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Ministry of Medical Services
Ministry of Public Health and Sanitation
National Stakeholders’ Consultation Workshop to Strengthen Results and Accountability for Women's and Children's Health and the health sector as a whole
Silver Springs Hotel, Nairobi, Kenya – 21-22 February 2013.
Every Woman Every Child; Kenya Accountability Framework From commitments to action
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TABLE OF CONTENTS
BACKGROUND .............................................................................................................................. 3 KENYA NATIONAL STAKEHOLDER CONSULTATION MEETING ..................................... 4
Meeting Objectives and Expected Outputs ................................................................................... 4 Progress towards MDG 4 and 5 in Kenya. ................................................................................... 4 Kenya Accountability Framework Tool Validation ..................................................................... 5
Delegates were divided into 7 groups covering all the seven country CAF focal areas. ...................... 6 Draft Accountability Roadmap 2013 – 2015. ............................................................................... 6
KEY SPEAKERS ............................................................................................................................ 12 GOVERNMENT CALL TO ACTION .......................................................................................... 14 NEXT STEPS ................................................................................................................................. 14 PHOTO GALLERY ....................................................................................................................... 15 APPENDICES ................................................................................................................................ 18
Appendix 1: Meeting Schedule ................................................................................................... 18 Appendix 2: List of participants ................................................................................................. 21 Appendix 3: HIIs......................................................................................................................... 24 Appendix 4: Global Initiatives .................................................................................................... 27
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BACKGROUND In September 2010, the UN Secretary General launched a global strategy for Women’s and Children’s Health, Every Woman, Every Child (EWEC) whose main goal is scaling up and prioritizing a package of high-impact interventions, strengthening health systems and integrating efforts across diseases and sectors such as health, education , water, sanitation and nutrition. The strategy aims to save the lives of 16 million women and children by 2015. In this launch meeting, more than 200 commitments from a range of constituency were made and about US$: 40 billion mobilized. The Kenyan government in this meeting made a commitment to:
• Kenya will recruit and deploy an additional 20,000 primary care health workers;
• Establish and operationalize 210 primary health facility centres of excellence to provide maternal and child health services to an additional 1.5 million women and 1.5 million children;
• Expand community health care, and decentralize resources.
A critical part of this strategy was the creation of a global oversight mechanism to ensure that commitments were being delivered on time and with impact. This led to establishment of Commission on Information and Accountability (CoIA) tasked to develop framework for accountability for women’s and children’s health. The CoIA made 10 recommendations and mapped out priority areas for actions at country and global levels as depicted in the figure below that illustrates how to progress from recommendations to actions.
1. Vital events (CRVS) 2. Health indicators & equity
3. Innovation
4. Resource tracking5. Country Compacts 6. Reaching Women/Children
7. National oversight
8. Transparency
9. Reporting aid for Women/Children’s health
10. Global Oversight
COMMISSION RECOMMENDATIONS
Country Actions
GlobalActions
Birth and death registration
Monitoring of results
Maternal death surveillance & response
Accountability Framework
eHealth & innovation
Monitoring country resources
Advocacy and action
Monitoring results
Tracking resources
Global review (iERG)
Concluding compacts
From recommendations to actions
WHO, lead partner in the commission, undertook country orientation meetings aimed at facilitating formulation of country accountability frameworks. Several regional meetings have been undertaken. Kenya has benefited from this orientation and progressed to hold a national accountability workshop for its stakeholders to validate and agree on a final national accountability framework to be used in
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holding different organizations accountable for resources we spend in providing health services to the people of Kenya.
KENYA NATIONAL STAKEHOLDER CONSULTATION MEETING
Meeting Objectives and Expected Outputs The one and half day national consultation workshop was held on 21-22 February 2013 at Silver Spring hotel Nairobi – see Annex 1 workshop schedule. The meeting aimed to:
• Orient key country stakeholders about the context and implications of the recommendations of the Commission on Information and Accountability (CoIA) for Women's and Children's Health.
• Assess the current situation in terms of progress and plans, opportunities and challenges for implementing the CoIA recommendations, and identify priority actions.
• Share and discuss the results of the assessment of the current situation on the implementation of the accountability framework.
• Finalize a country roadmap to strengthen accountability for 2013-15, building upon the initial roadmap done at the multi-country workshop (Dar 2012).
A total of 62 participants attended the meeting. The participants were drawn from GoK, Development partners, civil society organizations representing a rich diversity of national and regional stakeholders from public and private, academia, technology and donor organizations – See annex 2 for the list of participants The national workshop targeted to achieve the following outputs:
• Increased awareness and understanding by all stakeholders of the CoIA recommendations and opportunities/challenges for country implementation.
• A completed review of the assessment report, and final draft of the accountability roadmap identifying the priority actions.
• Group work and consensus on the identified priority areas for strengthening during 2013 – 2015 (with cost implications for 2013 – 2014).
Several presentations were made to give delegates an orientation and background to the Global strategy, CoIA recommendations, and the prioritized country actions. To guide group works sessions, MoPHS shared a presentation with an update of the country progress towards MDGs 4 and 5.
Progress on MDGs 4 and 5 in Kenya.
