Transition Work Plan 2011 - 2014 - REPUBLIC OF KENYA · support from USAID-funded Capacity Kenya...

Human Resources for Health (HRH) in the Constitution of Kenya 2010

MINISTRY OF MEDICAL SERVICES

MINISTRY OF PUBLIC HEALTH AND SANITATION

Transition Work Plan2011 - 2014

Human Resources for Health in the Constitution of Kenya 2010

Human Resources for Health (HRH) in the Constitution of Kenya 2010

Ministry of Medical Services

Ministry of Public Health and Sanitation

Transition Work plan2011 - 2014

Human Resources for Health in the Constitution of Kenya 2010ii

HRH Transition Work plan 2011 – 2014

THIS PUBLICATION is a Government of Kenya Document. It has been prepared by the two Ministries of Health - namely Ministry of

Medical Services and Ministry of Public Health and Sanitation- with substantial support from USAID-funded Capacity Kenya Project. The views expressed in

Agency for International Development (USAID) or the United States Government.

Any part of this document may be freely reviewed, quoted, reproduced and translated in full or in part, provided the source is acknowledged. It may not be

Transition Work Plan 2011 – 2014

Published by:

Ministry of Medical ServicesMinistry of Public Health and Sanitation

Afya HousePO Box 30016 00100, Nairobi

www.medical.go.kewww.publichealth.go.ke

Human Resources for Health in the Constitution of Kenya 2010 iii


TABLE OF CONTENTS

Human Resources for Health in the Constitution of Kenya 2010iv


ACRONYMS AND ABBREVIATIONS

CHW Community Health Worker

CPD Continuing Professional Development

FBO Faith Based Organization

HRMAF Human Resources Management Action Framework

HCW Health Care Worker

HR Human Resource

HRD Human Resources Development

HRH Human Resources for Health

HRIS Human Resource Information System

HRM Human Resources Management

M&E Monitoring and Evaluation

TWG Technical Working Group

Human Resources for Health in the Constitution of Kenya 2010 v


The Ministry of Medical Services and the Ministry of Public Health and Sanitation are committed to reforming the health sector, towards achieving the Kenya Vision 2030 and Millennium Development Goals and meet the overall health sector goal of provid-

ing accessible, affordable and quality health care to all Kenyans in line with the new con-stitution. A key feature of the new constitution is the devolution of services, authority and management to the county level. Devolution of health services including its management to the county level will lead to a leap in quality and access of health services. However, in the interim, devolution places enormous planning and management demands. The two Min-istries of Health have established national inter-ministerial taskforce to guide the reforms needed to ensure seamless transition.

Kenya’s health sector has recognized that transition to the devolved system of health man-agement requires adequate planning and management especially in the Human Resource for Health aspects. Against this background, the sector has taken on the task of defining short and long-term strategies for addressing the Transition HRH priorities to ensure there are adequate, well skilled and motivated health workers supported by effective and efficient systems for a smooth transition to a more devolved health service delivery model in line with the new constitution.

We recognize that successful implementation of the transition work plan requires the con-certed efforts and commitment of various stakeholders in different health subsectors and others outside the health sector. In this regard, the Ministries will continue to provide stew-ardship in coordination of the sector and further strengthen future engagement processes. We strongly believe that it is the sum total of all our efforts – big or small – that will contrib-ute towards strengthening health’s systems and the health sector in general.

We are grateful to the members of the Health Workforce Subcommittee, USAID-funded Capacity Kenya Project and other stakeholders that were involved in developing this work plan.

Ngari M.W. (Ms.), CBS Mark K. Bor, CBS Permanent Secretary Permanent Secretary Ministry of Medical Services Ministry of Public Health and Sanitation

FOREWORD

Human Resources for Health in the Constitution of Kenya 2010vi


The development of the Human Resource for Health Transitional Work Plan involved engage-ment of various stakeholders. The Ministry of Medical Services, and the Ministry of Public Health and Sanitation, wish to acknowledge the USAID and the USAID-funded Capacity Kenya Project for the financial and technical support in developing the Work Plan.

The two Ministries further acknowledge the contribution of the members of the Health Workforce Subcommittee, Capacity Kenya Team and other experts who took part in the de-velopment of this Transition Work Plan (See below the list of names and institutions).

