Integral to the UN Sustainable Development Goals (SDGs) is the idea that no one should be left behind. This report provides an early stocktake of progress on the ‘leave no one behind’ agenda in Kenya and Nepal’s health sectors. Using the WHO’s Reproductive Maternal Newborn and Child Health Composite Coverage Index as a proxy, it maps out who is being left behind in health care coverage and where they are located. It then uses a combination of financial, institutional and political economy analysis to assess current attempts to reach these groups, looking at evidence of progress and persistent challenges.
Kenya and Nepal have both made significant strides in aligning their constitutional, policy and, to some extent, financial frameworks with the aspiration to leave no one behind. However, efforts to put these policies into practice are constrained by insufficient or insufficiently used data, inadequate and misallocated resources, and political incentives that do not always favour the most marginalised. The report advises reform champions to think about a joined-up approach to data, policy, finance and service delivery, building coalitions that can overcome the blockages and constraints we have found.