Kirinyaga District AOP 3 - 16-5-07

KIRINYAGA DISTRICT HEALTH PLAN

2007/2008

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TABLE OF CONTENTS

Forematter

Foreword List of Abbreviations Executive Summary

Section 1: The District Health Service and Capacity Assessment 1.1 Mapping the health services and facilities in the district 1.2 Demographic profile and distribution 1.2.1 District population by service category 1.3 Workload by level of service delivery 1.4 Health facilities (GOK and non-GOK) 1.4.1 Number and type of health facilities in the district 1.5 Access/utilization to health care services both GOK and non GOK

1.5.1 Catchment population per facility 1.6 Human resources 1.6.1 Medical/technical personnel

1.7 Health care financing; Availability and Utilization Section 2: The district health services analysis

2.1 Key Issue 2.2 Challenges and Constraints 2.3 Priorities

Section 3: Results and targets 3.1 District Consolidated Targets

Section 4 The Work plan ` 4.1Coordination of Service Delivery

4.2 Coordination of Facility Based Management Support Activities 4.3. Management level (DHMT) Support plan

Section 5: the district budget 5.1 District resource envelope 5.2 Budget (DHMT plan) 5.3 Gap/Surplus

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Foreword: The Government through the Ministry of Health has developed strategies to be able to realize the Millennium Development goals and Economic Recovery. These strategies are operational zed through Annual operational plans. The district is currently implementing AOP2 and has now developed AOP3 to start in July 2007-2008.The DHMT members were introduced to the objectives and the planning process of AOP3, then to all health facility in-charges both GOK and FBOs in order to be all-inclusive and increase participation during the implementation. After introduction and training on facility planning, all facilities were requested to develop plans for AOP3 (2007-2008). The DHMT members supervised facilities during the planning period in January 2007 and completed plans were forwarded to the office of the DMOH by mid-February 2007. The plans were consolidated and the draft plan presented to the stakeholders for ratification early March this year. I wish to thank all who participated in the development of the AOP3, the DHMT members, all staffs from GOK, FBOs/NGOs, development partners, DHMB-Kirinyaga and all who made preparation of the plan a success. It is my sincere hope that the implementation of AOP 3 will go along way in improving the delivery of health services at all levels and more so community involvement/participation in preventive and promotive health services. DR. I. M. KIMANI DISTRICT MEDICAL OFFICER OF HEALTH KIRINYAGA DISTRICT

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List of Abbreviations:

DMOH - District Medical Officer of Health DPHN - District Public Health Nurse DPHO - District Health Officer DASCO - District Aids DCO - District Clinical Officer DNO - District Nutrition Officer DMLT - District Medical Laboratory Technologist DHAO - District Health Administrative Officer DHRIO - District Health Records Information Officer DHMT - District Health Management Team DDSC - District Disease Surveillance Coordinator PLWA - People Living With Aids VHC - Village Health Committee VCT - Voluntary Counseling PMTCT - Prevention of Mother to Child Transmission CHW - Community Health Worker GOK - Government of Kenya EU - European Union FIF - Facility Improvement Fund FBO - Faith Based Organization NGO - Non Governmental Organization DRH - Division of Reproductive Health AOP - Annual Operation Plan CWC - Child Welfare Clinic KRCHN - Kenya Registered Community Health Nurse KECHN - Kenya Enrolled Community Health Nurse PM&E - Planning Monitoring & Evaluation IPT - Intermittent Patient treatment ANC - Ante Natal Clinic FP - Family Planning OPD - Out patient Department OP - Out patient IDS - Integrated Disease Surveillance h/w - Health worker

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SECTION 1

The District Health Service and Capacity Assessment

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1.1 KIRINYAGA DISTRICT MAP

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1.2 DEMOGRAPHIC PROFILE INTRODUCTION Kirinyaga District covers a total area of 1, 478 Km2, which is 11.2 percent and 0.3 percent of Central Province and Kenya's total area respectively. The District being one of the seven Districts in the Central Province borders Nyeri and Murang'a Districts to the west, Mbeere District to the south and Embu District to the east. The District is located between latitudes 00 10 and 00 400 south and longitude 370 and 380 east. ADMINISTRATIVE AND POLITICAL AREAS The District has four (4) divisions namely; Gichugu, Ndia, Mwea and Central. The largest Division is Mwea, which is located to the Southern side while the smallest Division is Central, which is located almost at the centre of the District AREA OF THE DISTRICT BY DIVISION DIVISION AREA (KM²) Gichugu 292.7 Ndia 276.4 Central 108.5 Mwea 512.8 Forest area 350.7 Total 1478.1 SOURCE: District Development Office N/B: The area of 350.7 sq. km is made of the forest, which does not specifically fall within any of the Divisions though it could be less with the indiscriminate felling of the forests indigenous trees with no noticeable replacement at the moment. The District has 22 locations and 80 sub locations. Administrative Units by Division Divisions No. of Locations No. of Sub locations Gichugu 6 23 Ndia 6 24 Mwea 6 20 Central 4 13 Total 22 80 Source: DISTRICT DEVELOPMENT OFFICE

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The District has four (4) constituencies namely: Ndia, Gichugu, Mwea and Kerugoya/Kutus. Ndia constituency covers Ndia Division, Gichugu constituency covers Gichugu Division, and Mwea constituency covers Mwea Division while Kerugoya/Kutus constituency covers Central Division. The District has 3 local authorities namely: Kerugoya/Kutus Municipality, Sagana Town Council and Kirinyaga County council with a total of 37 elective wards. 1.2.1 District Population by Service category Description District proportions Eligible population 1 Total catchment’s population 491617 2 Children under 1 year (12 months) 2.76% 13, 569 3 Children under 5 years (60 months) 12% 58, 994 4 Under 15 year population 36.2% 177, 965 5 Women of child bearing age (15 – 49 Years) 26.3% 129, 295 6 Estimated Number of Pregnant Women 2.76% 13, 569 7 Estimated Number of Deliveries 2.76% 13, 569 8 Live Births 2.76% 13, 569 9 Estimated Number of emergency obstetric complications 0.75% 3, 687 10 Estimated Number of Post-Abortion Cases 11 Total number of Adolescent (15-24) 23% 113, 072 12 Adults (25-59) 33.7% 165, 675 13 Elderly (60+) 6.6% 32, 447 1.3 Workload by Level of Service Delivery Level of Service delivery Total Outpatient Total In Patient Grand

Total New Revisit Total Level II (Dispensary) 248, 169 280, 679 528, 848 0 528, 848 Level III ( Health Centre) 101, 187 119, 059 220, 246 1, 557 220, 246 Level IV (District Hospital 52, 354 53, 984 106, 338 12, 047 118, 385 Levels 5 & 6 Referral Hospital 0 0 0 0 0 Total 401, 710 453, 722 855, 432 13, 604 867, 479

Note: Outpatient services include general outpatient and other special outpatient services like MCH, FP, and Counseling etc.

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1.4 HEALTH FACILITIES (GOK AND NON-GOK) 1.4.1 Number and type of Health Facilities in the district

Number of Providers GOK FBO NGO Private Total

No. 2 2 0 1 5 1 Hospital (Includes District. And Sub-District Hosp) Centre

Beds & cots 296 160 0 53 509 No 7 2 0 0 9 2 Health Centre

Beds 51 24 0 0 75 3 Nursing /Maternity home No 0 0 0 2 2

Bed 0 0 0 38 38 4 Dispensary 37 27 0 0 64 5 Clinic 0 0 0 82 82 6 Hospitals with COs School 0

0 0 0 0 0

7 Hospitals with Nursing School 0 0 0 0 0 8 Private Pharmacies 0 0 38 38 9 Community Pharmacies 0 8 0 8

Sources: District Health Record

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1.5 ACCESS/UTILIZATION TO HEALTH CARE SERVICES BOTH GOK AND NON GOK 1.5.1 Catchment Populations per Facility

Name of Health Facility Total Catchment Population

Total Outpatient Attendance Utilization Rate

(a) (b) (c) (d) = c/d x 100

New Revisit Total

1 Kerugoya district hospital 22239 49324 28958 78,282 352

2 Kimbimbi sub-district hospital 16,673 29,735 11,586 41,321 2483 ACK Mt. Kenya hospital 1,979 3,001 1,618 4,619 2334 Mwea Mission hospital 6,347 9,081 10,477 19,558 3085 Mwea medical centre 2,793 456 60 516 186 Sagana H/C 29,236 23,878 38,364 62,242 2137 Kianyaga H/C 21,532 20,268 30,220 50,488 2348 Baricho H/C 16,807 9,565 7,234 16,799 1009 Kabare H/C 17,426 8,376 4,137 12,513 72

10 Difathas H/C 10,572 6,517 3,945 10,462 9911 Kiamutugu H/C 19,564 17,657 11,827 29,484 15112 Mutithi H/C 7,985 2,884 8,649 11,533 14413 Baricho catholic 3,975 1,597 4,791 6,388 16114 Kianyaga catholic H/C 1,214 630 256 886 7315 Baragwi maternity 759 211 633 844 11116 Kagio nursing home 1,869 269 300 569 3017 Kutus dispensary 3,971 3,128 1,553 4,681 11818 Ucheru dispensary 5,920 3,700 3,154 6,854 11619 Mutitu dispensary 3,149 2,454 363 2,817 8920 Gatwe dispensary 7,855 8,420 9,984 18,404 23421 Kangaita dispensary 8,072 11,170 6,694 17,864 22122 Kagumo dispensary 8,425 15,452 4,840 20,292 24123 Gathambi dispensary 12,512 7,962 7,554 15,516 12424 Kangaru dispensary 19,920 8,505 25,515 34,020 17125 Kiaragana dispensary 7,599 3,869 1,946 5,815 77