ACKNOWLEDGEMENT

NAME INSTITUTION

1. Hannah Kimemia Ministry of Public Health and Sanitation 2. David Njoroge Ministry of Public Health and Sanitation 3. Stephen Kimani Ministry of Public Health and Sanitation4. Titus Waita Ministry of Public Health and Sanitation5. Jane Oburu Ministry of Public Health and Sanitation6. Terry Wefwafwa Ministry of Public Health and Sanitation7. Andrew Nyanchoga Ministry of Medical Services 8. Grace Odwako Ministry of Medical Services9. Susan Agunda Ministry of Medical Services 10. Dr. Simon Mueke Ministry of Medical Services11. Dr. Lucy Musyoka Ministry of Medical Services 12. Dr. Izaq Odongo Ministry of Medical Services13. Dr. Makau Matheka Ministry of Medical Services14. Oscar Ouya Ministry of Medical Services 15. Dr. Racheal Nyamai Ministry of Medical Services 16. Dalip Abdi Ministry of Medical Services 17. Patrick Musichi Ministry of Medical Services18. Rosebell Wainaina Ministry of Medical Services19. Shem Ateka Ministry of Medical Services20. Fridah Moraa Ministry of Medical Services21. Maurice Osano Nursing Council of Kenya 22. Macdonald Adieno Kenya Medical Training College 23. Achim Chiaji Capacity Kenya Project 24. Dr. William Kiarie Capacity Kenya Project25. Joyce Nyaboga Capacity Kenya Project26. Linah Vihenda Capacity Kenya Project

Human Resources for Health in the Constitution of Kenya 2010 vii


Transition Workplan GoalDevelop and implement plans to ensure that at both the national and county level, there are adequate, skilled and motivated health workers and managers supported by effective and efficient systems for a smooth transition to a more devolved health service delivery

model in line with the constitution

TRANSITION WORKPLAN IN SUMMARY

Key Transition Areas

*HR Baseline Surveys *Workforce Planning*Recruitment and Deployment* Occupational Safety and Health* Career Planning* Attraction and Retention* HRIS/ICT* Performance Management

*Salaries and Allowances

* Budgeting and Projections

Leadership

*Establish Health Management Positions*Develop Management and leadership Capacity* Strengthen Regulatory and Profes-sional Associations* Communicate Transition plans

HRH Policy

*Professional Standards, Licensing and Accreditation

* Authorized Scopes of Practice

*Employment Law and Rules

Education

*Pre-Service Training

* In-Service Training

Partnerships

*HRH Multi-sectoral Coordination

* Public Private Partnerships

* HRH Dimensions of the Community Strategy

Human Resources Management HRH Financing

Human Resources for Health in the Constitution of Kenya 2010viii


Human Resources for Health in the Constitution of Kenya 2010 1


1. Introduction

Health workers form an integral part of the health system, and remain a key input in the provision of quality health care. The number of human resources for health across cadres has been increasing steadily over the year. However, significant HRH

challenges remain in respect to health worker shortages, inequitable distribution, skill im-balances and low health worker retention especially for scarce skills and in hard-to-reach areas.

The Government is committed to providing high quality health services to all Kenyans as enshrined in the constitution. There is need to match demand and supply of health workers as well as provide adequate numbers of skilled workers, Enhance equitable distribution of health workers, Reduce high attrition especially in marginalized areas, and improve com-pensation and benefits packages. Performance management and improved workforce pro-ductivity remains a major priority within the Sector.

In order to ensure smooth implementation of the Constitution of Kenya, the Health sector under the Government’s stewardship has prioritized health workforce issues in line with the constitution for urgent address. As such, a Health Work-force Sub-Committee has been constituted and is guided by the following Terms of Reference:

n Determine the optimal staffing level in each hospital and facilities by cadre.

n Conduct assessment of the current staffing levels in each facility and determine deficient.

n Recommend redistribution of staff.

n Sensitization of staff on the implication of the new constitution.

n Determine the capacity of Training Institution to train health workers.

n Make recommendation on ways to attract and retain motivated health workforce.

n Make recommendation on how to institutionalize performance management.

n Make recommendations for competency development of health workers.

n Explore the use of ICT in human resource management.

n Make proposal on transitional arrangement for state movement from National to County Government.

To achieve this, the Sub-committee has developed a work-plan and Road map for accelerat-ing its performance guided by:

n Article 10 (b): human dignity , equity, equality and non discrimination and protec-tion of marginalized

n Art.43 (a) and (c) on bills of social rights which stipulate that every person has the right highest attainable standard of health and emergency medical treatment.



n Art. 53 (c) on children’s right to basic nutrition and health care.

n Art. 54 (1 & 2): a person with disability to be treated with dignity, access to educational institutions & facilities and employment.

n Art. 56 (c & e) Special opportunities for access to employment and reason-able access to health services for minorities and marginalized groups.

n Art. 176 (2) on decentralization of functions.

n Art. 230 (4) on powers and functions of the Salaries and Remuneration Commission.

n Art. 235 (1) on staffing of County Government.

n Chapter six, Art. 5 on conduct of state officers.

n Fourth schedule on functions of National and County Governments.

1.1 Goal of the Transition HRH Workplan RoadmapThe goal of the transition HRH Workplan and Roadmap is to - “Develop and implement plans to ensure that at both the national and county level, there are adequate, well skilled and motivated health workers and managers supported by effective and efficient systems for a smooth transition to a more devolved health service delivery model in line with the con-stitution.”

