Kenya’s Health In All Policies Strategy: A Policy Analysis Using Kingdon’s Multiple Streams.

Background: Health in All Policies (HiAP) is an intersectoral approach that facilitates decision-making among
policy-makers to maximize positive health impacts of other public policies. Kenya, as a member of WHO, has
committed to adopting HiAP, which has been included in the Kenya Health Policy for the period 2014–2030. This
study aims to assess the extent to which this commitment is being translated into the process of governmental
policy-making and supported by international development partners as well as non-state actors. Methods: To examine HiAP in Kenya, a qualitative case study was performed, including a review of relevant policy
documents. Furthermore, 40 key informants with diverse backgrounds (government, UN agencies, development
agencies, civil society) were interviewed. Analysis was carried out using the main dimensions of Kingdon’s Multiple
Streams Approach (problems, policy, politics).

Results: Kenya is facing major health challenges that are influenced by various social determinants, but the
implementation of intersectoral action focusing on health promotion is still arbitrary. On the policy level, little is
known about HiAP in other government ministries. Many health-related collaborations exist under the concept of
intersectoral collaboration, which is prominent in the country’s development framework – Vision 2030 – but with
no specific reference to HiAP. Under the political stream, the study highlights that political commitment from the
highest office would facilitate mainstreaming the HiAP strategy, e.g. by setting up a department unde rthe
President’s Office. The budgeting process and planning for the Sustainable Development Goals were found to be
potential windows of opportunity.

Conclusion: While HiAP is being adopted as policy in Kenya, it is still perceived by many stakeholders as the
business of the health sector, rather than a policy for the whole government and beyond. Kenya’s Vision 2030
should use HiAP to foster progress in all sectors with health promotion as an explicit goal.
Keywords: Health in all policies, intersectoral collaboration, agenda-setting, social determinants of health, Kenya.