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(a) (b) (c) (d) = c/d x 100 26 Kiangai dispensary 8,582 14,394 1,608 16,002 18627 Kibirigwi dispensary 9,318 7,079 1,767 8,846 9528 Kianjege dispensary 7,663 4,426 5,698 10,124 13229 Gatithi dispensary 6,938 4,176 993 5,169 7530 Kiburu dispensary 4,088 2,289 6,867 9,156 22431 Gaciongo dispensary 7,411 2,230 3,067 5,297 7132 Gatugura dispensary 13,444 15,736 6,185 21,921 16333 Kamweti dispensary 13,526 7,923 15,235 23,158 17134 Karumande dispensary 10,027 9,599 3,739 13,338 13335 Kiangombe dispensary 9,099 14,550 9,290 23,840 26236 Mumbuini dispensary 3,093 837 2,101 2,938 9537 Kiumbu dispensary 5,507 7,472 3,601 11,073 20138 Thiba dispensary 10,374 8,262 2,235 10,497 10139 Wamumu dispensary 5,853 3,751 1,992 5,743 9840 Gathigiriri dispensary 6,029 12,522 1,712 14,234 23641 Murinduko dispensary 10,997 10,368 7,512 17,880 16342 Njegas dispensary 6,776 6,960 6,622 13,582 20043 Kandongu dispensary 8,489 9,801 6,268 16,069 18944 Nguka dispensary 9,976 9,448 6,162 15,610 15645 Ciagini dispensary 5,110 6,652 3,344 9,996 19646 GK prisons 2,854 1,000 1,122 2,122 7447 Rukanga dispensary 6,308 8,437 10,420 18,857 29948 Kajiji dispensary 4,219 3,510 1,816 5,326 126 49 Kiamanyeki dispensary 2,342 4,098 240 4,338 185 50 Kariini dispensary 1,395 200 434 634 45

51 Joshua Mbai 2,000 1,356 300 1,656 83

52 Kangu dispensary 2,000 1,234 453 1,687 84 53 Kerugoya catholic dispensary 1,669 718 1,120 1,838 11054 Kutus catholic dispensary 3,069 3,625 1,240 4,865 15955 CCS Kerugoya dispensary 1,669 744 1,150 1,894 113

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(a) (b) (c) (d) = c/d x 100 56 Kagumo catholic dispensary 5,051 5,900 5,052 10,952 21757 ACK Thaita dispensary 1,054 37 6 43 458 ACK Karaini dispensary 1,174 1,548 252 1,800 15359 Kagio catholic dispensary 3,124 300 269 569 1860 Sagana catholic dispensary 7,299 1,310 2,000 3,310 4561 ACK Mutira dispensary 1,342 403 300 703 5262 Gatumbi SDA dispensary 1,916 277 612 889 4663 Jesmond dispensary 1,458 345 954 1,299 8964 ACK Mbiri dispensary 1,296 1,164 679 1,843 14265 ACK Githure dispensary 466 236 708 944 20366 ACK Mugumo dispensary 1,649 380 1,140 1,520 9267 ACK Ngariama dispensary 2,315 266 798 1,064 4668 ACK ST. Andrews Kabare 754 100 210 310 4169 ACK ngiriambu dispensary 676 313 939 1,252 18570 CCS Wang’uru dispensary 1,162 810 1,670 2,480 21371 St. Teresa catholic dispensary 678 141 200 341 5072 Difathas catholic dispensary 677 500 182 682 10173 MCK Kiandegwa dispensary 746 256 130 386 5274 ACK Thumaita dispensary 412 132 200 332 8175 Rapha clinic 742 200 100 300 4076 Gatwe clinic 800 140 200 340 4377 Kangaita clinic 286 100 186 286 10078 Heshima clinic 242 80 240 320 13279 Kabuti clinic 1,414 271 813 1,084 7780 Afya bora clinic 899 271 813 1,084 12181 Ithare clinic 1,428 273 819 1,092 7682 Zawadi clinic 958 300 289 589 6183 Roadside clinic 921 200 151 351 3884 Manesh clinic 84 30 39 69 8285 Ssema clinic 314 120 141 261 8386 Imani clinic 503 367 230 597 119

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(a) (b) (c) (d) = c/d x 100 87 Tumaini clinic 142 56 46 102 7288 Mamuki clinic 261 200 193 393 15189 Kirimara clinic 658 130 100 230 3590 Kianugu clinic 93 90 52 142 15391 By Faith clinic 405 300 531 831 205 District total 491,617 449,052 360,195 809,247 165

1.6 Human Resources Availability 1.6.1 Medical/Technical Personnel

Description GoK FBO NGO / PRIVATE Total

Level Level Level Level Level Level Level Level Level Level 1 2 3 4 1 2 3 4

Level 1

Level 2 3 4

1 Consultants (MD 0 0 0 3 0 0 0 0 0 0 0 0 3 2 GP (MD) 0 0 0 8 0 0 0 5 0 0 0 2 15 3 Dentists 0 0 0 1 0 0 0 0 0 0 0 0 1 4 Dental Technologists 0 0 0 4 0 0 0 0 0 0 0 0 4 5 Community Oral Health Officers 0 0 0 2 0 0 0 0 0 0 0 0 2 6 Clinical Officer (Spec) 0 0 0 5 0 0 0 0 0 0 0 0 5 7 Clinical Officers (Gen.) 0 0 7 28 0 2 0 2 0 0 1 0 40 8 KRCHNs 0 0 8 51 0 2 0 10 0 0 0 0 71 9 KECHNs 0 56 40 141 0 27 0 36 0 3 2 0 305 10 Public Health Officers 0 5 5 2 0 0 0 0 0 0 0 0 12 11 Public Health Technicians 23 9 0 0 0 0 0 0 0 0 0 32 12 Pharmacists 0 0 0 3 0 0 0 0 0 0 0 0 3 13 Pharm. Technologist 0 0 0 2 0 0 0 3 0 0 0 0 5 14 Lab. Technologist 0 0 2 11 0 1 0 2 0 0 0 0 16 15 Lab. Technician 0 1 4 2 0 0 0 3 0 0 0 0 10 16 FHFEs 0 0 0 0 0 0 0 0 0 0 0 0 0

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Description GoK FBO NGO / PRIVATE Total

Level Level Level Level Level Level Level Level Level Level 1 2 3 4 1 2 3 4

Level 1

Level 2 3 4

17 Nutritionists 0 0 6 4 0 0 0 0 0 0 1 0 11 18 Nutritionists Assistant 0 0 1 0 0 0 0 0 0 0 0 1 19 Radiographers 0 0 0 2 0 0 0 0 0 0 0 0 2 20 Physiotherapists 0 0 2 5 0 0 0 0 0 0 0 0 7 21 Occupational Therapists 0 0 1 5 0 0 0 0 0 0 0 6 22 Plaster Technicians 0 0 0 2 0 0 0 0 0 0 0 2 23 Health Record & Information Officers 0 0 0 5 0 0 0 1 0 0 0 0 6 24 Community Health Workers 120 0 0 0 0 0 0 0 0 0 0 0 120 25 Orthopaedic officers 0 0 0 1 0 0 0 0 0 0 0 0 1 26 Medical engineering technologist 0 0 0 0 0 0 0 0 0 0 0 0 0 27 Medical engineering technicians 0 0 0 2 0 0 0 0 0 0 0 0 2 28 Medical engineering artisans 0 0 0 0 0 0 0 0 0 0 0 0 0 29 Support staff 0 1 1 7 0 2 0 65 0 0 0 0 76 30 Non medical 0 1 4 2 0 14 0 5 0 3 2 0 31 31 Administrator 0 0 0 2 0 3 0 1 0 0 0 0 6 33 Store man 0 0 0 1 0 0 0 1 0 0 0 0 2 34 Artisans 0 0 0 3 0 0 0 0 0 0 0 3 35 Accountants 0 1 0 1 0 0 0 1 0 0 0 0 36 Drivers 0 0 0 5 0 0 0 1 0 0 0 0 6

Sources: District Health Facilities Records

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1.7 HEALTH CARE FINANCING AVAILABILITY AND UTILIZATION Table 1.3 Resource availability and utilization for current Financial Year (AOP II)

Source Amount Budgeted

Amount Received

Expenditure Expenditure accounted for (SOE’s submitted)

Funds utilization rate=C/BAX100

Accounting rate=D/CX100

MOH FIF 7,097,322.00 7,097,322.00 6,621,896.15 5,673,146.15 93.30 85.67 RECURRENT 1,031,354.25 1,031,354.25 635,781.00 608,281.00 61.65 95.67 DEVELOPMENT 440,000.00 440,000.00 311,220.00 224,500.00 70.73 72.14 GLOBAL FUND 1,401,949.00 1,401,949.00 699,636.60 699,636.60 49.90 100.00 DVBD 80,000.00 80,000.00 16,500.00 16,500.00 20.63 100.00 Kerugoya hosp FIF 13,930,162.00 13,930,162.00 13,110,081.00 12,902,531.00 94.11 98.42 RECURRENT 3,883,941.25 3,883,941.25 3,144,832.80 2,801,782.80 80.97 89.09 DEVELOPMENT 0 0 0 0 0 0 Kimbimbi SDH FIF 1,748,878.00 1,748,878.00 1,516,024.45 1,396,852.50 86.69 92.14 RECURRENT 1,067,918.25 1,067,918.25 822,898.95 623,806.25 77.06 75.81 DEVELOPMENT 0 0 0 0 0 0 Kianyaga FIF 362,650.00 362,650.00 290,797.40 265,617.40 80.19 91.34 Baricho FIF 274,063.75 274,063.75 186,546.40 171,546.40 68.07 91.96 Sagana FIF 398,485.00 398,485.00 330,548.60 313,848.60 82.95 94.95 Kabare FIF 273,409.50 273,409.50 196,102.30 188,102.30 71.72 95.92 Dispensaries

FIF 4, 163, 463 4,105,134

4, 105, 134 4, 105, 134 100 100 DPHO FIF 948,716.00 948,716.00 627,747.90 612,747.90 66.17 97.61 RECURRENT 208,000.00 208,000.00 185,130.50 185,130.50 89.01 100.00 DEVELOPMENT 260,000.00 260,000.00 154,985.00 154,985.00 59.61 100.00