MDG 4 progress Mortality rates: current statistics indicate that under 5 mortality stands at 74/1000 live births; under 1 mortality rate at 52/1000 live births, and newborn mortality rate at 31/1000 live births. Current statistics confirm that 60% deaths in Kenya are due to neonatal causes. Under 5 mortality in Kenya has reduced with 34 % in less than 10 years. Despite the noted progress, Kenya is still way off track in achieving 70% under 5 mortality reductions by 2015. Similarly, infant mortality has reduced with 30 % way below expected 65% reduction by 2015. Nutrition: Exclusive breastfeeding stand at 31.9% ; Median duration of exclusive breastfeeding (months) - 2.6 ; Early initiation of breastfeeding (% newborns put to the breast within one hour of birth)
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- 58.1; and Vitamin A supplementation- 30.3% ( % children 6-59 months who received at least 2 high dose vitamin A supplements in the last 12 months)
MDG 5 progress The women of child-bearing age stand at 9.6 million and maternal mortality stand at 488/100,000 live births (2008-09) as compared to 414/100,000 (2003). Contraceptive prevalence rate stands at 46% with ANC standing at 92% first visit and 47% for 4 visits. Availability of delivery services at all health care services - both private and public remain too poor with poor distribution at the rural and marginalized areas where majority of the population in need of the services live. Further, Kenya has managed to identify not only the leading mortality causes but chosen maternal, neonatal and post neonatal (upto 5 yrs ) high impact interventions if implemented, would accelerate the progress towards achieving targeted results by 2015 – see Annex 3 for a full pull out of the HIIs. This means that what Kenya just like the rest of the world knows what to do to save lives and as a consequence reduce poverty.
Dr. Bashir, the head of the Department of Reproductive Health (DRH) wrapped up the presentation by highlighting the following:
That there is need to refocus the MNH initiatives. He called on participants to use the evidence and facts in from his presentation in
development of the accountability framework that clearly addresses key gaps. Reassured all participants that they represent Kenya, and that their inputs and dedication
to the process is extremely crucial. Dr. Bashir reassured the team that Kenya reduces MMR by 99% just like other developed countries.
He pointed out that Neonatal Mortality greatly contributes to IMR and some progress has been made in child health From KDHS 2003 to that of 2008/9. However some provinces have worsened over the period eg Nyanza and Nairobi.
Our strategies and plans need to ensure quality and accessible Continuum of care package of services from pre-pregnancy thro’ ANC, delivery and postpartum care. PNC is inadequate even for those patients who deliver in health facilities. There is need to change our mind set and commit to provide quality services for all the signal functions as a package.
He gave an example of Rwanda that has made a remarkable progress by improving CPR from 17% to 42% in less than 10yrs.
He sounded his distress to the participants that despite rolling out AMTSL to all regions, only 56% practice it in Kenya.
Because of not keeping the promises, we are far off our Targets eg MMR at 488 against 147; BEOC at 15% Vs 100 use as Anecdote.
Kenya Accountability Framework Tool Validation The delegates were taken through: The Tanzania multi-country CAF workshop report and the draft Kenya accountability
framework; Introduction to the country accountability framework and its development guiding principles as
conceived by the commission;
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Overview of the link between global and regional initiatives and processes – see annex 4.
Delegates were divided into 7 groups covering all the seven country CAF focal areas. The delegates were encouraged to follow the guiding principles in filling the framework. These include:
• Build on existing country plans and frameworks with the aim of enhancing accountability. • Outline how gaps and priorities will be addressed and implemented. • Identify priority activities and cost them (2013 – 2015 timeline). • Establish a shared understanding of the work required, and the roles and responsibilities of each
partner in implementation of the roadmap. Participants were assured that this is not a duplicative process and that it should complement existing country plans and frameworks to serve as an accountability tool that helps in monitoring results used in providing health services and the results achieved for evidence based policy. Group work results were presented in plenary for the wider delegate’s feedback. The following table summarizes priorities agreed on by different groups. Due to time constraints, final 2 – 3 key priorities for 2013 section was agreed to be filled later with consultation of the wider focal area team members. The focal persons are also presented in the second table below.
Draft Accountability Roadmap 2013 – 2015. The final scores after the self assessment did not change much from the Tanzania draft. Below is a summary of scores in the 7 areas of the Kenya Accountability Framework. February 2012
Civil registration and vital statistics systems (CRVS) 0%Monitoring of results 42%Maternal death surveillance and response 49%Innovation and eHealth 60%Monitoring of resources 42%Accountability processes 60%Advocacy & accountability 35%
0%
42%
49%
60%
42%
60%
35%
0% 20% 40% 60% 80%
Civil registration andvital statistics systems
(CRVS)
Monitoring of results
Maternal deathsurveillance and
response
Innovation andeHealth
Monitoring ofresources
Accountabilityprocesses
Advocacy &accountability
Monitoring Resources area recorded the highest score difference from the Tanzania draft- a big drop from 42% to 28%. The group felt that: The NHA exists but it is not institutionalized; that there is low involvement of the program managers; Reporting by the GoK and partners is inadequate; Information is not available to all; and that allocated resources cannot easily be linked to programme results. The final filled tool will be attached to this report for detailed record reference.
