Kenyan government policy alignment towards United States foreign aid goals for the development of healthcare infrastructure in Kenya

Cyrus Fundi Nyagah; Pontian G. Okoth; Frank K. Matanga

doi:10.51867/AQSSR.3.4.50

Authors

Cyrus Fundi Nyagah Masinde Muliro University of Science and Technology, Kenya Author https://orcid.org/0009-0001-5580-3105
Pontian G. Okoth Masinde Muliro University of Science and Technology (MMUST) Author https://orcid.org/0000-0001-8369-9029
Frank K. Matanga Masinde Muliro University of Science and Technology, Kenya Author https://orcid.org/0009-0005-1157-9980

DOI:

https://doi.org/10.51867/AQSSR.3.4.50

Keywords:

Development, Healthcare, Healthcare Infrastructure, Policies, US Foreign Aid

Abstract

Government policies imposed on USA foreign aid by different countries reflect a complex interplay of geopolitical strategies, economic interests, and humanitarian goals. Governments often utilize foreign aid as a tool for diplomacy and to strengthen bilateral relations. The moderating role of government policies is essential in determining the success of U.S. foreign aid aimed at improving healthcare infrastructure. The objective of the study was to Investigate the of Kenyan government policy alignment towards the relationship US foreign aid goals for the development of Healthcare Infrastructure in Kenya. The study was anchored on Human development theory. This study adopted descriptive and Evaluation Research Designs. The target population was 4,212 heads of departments in health care facilities in Nairobi. A sample size of 370 was determined using Yamane (1967) formular. The study was conducted in Nairobi City County. The study utilized probability and non-probability sampling techniques. Primary data was obtained through field using various data collection instruments including the use of Questionnaires, FGD Guides and KII schedules. The quantitative data was analysed using SPSS version 27 to generate descriptive statistics in the form of frequencies and percentages. Qualitative data analysis was done using content and interpretive analysis and verbatim quotations. The findings revealed that a substantial majority of the respondents, 222 (74%), strongly agreed that Kenyan government policies align well with USA foreign aid goals. The study further revealed that government policies provide a conducive environment for USA foreign aid effectiveness as supported by 246 (82%) of respondents. Additionally, 225 (75%), strongly agreed that USA foreign aid programs align with Kenya’s development priorities. The study concluded that there is strong alignment between Kenyan government policies and USA foreign aid objectives, indicating that the government plays a critical role in ensuring the effectiveness of aid programs. From the findings and conclusions, the study recommends that the Kenyan government should focus on improving governance, reducing corruption, and ensuring policy coherence to maximize the effectiveness of foreign aid.

References

Amref Health Africa. (2026, October 13). Amref warns of health system strain as global aid falls, urges African governments to boost funding. https://newsroom.amref.org/global-health/2026/10/amref-warns-of-health-system-strain-as-global-aid-falls-urges-african-governments-to-boost-funding/

Bhattacherjee, A. (2019). Social science research: Principles, methods and practices (Rev. ed.). University of Southern Queensland.

Devarajan, S., Khemani, S., & Shah, S. (2009). The politics of partial decentralization. In E. Ahmad & G. Brosio (Eds.), Does decentralization enhance service delivery and poverty reduction? https://doi.org/10.4337/9781849801850.00011

Easterly, W. (2014). The tyranny of experts: Economists, dictators, and the forgotten rights of the poor. Hachette UK.

Global Fund. (2024). Kenya and Global Fund launch new grants to sustain progress against AIDS, TB and malaria. https://www.theglobalfund.org/en/updates/2024/2024-06-28-kenya-global-fund-new-grants-progress-against-aids-tb-malaria/

Gottenhuber, S. (2026). Policy coherence in process and outcome: Solving sustainability goal conflicts? [Doctoral dissertation, Linköping University]. Linköping University Electronic Press. https://doi.org/10.3384/9789181184907

Government of Kenya. (2022). Kenya Vision 2030 flagship programmes and projects progress report (FY 2020/2021): Towards a globally competitive and prosperous nation. https://vision2030.go.ke/wp-content/uploads/2022/09/final-edited-vision-2030-flagship-project-progress-report_170820221-1.pdf

Helleiner, E. (2002). Economic nationalism as a challenge to economic liberalism? Lessons from the 19th century. International Studies Quarterly, 46(3), 307-329. https://doi.org/10.1111/1468-2478.00235

Kothari, C. R., & Garg, G. (2014). Research methodology: Methods and techniques (3rd ed.). New Age International Publishers.