Source: District Health Office

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2.0 HEALTH SERVICE ANALYSIS

2.1 KEY ISSUES, CONTRAINTS/ CHALLENGES AND PRIORITIES FOT THE NEXT YEAR

RESULT AREA SUPPLY SIDE UTILIZATION / COMMUNITY

CHALLENGES/CONSTRAINTS PRIORITIES FOR THIS YEAR

Maternal Health

- Few health facilities integrating PMTCT services into ANC

- Low Community awareness of ANC services - Low Antenatal care attendances -Late start of ANC - Low PMTCT services uptake

SUPPLY SIDE - Inadequate supply of haematinics - Inadequate ITN supply - inadequate knowledge and skills to health workers - staff attitude - inadequate supply of reagents - Inadequate staffing - Lack of recording tools -

SUPPLY SIDE - Ensure the ANC have adequate equipment and drugs - Procure & distribute ITNs - Train health workers on FANC/MIP - Redistribution of personnel according to qualifications and service need - Provide recording tools - Train/update h/Ws on PMTCT

- few facilities offering FP services -Culture & religious belief

- Irregular supply of FP commodities - Acquire and distribute FP commodities regularly - Update health workers on new FP methods - Procure FP equipments, non pharmaceuticals and FP training model

- Few facilities offering post-natal services

- Poverty -Low post-natal attendances

- Low deliveries by skilled attendant

- Inadequate delivery equipment - few facilities offering maternity services -

- Procure adequate delivery equipment for facilities offering maternity services - Increase no. of maternity units - Enhance timely referrals - Equip maternity theatre in Kerugoya and Kimbimbi hospitals -

- Low ITNs use by ANC mothers

DEMAND - Community attitude - High illiteracy level - Long distance

DEMAND - Enhance community education on maternal health - Train CORPs on FANC/MIP - Intensify micro teachings

Child Health

- Some facilities not offering immunization

- Low Community awareness of various

- Accessibility to immunizing facilities - Erratic supply of some antigens

- Increase the no. of h/f offering immunization services

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services - High child mortality and morbidity

child services - High immunization defaulters - stagnating immunization coverage

- Many cold chain breakdowns - Incomplete/inaccurate recording - Few staff trained in IMCI - staff shortage - Inadequate ITNs supply - Erratic supply of pediatrics’ preparations - Lack of growth monitoring tools - Lack of enough space for IMCI services in KDH

- Conduct outreach services - conduct child health days - Ensure adequate supply of vaccines - Regular maintenance of cold chain equipment - setting and reviewing immunization targets - Train h/ws on IMCI strategy - Procure growth monitoring equipment - Procure & distribute ITNs - Conduct school health programmes - Put up an IMCI block in KDH

- Few facilities offering paediatric HIV care ant treatment services -Culture & religious belief

- Few staff trained in pediatric ARV - Few facilities offering paediatric ARVs - Lack of space - Lack of systems for early infant diagnosis

- Train h/ws on paediatric ARVs - Increase no. of h/fs offering paediatric ART - Train h/ws on early infant diagnosis on HIV/AIDS - Provide logistics for early infant diagnosis

- - Poverty

DEMAND

- Community attitude - High illiteracy level - Long distance

- Enhance defaulter tracing - Train CORPS on community IMCI - Procure growth monitoring tools for CORPS

- Lack of community IMCI - Lack knowledge, skills and tools for community growth monitoring

- Lack of safe water -Procure aqua tabs - Procure immersion water pump - Repair existing water pump

Adolescence

- No facility offering adolescent health services

- Community awareness - Stigma - Culture and beliefs - low utilization of VCT services by adolescents

SUPPLY SIDE - Lack of youth friendly centres - Lack staff trained in peer counseling - Lack IEC materials - Staff attitude towards youths

- Increase no. of VCT sites - Train VCT counselors - Establish & equip youth centres - Train h/ws on peer counseling -

DEMAND SIDE - Lack of knowledge on adolescent health - Ignorance

DEMAND - Conduct mobile VCT - Intensify community health education and school health programmes

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Adults & elderly

- High morbidity and mortality - Few VCT sites - Few facilities offering quality health services

- Culture and belief - Community awareness - Stigma - Low ITN use - Low utilization of VCT services - Poor utilization of existing facilities

- Lack of decentralized specialized services - Inadequate drug supply - Inadequate supply of ITNs - Inadequate equipment - Inadequate laboratory reagents - Inadequate staff trained on adult ART - Few diagnostic and testing sites for TB - Poor state of infrastructure - Poor state of equipments -

- Procure & maintenance of equipments for various services - Procure & distribute ITNs - increase no. of VCT - Train VCT counselors - Train h/ws on adult ART - Provide lab reagents - Increase no. of TB treatment sites - Update h/ws on TB treatment and HIV collaboration - Carry out rehabilitation services in the various health facilities - Carry out landscaping activities -

DEMAND - High TB defaulter rate - Poor health seeking behavior - Illiteracy level - Poverty - Lifestyle

DEMAND - Establish support groups - Intensify community education of HIV/AIDS and behavioural change

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2.2 Management systems analysis 2.4.1. CONSOLIDATED ISSUES

MAIN SYSTEMS SUPPORT AREAS KEY ISSEUS CHALLANGES/ CONSTAINTS PRIORITES FOR THE COMING FINANCIAL YEAR

1. MAINTENANCE OF

BUILDINGS, EQUIPMENTS AND VEHICLES

- NO INVENTORY OR REGULAR INSPECTION OF THE STATE OF BUILDINGS, EQUIPMENT AND VEHICLES - GOVERNMENT TENDERING SYSTEM

- LACK OF SKILLED STAFF - LACK OF MAINTENANCE DEPARTMENT IN VARIOUS HEALTH FACILITIES - LACK OF TOOLS FOR ASSESSMENT AND REPORTING - LACK OF FUNDS

- DEVELOP INSPECTION TOOLS - HAVE INVENTORY OF BUILDINGS, EQUIPMENT VEHILCES - ANNUAL UPDATE OF INVENTORIES

2. PROCUREMENT AND MANAGEMENT OF DRUGS

- PUSH SYSTEM - GOVERNMENT TENDERING SYSTEM -

- IRREGULAR SUPPLY OF ESSENTIAL DRUGS - LACK TECHNICAL PERSONNEL TO MANAGE DRUGS - LACK OF DRUG STORES - INADEQUATE DRUG KITS - LACK OF SOME OF THE ESSENTIAL DRUGS IN THE KITS LACK FUNDS

- PROCURE DRUG CABINETS - TIMELY ORDERING OF DRUGS FROM KEMSA - PROCUREMENT OF EMERGENCY DRUGS

3. PLANNING FOR THE NEXT FINANCIAL YEAR

- SKILLS AND KNOWLEDGE OF PLANING -

- LACK OF FUNDS - LACK OF PLANNING SKILLS - SPACE TO HOLD MEETING - INADEQUATE TIME FRAME FOR PLANNING - COMPETING PROGRAMMES - LACK OF RESOURCE ENVEOLE FROM STAKEHOLDERS

- TRAIN H/WS ON PRIORITISATION AND PLANNING - EARLY PLANNING OF AOP4

4. MONITORING AND FOLLOWUP OF IMPLEMENTION WITH THE COMMMITTEE

- NO INTEGRATED MONITORING & EVALUATION TOOLS -

- LACK OF FUNDS - SHORT NOTICE FOR COMMITTEE MEMBERS - COMPETING PROGRAMMES - LACK 0F TRANSPORT MEANS

- MONTHLY MEEETINS FOR HEALTH WORKERS - TIMELY SUBMISSION OF REPORTS -AVAIL REPORTING TOOLS - ENHANCE COMMUNICATIONS

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2.4.2. MANAGEMENT SUPPORT ISSUES AT THE DISTRICT LEVEL

MAIN SYSTEMS SUPPORT AREAS KEY ISSEUS CHALLANGES/ CONSTAINTS PRIORITES FOR THE COMING FINANCIAL YEAR INTEFACE WITH THE COMMUNITY

- NO COMMUNITY STRUCTURES - NO COMMUNITY PARTICIPATION IN HEALTH ISSUES

- NO GUIDELINES ON ESTABLSIHING COMMUNITY UNITS - SHORTAGE OF TOTS - SHORTAGE OF FIELD HEALTH WORKERS - POOR LINKAGE OF LEVEL 1 WITH LEVEL 2 & 3 - HIGH DROP OUT RATES - LACK OF INCENTIVES - UNEVEN DISTRIBUTION OF HEALTH FACILITIES & SERVICES - LACK OF COMMUNITY STRUCTURES - CULTURE & RELIGION - POVERTY - LACK OF FUNDS -

- ESTABLISH & STRENGTHEN COMMUNITY STRUCTURES - ENHANCE COMMUNITY INFORMATION SYSTEM - ENHANCE COMMUNITY INVOLVEMENT AND

PARTICIPATION IN HEALTH ISSUES - TRAINING CORPS IN PHC - TRAIN CORPS ON PHC, RH COMMUNITY PACKAGES - ESTABLISH CHALK AND BOARD IN ALL GOK H/FS - CONDUCT MASS RETREATMENT OF NETS - STRENGTHEN DIVISIONAL TEAMS - INVOLVE CORPS IN DEFAULTER TRACING - INVOLVE CORPS IN GROWTH MONITORING - CARRY OUT SAFE WATER AND SANITATION

CAMPAIGNS

MAINTENANCE OF INFASTUCTURE, EQUIPMENT, COMMUNCIATION AND TRANSPORT

-NO REGULAR MAINTENANCE OF BUILDINGS AND EQUIPMENTS -POOR COMMUNICATION TO AND FACILITIES

-SHORTAGE OF SKILLED STAFFS -LACK OF FUNDS -ROUGH ROADS AND HENCE FREQUENT BREAKDOWN OF VEHICLES -FEW UTILITY VEHICLES -NO AIRTIME FOR OFFICERS BELOW JOB GROUP M -NO NETWORK INSOME AREAS

- REGULAR INSPECTION OF INFRASTRUCTURE—BUILDINGS - REGULAR VEHICLE CHECK-UP AND MAINTENANCE - PROCURE MOBILE PHONES TO RURAL FACILITIES TO ENHANCE

