Sustainable Financing For Kenyan Community Health Worker Programs

Community health workers (CHWs) are vital for providing healthcare access to underserved populations in sub-Saharan Africa, yet financing for CHW programs remains a challenge. This thesis explores potential financing instruments for Kenya's CHW program through an in-depth analysis of seven case studies spanning traditional grants, public loans, debt conversion, private loans, social enterprises, grant-based public-private partnerships, and results-based financing. Drawing from informant interviews and literature reviews, each model is evaluated across financial sustainability, CHW operational focus, and contextual alignment to Kenya. The analysis reveals that while public instruments have bolstered disease-specific initiatives, overreliance on external funding poses risks to long-term sustainability. Private solutions allow for self-sustainability in the long run, but funding size and initial capital needed remain a concern. Innovative approaches combining the public and private sectors have the potential to be tailored for CHW programs while generating sustainable revenue; however, they require substantial planning and investment. Across all models, shared characteristics for scalability and impact include robust governance, domestic resource mobilization, and country ownership.