Kenya’s Health Technology Assessment (HTA) Journey: Laying the Foundations for Evidence-based Policy

Health Technology Assessment (HTA) is quickly moving from an academic idea to a practical tool for decision-making in Kenya. As the country pursues Universal Health Coverage (UHC) and strives to spend scarce health resources wisely, HTA is emerging as the bridge between clinical evidence, economics, and the real priorities of Kenyan patients and policymakers.

This case study traces Kenya’s early steps toward institutionalized HTA, highlights what makes the journey locally relevant, and draws practical lessons for countries following a similar path.

Where Kenya started: Drivers and early momentum

Several converging forces set the stage for HTA in Kenya: pressure to define an explicit health benefits package under UHC, rising costs of new medicines and technologies, and a growing appetite among technocrats for transparent, evidence-based resource allocation.

These policy drivers, together with international partnerships and bilateral support, notably the Japan International Cooperation Agency (JICA), created the initial political and technical momentum for HTA activities and structures in Kenya. 

Building blocks: institutions, capacity and piloting

Rather than trying to create a fully fledged HTA agency overnight, Kenya adopted a pragmatic, incremental approach. Key elements have included:

• Creating organizational structures and pilots units and working groups linked to the Ministry of Health and existing technical committees (for example the Health Benefits Package Advisory Panel structures and market authorization/price advisory groups) have started performing HTA-type analyses and priority-setting work. These building blocks help demonstrate value before formal institutionalisation. 

  
  

• Capacity building and local methods work — Kenyan researchers and policy analysts have led pilots on economic evaluation, multicriteria decision analysis (MCDA), and priority-setting exercises to adapt HTA methods to the Kenyan context. Stakeholder preference studies have helped tailor criteria that matter locally (equity, financial protection, cost-effectiveness, feasibility). 

  
  

• Hospital and subnational practice — Hospital-based HTA (HB-HTA) initiatives in tertiary hospitals are creating a bottom-up route for HTA to influence procurement and clinical practice at the point of care. These efforts both meet immediate needs (device procurement, diagnostics) and expand the pool of people trained in HTA methods. 

What makes Kenya’s approach locally relevant

Three features stand out in why Kenya’s HTA work is grounded in local realities:

1. Policy alignment with UHC goals - HTA is being positioned explicitly as a tool to define a benefits package and make trade-offs visible — not as an academic exercise. This direct policy link raises demand for HTA outputs by decision-makers. 

   
   

2. Contextualised criteria and processes - Kenyan studies have actively sought stakeholder input on which decision criteria matter (beyond cost-effectiveness), embedding local values (e.g., equity, catastrophic expenditure reduction) into HTA frameworks. This improves legitimacy and uptake. 

   
   

3. Practical, phased institutionalisation - Pilots at national and hospital levels, supported by targeted capacity development and international technical assistance, reduce political risk and demonstrate short-term wins while longer-term governance arrangements are debated. 

Challenges Kenya is tackling

Institutionalising HTA is not without obstacles. Common and persistent challenges include:

• Human and analytic capacity: there are more questions than trained analysts today; sustained training pipelines are needed. 

  
  

• Data gaps: cost databases, routine outcomes data, and diagnostics use data are incomplete, which complicates economic modelling. 

  
  

• Financing and sustainability: HTA requires predictable funding lines; pilots often rely on project financing which is hard to scale. 

  
  

• Managing stakeholder interests:  Manufacturers, clinicians and parts of the health sector will respond to changes in access/pricing. Transparent processes and stakeholder engagement are essential. 

These constraints are familiar from international experience, and recent global guidance underlines practical steps for Low- and Middle-Income Countries (LMICs) to address them (method standardisation, staged roll-out, and investment in data systems). 

Early wins and signals of impact

Although formal HTA institutionalisation remains a work in progress, Kenya’s journey has produced tangible results:

• Evidence-informed decisions in procurement and pricing discussions at national and subnational levels. 

  
  

• Local methodological advances (e.g., MCDA exercises and stakeholder preference elicitation) that make HTA outputs more policy-relevant. 

  
  

• Growing practitioner networks and cross-country learning that accelerate capacity development. 

Practical recommendations: What Kenya (and peers) can prioritise next

1. Make HTA useful and visible: align HTA products to immediate policy questions (benefits package, procurement, essential diagnostics) so outputs are used and demand grows. 

2. Invest in people and routines: fund long-term training, embed HTA modules into public health curricula, and set up mentorship links with established HTA bodies. 

3. Build data foundations: create a national cost database and routine outcome reporting to reduce modelling uncertainty. 

4. Design staged governance: pilot HTA within existing technical structures while designing a transparent, permanent decision governance model. 

5. Protect HTA independence and transparency: ensure guidelines, conflict-of-interest rules, and public reporting to sustain trust. 

Final thought

Kenya’s HTA journey shows how a pragmatic, locally-adapted approach can lay strong foundations for evidence-based health policy. Through focusing on relevance, answering the questions that matter to Kenyan policymakers, clinicians and communities, and by building capacity incrementally, HTA can shift from pilot projects to routine practice.

The road is long, but the early steps are promising: smarter choices today can unlock broader, fairer access to health technologies for millions.