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