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Table 2 Actors’ interests, position and influences on implementation process

From: A Policy Analysis of the implementation of a Reproductive Health Vouchers Program in Kenya

Category of Actors Roles in the program Interest Level of power Position
The Project Executing Agency-NCAPD The MoH was engaged in conceiving and planning the introduction NSHIF. For this reason, the MoH’s capacities to introduce new concepts and approaches into the service delivery system were stretched to the limit. Ministry of Planning and National Development offered to step in as the temporary host with the Programme Executing Agency being the NCAPD High High Supportive
Advisory board Provided support and advice on the medical, administrative, economic, and ethical matters. Promoted and maintained communication with the steering committee. Endorsed the VMA’s quarterly progress report and plans. Oversaw the OBA program implementation and link program to policy and political stream High High Supportive
Steering committee Reviewed and approved draft contracts for distributors and providers, including the fee schedule; all planed activities, quarterly budgets and operational plans, evaluation and audit reports. Monitoring and coordination of the program on behalf of GOK; provided backstopping where necessary and made decisions regarding the implementation, adaptation and improvement of the program High High Supportive
MoH-DRH Overall policy guidance with less involvement in the implementation High Medium Supportive
Pricewaterhousecoopers Water House (PwC) VMA Contracted to train VSP; developed and implemented a marketing and distribution strategy for the vouchers, Collection and processing of claims; paid for the services according to the terms of the contracts High Medium Supportive
NHIF Selected as the government agency mandated to conduct quality assurance. Accreditation and quality assurance High Medium Middle support
Microd Consult Selected after tendering to support NCPAD to develop a monitoring and evaluation framework but did not to play an active role Low Low Middle support
Lowe Scanad Marketing the program in various project sites Low Low Middle support
International actors   
Marketing Consultant Provided independent evaluation of the effectiveness of the marketing and distribution functions Medium Medium Middle support
KfW Provided funding and were instrumental in designing the concept High High Supportive
Institut für Gesundheits- und Sozialforschung (IGES) Selected as consultants to the programme during its starting phase and to periodically provide professional inputs on the concept, overall programme management, medical aspects associated with the different services covered by the vouchers, marketing and reimbursement systems. Mediating different stakeholders. Contracted to offer back stopping services since it was the only one with knowledge on the voucher program High Medium Supportive
Local actors   
Voucher distributors Marketing of the vouchers, interviewing clients to ensure target beneficiaries obtain the voucher High Medium Supportive
Service providers Providing services to voucher clients, prepare the requisite documentation on services provided for claims processing and report to VMA any irregularities noted on vouchers presented by clients High Medium Supportive
Nairobi Women’s Hospital Identified based on being the only facility that provided gender-based violence recovery services High Medium Supportive
Kalzmat Security Print Ltd Printing vouchers Middle Low Immobilised
Marie Stopes Developed and provision of a participatory poverty grading tool that was used to identify eligible clients for the voucher system High Low Supportive
Kenya Medical and Educational Trust Involved in initial design phases but not in implementation Low Low Immobilised
Population Council Involved in development of the accreditation criteria and standards for voucher package and the quality assurance manual High Low Supportive
African Population and Health Research Center Involved in initial design phases but not in implementation Low Low Immobilized
Community level actors   
Beneficiaries Responsible for seeking the vouchers and using them to access services at the accredited VSP’s. Required to provide accurate and true information to the voucher distributor which is used to determine their eligibility High Low Supportive