1.2 Process of Developing the HRH Transition Workplan and RoadmapThe HRH Transition Workplan and Roadmap was developed using a participatory and consul-tative process under the leadership of the HRM directors of MOMS and MOPHS. The process was informed by progress made by the Heath workforce Transition Sub-Committee and the position paper developed by the two health Ministries. The draft transition workplan and roadmap was developed in a retreat held in Naivasha on 28 - 30 June, 2011, that was at-tended by senior health managers from MOMS and MOPHS.

2. HRH Transition Workplan Highlights

The HRH transition workplan was build around the Human Resources for Health Action Framework (HAF). This framework was selected to ensure that the workplan was compre-hensive and was informed by global best practice. The transition areas were organized around the six HRH action fields of the HAF. Below are the key areas that the workplan addressed:

n Human Resources Management

l HR Baseline Surveys

l Workforce Planning

l HRM and HRD Capacity



l Recruitment and Deployment

l Work Environment

l Occupational Safety and Health

l Career Planning

l Attraction and Retention

l HRIS/ICT

l Performance Management

n HRH Financing

l Salaries and Allowances

l HRH Budgeting and Projections

n HRH Policy

l Professional Standards, Licensing and Accreditation

l Authorized Scopes of Practice

l Employment law and Rules

n Leadership

l Establish Health Management Positions

l Develop Management and leadership Capacity

l Strengthen Regulatory and Professional associations

l Communicate Transition plans

n Education

l Pre-Service Training

l In-Service Training

n Partnerships

l HRH Multi-sectoral Coordination

l Public Private Partnerships

l HRH Dimensions of the Community Strategy



3. Transition Workplan Matrix

HRH Component

High Level Transition Actions

Level (Na-tional or County)

Sub-Sector(s)

Indicator Target Respon-sible Person

Timeline

Year 1 Year 2 Year 3

Comprehen-sive County and National Workforce Baseline Survey - HR Mapping

Establish an assess-ment team

Develop assess-ment objectives, TORs and approach

Secure funding and Technical assis-tance

Develop data col-lection tools

Sensitization

Training

Data collection, data analysis and report writing

Dissemination of -

mendations

National Public, FBO, NSA, PFP, PNFP

% assess-ment coverage

Baseline survey done in 47 counties and at national level

PSs/HRM Direc-tors/ Transi-tional Mgmt Unit

Establish an assess-ment team

Sensitization

Training

Data collection, data analysis and report writing

Dissemination of -

mendations

County

1. Human Resources Management



HRH Component



Sub-Sector(s)


Timeline


Determina-tion of Staff Require-ments and Rational-ization (Workforce Planning)+ Succession Planning and Mgmt

Undertake a rational-ization exercise for all health cadres. Make recommendations on cadres to retain, introduce and those to be abolished. Review job titles for cadres to

and do away with demeaning titles such as subordinate, mes-senger, sister

National

Develop revised stan-dards and norms to conform with the de-

Public, FBO

% of Gaps Redistri-bution address-es norms in 50% of counties in dire short-ages


Determine staff re-quirements and make recommendations on recruitment and re-distribution to support delivery of quality equitable services

National/County

Public Norms and standards devel-oped and adopted

Develop comprehen-sive County HR plans

County No. of County HR plans



HRH Component



Sub-Sector(s)


Timeline


Improving HRM and HRD Capac-ity (Number, Equitable Distribution and Capac-ity of HRM and HRD Staff)

Establish HRM and HRD positions, functions, norms and structures at both national and county levels.

National Public Structure and posi-tions in place

PSs/HRM-HRD Di-rectors/ Transi-tional Mgmt UnitIdentify , recruit and

deploy professional

national level and counties

National and County

No. of positions

Develop and adapt standard operational procedures, guide-lines and budgets to support decentraliza-tion of HR functions

SOPs in place

Develop and imple-ment a HR decentral-ization timetable

Time-table in place

Train HRM and HRD Staff

No. of staff trained



HRH Component



Sub-Sector(s)


Timeline


Recruit-ment, Deployment and Staff Redistribu-tion (two-way)

Develop a recruitment and deployment plans for the health work-force

National and County

Public Plans in place


Develop a recruitment manual to guide pro-cess at national and county level

National and County

Public/FBO Manual in place

Ap-proved Recruit-ment Manuals in place by March 2012

Provide training on re-cruitment to national and county level HR staff

Public No. of staff trained

Recruit, redistribute and deploy staff

Public No. of staff recruited and de-ployed

Work Envi-ronment

Conduct a rapid assessment (incor-porating employee satisfaction surveys) at national and county levels and formulate recommendations and disseminate to stake-holders

National and County

Public Work Environ-ment Norms and Stan-dards in place

Revised Norms and Stan-dards incorpo-rating work environ-ment

PS/HRM Direc-tors/ SDDMS

Incorporate recom-mendations in the Norms and Standards guidelines

Implement open of-

policy and culture to engender teamwork and openness

Policy in place

Develop mechanisms for staff to provide feedback and articu-late grievances



HRH Component



Sub-Sector(s)