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Self-Assessment scores as at February 2013 Accountability framework KENYA
Summary scores of self assessmentFebruary 2012
Civil registration and vital statistics systems (CRVS) 48%Monitoring of results 42%Maternal death surveillance and response 49%Innovation and eHealth 63%Monitoring of resources 28%Accountability processes 58%Advocacy & accountability 35%
48%
42%
49%
63%
28%
58%
35%
0% 20% 40% 60% 80%
Civil registration andvital statistics systems
(CRVS)
Monitoring of results
Maternal deathsurveillance and
response
Innovation andeHealth
Monitoring ofresources
Accountabilityprocesses
Advocacy &accountability
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Results areas focal teams
CAF Responsible PersonsComponent Focal Persons
MOH WHO Other Partners
CRVS Dr. Charles Nzioka, Dr Kabaka
Hillary Kipruto Judy Kilobi (CR-MoI)
Monitoring of Results
Dr Were, Dr KitetuB.Wambu, Tecklar
Joyce Lavussa/Kipruto
Rhoda and Dr Kimuu(Danida) Pauline (MOP)
MPDSR Dr. Shiphrah Kuria Joyce Lavussa Khadija Abdalla (UNICEF), Dr Okoro(UNFPA)
Innovation and eHealth
Dr Ogara Hillary Kipruto Khalila (KimMCHip)
Monitoring of Resources
Nzoya MungutiAndolo Miheso
Stephen Cheruiyot Ramana (World Bank)Isack( MOF)
Accountability Process
Dr Were, Dr KitetuDr Nyakiongora
Humphrey Karamagi Dr Osumba (USAID), Ramana (World bank)
Advocacy and Outreach
Dr Migiro, Katama Christine Kisia Angela Mutunga (FCI)
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Table 2: CAF priorities and budget summary for catalytic funding
Focus Area Priorities Top 2-3 select Priorities for 2013
Budget
1. Monitoring Results
a) Strengthen analysis skills, analytical data and staffing especially at sub-national level.
b) Strengthen equity focus of reviews
c) Strengthen capacity to conduct annual Data Quality Assurance.
d) Improve involvement of key institutions - Academia, private sector and women orgs
e) Strengthen national data repository with all relevant data and reports
USD: 30,000
2. Resource Tracking
a) MoH needs to be pro-active and make development partners report on their resources.
b) Declare sources of funding. c) NHA be done as per programme- including relevant
results expected. d) This can be started at national level then sub-national at a
later stage.
US$: 40,000
3. Advocacy Action Plan
a) Enhance involvement of Private sector, academia and women organizations in the review and planning process.
b) Strengthen feedback of national reviews to sub-national levels and up to the community
c) Strengthening capacity and staffing to improve data analysis and synthesis of relevant health data
d) Parliamentarians are informed and encouraged to engage in RMNCH accountability, especially on financing.
US$: 50,000
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– Advocacy for more budgetary allocation and utilization.
– Capacity building of parliamentarians and county assemblies.
e) support /strengthen coalition, Support capacity to synthesize evidence and disseminate messages
– Partnership between MOH, NGOs, line ministries, development partners is key.
– Capacity building of CSOs and service providers. – Monitoring and evaluation. – Establish national and county coordination
mechanisms. – National mapping of service providers and CSOs – Countdown down Coordinating Committee to
Prepare CD report / profile using all evidence. – Quarterly Countdown Down stakeholder meetings.
4. Innovation and E
health a) Disseminate E-Health policy and strategy; strengthen
leadership and buy in. b) Develop/strengthen the use of e-Health services to
improve information sharing. c) Enhance interoperability through e-Health services, and
improved resource mobilization.
US$: 20,000
5. Maternal Death and Surveillance Response
a) Advocate for full enforcement of the national policy on MD notifications
i. Lobby and advocate for an MCH Bill to include MD
b) Strengthen capacity through training in MDSR i. Mobilize resources for trainings ii. Conduct training of ToT's
c) Improve hospital reporting and use of ICD 10 i. Build capacity of hospitals by training on ICD 10
tools
US$: 50,000
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ii. Train on dissemination of the tools iii. Distribution of the tools
d) Strengthen community reporting and Verbal Autopsy of Maternal deaths
i. Train CHW's on Verbal Autopsy ii. Community sensitization through mass campaigns
for awareness creation- chief's barazas, media, women's groups
iii. Establish MSDR advocacy committee
6. Civil Registration Vital Statistics Systems (CVRS)
a) Improve hospital reporting. i. Use of electronic reporting system.
b) Training of doctors and other clinicians in ICD 10. c) Conduct regular quality control of certification d) Strengthen community reporting of births and deaths
through community workers. e) Test new approaches, e.g. cell phones. f) Develop/strengthen use of VA by community workers,
test new approaches g) Develop and strengthen a national representative Health
Demographic Surveillance System which is government led.
h) Improve involvement of key institutions - Academia, private sector and women organizations
US$: 40,000
7. Country Reviews and Accountability Mechanisms
a) Finalize the country compact in line with the KHSSP III
b) Review the existing Code of Conduct and develop a new one
c) In liaison with the counties ; put in place health sector governance and partnership structures
US$: 20,000
Totals US$: 250,000
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Day 2
This is the day we had the official opening of the stakeholder’s workshop and the meeting was graced by high ranking officials from the Ministries of Health, Development partners. On day 2, the advanced Kenya CAF tool was reviewed in a plenary for finalization under the leadership and facilitation Dr. Sharif, Director, MoPHS and Dr. Annah Wamae, Head, Division of family health. Other key quests included, Dr Custodia Mandlhate, WHO Kenya Representative who spoke on behalf of the UN family in Kenya and Dr. Sheila Macharia, Manager Family Health division, USAID Kenya.