COMMUNICATIONS - PROVIDE AIRTIME TO FACILITIES - ENSURE BASIC EQUIPMENTS AVAILABILITY IN ALL FACILITIES

HUMAN REOURCE MANAGMENT

- MANY FACILITIES NOT OFFERING VARIETY OF SERVICES

- NO PLANNING AND MANAGEMENT SKILLS

-SHOTAGE OF STAFFS IN ALMOST ALL CARDRES -LACK OF SOME SKILLS IN STAFFS -LACK OF FUNDS FOR TRAINING STAFFS -STAFF TRANSFERS -STAFFS GOING FOR BRIDGING COURSES -STAFF IN-DISPLINE

- STAFF TRAININGS ESPECIALLY MANAGEMENT - RE-DISTRIBUTION OF STAFFS ACCORDING TO QUALIFICATIONS AND

SERVICE NEEDS - STAFF TRAINING ON PLANNING SKILLS - CONTINOUS MEDICAL EDUCATION OF STAFFS - REGULAR STAFF UPDATES - HOLD REGULAR DISPLINARY MEETINGS

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MAIN SYSTEMS SUPPORT AREAS KEY ISSEUS CHALLANGES/ CONSTAINTS PRIORITES FOR THE COMING FINANCIAL YEAR ESSENTIAL MEDICINES AND MEDICAL SUPPLIES

-FEW ESSENTIAL DRUGS IN PHARMACIES -PUSH SYSTEM -NO DRUGS FOR CERTAIN DISEASES ESPECIALLY THE CHRONIC ILLNESS -STORAGE SPACE—STORE -IRREGULAR SUPPLY OF DRUGS

-TIMELY ORDERING OF ESSENTIAL DRUGS -USE OF THE PULL-SYSTEM -DRUG QUANTIFICATION BY ALL FACILITIES -ENSURING EMERGENCY DRUGS AVAILABILITY IN ALL FACILITIES

GOVERNANCE FINANCAIL MANAGEMENT

- POOR FINANCIAL MANAGEMENT - NO REGULAR MEETING FOR

DHMT, STAKEHOLDERS FORUM AND WITH HEALTH WORKERS

-COMPETING PROGRAMMES -LACK OF FINANCIAL MANAGEMENT SKILLS BY STAFFS -LACK OF MANAGEMENT SKILLS BY THE DHMT MEMBERS

-HOLD QUARTERLY STAKEHOLDERS FORUM -REGULAR DHMT MEETINGS -QUARTERLY DHMB-MEETINGS -MONTHLY MEETINGS WITH THE HEALTH WORKERS -TRAINING OF FACILITY MANAGEMENT COMMITTEES ON FINANCIAL MANAGEMENT -BI-ANNUAL MEETING WITH FACIITY COMMITTES CHAIRMEN AND OFFICER IN-CHARGES -TRAIINING OF H/WS ON FINANCIAL MANAGEMENT -DHMT TRAINING ON MANAGEMENT

PLANNING, PM&E

- POOR M&E OF HEALTH ACTIVITIES IN THE DISTRICT

- POOR ANALYSIS AND REPORTING

-NO INTEGRATED MONITORING AND EVALUATION TOOLS -MOST OF THE DHMT NOT COMPUTER LITERATE -COMPETEING PROGRAMMES -SHOTAGE OF ICT EQUIPMENTS -LACK OF M& E SKILLS BY DHMT MEMEBERS -LACK OF FUNDS -NO TARGETS FOR MANY SERVICES

- DEVELOP AND INTEGRATED M&E TOOL -TRAINING DHMT ON M&E SKILLS -DHMT TRAINING ON COMPUTER PACKAGES -PROCURE ICT EQUIPMENTS -ANNUAL TARGET SETTING WITH THE HEALTH WORKERS -REGULAR RRI TO VARIOUS SERVICES AND ACTIVITIES

22

SECTION 3

RESULTS AND TARGETS

23

3.1 DISTRICT CONSOLIDATED TARGETS District Eligible Targets

Populati

on District Baseline District Total Contribution of NGOs and FBOs

Performance indicators

Level 2

Level 3

Level 4 Total

Level 2

Level 3 Level 4 Total

Level 2 Level 3

Level 4 Total

Number of pregnant women receiving two doses of IPT 13, 569 4170 2404 2432 9006 4212 2428 2456 9096 421 243 246 910 Number of maternal health audit 0 12 12 24 0 12 12 24 0 1 1 2 Mothers are kept

healthy during pregnancy

Number of pregnant women having 4 ANC visits 13, 569 2000 1136 984 4120 2020 1147 994 4161 202 115 99 416 Number of women of reproductive age receiving FP commodities 129, 295

11024 24402

85958

121384 11134 24646 86818 122598 1113 2465 8682

12260 Mothers are able

to have normal deliveries

Number of deliveries conducted by skilled staff 13, 569 0 1658 6012 7670 0 1675 6072 7747 0 167 607 775 New borne with low birth weight 13, 569 0 28 256 284 0 28 259 287 0 3 26 29 Number of new borne receiving BCG 13, 569 6462 2068 2608 11138 6527 2089 2634 11249 653 209 263 1125 Number of Pregnant mothers Counselled and Tested for HIV 13, 569 0 0 0 0 0 0 0 0 0 0 0 0

All newborns (up to 2 weeks) receive protection against immunizable conditions

Number of children under one fully immunized 13, 569 1828 2486 8008 12322 1846 2511 8088 12445 185 251 809 1245 Number of children under one vaccinated against measles 13, 569 1830 2486 8010 12326 1848 2511 8090 12449 185 251 809 1245 Number of children receiving Vitamin A 58, 994 8514 632 1398 10544 8599 638 1412 10649 860 64 141 1065

Children receive protection against immunizable diseases

Number of children under five treated for malaria 58, 994

19641.6

10652.4 7314 37608 19838 10759 7387 37984 1984 1076 739 3798

Children are able to survive childhood illnesses

Number of school children correctly de-wormed at least once a year

91861 0 0 0 0 0 0 0 0 0 0 0 0 Healthy lifestyle is adopted amongst children

Number underweight among children under five

59, 994 4632 1384 1390 7406 4169 1258 1263 6690 468 140 140 748

Number of children under 5 years attending Growth Monitoring Clinic 58, 994

331080 80844

51592

463516

334391 81652 52108 468151

33439 8165 5211

46815

24

District Eligible Targets

Populati



Level 2

Level 3

Level 4 Total

Level 2


Level 2 Level 3

Level 4 Total

Number of health facilities offering the standard package of youth – friendly health services

0 0 0 0 0 0 0 0 0 0 0 0 0 Behaviour change is promoted amongst adolescents that leads to healthy lifestyle

0 0 0 0 0 0 0 0 0 0 0 0 Adolescents are able to survive common health conditions affecting them

0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0

Number of functioning community health units 99 0 0 0 0 0 0 0 0 0 0 0 0

Number of Households with access to clean water and latrine 123098 0 0 0

87020 0 0 0 87890 0 0 0 0

Number of households sprayed with IRS 123098 0 0 0 460 0 0 0 465 0 0 0 0 Number of HIV positive patients receiving ART treatment 0 0 692 692 0 0 700 700 0 0 100 100

Adults are able to survive common health conditions affecting them

Number of VCT clients 0 3008 4600 7608 0 3037 4645 7682 0 1290 2219 0

Elderly are able to survive common health conditions affecting them

0 0 0 0 0 0 0 0 0 0 0 0

Percentage of clients satisfied with the services offered 0 0 0 0 0 0 0 0 0 0 0 0

OPD attendance

491617 1657

80 28328

6 76885

4 1217

920 1674

38 286119 776543 123009

9 1674

4 28612 7765

4 1230

10 Total Patients in ward during 0 0 0 0 0 0 0 0 0 0 0 0

25

District Eligible Targets

Populati



Level 2

Level 3

Level 4 Total

Level 2


Level 2 Level 3

Level 4 Total

the reporting period

Number of days without the tracer drugs 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

26

SECTION 4 THE WORK PLAN

27

4.1Coordination of Service Delivery

Output 1: Increased no. of pregnant women receiving 2nd IPT

Activities

(Responsible Person)Coordinator at DHMT Level

Budget Source Code

Level IV

Train 40 health workers on FANC/MIP

350,000 WHO/RH 2210701

Intensify microteaching in 5 health facilities

DPHN 100,000.00 ADB 2210701

Implementation of FANC/MIP programme in 5 health facilities that offer ANC services

DPHN 200,000.00 ADB 2210701

Ensure adequate supplies of IPT drugs in 5 health facilities with ANC services

Pharmacist 0.00

Ensure all data collecting and reporting tools are available and well documented

DHRIO 50,000.00 ADB 2210502

Level III


DPHN 0.00


DPHN 0.00


DPHN 0.00

Ensure all data collecting and reporting tools are available

DHRIO 50,000.00 ADB 2210502

Level II

Result Area 1: Mothers are kept healthy during pregnancy

Intensify microteaching in all health facilities

DPHN 0.00

28


DPHN 0.00


Pharmacist 0.00

Ensure all data collecting and reporting tools are available

DHRIO 50,000.00 ADB 2210502

level 1

Intensify social mobilization through barazas, schools by the PHT to encourage mother come for ANC early enough

DPHO 100,000.00 FIF/GOK 2210303

2210031 Train 200 CORPS on community FANC/MIP

DPHN 400,000.00 WHO/RH

2210303 Develop IEC materials in local

language & distribute to community

DPHN 500,000.00 WHO/RH 2210502

Conduct 10 roadshows in the 4 divisions

500,000.00 WHO/RH 2210303

Output 2: Reduced no. of maternal deaths Level IV (Responsible Person)Coordinator at DHMT Level

Source Code

Train 40 health workers on maternal & perinatal audit

RH/coordinator/DPHN 350,000.00 WHO/RH 2210701

Provide audit tools DHRIO 50,000.00 WHO/RH 2210701

Conduct monthly maternal mortality meetings

RH/coordinator/DPHN 40,000.00 WHO/RH 2210701 Train 20 health workers on PAC DPHN 400,000.00 GOK/FIF 2210701

