Abstract
Though difficult to ascertain because faith based organizations (FBOs) might keep a low profile, be confused with other non-governmental organizations (NGOs), or survey respondents may not know the nature of facilities attended to, these organizations have a long presence in teaching health personnel and delivering health services in many rural and remote populations in the developing world. It is argued that their large networks, logistics agreements with governments, and mission-driven stance brings them closer to the communities they serve, and their services believed of higher quality than average.
 Kenya has a long history of established FBOs substantial recent health investment by the government. We aimed to find the quantitative and qualitative contributions of FBOs by analyzing two recent data sources: the live web-based nationwide Master Health Facility List, and the 2010 nationwide Service Provision Assessment (SPA) survey. Using this information, we found that FBOs contribute to 11% of all health facilities’ presence in the country, doubling to 23% of all available beds, indicating their relative strength in owning mid-level hospitals around the country.
 We also constructed an index of readiness as a weighted average from services offered, good management practices and availability of medicines and commodities for 17 items assessed during the SPA survey. We found that FBOs topped the list of managing authorities, with 70 percent of health facility readiness, followed closely by the government at 69 percent, NGOs at 61 percent and lastly a distant private for profit sector at 50 percent.
 These results seem to indicate that FBOs continue to contribute to an important proportion of health care coverage in Kenya, and that they do so with a relatively high quality of care among all actors.
 It would be of interest to replicate the analysis with similar databases for other countries in the developing world.
Highlights
As part of a current trend and initiatives advocating for the strengthening of health systems in the developing world, there is increasing interest in assessing the contribution of non-governmental sectors such as the private sector in the provision of health care.[1,2] In this trend, several publications have tried to estimate the contribution of faith based organizations (FBOs) to health service delivery in the developing world
Claims have surfaced in the last decade or so that “between 30% and 70% of the health infrastructure in Africa is currently owned by faith-based organizations . . . ,”3 up to 50% of the market share on beds and health facilities are related to FBOs,[4] or they contribute to healthcare between 12% and 50% among ten assessed African Christian Health Association Member countries.[5]
There have been several claims of a high contribution of faith based organizations to the amount of healthcare provided in a country, with some estimates up to 50 percent, our findings suggest that the FBO contribution is more conservative, at least for Kenya
Summary
As part of a current trend and initiatives advocating for the strengthening of health systems in the developing world, there is increasing interest in assessing the contribution of non-governmental sectors such as the private sector in the provision of health care.[1,2] In this trend, several publications have tried to estimate the contribution of faith based organizations (FBOs) to health service delivery in the developing world. A couple of recent publications make a lengthy review of the inaccuracies of and difficulties with different estimates (e.g., from inventories of facilities, published routine data on health information systems, household and facility surveys, or from international agencies’ reports) of the market share, facilities, beds, or “healthcare” of faithinspired institutions compared to the universe.[7,8] Estimates of FBO contribution can be difficult due to the complexities of definitions, identification, politics, and modalities of healthcare beyond health infrastructure. They note the large evidence gap and urge for the need to study further the quality, efficiency, and sustainability of their efforts
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