NCD Financing Impact Case Study

Reframing health systems research as an operational and economic decision case

Project D · Business Impact Case Study

Financing chronic care as an operations problem.

This page reframes the Kisumu NCD financing work in language that a strategy, operations, or investment audience can absorb quickly: bottlenecks, risk, intervention options, and expected service gains.

Challenge

Seven public facilities were expected to maintain hypertension and diabetes care, but they operated with:

  • no dedicated NCD budget line
  • delayed procurement and reimbursement cycles
  • limited autonomy to redirect funds when chronic medicine demand changed

Data approach

The case combined facility records, financial process review, and qualitative evidence from staff and managers to identify where service continuity breaks down.

Scenario modeling

85.7%Facilities reporting frequent stockouts
100%Facilities without direct spending autonomy
18%Projected continuity gain with faster approvals
3Operational levers modeled
Lever Modeled effect
Faster procurement approval Fewer medicine interruption days
Protected chronic care budget line More predictable medicine availability
Local facility spending discretion Quicker response to small stock gaps

Operational recommendation

The most realistic first move is not a full financing overhaul. It is a tighter operating model:

  • protect a minimum NCD budget line
  • monitor reimbursement lag as a service KPI
  • authorize low-cost local purchases when stockout risk passes a threshold

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