Timeline


Occupation-al Safety, Health and wellness

Ensure incorporation of health issues in the revision of OSHA 2007

National All sub-sectors

Revised act in place

PSs/HRM - HRD Direc-tors/ Transi-tional Mgmt Unit

Carry out Baseline OSH Assessments

Policy in place

Develop policy guide-lines for the health sector including wellness/psychosocial issues

Review national OSH committees

No. of recreation/sports/health clubs/facilities for health workers and families

No of recre-ation/…facilities

Establish a compre-hensive insurance scheme for health workers and their families - (medical/accident/disability/occupational haz-ards/death)

Medical Insurance Scheme in place

Design, adapt and conduct team-build-ing sessions

% of staff that at-tend

95% of staff attend within 3 years

Establish recreation, sports and health clubs, facilities for health workers

County Public

Conduct regular team-building ses-sions

% of staff that at-tend

95% of staff attend within 3 years

Establish OSH com-mittees at county level



HRH Component



Sub-Sector(s)


Timeline


Career Planning (Schemes of Service)

Develop, review and harmonize schemes of service for all cadres in the health sector (Post-rational-ization)

National Public No. of schemes devel-oped

No. of schemes reviewed

All cad-res have schemes of ser-vice

PS/DA/DMS/DPHS/HRM Direc-tors/

Develop succession policy guidelines

Suc-cession policy guide-lines in place

Implement succession planning guidelines

National and County

Develop-ment of At-traction and Retention Schemes

Develop clear and comprehensive policy guidelines on attrac-tion and retention of health workers at all levels

National and County

Public, FBO, NSA, PFP, PNFP

Policy guide-lines in place

100% Policy on attrac-tion and reten-tion de-veloped

PS/ D HRM

HRIS/ICT Develop HRIS policy and strategy guide-lines at national and county level guidelines

National All Guide-lines in place

PS/DD HRM

Develop Training programs for HRIS

National and County

Programs in place

Rollout a sector- wide comprehensive HRIS linked to other data-bases including HMIS at national and county level



HRH Component



Sub-Sector(s)


Timeline


Perfor-mance Man-agement and Super-vision

Reviewing of Perfor-mance Management policy , systems and tools


Reviewed policies in place

100% Review

PS/D HRM/ HRD

Development of standards and tools for performance monitor-ing for the county

Stan-dards and tools in place

Sensitization and capacity building of staff on Performance Management

National and County

Public, FBO, NSA, PFP, PNFP

No. of person-nel sensi-tized

47 coun-ties

HRH Component



Sector(s) Indicator Target Responsible Person

Timeline

Year 1

Year 2 Year 3

Setting Levels of Salaries and Allow-ances

Make proposals to the Pay and Remuneration Review Commission to ensure health work-ers are adequately and equitably compensated to support attraction, retention and productiv-ity

National Public PS/DA/DMS/DPHS/HRM Directors/

Develop guidelines for counties role in provid-ing additional remunera-tion/top-ups

Budgeting and Projec-tions for HRH inter-vention resource require-ments

Develop comprehensive HRH budgets and projec-tions linked to workforce planning and other HR interventions includ-ing transfers, induction, training etc. for national level and counties

National and county

Public budgets and pro-jections in place

PS/DA/DMS/DPHS/HRM Directors/

2. HRH Financing



HRH Component




Timeline

Year 1

Year 2

Year 3

Professional Standards, Licensing and Accreditation

Integrate ethical and practice standards into schemes of ser-vices

National All Revised schemes of service In place

PSs/HRM Directors/ Transitional Mgmt Unit/ regulatory bodies

Authorized Scopes of Practice for Health Cadres

Establish a compre-hensive framework for review of various scopes of practice in line with the exigen-cies of the constitu-tion including the need for task sharing across certain cadres.

National and County

All Frame-work in place

PSs/HRM Directors/ Transitional Mgmt Unit/ regulatory bodies

Employment Law and Rules

Develop a comprehen-sive HR Policy manual to guide HRH at the national level

National Public Manual in place

PSs/HRM Directors/ Transitional Mgmt Unit

Develop a comprehen-sive HR Policy manual to guide HRH at the national level

County

Develop Policy guide-lines for short term consultancies and contractual services e.g. for medical spe-cialists

National and County

Policy guide-lines in place

3. HRH Policy



HRH Compo-nent

High Level Transition Actions Level (Na-tional or County)

Sector(s) Indicator Target Respon-sible Person

TimelineYear 1

Year 2

Year 3

Establishment of Health Man-agement Posi-tions

Identify health management posi-tions at national and county level (Linked to rationalization and pro-posed organizational structure)

National Public DA/DMS/DPHS/HRM Di-rectors

Work with PSC to establish the positions (linked to schemes of service development process)

No. of positions established

positions in line with constitutional provisions at national and county level

National and County

No. of positions

Development Leadership and Management Capacity of Health Manag-ers

Develop leadership, management

competencies guidelines to inform recruitment, appointment, deploy-ment and training

National Public guide-lines in place

PS/DA/DMS/DPHS/HRM Direc-tors/HRD Directors

Conduct induction for health man-agers on leadership, management and governance issues in the de-volved context

National and County

% of managers inducted

95% of managers inducted

Develop a competency-based, practical and hands-on training curriculum for health managers at national and county level

National Curricu-lum in place

Roll-out leadership, management and governance training to health managers

National and county

% of man-agers trained

95% of man-agers trained

Strengthening Health Regula-tory and Pro-fessional Asso-ciations

Review the Acts of existing health regulatory bodies.

