Safety Inspections in the Health Market in Kenya

May 5, 2021

A mother and child getting nutritional advice at a health clinic in Turkana supported by UK aid.
Photo: Noor Khamis/Department for International (UK)

Policy Issue:

Inspections and other forms of accountability mechanisms are increasingly salient as a monitoring mechanism and a punitive tool for governments to achieve better delivery of public services, increased compliance with regulatory standards and decreased administrative costs of compliance.

In Kenya, at the beginning of this study. Only 2 percent of facilities were compliant with minimum safety standards. Private facilities, the majority of providers in the market, complained about lack of transparency and the high cost of complying with the regulation.

This study pilots the effectiveness of an improved inspection scheme that introduces communication protocols, monitoring systems, and scorecards. The improved scheme is expected to affect compliance, patient safety, and market outcomes linked to the performance of facilities (such as the demand for services and patient health expenditures).


Impact Evaluation Note

Process Evaluation

Design Brief

Detailed Methodology Note

Measurement instruments (paper 1) (paper 2) (paper 3)


Jishnu Das, Lead Economist, the World Bank

Guadalupe Bedoya, Economist, the World Bank

Jorge Coarasa, Senior Economist, the World Bank

Amy Dolinger, Project Coordinator, the World Bank

Ana Goicoechea, Senior Economist, the World Bank

Funding Partners:

Strategic Impact Evaluation Fund (SIEF)

Competitiveness Policy Evaluation Lab

Development Economics Research Group (DECRG)

Impact Evaluation to Development Impact (i2i)       

Kenya Health in Africa Initiative

Korea World Bank Group Partnership Facility (KWPF)

Primary Health Care Performance Initiative

Korea Institute for International Economic Policy