Level III Conduct monthly maternal

mortality meetings DPHN 100,000.00 WHO/RH 2210031

29

Level II

Output 3: Increased no. of pregnant women having 4 ANC visits


Source Code

Level IV Intensify microteaching in 5

health facilities DPHN 0.00


DPHN 0.00

Level III


DPHN 0.00


DPHN 0.00

Level II 0.00


DPHN 0.00


DPHN 0.00

Level I Conduct monthly social

mobilization through barazas by PHT to encourage early ANC attendance

DPHO 150,000.00 FIF/GOK 2210031

Output 4: Increased no. of women of reproductive age receiving FP commodities


Source Code

Level IV Acquire & distribute FP

commodities to all h/fs quaterly DPHN 80,000.00 WHO/RH 2210303

Train 20 health workers on contraceptive logistic management

100,000.00 2210701

30


DPHN 0.00

Ensure timely ordering of FP commodities in 4 health facilities

DPHN 0.00

Quarterly submission of FP reports by the 4 health facilities

DPHN 0.00

Ensure data collecting and reporting tools are available

DPHN 0.00

Acquire 4 FP teaching tools DPHN 0.00

Train 20 health workers on implants insertion

DPHN 100,000.00 WHO/RH 2210701

Level III Intensify microteaching in 9

health facilities DPHN 0.00


DPHN 0.00

Quarterly submission of FP reports by the 9 health facilities

DPHN 0.00


DPHN 0.00

Increase no. of SDP offering FP commodities

DPHN 0.00

Acquire 9 FP teaching tools DPHN 0.00

Level II


DPHN 0.00


DPHN 0.00

Quarterly submission of FP reports

DPHN 0.00


DPHN 0.00

31

Increase no. of SDP offering FP commodities

DPHN 0.00

level I DPHN 0.00

Conduct monthly social mobilization through barazas by PHT to increase FP commodities uptake

DPHO 0.00

Output 4: Increased no. of deliveries conducted by skilled staff


Source Code

Level IV

Train 40 health workers on obstetric care

DPHN 200,000.00 WHO/RH 22107012

Procure 100 ampoules ergometrine in 11 health facilities per quarter to carter for deliveries

Pharmacist 416,000.00 2211002

Intensify microteaching in 5 health facilities to increase no. of deliveries conducted by skilled labour

DPHN 0.00 FIF

Ensure preparedness for obstetric care in 5 health facilities

DPHN 0.00

Intensify implementation of FANC/MIP in 5 health facilities offering ANC facilities

DPHN 0.00

Enhance referral system for maternity cases

DMOH 0.00

Enhance active monitor of labour

DPHN 0.00

Provide maternity data collecting and reporting tools

DHRIO 0.00

Level III

Result Area 2: Mothers are able to have normal deliveries

Intensify microteaching in 11 health facilities to increase no. of deliveries conducted by skilled labour

DPHN 0.00

32

Ensure preparedness for obstetric care in 16 health facilities

DPHN 0.00


DPHN 0.00

Enhance referral system for maternity cases

DMOH

Enhance active monitor of labour

DPHN 0.00

Provide maternity data collecting and reporting tools

DHRIO 0.00

Level II

Intensify microteaching in health facilities

DPHN 0.00

Ensure preparedness for obstetric care

DPHN 0.00


DPHN 0.00

Level I

Conduct monthly social mobilization through barazas by PHT to encourage mothers deliver in facility level

DPHO 0.00

Output 1: Reduced no. of newborn with low birth weight

Activities


Source Code

Level IV

Intensify microteaching on good nutritional in 5 health facilities during ANC visits

DPHN 0.00

Ensure adequate supply of maternal supplements e.g. ferrous and folic

DNO 0.00

Result Area 3: All newborns (upto 2 weeks) receive protection against immunisable conditions

Purchase nutritional supplement quarterly in 5 health facilities

DNO 400,000.00 FIF 2211015

33

Procure 5000 LLINs for pregnant women

DPHO 150,000.00 IFAD/GOK/FIF 2211015

Train 40 health workers on newborn care

RH/coordinator/DPHN 350,000.00 wHO/RH 2210701

Level III


DPHN 0.00


DNO 0.00

Purchase nutritional supplement quarterly in 11 health facilities

DNO 132,000.00 FIF 2211015


DPHO 150,000.00 EU/FIF/GOK

Level II


DPHN 0.00


DNO 0.00


DPHO 150,000.00 EU/FIF/GOK

Level 1

Output 2: Increased no. of newborns receiving BCG


Source Code

Level IV

Intensify microteaching in 5 health facilities on importance of BCG uptake

DPHN 0.00

Do monthly forecasting and ordering to ensure adequate supply of BCG

DPHN 0.00

34

Ensure BCG vaccines are kept potent by regular maintenance of cold chain equipment

HMU 0.00

Ensure that the 5 health facilities give BCG in the maternity before discharge

DPHN 0.00

Level III


DPHN

Do monthly forecasting and ordering to ensure adequate supply of BCG

DPHN 120,000.00 2210701


DPHN 0.00

Ensure that the 5 health facilities give BCG in the maternity before discharge

DPHN 0.00

Level II


DPHN 0.00

Do monthly forecasting and ordering to ensure adequate supply

DPHN 0.00


HMU 0.00

Output 3: Increased no. of pregnant mothers counseled and tested for HIV


Source Code

Level IV

Train 40 health workers on PMTCT

200,000.00 NARESA/EU 2210701

Integrate PMTCT services with the ANC services in 5 health facilities offering ANC services

DASCO 0.00

Intensify microteaching in the 5 health facilities and document

DPHN 0.00

35

Acquire HIV testing kits timely for the 5 health facilities

DMLT 0.00

Level III


DPHN 0.00


DPHN 0.00

Acquire HIV testing kits timely DMLT 0.00

Level II


DPHN/DASCO 0.00


DPHN 0.00

Acquire HIV testing kits timely DMLT 0.00

Result Area 4: Children receive protection against immunizable diseases

Output 1: Increased no. of under 1 fully immunized


Source Code

Level IV

set annual targets with 100 health workers

DPHN 400,000.00 FIF 2210701

Train 20 health workers on operational KEPI

DPHN 430,000.00 KEPI/WHO 2210701

2210302

2210303

Cold chain maintenance in all health units

HMU 200,000.00 KEPI/WHO/FIF

Acquire & distribute vaccines DPHN 160,000.00 KEPI/WHO/FIF 2210302

36

2210303

Intensify microteaching in the 7 immunizing facilities and document

DPHN 0.00

Monthly monitoring of immunization status

DPHN

Monthly forecasting and ordering to ensure adequate vaccine supplies

DPHN 0.00

Level III


DPHN 0.00

2210302

2210303

Active defaulter tracing by the PHT and CHWs in the 7 health facilities

DPHO 109,200.00 FIF/GOK



DPHN 0.00

Level II


DPHN 0.00

2210302

2210303

Active defaulter tracing by the PHT and CHWs in the 37 health facilities


37


DPHN 0.00


DPHN 0.00

Start immunization services in 3 more dispensaries (Purchase 3 RCW)

DPHN 600,000.00 WHO/KEPI/EU/ADB 3111002

Output 2: Increased no. of children under 5yrs receiving Vit A


Source Code

Level IV

Level III

Conduct biannual Vit A supplementation

DNO 1,000,000.00 WHO/UNICEF 2210701

Intensify microteaching for children to be brought for Vitamin in all health facilities

DNO 0.00

Acquire enough Vitamin A supplement

DNO 0.00

Level III


DNO 0.00

Increase no. of SDP giving Vitamin A by 2

DNO 0.00

Acquire enough Vitamin A supplement

DNO 0.00

Level II


DNO 0.00

38

Increase no. of SDP giving Vitamin A by 10

DNO 0.00

level 1

Intensify social mobilization on the importance of Vitamin A intake by children under 5yrs by PHT/CHWs

DPHO 0.00

Result Area 5: Children are able to survive childhood illnesses

Output 1: Reduced no. of under 5yrs treated for malaria


Source Code

Level IV

Train 20 health workers on

IMCI strategy DCO 1,800,000.00 2210701

Train 100 health workers on malaria case management

Pharmacist 500,000.00 2210701

Acquire anti-malaria drugs for 5 health facilities

Pharmacist 0.00

conduct social mobilization on correct use of LLINs/ITNs

DPHO 0.00

Level III


Pharmacist 0.00

conduct social mobilization on correct use of LLINs/ITNs

DPHO 0.00

Making of mosquito nets using available resources


Level II


Pharmacist 0.00

conduct social mobilisation on correct use of LLINs/ITNs

DPHO

39

Level I

2210302

2210303

Conduct mass retreatment of ITN by CHWs

DPHO 300,000.00 GOK/IFAD/ADB

Social mobilization on correct use of LLINs/ITNs

DPHO 0.00

Output 2: Increased no. of school children correctly dewormed at least once a year

Activities


Source Code

Level IV

Acquire anti-helminths for 5 health facilities

Pharmacist 0.00

Conduct at least 5 school health education

DHEO 0.00

Level III 0.00


Pharmacist 0.00

Conduct at least 7 school health education

DHEO 0.00

Level II


Pharmacist 0.00

Conduct at least 20 school health programme

DHEO 0.00

Level I

40

Ouput 3: Reduced no. of underweight children under 5yrs


Source Code

Level IV

Level III

Intensify microteaching on dietary counseling in11 health facilities

DNO 0.00

Enhance growth monitoring at 11health facilities

DNO 0.00

Level II

Intensify microteaching on dietary counseling in 58 health facilities

DNO 0.00

Establish growth monitoring in 10 more health facilities

DNO 0.00

Level I

Intensify growth monitoring by the CHWs and give guidance

DNO 0.00

2210302 Monthly supervision of CHWS by CHEWs and submission of CHANIS report

DPHO 36,000.00 IFAD/GOK/FIF

2210303

Output 4: Increased no. of children under 5yrs attending growth monitoring clinics


Source Code

Level IV

Intensify microteaching in 5

clinic offering growth monitoring

DNO 0.00

41

0.00

Level III 0.00

Intensify microteaching in 5 clinic offering growth monitoring

DNO 0.00

Level II

Intensify microteaching in 49 clinic offering growth monitoring

DNO 0.00

Acquire 20 growth monitoring kits to increase no. of SDP offering growth monitoring