National All Sub-sectors

Revised Acts in place

PS/DA/DMS/DPHS/HRM Di-rectors/CEOs of the councils and boards

Develop the Kenya Health Profes-sional Authority Bill

Kenya Health Profes-sional Author-ity Bill in place

Link databases of the different regulatory authorities to MFL (Under Health Information and ICT Sub-Committee)Establish county health regulatory

government)

County No. of county reg. of-

upCommunication of Transition Plans to Stake-holders

Develop a two-way communication package and roll-out plan

National Public Package in place

DA/DMS/DPHS/HRM Di-rectors/

Disseminate communication mes-sages using a wide variety of media - print, online, email, integration in induction programs, help desks, SMS etc

National and County

% of staff reached

Reach 95% of staff within 3 years

4. Leadership



HRH Component



Sector(s) Indicator Target Respon-sible Person

Timeline

Year 1

Year 2

Year 3

HRH Multi-sectoral Coordina-tion

Realign HRH Coordination structures and review TORS in line with the requirement of the new constitution

National All PSs/HRM Direc-tors/ Transi-tional Mgmt UnitDevelop clear guidelines

for HRH coordination at the county level

County Guide-lines in place

Determine a priority list of coordination issues for key sub sectors e.g. FBOs, Pri-vate Sector etc

National and Coun-ty

Prior-ity list in place

Mobilize resources to sup-port critical coordination actions

Amount of re-sources mobilized

Public-Private HRH Partner-ships and Agreements

Review existing PPP mechanisms at national and county level

National/county

All sectors -HRH plan and MOUs in place

PS/DMS/DPHS/HRM Di-rectors/

Identify critical areas of PPP interventions and sup-port at national and county level

HRH Dimen-sions of the Community Strategy

Review and revise the HR dimensions of the commu-nity health strategy (Clear roles and responsibilities

linked to task shifting strat-egies)

National Public/FBO Revised Strategy in place

PS / Technical Heads / Stake-holders

Revise the community Health organizational Struc-tures

Struc-tures in place

Develop clear polices for Recruitment, compensating, developing and regulating CHWs

Policies in place

Develop a Retention pack-age for CHWs –(To be Linked with the other Retention strategies for health work-ers)

Retention strategies in place

5. Partnerships



HRH Component




Timeline

Year 1

Year 2

Year 3

Pre-Service Education

Establishment of mechanisms for link-ages between the training institutions and the employers (pri-vate/ county/national government) to address market demands


PS/HRD /Techni-cal Heads/ KMTC and other regu-latory board

Development of Policy guidelines on expansion of training institutions - Faculty and Infrastruc-ture

Guide-lines In place

Revision of selection criteria and process (from advertising,

selection) to align with the constitutional provisions

Criteria in place

Development of a policy direction to ensure that national principles and val-ues are integrated in pre-service curricula as provided for in the Constitution

Policy direction in place

6. Education



HRH Component




Timeline

Year 1

Year 2

Year 3

In-Service Training

Development of policy guidelines on com-petencies and skills

cadres


Guide-lines in place

100% com-plete policy guide-lines

Conducting of TNA and establishment of skills inventories for the Health Workforce

National and County

TNA Re-port

Development of clear policy guidelines on

education

Guide-lines in place

Develop CPD guidelines Guide-lines in place

Rollout CPD

Expansion of in-service education opportunities –faculty and infrastruc-ture.



4. HRH Transition Workplan Implementation Roadmap

2011/12 2012/13 2013/14

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Milestones HR Baseline Surveys

Revised Staff-ing Norms and

Standards

National and County HR Plans

Mid- Term As-sessments

Deploy Critical Staff * Induct and Train Staff

Develop Commu-nication Package

New HRH/HRD Structures

Conduct National and County Preparedness Assess-ments

HRH Transition Leader-ship Team

National• HRM Directors• HRD Directors• HRH ICC Representatives

County• County Health Director• County HR Officer

Transition Workplan Imple-mentation Mecha-nism

National• Health Workforce Sub-Committee to

remain for the entire transition pe-riod

• Have a full-time secretariat• Establish thematic TWGs• Hold regular meetings and issue com-

munication briefs • Maintain links with the National

Health Transition Unit and the HRH ICC

County• Form Transition committees• Hold regular meetings and issue communication briefs• Maintain links with the Health Workforce Sub-Commit-

tee to remain for the entire transition period

Monitor-ing and Evaluation

*Develop an M&E Framework *Conduct a mid-term review * Develop Preparedness Checklists * Regular M&E Reports



5. Transition Workplan Budget

The 3-year transition workplan was costed to estimate the budgetary requirements for implementation. It is estimated that the transition workplan will cost Kshs. 1.2 billion over the three years with GOK at national

table below provides a summary of the budgets.