KEY SPEAKERS Dr. Wamae, Head, Department of Family Health gave an overview of the progress towards MDG 4 and 5 and the link of the Kenya accountability framework to other various initiatives. She noted that there are many global and regional initiatives that most of the time is too confusing at the country level. She noted some these initiatives going on in Kenya to include; Millennium Acceleration Framework (MAF) due for validation and operationalization; CARMMA, Already launched in Kenya and planned for dissemination to all the counties as campaign strategy for all sectors among others. Dr. Wamae acknowledged that not much progress has been made in MDG 4 & 5 in many countries including Kenya. This notwithstanding, Kenya aims to reduce child mortality in every county at much faster rate than before. Despite the slow progress in achieving MDGs 4 and 5, Dr. Wamae noted that we have realized some great gains that need to be sustained and move faster to improve on low areas of performance. On behalf of USAID, Dr. Macharia congratulated the Kenya health sector in its relentless efforts to improve MNCH. She reassured Kenya that the US Government is and remains committed to supporting the government of Kenya in saving lives women and children .She noted the huge investments US government has put in service delivery across the country through programs such as the APHIA consortiums and Education projects such as the Wings to fly initiative among others. In USAID’s support, Dr. Macharia reassured participants that USAID will continue align and support the Kenya government health plans priorities. Dr. Macharia noted that a lot needs to be done and pledged USAID Kenya program support to the accountability framework in support of the global strategy through its current ongoing funded projects. Dr Custodia Mandlhate, WHO Kenya Representative, attended the meeting not only to represent WHO but the UN Family in Kenya. She thanked Kenya for holding the CAF partner consultation meeting with such a rich multi-stakeholders participation. She emphasized the need for consulted efforts, focused and targeted actions to strengthen MNCH service delivery for improved health outcomes of women and children in the country. Dr. Custodia reminded participants of the 2015 set
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deadline for MDG’s 4 & 5, hence the need to do everything possible to accelerate achievement of the set targets. The WHO Kenya WR noted that the accountability framework tool is designed to address areas that the commission’s recommendations noted as weakest in the 75 high burdened countries. For example Kenya is not doing well on the actual identification of and registration of births and deaths. These are vital statistics, very important at guiding policy and investments shifts required to accelerate progress. To track progress, Dr. Custodia reaffirmed that WHO remains committed and the entire UN family in supporting Countries accountability processes following the commission’s 10 recommendations. The WHO WR Kenya emphasized that Accountability at country level is very crucial. She noted that reviewing causes of Maternal and Perinatal Deaths and addressing them tactifully and quickly is crucial. She called on partners to offer technical assistance and resources needed to catalyze actions aimed at saving women’s and children’s lives. She reiterated big support to Kenya from the UN family and other partners towards achieving the set MDG targets in 2015 and beyond 2015. Dr. Custodia called on all stakeholders to accept to be held accountable to the citizens of this country.
Dr. Custodia delivers her speech on behalf of the UN Family She reiterated that strategies succeed if drawn from partnerships, national leadership and ownership. At the country level, the concept of accountability should be mainstreamed in service delivery and programme operations;
Dr. Sharif, Director, Ministry of Public Health and Sanitation thanked participants and the organizers for good attendance. He pointed out some of the gains that Kenya has made overtime on RMNCH to include:
So far 201 Model Health Centers have been established and60% of them (through the Economic Stimulus Package by the Kenyan government) is fully functional. These centers are meant to serve Women’s and Children’s Health.
Kenya now has a dedicated Budget line for Family Planning (FP). Equipment for health facilities is being sourced and targets services that are offered in
under BEoC and EMoC
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Capacity building of service providers continuing in the areas maternal and child health Health facilities are now accessing direct funding through HSSF for HFs and OBA has
been piloted to increase uptake of reproductive health services The Director observed that there are proven interventions known to work, easily be
implementable and that promise quick and high impact. There is improved immunization up to 80%.
GOVERNMENT CALL TO ACTION On behalf of the Kenyan government, Dr. Sharif called on all stakeholders to:
• Prioritize multi-stakeholder engagement strategies. The complex and ideal system required to accelerate achievement of MDG 4 and 5 stretched beyond the health sector thus requiring a well thought engagement strategy;
• Timely planning and implementation of interventions; • All partners to own and support the country accountability
framework
Dr. Sharif, Director, Ministry of Public Health and Sanitation deliver his speech
NEXT STEPS Led by Dr. Sharif, the following was agreed as the way forward:
1. Sent a letter of request for Catalytic funding to WHO 28th February, 2013 2. The advanced CAF tool validated by the stakeholders should be edited for finalization by end of
March 2013 with the leadership of the focal persons in each of the 7 thematic areas ; 3. The Country Accountability Framework document be finalized and printed by end of March 2013; 4. Hold dissemination including uploading it into the relevant websites such as MoPHS, DFH, WHO)
by the secretariat; 5. Provide costing of the roadmap (CAF) for continued resource mobilization by end of April by the
focal teams; 6. Facilitate development of regional MNCH score card as a platform for comparing performances
between regions and encourage competition. Dr. Sharif confirmed that he has resources for placement of scorecards in the media.