Leavy, P. (2017). Research design: Quantitative, qualitative, mixed methods, arts-based, and community-based participatory research approaches. The Guilford Press.

McDade, K. K., Munge, K., Kokwaro, G., & Ogbuoji, O. (2021). Development finance in transition: Donor dependency and concentration in Kenya's health sector (Duke Global Working Paper Series No. 29). Center for Policy Impact in Global Health. https://centerforpolicyimpact.org/wp-content/uploads/sites/18/2021/03/Kenya-Donor-Dependency_FINAL.pdf

https://doi.org/10.2139/ssrn.3797710

Ministry of Health. (2014). Kenya health policy 2014-2030: Towards attaining the highest standard of health. https://faolex.fao.org/docs/pdf/ken175055.pdf

Ministry of Health. (2023). The Social Health Insurance (General) Regulations, 2023 [Draft regulations]. https://www.health.go.ke/sites/default/files/2023-11/SOCIAL%20HEALTH%20INSURANCE%20%28GENERAL%29%20REGULATIONS%20%2C2023.pdf

Moyo, D. (2009). Dead aid: Why aid is not working and how there is a better way for Africa. Macmillan.

Müller, C. (2022, August 16). Foreign aid and the challenges in Kenya. Institute of Economic Affairs Kenya. https://ieakenya.or.ke/blog/foreign-aid-and-the-challenges-in-kenya/

Mutapi, F. (2025). Africa relies too heavily on foreign aid for health - 4 ways to fix this. Democracy in Africa. https://democracyinafrica.org/africa-relies-too-heavily-on-foreign-aid-for-health-4-ways-to-fix-this/

https://doi.org/10.64628/AAJ.ggjammqek

Njeru, J. (2003). The impact of foreign aid on public expenditure: The case of Kenya (AERC Research Paper No. 135). African Economic Research Consortium.

Organisation for Economic Co-operation and Development. (2005). Paris declaration on aid effectiveness. OECD Publishing. https://doi.org/10.1787/9789264098084-en

Qian, N., & Yanagizawa-Drott, D. (2021). The local economic effects of aid: Evidence from the Millennium Villages Project. Journal of Political Economy, 129(1), 161-200.

Radelet, S. (2015). The great surge: The ascent of the developing world. Simon & Schuster.

Riddell, R. C. (2025). Does foreign aid work? In Doing good or doing better (pp. 47-79). Routledge.

Shaikh, N. (2004, December 6). Amartya Sen: A more human theory of development. Asia Society. https://asiasociety.org/amartya-sen-more-human-theory-development

Stover, J., Glaubius, R., Teng, Y., Kelly, S., Brown, T., Hallett, T. B., Revill, P., Bärnighausen, T., Phillips, A. N., Fontaine, C., Frescura, L., Izazola-Licea, J. A., Semini, I., Godfrey-Faussett, P., De Lay, P. R., Benzaken, A. S., & Ghys, P. D. (2021). Modeling the epidemiological impact of the UNAIDS 2025 targets to end AIDS as a public health threat by 2030. PLOS Medicine, 18(10), Article e1003831. https://doi.org/10.1371/journal.pmed.1003831

Stover, J., Sonneveldt, E., Tam, Y., Horton, K. C., Phillips, A. N., Smith, J., Martin-Hughes, R., Ten Brink, D., Citron, D. T., Kim, H.-Y., Akullian, A., Mudimu, E., Pickles, M., Bershteyn, A., Williamson, J., Meyer-Rath, G., Jamieson, L., Sully, E. A., White, J. N., . . . Kaftan, D. (2025). Effects of reductions in US foreign assistance on HIV, tuberculosis, family planning, and maternal and child health: A modelling study. The Lancet Global Health, 13(10), e1669-e1680. https://doi.org/10.1016/S2214-109X(25)00281-5

U.S. Department of State. (2025, December 4). United States and Kenya sign five-year, $2.5 billion health cooperation framework. https://www.state.gov/united-states-and-kenya-sign-five-year-2-5-billion-health-cooperation-framework

Vizard, P. (2001, November). Economic theory, freedom and human rights: The work of Amartya Sen [Briefing paper]. Overseas Development Institute. https://media.odi.org/documents/2321.pdf

World Bank. (2011). World development report 2011: Conflict, security, and development. https://doi.org/10.1596/978-0-8213-8439-8

https://doi.org/10.1596/978-0-8213-8439-8

Yamane, T. (1967). Statistics: An introductory analysis (2nd ed.). Harper & Row.