HRH Compo-nent

Budget Estimates Budget Split

Year 1

2011-2012

Year 2

2012-2013

Year 3

2013-2014

Total GOK s Partner -

Others

Human Re-sources Man-agement

283,038,719 301,898,943 301,569,886 886,507,548 605,973,783 280,533,765

HRH Financing 4,085,000 4,032,000 - 8,117,000 2,592,600 5,524,400

HRH Policy 4,600,000 5,568,000 4,000,000 14,168,000 4,096,400 10,071,600

Leadership 50,215,565 83,922,864 85,842,864 219,981,293 168,172,763 51,808,529

Partnerships 1,710,000 2,165,000 1,175,000 5,050,000 1,280,000 3,770,000

Education - 4,111,000 4,531,000 17,284,000 4,984,400 12,299,600

Total 343,649,285 401,697,806 397,118,750 1,151,107,841 787,099,946 364,007,895

% Budget Split 68 32

Human Resources Management constitutes the largest portion of the budget at 77%. This is made up largely of personnel emolument costs, assessments and development of national and county HRH plans. The share of the budget by different HRH component is shown in the chart below.



Budget by HRH Component

Refer to the Budget Matrix chapter for the detailed budget.

National Human Resources for Health (HRH) Transition Workplan, 2011 - 2014

77

.



6. Budget Matrix

HRH Component

High Level Tran-sition Actions



Year 1 Year 2 Year 3 Total GOK Partner -Others

Comprehen-sive County and National Workforce Baseline Survey - HR Mapping

Establish an as-sessment team

National

Develop assess-ment objectives, TORs and ap-proach

660,000 660,000

660,000

Secure funding and Technical assistance

Develop Data collection tools

1,630,000 1,630,000

1,630,000

Sensitization 11,500,000 11,500,000

11,500,000

Training of data clerks

10,648,000 10,648,000

10,648,000

Data collection, 55,780,000 55,780,000

55,780,000

Data analysis and report writing

1,080,000 1,080,000

1,080,000

Dissemination of findings and rec-ommendations

2,060,000 2,060,000

2,060,000

1. Human Resources Management



HRH Component





Determina-tion of Staff Require-ments and Rational-ization (Workforce Planning)+ Succession Planning and Mgmt

Undertake a rationalization exercise for all health cadres. Make recommen-dations on cadres to retain, intro-duce and those to be abolished. Review job titles for cadres to reflect chang-ing roles and do away with demeaning titles such as subordi-nate, messenger, sister

National 990,000

990,000

990,000

Develop revised standards and norms to con-form with the defined levels of service

2,580,000

2,580,000

2,580,000

Determine Staff requirements and make recom-mendations on recruitment and redistribution to support delivery of quality equi-table services

National and County

-

Develop compre-hensive County HR plans

County 3,789,750 8,842,750 12,632,500 5,053,000 7,579,500



HRH Component





Improving HRM and HRD Capac-ity ( Number , Equitable Distribution and Capacity of HRM and HRD Staff)

Establish HRM and HRD posi-tions functions, norms and struc-tures at both national and county levels.

National -

Identify , recruit and deploy professional HR officers to the national level and counties

National and County

50,699,088 105,454,103 109,672,267 265,825,458 239,242,912 26,582,546

Develop and adapt standard operational pro-cedures, guide-lines and bud-gets to support decentralization of HR functions

-

Develop and implement a HR decentralization timetable

-

Train HRM and HRD Staff (188 at county level)

4,956,250 5,451,875 5,997,063 16,405,188 4,921,556 11,483,631



HRH Component





Recruitment, Deployment and Staff Re-distribution (two-way)

Develop a recruitment and deployment plans for the health workforce

National and County

- - -

Develop a recruitment manual to guide process at na-tional and county level

990,000

990,000

297,000

693,000

Provide training on recruitment to national and county level HR staff and line managers

4,778,333 4,778,333 4,778,333 14,335,000 4,300,500 10,034,500

Redistribute and deploy staff

83,035,715 83,035,715 83,035,715 249,107,144 249,107,144



HRH Component





Work Envi-ronment

Conduct a rapid assessment (incorporating employee satis-faction surveys) at national and county levels and formulate rec-ommendations and disseminate to stakeholders

national and County

980,250 980,250 1,960,500 588,150 1,372,350

Implementation in line with the Norms and Stan-dards guidelines

-

- -

Implement open -

ture, policy and culture to engen-der teamwork and openness

-

- -

Develop mecha-nisms for staff to provide feedback and articulate grievances

-

- -



HRH Component





Occupa-tional Safety, Health and Wellness

Carry out Base-line OSH Assess-ments

National 1,960,500 1,960,500

588,150

1,372,350

Ensure incorpo-ration of health issues in the revision of OSHA 2007

- - -

Develop policy guidelines for the health sector including well-ness/psychoso-cial issues