7. Plan for annual sharing of information with the public; this can be through media or other forums.
Dr Shariff wrapped up the session by calling on the delegates with leadership from the secretariat to ensure continued engagement of the Provincial teams in the entire process and to closely link the CAF activities to ongoing projects such as ICD 10 by WHO and Futures, e-health by KiMNCHip, JICA,
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PHOTO GALLERY
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APPENDICES
Appendix 1: Meeting Schedule
Ministry of Medical Services
Ministry of Public Health and Sanitation
National Stakeholders’ Consultation Workshop to Strengthen Results and Accountability for Women's and Children's Health and the health sector as a whole
Silver Springs Hotel, Nairobi, Kenya – 21-22 February 2013.
TIME ACTIVITY PRESENTER 8.30 – 9.00 Registration DFH (Zainabu) 9.00 – 9.15 Welcome and Introductions Dr. A. Wamae 9.15 – 9.25 Objectives and Expected Output of the
workshop Dr. Kabaka, Head-DCH
9.25-10.00 Progress towards MDG4 and 5 targets, and Country Commitments to the UN Global Strategy for Women and Children’s Health
Dr. Bashir
Linking to other ongoing initiatives and country processes (MAF, Count Down 2015, Call to Action for Child Survival, CARMMA, EAC Open Health Initiative)
Head-DRH
10.00-10.15 Introduction of the accountability framework
based on the recommendations of the UN Commission on Information & Accountability for Women’s and Children’s Health
Dr Lavussa
10.15-11.00 TEA BREAK
11.00 – 11.30 Report and results from the multi-country workshop: Process and results
Dr. Ruth Kitetu
Technical Planning (MoPHS)
11.30–12.00 Mapping of current country and partner efforts in implementing the accountability framework
Dr. Nzoya Munguti
DCE (MoPHS)
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12.00-12:15
Group Work Introduction to Group Work on the components of the Accountability Framework: assessment, priorities, roadmap (4-6 groups)
Dr. Khadija Abdalla
(UNICEF)
12:15-13.00
Group 1: Civil registration and vital statistics systems (assessment, plan, coordination mechanisms, hospital reporting, …)
Group 2: Monitoring of results (plan, coordination, surveys, facility data, analytical capacity, equity,)
General and cross-cutting situation
Programme specific (HIV, TB and malaria)
Group 3: Maternal death surveillance and response (notification, capacity, facilities, quality of care, community reporting…)
Group 4: ICT (policy, infrastructure, services, standards, …)
Group 5: Tracking of resources (framework, governance, coordination, production, analysis…)
General and cross-cutting situation
Programme specific (HIV, TB and malaria)
Group 6: Annual reviews, advocacy and outreach (context, planning, compacts, …)
Health sector Programme specific
Group work : ·identify priority actions ·define methods and approach ·define roles and responsibilities ·identify timelines for actions implementation ·Identify priority actions for 2012-2013 with cost implication
13:00 – 14:00 LUNCH BREAK
14:00-15:00 Group work (continued) Group work
15:00-16:00 Groups feedback to plenary and discussion Plenary
16:00-16:30 TEA BREAK
16.30-18.00 Integration of plenary feedback into the final roadmap
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DAY 2
8.30 – 9.00 Registration DFH (Zainabu)
9.00 – 9.15 Welcome and Introduction Dr. Bashir
9.15 – 9.30 Remarks from the UN agencies Dr Custodia Mandlhate
(WHO Country Representative)
9.30 – 9.45 Official Opening Dr. Sharif
Director PHS
9.45 – 10.00 Overview of the progress towards MDG 4 and 5 and the link to the various initiatives; Global Strategy on Women’s’ and Children’s Health, Commission on Information and Accountability (COIA) and Country Accountability Framework (CAF)
Dr. Wamae
10.00 – 10.30 TEA BREAK
10.30 – 11.15 Presentation of the draft Accountability Roadmap 2013 – 2015.
