Request for Application #2019-020

Digital Financial Services on Health Outcomes and Health Systems

Hecta Consulting_An Assessment of the Impact of Digital Financial Services on Health Outcomes and Health Systems in Kenya and Uganda.

Executive summary: 

The world made a unanimous decision to improve access to quality and affordable healthcare services and expressed that through the Sustainable Development Goal 3.0. The World Health Organization (WHO) was charged with the responsibility for supporting its member states operationalize that declaration. Attainment of SDG 3.0 is anchored on successful implementation of the Universal Health Coverage (UHC) which many WHO member countries have prioritized in their domestic development agenda. In Kenya, the current administration has articulately expressed UHC as a priority by including it in the Big Four agenda, a blueprint for socio-economic development for the country.  One of the core strategies to achieve 100% UHC in Kenya is to scale up uptake of the National Health Insurance Fund (NHIF) services. Uganda also set out to achieve UHC as envisioned in its Vision 2040.

Kenya is a world leader in digital financial services, mobile money in particular, providing accessible formal financial services for the country's unbanked through M-Pesa services. Uganda has a growing digital financial services sector that is yet to penetrate its population due to infrastructural and regulatory challenges inter alia. In this project, we aim to investigate the impact of digital financial services on the health system in terms of financial protection, service utilization and health system performance. Additionally, we aim to find out the factors that influence the success of digital financial services implementation by gathering data from the key players and consumers of digital financial services. Our team of experts in health informatics, health systems strengthening, and health finance and policy has an outstanding global track record in policy research, technical assistance as well as related project implementation across different settings. This will guarantee competent delivery of the requisite comprehensive landscape report and peer reviewed publications of the findings.

Consortium Team: 

Hecta Consulting Limited ( is a health systems consulting firm that was established in 2010. The firm boasts of a rich mix of health systems consultants with expertise across the different building blocks, including leadership and governance of health systems, healthcare financing and health information technology. Hecta has undertaken assignments around financial risk protection and equity in health systems. Recent assignments include doing a process evaluation of the Universal Health Coverage program across four Kenyan pilot counties (project done for the World Bank and Ministry of Health), conducting a socio-economic impact assessment of the government’s Managed Equipment Leasing scheme (project done for the Ministry of Health), and examining how poorer groups in Kenya, Uganda, Malawi, Madagascar and Rwanda benefit from various types of interventions aimed at improving access to quality health services (project done for UNICEF, ESARO). Dr Francis Wafula leads the health systems component, with Dr Matiko Riro leading the healthcare financing component. Hecta will lead the sub-component of work that seeks to examine the impact of DFSs on access and financial protection of poorer groups to healthcare services as well as health system responsiveness.

IntelliSOFT Consulting Limited ( is a well-established, globally recognized and respected leading digital health technology firm based out of Nairobi, Kenya. IntelliSOFT has focused its work specifically on digital health solutions in terms of research and innovation, implementation and use. Additionally, IntellISOFT has significantly contributed at local, regional and global level to progression of digital health by supporting countries develop digital health policies and strategies, relevant standards and guidelines, and global digital health goods such as the interoperability maturity model toolkit. IntelliSOFT’s direct and hands-on experience and expertise in developing, implementing, and supporting meaningful use of digital health solutions, of which DFS falls within that, makes it an extremely valuable and complementary partner to the prime, Hecta.

The consortium will also engage resource partners as relevant. At this point, we have identified a leading mobile data collection firm Hoji ( as an important resource partner in the consortium because of the importance of efficient and effective collection and use of the assessment data. Other resource partners will be identified and engaged on a need basis.

In the consortium are also key personnel with extremely relevant and highly useful contributions to make for achievement of the goal and objectives of this assessment;

Dr. Mike Mulongo is a medical doctor and Mandela Washington Fellow (Business and Entrepreneurship), currently working as an International Health Consultant in Kenya. He has been a technical lead in consultancies for global advocacy, global health and medical product agencies within East Africa and Europe with a keen focus on health financing policy, health systems strengthening and market strategy.

Dr. Job Nyangena is a highly trained health informatician and a medical doctor. He is currently actively involved in research, implementation of digital health solutions through Lonius Health Technologies and building capacity of health informatics as a tutorial fellow and researcher at the Institute of Biomedical Informatics (IBMI), Moi University, Kenya. Moi University is also famous for establishing the Academic Model Providing Access to Healthcare (AMPATH) which brought forth the most globally popular open source medical records system, OpenMRS (

Dr. Torooti Mwirigi is a healthcare technology and health financing consultant with ASKADOC ( ) and currently the Commercial Director at M-TIBA. M-TIBA is the fastest growing provider of Digital Health Financial Services in Kenya and Nigeria. Torooti’s deep working knowledge of DFS and insights will provide this consortium a distinct advantage in terms of access to resources and experiences that would otherwise be largely inaccessible. He will only be engaged in an advisory capacity as he is engaged on a full time basis by M-TIBA.

Application Status: 
Not Approved


The reformulation of the research questions are expanded and well detailed. The methodological approach leverages mixed methods, which is good--as is the proposition of an analytical framework. We note that one of the members of the consortia is a representative of a firm which has applied separately, the rationale for this is unclear (i.e. MTIBA/PharmAccess Foundation.)

The methods offered for data analysis are interesting and focus on both impact and implementation research assessments. We suggest remaining focused on health systems issues and not expanding to multi-sectoral DFS applications, given the budget and time allocated for this.

Thank you Celia for this feedback.

The member in our team works for M-TIBA which on accassion works with PharmAccess. The latter have put in an application in this call hence the association. In view of this concern, to mitigate against conflict of interest, we have opted at having the concerned member only play an occassional advisory role and not direct engagement.

We have also made ammendments on the methodology to guard against scope creep and focus only on sectors that directly interface with health in our eavaluation.

A framework (not illustrative, but actual) could help prevent scope-creep and maintain focus.  Also, can you comment in your application response how your deliverables help USAID in achieving its objectives with this work, given the target audience may not read academic studies?

Thank you Amanda for the feedback.

We have made changes in the methodology to incorporate a preliminary guiding framework (Mobile Money For the Poor Honeycomb). This will also help mitigate against scope creep as we seek to enhance the existing framework.

We have also poposed a separate output for information dissemination via newsletters, infographics, blogs inter alia  for the audience that may not access academic publications.

In our problem statement, we have included a brief on the utility of our findings to USAID and other stakeholders.

Thank you.