Abstract
BackgroundHealth in All Policies (HiAP) is an intersectoral approach that facilitates decision-making among policy-makers to maximise positive health impacts of other public policies. Kenya, as a member of WHO, has committed to adopting HiAP, which has been included in the Kenya Health Policy for the period 2014–2030. This study aims to assess the extent to which this commitment is being translated into the process of governmental policy-making and supported by international development partners as well as non-state actors.MethodsTo examine HiAP in Kenya, a qualitative case study was performed, including a review of relevant policy documents. Furthermore, 40 key informants with diverse backgrounds (government, UN agencies, development agencies, civil society) were interviewed. Analysis was carried out using the main dimensions of Kingdon’s Multiple Streams Approach (problems, policy, politics).ResultsKenya is facing major health challenges that are influenced by various social determinants, but the implementation of intersectoral action focusing on health promotion is still arbitrary. On the policy level, little is known about HiAP in other government ministries. Many health-related collaborations exist under the concept of intersectoral collaboration, which is prominent in the country’s development framework – Vision 2030 – but with no specific reference to HiAP. Under the political stream, the study highlights that political commitment from the highest office would facilitate mainstreaming the HiAP strategy, e.g. by setting up a department under the President’s Office. The budgeting process and planning for the Sustainable Development Goals were found to be potential windows of opportunity.ConclusionWhile HiAP is being adopted as policy in Kenya, it is still perceived by many stakeholders as the business of the health sector, rather than a policy for the whole government and beyond. Kenya’s Vision 2030 should use HiAP to foster progress in all sectors with health promotion as an explicit goal.
Highlights
Health in All Policies (HiAP) is an intersectoral approach that facilitates decision-making among policy-makers to maximise positive health impacts of other public policies
The double burden of diseases calling for a social determinants of health (SDH) approach Over the years, Kenya has sought interventions to address key health challenges, such as maternal and child health and nutrition, HIV/AIDS and tuberculosis, malaria, and the emerging threat of non-communicable diseases, with mixed results
This study aimed to investigate how HiAP rose to the agenda-setting level and its adoption in Kenya using the Kingdon framework
Summary
Health in All Policies (HiAP) is an intersectoral approach that facilitates decision-making among policy-makers to maximise positive health impacts of other public policies. Health in All Policies (HiAP) is an emerging strategy for governance in health in low- and middle-income countries (LMICs); it aims to ensure that the social determinants of health (SDH) are taken into account by other development sectors [1, 2]. Director to prepare a strategy for Africa to address SDH [3] This resulted in the African region endorsing a regional framework for “tackling health inequalities and improving the health of the poor and vulnerable through action on the social determinants of health” [4]. The discussions revolved around a draft analytic framework for HiAP and intersectoral collaboration (ISC) [4, 5]. In this meeting, WHO AFRO drafted a regional position
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