Evaluation of Danish Health Sector Support to Kenya 2004-2024

Denmark has supported the health sector in Kenya for over 40 years with a broad range of interventions and various levels of intensity. Since the preparation of the first phase of Health Sector Programme Support in 2004, the support has comprised a closer involvement with government at different levels, lately with an important link to the devolution process in Kenya. The Danish health sector support has comprised the following five overall phases: (1) Health Sector Programme Support (HSPS) 2004-2006; (2) Health Sector Programme Support to Kenya, HSPS Phase II (2007-2011); (3) Kenya Health Sector Programme Support - HSPS Phase III (2012-2016); (4) Thematic Programme for Health, (including Support to Universal Health Care (UHC) in the devolved system and Support for SRHR) as part of the 2016-2020 Denmark-Kenya Country programme; (5) Support to Democratic Governance, Human Rights and Equitable Access to Services (including the Primary Health Care Support Programme 2021-2025 and the ACCELERATE programme) as part of the Strategic Framework Denmark-Kenya Partnership 2021-2025. Over the years, more than DKK 1 billion has been allocated for the support, including support for a devolved health sector. The evaluation will assess what has been achieved from the last approximately 20 years of Danish support to the health sector in Kenya. Thereby, it will be an opportunity to dive into strengths and weaknesses of one of the few remaining bilateral social sector programmes in the Danish development cooperation portfolio and assess implications of the approach to partnership and dialogue. The overall purpose is to document and assess the contribution of the Danish support to the health sector in Kenya over the last 20 years, both with regards to results to which Denmark has contributed and the value added of the Danish approach and partnerships. Based on this, the evaluation should distil relevant lessons for future health sector support to Kenya as well as more broadly for working with partnerships and local ownership. The overall objectives of the evaluation are: (1) Map the development of the health sector in Kenya as well as the evolving Danish support hereto; (2) Document and assess the Danish contribution to results and long-term changes in the health sector, health services and health outcomes in Kenya 2004-2023, including in the context of heath as a devolved service sector in Kenya; both at the level of the individual programme phases and looking across programme phases; (3) Assess the extent to which the Danish approach to the support and partnership as well as the ability of Denmark as a donor to adapt to changing contexts and priorities have been of relevance to the health sector in Kenya in the period, and how it has influenced the performance of the support; (4) Provide potential lessons learned based on the findings from the health sector support and partnership, with emphasis on lessons regarding the modality and approach, including partnerships and local ownership, and the implications hereof for Danish development cooperation in the health sector and broader.