Presented by S. N. Njoroge Presented by S. N. Njoroge Community Health and Development Unit Ministry of Health
Apr 12, 2017
Presented by S. N. NjorogePresented by S. N. Njoroge Community Health and Development Unit
Ministry of Health
Is a strategy that empowers individuals, households and the community so that they are informed
Informed communities can hold policy duty bearers to be accountable and
Are able to take control of their own healthNote: Communities are at the foundation of affordable,
equitable and effective health care They are the core of the Kenya Essential Package for
Health
Goal -To enhance community access to health care
Methodology – Establishment of sustainable community health services
Aim - Promoting dignified livelihoods across all the stages of the life cycle
A key pillar in Kenya’s Vision 2030
A flagship program in MTP II
Focus on community empowerment and participation in their own health
Provides a platform for convergence not only within the health sector, but also with other sectors
Aim at reaching the unreached and the vulnerable populations
CHU position in the Health Care System
Primary health care ( Tier 2)
Community Health care (Tier 1)
10 CHVs CHVs CHVs5 CHEWs
5,000 people
National & County referrals ( Tiers 1&2)
By end of 2015 a total of 4587 Community Units had been established
There were 4048 CHEWs giving services at the community
A total of 90579 were giving services at the community level
Master Community Health Unit Listing (MCHUL)The MCUL is an extension of the Master Facility List (MFL), which is a list of all approved health facilities in the countryURL: http://mfl.health.go.ke/mcul/From the MCHUL, one can quickly generate and stratify CHUs by functionality status
Development of Policy documents: draft policy; KQMH standards for level 1; Training curriculums
Evaluation of CHS: (http://www.unicef.org/evaldatabase/files/14_2010_HE_002_Community_Strategy_Evaluation_report_October_2010.pdf)
Improved child health indicators and maternal health indicators
Lack of prioritization of CHS in some counties Inadequate resources (finances, human,
skills)Non uniform supervisionPartner vested interests, down scalingProper governance of CHSHigh turn over/low retention of CHVsManagement of CHIS: cost, skills,
coordination
Recruitment and retention of CHEWs and CHVs
Allocation of funding by the county to the community health activities
The UHC program in MOH-CHSS CHIS: DigitalizationAdvocacy and communicationCounty sharing of information/best practicesAwareness on Global commitments/supportFormation of IGAs at CHUs level
Research driven CHSDevolutionPartners: PPPNHIFFree maternity services: Birth CompanionsRiding on other MOH and non health sector
programsRMNCH implementation in KenyaUHC implementationGlobal movements: 1 Million CHWs
Campaign
Planning for health care to include CHSAll programs to mainstream CHSHSS: Should be inclusive of CSSCHS implementation should be guided by
the policy documents availableCHIS should be digitalizedSustainable mechanisms for CHEWs, CHCs
and CHVs be explored Implementation should be M& ERoutine CHIS should be taken as a priority
In Kenya, a study in Busia County conducted from 2008-10 showed that community health contributed to: Increase in women attending at least four ANC visits (39% to 62%)Increase in share of deliveries by skilled birth attendants (31% to 57%)Increased testing for HIV during pregnancy (73% to 90%) Increase in exclusive breastfeeding (20% to 52%).Increase in women receiving intermittent preventive treatment for malaria (23% to 57%)
• Source: Wangalwa et al, 2012 (AMREF)
Analysis of the Countdown to 2015 Report shows that countries with the strongest progress in reducing under-5 mortality also have strong CHW programs – this includes Brazil, Ethiopia, Nepal, Bangladesh, and Rwanda
By frequently visiting homes and building trust with families, CHWs are uniquely positioned to change behavior that leads to better health outcomes, and even the reduction of childhood mortality.
Homegrown research needed on evidence that CHS works
Need to have evidence based CHS implementation
Research on cost benefit analysis of CHSEvidence on Inter/intra sectoral
action/collaboration & PPPEvaluation of CHS needs to be done
Afya Yetu, Jukumu Letu (Our Health, Our Responsibility)
Asante Sana