2,990,000 2,990,000 897,000 2,093,000

Review national OSH committees

-

Establish rec-reation/sports/health clubs/fa-cilities for health workers and families (develop concepts and designs)

1,080,000 1,080,000 432,000 648,000

Establish a com-prehensive insur-ance scheme for health workers and their fami-lies - (medical/accident/disabil-ity/occupational hazards/death)

-

Design, adapt and conduct team-building sessions

37,600,000 37,600,000 75,200,000 30,080,000 45,120,000

Establish rec-reation/sports/health clubs/fa-cilities for health workers

County -

Conduct regular team-building sessions

-

Establish OSH committees at county level and

-



HRH Component





Career Planning (Schemes of Service)

Develop, review and harmonize schemes of ser-vice for all cad-res in the health sector (Post-rationalization)

National - - -

Develop suc-cession policy guidelines

1,780,000 1,780,000 534,000 1,246,000

Implement suc-cession planning guidelines

National and County

- - -

Development of Attraction and Reten-tion Schemes

Develop clear and compre-hensive policy guidelines on attraction and retention of health workers at all levels

National and County

2,880,000 1,300,000 4,180,000 1,254,000 2,926,000

HRIS/ICT Develop HRIS policy and strat-egy guidelines at national and county level

National 360,000 360,000 72,000 288,000

Develop train-ing programs for HRIS

National and County

-

Rollout a sector- wide comprehen-sive HRIS linked to other databas-es including HMIS at national and county level

20,484,167 22,532,583 24,785,842 67,802,592 27,121,037 40,681,555



HRH Component





Performance Management and Supervi-sion

Reviewing of Performance Management policy , systems and tools

National -

Development of standards and tools for perfor-mance moni-toring for the county

-

Sensitization and capacity build-ing of staff on Performance Management

National and County

25,066,667 27,573,333 30,330,667 82,970,667 41,485,333 41,485,333

SUB TOTAL Human Resources Management

283,038,719 301,898,943 301,569,886 886,507,548 605,973,783 280,533,765




2. HRH Financing

HRH Component





Setting Levels of Salaries and Allow-ances

Make propos-als to the Pay and Remunera-tion Review Commission to ensure health workers are adequately and equitably compensated to support attraction, retention and productivity

national 225,000 225,000 225,000

Develop guidelines for counties role in providing additional remuneration/top-ups

3,140,000 3,140,000 942,000 2,198,000

Budgeting and Projec-tions for HRH Inter-vention resource Require-ments

Develop comprehensive HRH budgets and projec-tions linked to workforce planning and other HR interventions including transfers, in-duction, train-ing etc. for national level and counties

National and county

720,000 4,032,000 4,752,000 1,425,600 3,326,400

Sub Totals HRH Financing 4,085,000 4,032,000 - 8,117,000 2,592,600 5,524,400




3. HRH Policy

HRH Component

High Level Transi-tion

Actions

Level (Nation-

al or County)



Professional Standards, Licensing and Accred-itation

Integrate ethical and practice stan-dards into schemes of services

National 2,980,000

2,980,000

894,000

2,086,000

Authorized scopes of Practice for Health Cadres

Establish a compre-hensive framework for review of vari-ous scopes of prac-tice in line with the exigencies of the constitution includ-ing the need for task sharing across certain cadres.

National and County

1,620,000

1,620,000

486,000

1,134,000

Employ-ment Law and Rules

Develop a compre-hensive HR Policy manual to guide HRH at the national level

National 4,028,000

4,000,000

8,028,000

2,408,400

5,619,600

Develop a compre-hensive HR Policy manual to guide HRH at the county level

County

Develop Policy guidelines for short term consultan-cies/contractual services e.g. for medical specialists

National and County

1,540,000

1,540,000

308,000

1,232,000

Sub Totals HRH Policy 4,600,000 5,568,000 4,000,000 14,168,000 4,096,400 10,071,600




4. Leadership

HRH Component

High Level Transition Ac-tions


Budget Estimates

Budget Split


Establish-ment of Health Management Positions

Identify health manage-ment positions at national and county level (Linked to rationalization and proposed organizational structure)

National

Work with PSC to establish the positions (linked to schemes of service devel-opment process)

-

Competitively and transpar-ently fill positions in line with constitutional provisions at national and county level

National and County

42,419,899 68,822,197 68,822,197 180,064,293 162,057,863 18,006,429

Develop Leadership and Man-agement Capacity of Health Managers

Develop leadership, man-agement and governance qualifications/ competen-cies guidelines to inform recruitment, appointment, deployment and training

National 2,925,000 2,925,000 292,500 2,632,500

Conduct induction for health managers on lead-ership, management and governance issues in the devolved context