Plenary discussion
Dr Angela Mutunga/ Dr. Shiprah Kuria
11.15 – 11.45 Official validation of the Country Accountability Roadmap
Plenary consensus
Dr. Wamae
11.45 – 12.30 Next Steps
Official closing
Dr. Sharif
12.30 – 14.00 LUNCH
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Appendix 2: List of participants
WHO/MOH WORKSHOP REGISTRATION FORM
Name of Workshop: Country Accountability Framework National Stakeholders' Workshop Status of Meeting: Day Participation/Residential for sub national staff
Dates of the Workshop: 21st - 22nd February 2013 Venue: Silver Springs Hotel
Day 1 - 21.02.2013
No. Names Title Organization Country Date In Date Out Telephone 1 Esha S. Yahya PLO MOPHS-COAST Kenya 21/02/13 22/02/13 0722234888 2 Cosmas Mutunga PO DRH Kenya 21/02/13 22/02/13 0721434893 3 Khalila A. Salim MHEARTH KIMMNCHIP Kenya 21/02/13
0705408485
4 Zof Kelly PO UNAIDS Kenya 21/02/13 22/02/13 0708848354 5 Abdirahman Farel PLO MOPHS-NEP Kenya 21/02/13 22/02/13 0716831586 6 Joyce Lavussa NPO WHO Kenya 21/02/13
0722785941
7 Daniel Gakuu SAINO MOPHS Kenya 21/02/13 22/02/13 0722414678
8 Dr. Manson Solomon Director FAI360 Kenya 21/02/13
0722736813
9 Dr. Bashir DRH MOPHS Kenya 21/02/13 10 Joan Odunga
MOPHS Kenya 21/02/13
11 Clifton Katama PO DRH-MOH Kenya 21/02/13
0721960025 12 Charity Ndwiga PO POP COUNCIL Kenya 21/02/13
0722395611
13 D Mohamed STD DRH Kenya 21/02/13
0726171400 14 Tiberius Matofari PCO MOPHS Kenya 21/02/13
0722866989
15 Loise N. Kingori
MOPHS Kenya 21/02/13
0715314907
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16 Assumpta Matela PRHC MOPHS Kenya 21/02/13
0724270308 17 Ruth Muia PO DRH Kenya 21/02/13
0735712315
18 Stephen Cheruiyot HEC WHO Kenya 21/02/13
0736113561 19 Dr. Ruth Kitetu SADMS MOPHS Kenya 21/02/13 0729344256 20 Dr. Kiongora A ASMS MOPHS Kenya 21/02/13
0722351102
21 Angela Mutunga CD FCI Kenya 21/02/13
0724975955 22 Norah Bett PRHC MOPHS Kenya 21/02/13
0722229528
23 Raphael Nguni PCO MOPHS Kenya 21/02/13
0722459414 24 Agnes Gichogo PRHC MOPHS Kenya 21/02/13
0722636490
25 Okoro Dan
UNFPA Kenya 21/02/13
0721203151 26 Florence Gachanja PO UNFPA Kenya 21/02/13
0733768152
27 Fridah Lunani
MOH Kenya 21/02/13
0724336092 28 Stephen Mwangi PO MOPHS Kenya 21/02/13 22/02/13 0720852107 29 Charles Ngwalla PCO MOPHS Kenya 21/02/13
0722922466
30 Stine Llun Intern Danish Embassy Denmark 21/02/13
- 31 Hjorois Ogendo
EV Delegation EU 21/02/13
-
32 Martin Matingi PO DCAH-MOPHS Kenya 21/02/13
0724072711 33 Yufeng Xue Intern DRH-MOPHS China 21/02/13 21/02/13 - 34 Hellen Bonke PO DANIDA Kenya 21/02/13 21/02/13 - 35 Dr. Nande Putta Advisor UNICEF Kenya 21/02/13
0713010568
36 Dr. Sheila Macharia Senior Health Adviser USAID Kenya 21/02/13
0713601472 37 Caroline C Sangi PO MOPHS Kenya 21/02/13
0724224291
38 Judy Kilobi Ass. Director
Department of Civil Registration Kenya 21/02/13
0721801783
39 Robinson Karuga Reasearch Assistant. A FCI Kenya 21/02/13`
0729831226 40 Lillian Mutea PWG USAID Kenya 21/02/13
0714606517
41 Wycliffe Sadia ICT FCI Kenya 21/02/13
0722684118 42 Louisa Muteti PRHEO MOPHS Kenya 21/02/13
0722483245
43 Christopher W. PCO MOPHS Kenya 21/02/13
0722512972 44 Dr.Kuria N.S. D/Head DRH Kenya 21/02/13
0722300279
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45 Leah Rutto PCO MOPHS Kenya 21/02/13
0722761138 46 Annie Gituto PM DRH Kenya 21/02/13
0733606404
47 D.G.Ndirangu RHTA DRH Kenya 21/02/13
0722804750 48 Absalom Ingabo PCO MOPHS Kenya 21/02/13
0722865183
49 Fatuma Iman PRHC MOPHS Kenya 21/02/13
0721661125 50 John Anampiu ADP NCPD Kenya 21/02/13
0701858463
51 Dr. Charles DDMS MOPHS Kenya 21/02/13
0721234904 52 Angela Njiru PRHC MOPHS Kenya 21/02/13
0722605687
53 Elsa Odisa PWG OCAH Kenya 21/02/13
0722883730 54 Dr.Annah Wamae H/DFH MOPHS Kenya 21/02/13
0722674681
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Appendix 3: HIIs MATERNAL:
Crosscutting -
Early initiation of ANC Individualized birth plan Emergency preparedness Use of Partograph Maternal nutrition Family planning Maternal and Perinatal Death review and Verbal Autopsy
Community -
• Haemorrhage (PPH) Emergency preparedness Prompt referral
• Eclampsia Early initiation of ANC
• Sepsis Hand washing
• Anaemia Iron and Folic acid supplementation De-worming Recognition of danger signs Prompt referral
• Malaria Sleep under LLIN Recognition of danger signs Prompt referral
• HIV/AIDS Early ANC
Facility – • Haemorrhage (PPH)
AMTSL Manual removal of placenta Manual Vacuum Aspiration Blood Transfusion
• Eclampsia Use of Magnesium sulphate Calcium supplementation
• Sepsis Infection prevention IV Antibiotics
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Facility HIIs –
• Anaemia Iron and folic acid supplementation De-worming Prompt malaria case management Blood transfusion
• Malaria Sleep under LLIN IPTp Prompt diagnosis and Case management
• HIV/AIDS PMTCT
NEONATAL:
Community - Sepsis • Hand washing with soap and water • Early and exclusive breastfeeding • Identification of danger signs and referral LBW • Early ANC • As above • Temperature management (kangaroo method) Asphyxia • Skilled delivery • Clear nose and mouth for secretions
Facility -
Sepsis • Infection Prevention • Early and exclusive breastfeeding • Temperature management • Antibiotics LBW • As above • Kangaroo method Asphyxia • Neonatal resuscitation
POST NEONATAL UP TO 5 YRS
Community - Malaria • Sleep under LLITN • Prompt diagnosis and treatment (iCCM)
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Pneumonia • Immunization • Prompt diagnosis and treatment (iCCM) Diarrhea • Hand washing with soap and water • Prompt diagnosis and treatment –iCCM (ORT -fluids, Zn, Continued feeding) • Vitamin A Malnutrition • Breastfeeding • Temperature Mx • Complimentary feeding • Vitamin A • Therapeutic feeding
Facility -
Malaria • Sleep under LLITN • Testing and Rx of fever • ACTs for Malaria Pneumonia • Immunization • Antibiotics Diarrhea • Hand washing with soap and water • ORT (fluids, Zn, CT feeding) • Vitamin A Malnutrition • Breastfeeding • Complimentary feeding • Vitamin A • Therapeutic feeding HIV/ AIDS • Early infant diagnosis • Pediatric ARVs