DNO 0.00

Level I

Acquire 20 growth monitoring kits to increase no. of CHWs offering growth monitoring

DNO 0.00

Social mobilization on under 5yrs children attending growth monitoring clinics by CHWs and PHT

DNO 0.00

2210302

2210303

Conduct monthly defaulter tracing on children attending growth monitoring clinics by CHWs

DNO 153,600.00 IFAD/GOK/FIF

Provide 20 sets of growth monitoring tools for CORPS

DNO 200,000.00 IFAD/GOK/FIF 3111002

42

Result Area 6: Behaviour change is promoted amongst adolescents that leads to healthy lifestyle

Output 1: Increased no. of health facilities offering standard package of youth friendly health services


Source Code

Level IV

Establish and equip 1youth friendly clinics at Kimbimbi SDH

MO i/c 3,000,000.00 WHO/RH 3110202

Train 8 peer counselors for Kerugoya and Kimbimbi SDH

DMOH 150,000.00 WHO/RH 2210701

Train 40 health workers on adolescent reproductive health

350, 000 WHO/RH 2210701

Level III

Level 11

22202053

Establish 3 youth friendly sites (Ngariama, Gatugura and Kutus dispensaries

DASCO 3,000,000.00 Partners in Prevention

3110203

Level 1

2210302

2210303

Intensify health promotions and health education in schools

DHEO 160,000.00 IFAD

Create community awareness on reproductive health issues in the youth

DPHO/RH coordinator 500,000.00 WHO/RH 2210303

43

Output 1:Increased no. of households with access to clean water and latrine


Source Code Result Area 7: Adults are able to survive health conditions affecting them

Activities

Level IV

Train 40 health workers on PHAST

DPHO 400,000.00 IFAD 22010701

Level III

Level II

Quarterly social mobilization on save sanitation and safe water

DPHO 76,000.00 IFAD//FIF 2210302

Level I

Conduct open sanitation campaigns in 10 shopping centre

DPHO 100, 000 EU/IFAD/FIF 2210302

Construct 10 VIP for demonstration

DPHO 250,000.00 IFAD/FIF 3110202

Protect 4 watersprings DPHO 200,000.00 IFAD/FIF/ADB 3110202

Cast 100 slabs for demonstration DPHO 300,000.00 IFAD/ADB 3110202

Output 2: Increased no. of households sprayed with IRS


Source Code

Level IV Conduct IRS in 5 health

facilities DPHO 15, 000 IFAD/FIF 2210303

Level III 2210303 Conduct IRS in 7 health

facilities DPHO 15,000.00 IFAD/FIF 2210303

44

Level II

Level I

Conduct IRS in 20 homesteads DPHO 100,000.00 IFAD/GOK/FIF 2210303

Output 3: Increased no. of HIV positive patients receiving ART treatment


Source Code

Level IV Train 20 health workers on ART DASCO 200,000.00 ICAP/AIPHA/NARESA 22010701

Train 60 health workers on TB/HIV collaboration

DTLC 450,000.00 NASCOP/NLTP 22010701

Train 20 health workers on HBC HBC coordinator 200,000.00 GOK/FIF 22010701

Train 6 VCT counselors DASCO 200,000.00 ICAP/AIPHA/NARESA 22010701

Procure baseline HIV test kits DMLT 80,000.00 NASCOP 2210303

Acquire ART drugs Pharmacist 0.00

2210302

2210303

Form 2 support groups DASCO 10,000.00 ICAP

Refurbish and integrate CCC services in Kimbimbi and Kerugoya hospital

DASCO 3,000,000.00 ICAP 2220205

Employ 8 technical personnel to work in the ART clinic (Kimbimbi and Kerugoya)

MO i/c 1,920,000.00 ICAP 2110201

Procure reagents for AFB microscopy for 4 diagnostic centres

DMLT 89,000.00 NASCOP 2210303

Procure safety hood for 4 centres

DMLT 400,000.00 NASCOP 2210303 Provision of data collecting and

reporting tools DHRIO 50,000.00 FIF/GOK/NASCOP 22110501

Level III

Train 8 VCT counselors DASCO 200,000.00 NASCOP 2210302

45

Procure safety-hood for 7 centres

DMLT 500,000.00 NASCOP 2210303

Level II

Level I

2210302

2210303

Carryout monthly community VCT

DASCO 72,000.00 Liverpool

Output 4: Increased no. of functioning community health units


Source Code

Level IV

Level III

Level II

Train 10 CHEWS DPHO 50,000.00 FIF/GOK/IFAD 2210701

Train 40 PHC TOTs DPHO 200,000.00 ADB/IFAD 2210701

Quarterly meetings with divisional PHC core team

200,000.00 ADB/IFAD 2210302

Level I

2210302

2210303

Select and train 10 VHCs DPHO 50,000.00 FIF/GOK/IFAD

2210302

2210303

Establish 4 community health units throughout the district

DPHO 100,000.00 FIF

Train 200 CORPS on new community strrategy (PHC)

DPHO 600,000.00 FIF/GOK/IFAD 2210701

Hold biannual meeting with all CORPS

DPHO 200,000.00 IFAD 2210302

46

2210302

2210303

Hold an exchange tour for the 20 CORPS

DPHO 200,000.00 /IFAD

2210302

2210303

Form 2 support groups DASCO 10,000.00 ICAP

Procure typhi vaccive DPHO 400,000.00 FIF

Provide chalk and board in 44 health facilities

DHRIO 200,000.00 ADB/IFAD

Output 1: Increased OPD attendance

Activities


Source Code

Level IV

Train 40 health workers on VIA/VILLI

RH/DPHN 350,000.00 WHO/RH

Establish customer care desk at Kerugoya and Kimbimbi hospital

MO i/c 0.00 2210701

Reduce patient waiting time at Kerugoya and Kimbimbi hospitals

MO i/c 100,000.00 FIF 2210701

Maintenance of OPD equipments and instruments at Kerugoya and Kimbimbi hospital

MO i/c 2,000,000.00 EU/IFAD/GOK/FIF 2220205

Procure dressings and other non pharmaceuticals in Kerugoya and Kimbimbi hospitals

MO i/c 12,000,000.00 EU/IFAD/GOK/FIF 2211024

Purchase dentall equipments and cartridges at Kerugoya hospital

Dentists 1,500,000.00 EU/IFAD/GOK/FIF 3110203

Purchase X-ray equipments and consumables at Kerugoya hospital

Radiographer i/c 1,500,000.00 EU/IFAD/GOK/FIF 3110203

Train 1 radiographer on ultrasound operations in Kerugoya hospital

Radiographer i/c 120,000.00 EU/IFAD/GOK/FIF 2210701

Result Area 8: Elderly are able to survive common health condition affecting them

Purchase ENT clinic equipment in Kerugoya hospital

MO i/c 107,000.00 EU/IFAD/GOK/FIF 3110203

47

Procure essential & emergency drugs for Kerugoya and Kimbimbi hospitals MO i/c

1,600,000.00 EU/IFAD/GOK/FIF 2211001

Put up a canopy for patients in reception area and physically challenged persons walkway in kerugoya hospital

MO i/c 50,000.00 GOK/FIF/CDF/EU 2220205

Purchase equipmemt for cold room in the kitchen at Kimbimbi hospital

MO i/c 1,500,000.00 GOK/EU 3110203

Purchase modern jiko for kitchen at Kimbimbi hospital

MO i/c 150,000.00 GOK/EU 3110203

Level III

Procure of consumables to 11 health facilities

DPHN 1,400,000.00 EU/IFAD/GOK/FIF 2211024

Procure of emergency drugs for 11 health facilities

PHARMACIST 200,000.00 EU/IFAD/GOK/FIF 2211001

Acquire 11 health centre kits monthly

PHARMACIST 0.00 EU/IFAD/GOK/FIF

Paint 7 health centres DPHO 2,000,000.00 GOK/FIF/CDF/EU 2220205

Recarpet the floor of 7 health facilities (Mutithi, Baricho, Baricho catholic, Kianyaga h/c, Kiamututgu, Kabare and Kianyaga catholic

DPHO 3,000,000.00 GOK/FIF/CDF/EU 2220205

Fence 3 health facilities (Mutithi, Kianyaga h/c, Kiamutugu)

DPHO 841, 880 GOK/FIF/CDF/EU 2220205

Put up gates in 4 health facilities DPHO 300,000.00 GOK/FIF/CDF/EU 2220205

Repair the ceiling of 8 health facilities (Sagana h/c, Mutithi, Baricho h/c, Baricho catholic, Kianyaga h/c, Kiamutugu, Kabare, Kianyaga catholic


Repair of portable light equipment in 8 health facilities(Sagana h/c, Muitithi h/c, Baricho h/c, Baricho catholic, Kianyaga h/c, Difathas, Kabare, Kianyaga catholic

HMU 400,000.00 GOK/FIF/CDF/EU 2220205

Purchase immersible water pump for 1 health facility (Mutithi)

DMOH 50,000.00 GOK/FIF/CDF/EU 3110203

48

Purchase electric heater for 5 health facilities (Mutithi, Sagana h/c, Baricho h/c, Kianyaga h/c, Kiamutugu)


Purchase portable light for 5 health facilities (Mutithi, Sagana h/c, Baricho h/c, Kianyaga h/c, Kiamutugu)


Purchase 5 autoclave for 5 health facilities (Mutithi, Sagana h/c, Baricho h/c, Kianyaga h/c, Kiamutugu)


Purchase lawn mower for 5 health facilities (Mutithi, Sagana h/c, Baricho h/c, Kianyaga h/c, Kiamutugu)


Purchase 7 delivery bed for 1 health facility(Kianyaga h/c, Mutithi, Baricho, Kabare, Kiamutugu, Difathas, Sagana)

DMOH 1,400,000.00 GOK/FIF/CDF/EU 3110203

Purchase 7 generator for 7 health centres

DMOH 1,350,000.00 GOK/FIF/CDF/EU 3110203

Purchase 7 television and deck for 7health centres

DMOH 280,000.00 GOK/FIF/CDF/EU

Purchase 3 water tanks for 3 health facility (Difathas, Kianyaga mutithi)


