15
percent of total budgets to Abuja targets for allocations to health.
Whereas Kenya is a signatory of the 2001 Abuja
Declaration by African states, the country has vii. Institute financial protection to individuals and lessen the burden
only achieved around 7% level of allocation of
of out-of-pocket spending on health by the most-poor households
national budget to health care.
by availing other options for financing such as improved social
Insufficient funding for health has led to
health insurance, subsidization and voucher systems.
dependence on external donor funds which are
on a diminishing scale for the last decade. viii. Prioritize investments in health care delivery, particularly primary
health services for a healthy citizenry. Provide individuals with
The Budget shortfalls have made it difficult for chronic conditions protection from financially catastrophic events
citizens, especially the most-poor to get
by capping annual out of pocket expenses and ending lifetime
essential primary healthcare.
limits for people with conditions.
ix. Forge partnerships with the private sector to bridge gaps and to
Compounded with poor purchasing
arrangements through NHIF, families depend on lessen the burden on the public sector especially among the
out of pocket expenses for health which have
population segments that can pay higher premiums.
led to catastrophic results and impoverishment
when faced with costly and chronic illnesses.

The Ufanisi Collaborative is keen to support the necessary policy amendments to pave way for these needed reforms and
call on the Ministry of health to make bold actions.

Published by the Ufanisi Collaborative. November 27, 2021

Addressing Common Challenges with Policy Advocacy

The policy advocacy work demands constant navigation of challenges. The policy making
processes are inherently political processes fraught with power struggles. Therefore, among the first
challenges with advocacy is management of the strong political tides. Political influences can delay
accomplishment of advocacy activities quite significantly and therefore to mitigate this challenge,
lobbyists maintain a high level of flexibility. They also focus on milestones achieved rather than
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taking on big chunks of goals that are unrealistic to achieve quickly. In relation to health financing
reforms in Kenya, progress with the NHIF amendment bill has been marked by political games for
years with opposition from strong bodies such as the Central Organization of Trade Unions (Kamau,
May 28, 2021; Kamunyo, July 22, 2021).
Secondly, advocacy efforts can run into trouble due to ethical shortcomings. Advocacy
nonprofits have been spotlighted for unethical practices that put people at risk or made them more
vulnerable (Peterson & Pfitzer, 2009). Another challenge is the fluid manner in which individuals
participate in advocacy activities in that government officials such as legislators often cross over into
the lobbying space when out of office and may fail advance adversarial positions when engaging
with governments they have worked for (Lumen Learning, n.d.). To address this issue advocacy
teams can constitute teams so that they do not have to rely on one individual whose position is
compromised.
Christian (June 14, 2013) named three types of challenges in policy advocacy; administrative
and structural, social and cultural and political and legal challenges. Administrative challenges
include insufficient funding for advocacy, poor capacity to organize and poor participation due to
lack of constituency. Social and cultural obstacles include conflict between officials and civil society
representatives, a culture of low participation in advocacy initiatives and unequal distribution of
enabling resources. The political challenges include negative government belief in the role of civil
society organizations, poor participatory mechanisms and low control of the use of state authority.
A further challenge is inadequate understanding of how the administrative and governance
structures in a country impact policy advocacy actions. In Kenya, policy is the mandate of national
government while legislation to make the policies operational takes place at both national and county
levels. Nonprofits and other policy lobbyists would need to be cognizant of how the dynamics in
government affect their work in order to apply the right strategy at the right level.
Additionally, sometimes policy advocacy actions omit public participation in their work and
run the risk of being rejected by the grassroots. The people’s voice needs to be included through
public participation processes. Hahn (July 12, 2012) emphasizes channels for public involvement
must be created and improved in public policy processes. Policy makers and advocates must
deliberately plan and execute the public’s intelligence and meaningfully engage them in policy
actions.

Discussion
This paper has presented an advocacy plan to support the increase of domestic financing for
health care in Kenya. Some important lessons have emerged. The health policy and law reforms on
 14

health financing are anticipated to shift towards more efficient local revenues that support health
services. Some of the key reorganization will require redefining the role of the NHIF, getting more
people covered by health insurance and improving management of purchasing of health services in
the country. The policy and legal reforms will require partnership of government, private sector and
nonprofits working in synchrony to monitor the implementation for effectiveness.
In addition to the national and county level policy reforms, health facility planning and
budgeting processes need better accountability. Leaders of policy advocacy organizations can
influence the needed change by applying relevant theory and strategies to bolster the progress made
so far in improving the health financing landscape to ensure funds flow to facility level and that
national government increases the percentage of funding allocation to the sector to meet the Abuja
targets.
Relevant policy and regulatory frameworks lead to tangible reforms. The World Bank,
DANIDA, USAID and DFID have supported the Ministry of Health in developing strategic priorities
for domestic financing of health and implementing measures to motivate county governments to do
the same. They have supported drafting of Bills in the Parliament of Kenya as well as county
government level. The Health Bill is currently under debate in the Parliament. These policy and
legal frameworks enable full institutionalization of the reforms for increased domestic financing for
health.
Since devolution of health services in Kenya in 2013, there have been deadlocks that
delayed implementation of certain government mandates until legal interpretation by the Office of
the Attorney General could be obtained. For example, on annual basis there has been an impasse
on the Division of Revenue Bill which allocates funds from the National Treasury to the County
Governments. The subject of increased allocation of domestic resources to the health sector has
potential for delay due to similar legal deadlocks. To address these issues institutional
partnerships strategies as well as insider strategies that will influence will be necessary, such that
a champion inside the decision-making body is nurtured to lobby through the internal processes.
The inside-outside strategy will be useful to combine in building public support (Gen &Wright,
2018).

Conclusion
Leadership of policy advocacy takes multi-faceted strategic thinking and actions for success.
An understanding and application of approriate theories and strategies that underpin advocacy efforts
must be clearly thought and determined. Where ammendments of policy and legislation is required,
a mix of approaches relevant to each stakeholder grouping is necessary. In the context of Kenya’s
 15

health financing policy, advocacy actions will enable higher allocation to the health sector towards
universal health coverage. The government should focus on reforming health financing policies to
avail necessary reources.
 16

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