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Appendix 4: Global Initiatives RMNCH Initiatives – GLOBAL INITIATIVES Every Woman, Every Child Launched by UN Secretary-General Ban Ki-moon during the United Nations Millennium Development Goals Summit in September 2010, Every Woman Every Child aims to save the lives of 16 million women and children by 2015. More than $40 billion was pledged at the 2010 launch, and numerous partners have made additional, and critical, financial, policy and service delivery commitments. The effort puts into action the Global Strategy for Women’s and Children’s Health, which presents a roadmap on how to enhance financing, strengthen policy and improve service on the ground for the most vulnerable women and children. (http://www.everywomaneverychild.org/about)
- iERG: Starting in 2012 and ending in 2015, an independent Expert Review Group (iERG) is reporting regularly to the United Nations Secretary-General on the results and resources related to the Global Strategy and on progress in implementing this Commission's recommendations. The iERG will assess the extent to which all stakeholders honor their commitments to the Global Strategy and the Commission, identify obstacles to implementing both the Global Strategy and the Commission’s recommendations, make recommendations to improve the effectiveness of the accountability framework developed by the Commission. (http://www.who.int/woman_child_accountability/about/ierg/en/index.html)
- COIA: A high-level commission to improve global reporting, oversight and accountability for women's and children’s health – the Commission on Information and Accountability for Women’s and Children’s Health (COIA) – was established in January 2011 following the launch of the Global Strategy for Women’s and Children’s Health in September 2010 at the UN with increased pledges worldwide to achieve Millennium Development Goals (MDGs) 4 and 5 to reduce child mortality and improve maternal health. (http://www.who.int/pmnch/media/membernews/2011/20110620_commission_on_accountability/en/index.html)
- UN Commission on Lifesaving Commodities: The UN Commission on Life-Saving
Commodities for Women and Children aims to increase access to life-saving medicines and health supplies for the world’s most vulnerable people. As part of the Every Woman Every Child movement and efforts to meet the health-related Millennium Development Goals, the Commission will champion efforts to reduce barriers that block access to essential health commodities. The Commission’s work focuses on the needs of countries where the most women, newborns, and children under five die from preventable causes. (http://www.everywomaneverychild.org/resources/un-commission-on-life-saving-commodities)
A Promise Renewed/Child Survival Call to Action
The Call to Action challenges the world to reduce child mortality to below 20 child deaths or fewer per 1,000 live births in every country by 2035. Reaching this historic target will have saved an estimated
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additional 45 million children’s lives between 2010 and 2035, bringing the world closer to the ultimate goal of ending preventable child deaths. The Call to Action forum will launch Committing to Child Survival: A Promise Renewed, a pledge to accelerate declines in maternal and child mortality. Through national action and international cooperation, governments and partners renew the world’s commitment to give every last child the best possible start in life. (http://www.who.int/pmnch/media/news/2012/20120614_childsurvival_call/en/index.html)
A Promise Renewed aims to build on the global success in reducing preventable child deaths and renew political will to get the job done. By pledging support for A Promise Renewed, partners vow to redouble efforts to achieve Millennium Development Goals 4 and 5 by 2015 and to reduce child mortality in all countries, achieving 20 or fewer under-five deaths per 1,000 live births by 2035, with a focus on reaching the most disadvantaged and hardest-to-reach children in every country. (http://www.who.int/pmnch/media/news/2012/20120614_childsurvival_call/en/index.html) MDG Acceleration Framework The United Nations Development Programme (UNDP) has developed the MDG Acceleration Framework (MAF), with the technical inputs and collaboration of other UN agencies, to help accelerate progress at the country level on those MDGs currently seen as unlikely to be reached by 2015. The goals of the MAF are to respond to national/local political determination to tackle identified off-track MDGs, draw upon country experiences and ongoing processes to identify and prioritize bottlenecks interfering with the implementation of key MDG interventions, use lessons learned to determine objective and feasible solutions for accelerating MDG progress, and create a partnership with identified roles for all relevant stakeholders to jointly achieve MDG progress. The MAF can be applied to any MDG target at the national or subnational level. UNDP, in collaboration with the UN System organizations, has been supporting the development of MDG accelerated Action Plans in about 37 countries, including Kenya. (http://www.undp.org/content/undp/en/home/mdgoverview/mdg_goals/acceleration_framework/) Family Planning 2020 Family Planning 2020 (FP2020) builds on the partnerships launched at the London Summit on Family Planning. By 2020, the goal is to deliver contraceptives, information, and services to a total of 380 million women and girls in developing countries so they can plan their families. FP2020 will:
- Track progress and report on financial and policy commitments made at the Summit, linking with established accountability processes for the UN Secretary General's Every Woman Every Child strategy;
- Monitor and report on global and country progress toward the FP2020 Summit goals; - Identify obstacles and barriers to achieving Summit goals and recommend solutions; - Ensure promotion of voluntary family planning and concrete measures to prevent coercion and
discrimination, and ensure respect for human rights; - Ensure data availability to support all of the above, consistent with country processes and
sharing data, such as through a global score card; and - Publish an annual report to update the global community on progress and challenges.