Purchase emergency drugs for 11 health facilities

Pharmacist 1,152,000.00 GOK/FIF/CDF/EU

2211001 Purchase various medical

equipment DMOH 40,000,000.00 GOK/FIF/CDF/EU

3110203 Construct 7 incicerators DPHO 1,750,000.00 ADB/IFAD 3110202 Level II

Procure of consumables to 65 health facilities

DPHN 1,400,000.00 EU/IFAD/GOK/FIF 2211002

Procure of emergency drugs for 65 health facilities

PHARMACIST 600,000.00 EU/IFAD/GOK/FIF

2211001 Acquire 65 dispensary kits

monthly PHARMACIST 0.00

49

Paint 28 health facilities (Rukanga, Karumande, Nguka, Kiangai, Murinduko, St. Mugumo, ACK Mutira, ACK Mbiri, Gatithi, St. Andrews Kabare, Kamweti, Kiangombe, Gatugura, Gatumbi SDA, Gathigiriri, Gaciongo, Kangaru, Gathambi, Kianjege, Njegas, Kiamanyeki, Ciagini, Thiba, Kajiji, Wamumu, Kiaragana, Mumbuini, CCS Wanguru, ACK Ngiriambu, ACK Githure, Jesmond, Ithare, Kagumo catholic, Kagumo disp, ack Karaini, Kutus catholic, ACK Thaita, Sagana catholic, Kagio catholic, Kutus disp, Kangaita, Mutitu)

3,000,000.00 GOK/FIF/CDF/ADB 2220205

Recarpet the floor of 5 health facilities (Gatugura, Gathigiriri, ACK Mutira, ACK Ngiriambu, ACK Karaini,

3,000,000.00 GOK/FIF/CDF/ADB 2220205

Putting ceilings in 15 health facilities (average 3 rooms)( Nguka, Kiangai, Murinduko, Kiangombe, Gatumbi SDA, Gathigiriri, Kangaru, Gathambi, Njegas, Kiburu, Kiamanyeki, Ciagini, Thiba, Kajiji, Wamumu, Kiaragana, Mumbuini, CCS Wanguru, ACK Ngiriambu, ACK Githure, Jesmond, Ithare, Kagumo catholic, Kagumo disp, ack Karaini, Kutus catholic, ACK Thaita, Sagana catholic, Kagio catholic, Kutus disp, Kangaita, Mutitu)

2,000,000.00 GOK/FIF/CDF/EU/ADB 2220205

Put up gates and fence 22 health faciliies (Karumande, Nguka, ACK Mutira, ACK Mbiri, Gatithi, St. Andrews Kabare, Kamweti, Gatugura, Gathigiriri, Gathambi, Kianjege, Rurii Kiandegwa, Njegas, Kiamanyeki, Ciagini, Thiba, Kiaragana, Sagana catholic, Kagio catholic, Kutus disp, Kangaita, Mutitu)

DPHIO 3,520,000.00 GOK/FIF/CDF/EU/ADB 2220205

50

Purchase of various equipment DMOH 2,000,000.00 ADB/IFAD 3110203 Construct 30 incinerators DPHO 4,500,000.00 ADB/IFAD 3110202

Do electricity wiring in health facilities (Rukanga, Nguka, Rurii Kiandegwa, Kajiji, Kagio catholic,ACK Thumaita)

HMU 2,000,000.00 GOK/FIF/CDF/EU

Put up fencing alone in 10 health facilities (Rukanga, Karumande, Kiangai, Murinduko, ACK Mbiri, St. Andrews Kabare, Kiangombe, Gatumbi SDA, Kangaru, Gathambi, Kajiji, Wamumu, Mumbuini)


0utput 2: Improved quality of care of the in-patients


Source Code

Level IV Renovate ward 10, 11, 9 in

Kerugoya hospital (whole ward) MO i/c 2,400,000.00 GOK/FIF/CDF/EU 2220205

Renovate amenity ward in Kerugoya district hospital (repair leaking roof, repair floor, put curtail rails, painting the walls, and provide water)

MO i/c 900,000.00 GOK/FIF/CDF/EU 2220205

Put up placenta pits for Kerugoya hospital

MO i/c 300, 000 JSI/FIF 3110202

Complete 18 bed ward construction in Kimbimbi hospital

MO i/c 5,000,000.00 GOK 3110202

Purchase various equipments for the various wards in Kerugoya hospital (4 infant weighing scales, 4 adult weighing scales, 2 suckers, 1 resuscitaire, 2 resuscitation trays, 60 waste bins, polythene liners, safety boxes)

MO i/c 1,964,852.00 fIF/GOK/EU

3110203 Purchase equipment for theatre

in Kimbimbi hospital including a generator

MO i/c 5,000,000.00 GOK/FIF/CDF/EU

3110203 Purchase equipment for the 18

bed ward at Kimbimbi hospital MO i/c 1,000,000.00 GOK/EU

3110203

Purchase mortuary equipment for Kimbimbi hospital

MO i/c 2,000,000.00 GOK

3110203

51

Purchase equipment for maternity

MO i/c 1,500,000.00 GOK/EU 3110203

Ensure adequate supply of food rations in Kerugoya and Kimbimbi hospital

HAO 2,000,000.00 FIF/GOK

2211015 Level II1

Put up placenta pits for 7 health centres

DPHO 330, 852 GOK 3110202

Level 1

Create awareness on cervical cancer screening through organised women groups

RH/DPHN 200,000.00 WHO/RH

Output 2: Reduced no. of days without tracer drugs


Source Code

Level IV 2210303

Acquire & distribute drugs Pharmacist 80,000.00 FIF/GOK/ADB

2210302

Forecast the drugs needs for 5 health facilities

Pharmacist 0.00

Timely ordering and acquisition of drugs for 5 health facilities

Pharmacist 0.00

Ensure proper records on drug consumption

Pharmacist 0.00

Level III

Forecast the drugs needs for 11 health facilities

Pharmacist 0.00

Timely ordering and acquisition of drugs for 11 health facilities

Pharmacist 0.00

Ensure proper records on drug consumption

Pharmacist 0.00

Level II

Level I

GRAND TOTAL 153,489,652

52

4.2 Coordination of Facility Based Management Support Activities

Output 1: Vehicles are

maintained

Activities


Budget Source

Level IV

Routine services of 4 vehicles in Kerugoya hospital and 2 vehicles in Kimbimbi hospital

MO i/c 666,750 FIF/GOK/EU

Provide adequate fuel and lubricants for Kerugoya and Kimbimbi hospital

MO i/c 3,000,000 FIF/GOK/EU

Level III

Quarterly maintenance of 4 vehicles (Kabare, Kianyaga, Sagana, Baricho)

DHAO 240,000 GOK/FIF/CDF/EU

Result Area 1: Maintenance of buildings, equipment and vehicles

Level II

Activities


Budget Source

Output 1: Motivated health workers in all health facilities

Level IV

Hold monthly staff meetings in 5 health facilities

MO I/C 475,200 GOK/FIF/CDF/EU

Provide daily staff teas in 5 health facilities HAO 300,000 GOK/FIF/CDF/EU

Quarterly HMB meetings for Kerugoya and Kimbimbi hospital

HAO 130,400 GOK/FIF/CDF/EU

Scientific conferences for health workers in Kimbimbi and Kerugoya hospitals

MO I/C 200,000 GOK/FIF/CDF/EU

Update 100 health workers on planning skills

350,000 GOK/FIF/ADB

Result Area 2: Monitoring and follow up of implementation with the committees

Level III

53

Hold monthly staff meetings in 11 health facilities

DPHN 475,200 GOK/FIF/CDF/EU

Provide daily staff teas in 11 health facilities DHAO 500,000 GOK/FIF/CDF/EU

Quarterly committee meeting DHAO 176,000 GOK/FIF/CDF/EU

Level II

Hold monthly staff meetings in 65 health facilities (5 h/ws)

DPHN 390,000 GOK/FIF/CDF/EU

Provide daily staff teas in 65 health facilities DHAO 745,000 GOK/FIF/CDF/EU

Level 1

Output 2: Improved data collection and report submission


Budget Source

Level IV Provide data collecting and reporting tools

for Kerugoya and Kimbimbi hospital HRIO i/c 1,300,000 GOK/FIF/CDF/EU

Monthly submission of reports in 5 health facilities


Hire casuals (53 in Kerugoya and 20 in Kimbimbi)

HAO 4,231,080 GOK/FIF/CDF/EU

-Purchase of one commercial copy printer for the KDH

HAO 300,000 FIF/GOK/EU

Level III GOK/FIF/CDF/EU

Timely submission of monthly reports' DHRIO 66,000 GOK/FIF/CDF/EU

Hire 3 casual workers for 8 health facilities DHAO 1,391,000 GOK/FIF/CDF/EU

Train 60 health workers on M & E DHRIO 305,000 AIPHA/GOK/ADB

Level II

Timely submission of monthly reports' by 65 health facilities

DHRIO 66,000 GOK/FIF/CDF/EU

Hire 3 casual workers for 65 health facilities DHAO 11,320,000 GOK/FIF/CDF/EU

Output 3: improved office operations


Budget Source

Level IV Provide stationery for Kerugoya and

Kimbimbi hospital HAO 1,200,000 GOK/FIF/CDF/EU

54

Pay telephone bills for Kerugoya and Kimbimbi hospitals


Maintenance of computers/email/ fax/ photocopiers


Accommodation and travel (patient referral) for Kerugoya and Kimbimbi hospital

HAO 1,600,000 GOK/FIF/CDF/EU

Provision for postal couriers for Kerugoya and Kimbimbi hospitals

HAO 15,000 FIF/GOK

Staff uniform and clothing’s for Kerugoya and Kimbimbi

HAO 50,000 FIF/GOK

General office supply for Kerugoya and Kimbimbi

HAO 100,000 FIF/GOK

Provide sanitary and cleansing materials for Kerugoya and Kimbimbi hospital

HAO 700,000 FIF/GOK

Provide for water and sewerage HAO 1,000,000 FIF/GOK

GRAND TOTAL 14,344,630.00

4.3. Management level (DHMT) Support plan

ACTIVITIES TIMEFRAME RESPO

SIBLE FUNDS SOURCE CODE

PLANNING Output 1: Developed integrated DHP

J A S O N D J F M A M J

Develop an annual integrated District Heath Plan

DMOH 450,000.00 EU 2210302

Output 2: Enhanced planning skills Hold quarterly meetings with health

workers DPHN 240,000.00 FIF 2210303

MAINTENANCE OF BUILDING, INFRASTRUCTURE, EQUIPMENT COMMUNICATI

Output 1: Maintained buildings

Painting of DHMT block DMOH 50,000.00 FIF /GOK 2220205

55

ACTIVITIES TIMEFRAME RESPOSIBLE

FUNDS SOURCE CODE

ON & TRANSPORT Repairs of WC toilet DMOH 6,000.00 FIF 2220205

Purchase 20 telephone heads DHAO 100,000.00 FIF /GOK 2210201

Purchase mobile phone for 22 DHMT @ 15,000

DHAO 300,000.00 FIF

Output 2: Communication improved

Maintenance of office equip computers, printers, fax machine photocopier and scanners

