The Ministry of Health (MoH) and the Council of Governors (COG) have announced the end of the Medical Equipment Service (MES) program and the introduction of the Fixed Fee-for-Service (FFS) model. This transition marks a strategic move to optimize healthcare delivery across Kenya, enabling counties to focus on patient care while leveraging advanced medical technology. Health Cabinet Secretary Deborah Barasa and COG Chair Ahmed Abdullahi jointly explained that the new approach aims to transfer the financial responsibility for medical equipment from government and county facilities to contracted vendors, thus allowing for the continuous supply, maintenance, and upgrading of state-of-the-art equipment without upfront costs.
The Shift from MES to FFS Model
The MES program, initiated several years ago, was designed to equip public health facilities with modern medical equipment. However, over time, several challenges emerged, including financial strain on counties, maintenance issues, and the lack of sustainability in the procurement process. The decision to shift to the FFS model is therefore a response to these limitations, offering a more sustainable and transparent framework for the provision of medical equipment.
The FFS model operates on a pay-per-use basis, ensuring that county health facilities can access and use advanced medical equipment without incurring significant upfront costs. According to Barasa and Abdullahi, the model allows vendors to take responsibility for the supply, maintenance, and upgrading of the equipment. This approach not only alleviates the financial burden on counties but also guarantees the availability of modern medical tools for effective diagnosis, treatment, and patient care. The Health Cabinet Secretary highlighted that this model is fundamentally different from leasing, as it provides a more comprehensive solution by including service and maintenance in the contract.
Implementation Process
The transition to the FFS model was executed through a transparent and competitive tendering process. In June 2024, the MoH published public advertisements in multiple channels, including the MyGOV bulletin, the Ministry’s website, and the Public Procurement Information Portal, inviting interested vendors to submit tenders. The evaluation process involved rigorous assessment by a joint committee comprising representatives from the MoH, county governments, and independent evaluators, ensuring adherence to the Public Procurement and Asset Disposal Act. This approach aimed to select vendors based on their capability to provide high-quality service and maintain the latest medical technology.
In October 2024, seven qualified bidders were awarded contracts to supply medical equipment to county health facilities across the country. The selection was based on a thorough evaluation of proposals, considering factors such as financial sustainability, service delivery models, and alignment with the Social Health Authority’s benefit tariffs. This collaborative approach ensured that the chosen vendors would not only provide the equipment but also maintain it and supply upgrades as needed, thus ensuring that the technology remains relevant and up-to-date for healthcare providers.
To facilitate the implementation of the FFS model, the MoH and county governments have established an administrative framework to guide the program’s execution. County governments have voluntarily entered into Intergovernmental Participatory Agreements, under which suppliers invest in and place medical equipment in county facilities at front cost. They are then reimbursed through the Social Health Authority for services rendered based on the gazetted tariff amounts. This system ensures transparency, accountability, and efficiency in the reimbursement process, aligning with the overarching goal of enhancing healthcare delivery nationwide.
Benefits of the FFS Model
The transition to the FFS model is expected to significantly improve healthcare access and quality across Kenya. By reducing financial barriers for counties, the model allows them to allocate resources more effectively towards patient care, staff training, and other critical health services. The shift also enhances sustainability, as counties are no longer burdened with the upfront costs associated with the procurement and maintenance of medical equipment. The MoH and COG emphasized that the FFS model fosters transparency by ensuring that payments for services are directly tied to the use of the equipment, thereby reducing opportunities for misuse and inefficiency.
Moreover, the new model promotes innovation in healthcare technology. Vendors are incentivized to provide the latest equipment, software, and diagnostic tools, ensuring that county health facilities remain at the forefront of medical technology. This is crucial for improving diagnostic accuracy, patient outcomes, and overall healthcare delivery standards.
Conclusion
The transition from the MES program to the FFS model represents a strategic shift towards a more sustainable, accountable, and patient-centered healthcare system in Kenya. By leveraging modern procurement processes and transparent tendering, the MoH and COG have set a precedent for how public-private partnerships can enhance service delivery in the health sector. As the FFS model continues to be implemented, it is expected to not only improve the quality of care provided to Kenyans but also provide a framework for other sectors to emulate in achieving sustainable development goals.