(http://www.londonfamilyplanningsummit.co.uk/fp2020.php) REGIONAL INITIATIVES Maputo Plan of Action
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In September 2006, ministers of health and delegates from 48 African countries met in Maputo, Mozambique where they agreed unanimously that the right to health is under serious threat in Africa, and that poor sexual and reproductive health is a leading killer. To address this problem, they adopted a plan of action to reduce maternal mortality and ensure universal access to comprehensive sexual and reproductive health (SRH) services on the continent. The plan of action makes a number of recommendations, including:
- integrating HIV/AIDS services into sexual and reproductive health and rights; - promoting family planning as a crucial factor in attaining the Millennium Development Goals; - supporting the sexual and reproductive health needs of adolescents and young people as a key
SRH component; - addressing unsafe abortions through family planning; - delivering quality and affordable health services to promote safe motherhood, child survival, and
maternal, newborn and child health; - adopting strategies that would ensure reproductive health commodity security
(http://pages.au.int/pages/carmma/maputo) The Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA) CARMMA is an African Union Commission (AUC) and UNFPA initiative to intensify the implementation of the Maputo Plan of Action for the reduction of maternal mortality in the Africa region. Several United Nations agencies, bilateral donors and International Planned Parenthood Federation (IPPF) support CARMMA at the national, regional and global levels. CARMMA works to reduce maternal mortality in most African countries by 75 per cent by 2015, as recommended in Millennium Development Goal 5 (MDG5). CARMMA uses policy discussions, advocacy and community social mobilization to enlist political commitment and increase resources and societal change in support of maternal health. It is a country-driven undertaking. All African countries are expected to launch CARMMA and have a follow-up implementation plan, as well as to monitor progress. (http://pages.au.int/pages/carmma/whatis) GLOBAL STRUCTURES Countdown to 2015 Established in 2005 as a multi-disciplinary, multi-institutional collaboration, Countdown to 2015 is a global movement of academics, governments, international agencies, health-care professional associations, donors, and nongovernmental organizations. Countdown to 2015 tracks coverage levels for health interventions proven to reduce maternal, newborn and child mortality. It calls on governments and development partners to be accountable, identifies knowledge gaps, and proposes new actions to reach Millennium Development Goals 4 and 5, to reduce child mortality and improve maternal health. (http://www.countdown2015mnch.org/about-countdown) The Partnership for Maternal, Newborn and Child Health (PMNCH) PMNCH was launched in 2005 and joins the reproductive, maternal, newborn and child health (RMNCH) communities into an alliance of more than 450 members to ensure that all women, infants and children not only remain healthy, but thrive. The 2013 work plan is structured around 4 outcomes:
- 1: Highest possible political commitment to women’s and children’s health achieved and maintained in the years to 2015 and beyond.
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- 2: Increased and improved coverage and implementation of essential interventions for women’s and children’s health (in priority countries).
- 3: Information to guide/ track investments and promote accountability on progress, commitments and processes towards improving women’s and children’s health synthesized and disseminated.
- 4: Strengthened Partner engagement and alignment nationally, regionally, globally. (http://www.who.int/pmnch/about/history/en/index.html and http://www.who.int/pmnch/activities/advocacy/pmnch_workplans/en/index.html)
H4+ The H4+ is a joint effort by United Nations and related agencies and programmes UNAIDS, UNFPA, UNICEF, UN Women, WHO, and the World Bank. Harnessing the collective power of each partner’s strengths and capacities, the H4+ works to improve the health of women and children and accelerate progress towards achieving MDGs 4 and 5. The H4+ serves as lead technical partners for the United Nations Secretary-General’s Global Strategy for Women’s and Children’s Health. The partnership works to ensure the full involvement of countries targeted in the Global Strategy and to support them in fulfilling their commitments. As part of its mission to address maternal, newborn and child mortality and morbidity the H4+ works to tackle the root causes of these issues, which include gender inequality, low access to education for girls and child marriage, and ensures that linkages with HIV/AIDS programmes are made by working towards the elimination of mother-to-child transmission. The work of the H4+ is also therefore linked to MDGs 3 (promoting gender equality and empower women) and 6 (combating HIV/AIDS, malaria, and other diseases). (http://www.everywomaneverychild.org/resources/h4)