DHAO 1,200,000.00 FIF GOK 2211101

Payment of telephone, Email and postage services

DHAO 600,000.00 FIF GOK 2210201

Maintenance of 8 GOK vehicles in the DMOH office

DHAO 600,000.00 FIF GOK 2220101

Purchase of fuel and lubricants for the DMOH for 8 vehicles

DHAO 1,200,000.00 FIF GOK /WHO/RH

2211201

2211201

Enhance referrals from the rural health facilities

DHAO 1,000,000.00 FIF GOK/WHO/RH 2220101

Regular maintenance of medical equipment and instruments

HMU 300,000.00 FIF GOK 2220203

Output 3: Improved transport & referral system

2210302 INTERFACE WITH COMMUNITY

Output 1: Improved community participation and involvement

Conduct CBR, Mental, Dental, Immunization outreaches

DOT 264,000.00 FIF GOK

2210303

2210302

Conduct community oral health screening

DASCO 34,500.00 FIF GOK

2210303 2210302

Celebrate World days (mental, AIDs, Breastfeeding, TB)

DHEO 500,000.00 FIF GOK

2210303

Hold quarterly review meetings with PLWAs

DASCO 840,000.00 2210302

56


FUNDS SOURCE CODE

2210303 Provide 30 infants born to HIV

positive mothers with supplemental formula in KDH, KDSH, Mwea mission hospital

DNO 406,800.00 VIDHA

Procure 120 bicycles for CORPS

DHAO 4,800,000.00 AIPHA/NARESA

Output 2:Improved education,health & communication to the community

Procurement of Teaching aids (Generator and white board)

DHEO 70,000.00 FIF/GOK

GOVERNANCE

DMOH

2210302

Hold Monthly DHMT meeting DMOH 52,800.00 FIF GOK

2210303 2210302

Hold Quaterly D. H.M.B meetings DMOH 65,200.00 FIF GOK

2210303 2210302

Hold quarterly stake holders meetings

DMOH 400,000.00 WHO/RH

2210303 Payment of 24 casuals DHAO 1,580,640.00 FIF 2110202

Train 20 DHMB and HMB members on facilty management

DHAO 100,000.00 FIF GOK 2210701

Output 1: Enhanced teamwork

Train 120 health facility committee DHAO 400,000.00 FIF GOK 2210701

HUMAN RESOURCE MANAGEMENT

Sensitize DHMT on HIV/ART/TB DMOH 112,500.00 AIPHA/NARESA

2210302

Output 1: improved skills and knowledge

Hold quarterly meetings with health workers working in VCT/CCC

DASCO 100,000.00 AIPHA/NARESA

2210303 2210302

Conduct monthly supervisory visits for all DHMT members

DMOH 1,200,000.00 FIF/AIPHA/NARESA/WHO/RH 2210303

-Output 2: improved supervision

Conduct supervisory visit by the DTLC and DMLT on AFB

DMLT 94,400.00 NASCOP 2210302

57


FUNDS SOURCE CODE

microscopy 2210303 Conduct IMCI supervision DCO 72,000.00 FIF GOK 2210302

MONITORING & EVALUATION

Provide data collecting and reporting tools

DHRIO 400,000.00 FIF GOK 2210501

Purchase of 5 desk top computers and 2 LAPTOP

DHRIO 700,000.00 FIF GOK

Interconnect computers and provide internet services

DHRIO 600,000.00 FIF GOK

Train 10 health workers on computer applications

DHRIO 80,000.00 FIF GOK 2210701

Purchase duplo machine for Kimbimbi SDH

DMOH 400,000.00 EU

Purchase 1 digital camera DHRIO 50,000.00 FIF GOK

Purchase 1 GPS DHRIO 100,000.00 FIF/GOK

Output1: Improved HMIS

Train 20 DHMT on facilitative supervision

200,000.00 WHO/RH

FINANCIAL MANAGMENT

Train DHMT/HMT members on budget preparation

DMOH 100,750.00 FIF/GOK 2210701

Update revenue / accounts personnel on current financial management systems

DMOH 37,000.00 FIF/GOK 2210701

Computerize and network financial management system in all DEPT

DMOH 100,000.00 FIF/GOK

Train revenue / accounts personnel on current financial computer packages

DMOH 25,000.00 FIF/GOK 2210701

Output 1: Improved financial management systems

Train DHMT/HMT members on financial management packages

DMOH 800,000.00 FIF/GOK 2210701

GRAND TOTAL 18,372,440.00

58

SECTION 5 THE DISTRICT BUDGET

59

5.1 District Resource Envelope 5.1.1 District resource envelope by level of care and source Level /Source GOK FIF ICAP PARTNERS IN

PREVENTION WHO DHS & SP ADB IFAD Total

Level 1 3, 374, 800 0 9, 638, 000 4,000,000 17, 012, 800 Level 2 28, 144, 640 8, 210, 268 3, 000, 000 39, 354, 908 Level 3 17, 601, 764 2, 617, 216 20, 218, 980 Level 4 24, 368, 110 31, 358, 080 3, 392, 000 7, 000,000 14, 223, 200 80, 341, 390

DHMT (Coordination) 14, 194, 644 10, 920,000 4, 164, 000 29, 278, 644 Total 73, 489, 314 56, 380, 208 3, 392, 000 3, 000,000 10, 920, 000 7, 000, 000 23, 861, 200 8, 164, 000 186, 206, 722

5.2 Budget

Budget item Code Total budget by source

GOK FIF Other Total

TRAINING 2210701 0.00 6,070,000.00 9,975,500.00 16,045,500.00

CASUAL WORKERS 2110202 0.00 5,561,720.00 0.00 5,561,720.00 MAINTENANCE OF VEHICLES 2220101 200,000.00 366,750.00 100,000.00 666,750.00

SUBSISTENCE ALLOWANCE 2210302 500,000.00 9,903,700.00 5,000,000.00 15,403,700.00 TRAVEL & ACCOMODATION 2210302 200,000.00 8,268,236.00 3,000,000.00 11,468,236.00

ALLOWANCE FOR BOARD 2210802 0.00 371,600.00 0.00 371,600.00

CONSTRUCTION OF BUILDINGS 3110202

11,084,314.00 2,000,000.00 12,714,064.00 25,798,378.00

GENERAL OFFICE SUPPLIES 2211101 0.00 100,000.00 0.00 100,000.00 MAINTENANCE OF COMPUTERS 2220201 500,000.00 500,000.00 200,000.00 1,200,000.00

MAINTENANCE OF BUILDINGS 2220205 46,800,000.00 2,000,000.00 8,761,018.00 57,561,018.00 DRUGS 2211001 0.00 1,000,000.00 1,816,000.00 2,816,000.00 LAB REAGENTS 2211008 200,000.00 400,000.00 1,538,000.00 2,138,000.00 NON PHARMACEUTICALS 2211002 480,000.00 8,000,000.00 2,000,000.00 10,480,000.00

ENTERTAINMENT 2210801 0.00 2,938,200.00 0.00 2,938,200.00

CLEANSING MATERIALS 2211103 200,000.00 500,000.00 0.00 700,000.00

STATIONERY 2211001 200,000.00 900,000.00 100,000.00 1,200,000.00

POSTAGE & TELEGRAMS 2210203 0.00 15,000.00 0.00 15,000.00

PRINTING 2210502 0.00 560,000.00 0.00 560,000.00

PURCHASE OF EQUIPMENT 3111002 10,000,000.00 3,000,000.00 7,871,920.00 20,871,920.00

60

Budget item Code Total budget by source

GOK FIF Other Total

NUTRITION 0.00 100,000.00 704,000.00 804,000.00

FOOD & RATION 2211015 1,500,000.00 500,000.00 2,000,000.00

PURCHASE OF COMPUTERS 3111002 0.00 500,000.00 850,000.00 1,350,000.00

FUEL & LUBRICANT 2211201 900,000.00 2,000,000.00 1,300,000.00 4,200,000.00

MAINTENANCE OF VEHICLES 2220101 500,000.00 500,000.00 306,700.00 1,306,700.00

UNIFORMS & CLOTHINGS 2211016 25,000.00 25,000.00 50,000.00

TELEPHONE 2110201 200,000.00 300,000.00 100,000.00 600,000.00

TOTAL 73,489,314.00 56,380,206.00 56,337,202.00 186,206,722.00

5.3 Gap/ Surplus Budget item Code Total by source TOTAL

GOK FIF WHO ICAP PP IFAD DHS & SP ADB Revenue 73, 489, 314 56, 380, 208 10, 920, 000 3, 392, 000 3, 000,000 8,164,000 7, 000, 000 23, 861, 200 186, 206, 722 Budget 73, 489, 314 56, 380, 208 10, 920, 0000 3, 392, 000 3, 000, 000 8,164,000 7,000,00 23, 861, 200 186, 206, 722 Gap 0 0 0 0 0 0 0 0 0

Kirinyaga District AOP 3 - 16-5-07

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