Nation-al and County

2,770,667 2,770,667 2,770,667 8,312,000 1,662,400 6,649,600

Develop a competency-based, practical and hands-on training curriculum for health managers at nation-al and county level

National -

Roll-out leadership, man-agement and governance training to health manag-ers

national and County

7,637,500 7,637,500 15,275,000 1,527,500 13,747,500



HRH Component

High Level Transition Ac-tions


Budget Estimates

Budget Split


Strengthen-ing Health Regulatory and Profes-sional Asso-ciations

Review the Acts of existing health regulatory bodies.

national 2,160,000 2,160,000 4,320,000 1,296,000 3,024,000

Develop the Kenya Health Professional Authority Bill

1,070,000 1,070,000 2,140,000

642,000

1,498,000

Link databases of the dif-ferent regulatory authori-ties to MFL (Under Health Information and ICT Sub-Committee)

-

Establish county Health Regulatory offices( With support of national govern-ment)

County 1,920,000

1,920,000

192,000

1,728,000

Communi-cation of Transition Plans to Stakehold-ers

Develop a two-way com-munication package and roll-out plan

2,100,000 2,100,000 210,000 1,890,000

Disseminate communica-tion messages using a wide variety of media - print, online, email, integration in induction programs, help desks, SMS etc

1,462,500 1,462,500 2,925,000 292,500 2,632,500

Sub-Total Leadership 50,215,565 83,922,864 85,842,864 219,981,293 168,172,763 51,808,529

Budget Split 76 24



5. Partnerships

HRH Component


Level (National or County)



HRH Multi-sec-toral Coordi-nation

Realign HRH Coordi-nation structures and review TORS in line with the requirement of the new constitu-tion

National

Develop clear guide-lines for HRH coordi-nation at the county level

County

Determine a priority list of coordination issues for key sub sectors e.g. FBOs, Private Sector etc

National and

County

Mobilize resources to support critical coor-dination actions

1,175,000

1,175,000

2,350,000

470,000

1,880,000

Public-Private HRH Partner-ships and Agreements

Review existing PPP mechanisms at national and county level

National and County

990,000

990,000

297,000

693,000

Identify critical areas of PPP interven-tions and support at national and county level

-

-



HRH Component


Level (National or County)



HRH Dimensions of the Commu-nity Strategy

Review and revise the HR dimensions of the community health strategy (Clear roles and responsibilities defined / scope of practice/linked to task shifting strate-gies)

National 1,710,000 1,710,000 513,000 1,197,000

Revise the community Health organizational Structures

Develop clear polices for Recruitment, compensating, devel-oping and regulating CHWs

Develop a Retention package for CHWs –(To be Linked with the other Retention strategies for health workers)

SUB TOTALS Partnerships

1,710,000

2,165,000

1,175,000

5,050,000

1,280,000

3,770,000




6. Education

HRH Component

High Level Transi-tion Actions


Budget Estimates

Budget Split

Year 1 Year 2 Year 3 Total GOK Partner -Oth-ers

Pre-Service Education

Establishment of mechanisms for linkages between the training insti-tutions and the employers ( private/ county/national gov-ernment ) to address market demands

National 1,330,000 1,330,000 2,660,000 532,000 2,128,000

Development of Policy guidelines on expansion of training institutions - Faculty and Infrastructure

-

Revision of selec-tion criteria and process (from adver-tising, interviewing and final selection) to align with the constitutional provi-sions

326,000 326,000 652,000 260,800 391,200

Development of a policy direction to ensure that national principles and values are integrated in pre-service curricula as provided for in the Constitution

-



HRH Component

High Level Transi-tion Actions


Budget Estimates

Budget Split

Year 1 Year 2 Year 3 Total GOK Partner -Oth-ers

In-Service Training

Development of policy guidelines on competencies and skills required for specific cadres

National

Conducting of TNA and establishment of skills inventories for the Health Work-force

National and

County

Conducting of TNA and establishment of skills inventories for the Health Work-force

Develop/ Revise CPD guidelines

1,245,000

1,245,000

2,490,000

747,000.0

1,743,000

Rollout CPD 420,000

420,000

126,000.0

294,000.0

Expansion of in-service education op-portunities –faculty and infrastructure.

1,210,000

1,210,000

11,062,000

3,318,600

7,743,400

Sub-Total Education -

4,111,000

4,531,000

17,284,000

4,984,400

12,299,600

Percentage 29 71



7. Appendices

7.1 County Preparedness Checklist (Sample)

County_____________________________________________ Date_________________

Component Colour Score Remarks

1. HRH Transition Sub-Committee Formed and Func-tional

10

2. HRH Baseline Surveys Conducted and Report Is-sued

3. Staffing Norms and Standards Reviewed

4. HR Plans Developed

5. Critical Staff Deployed (to be defined)

6. Communication Plan Developed

7. Communication Plan Rolled-out

8. Staff Inducted

Aggregate Score

Key

Colour Description Score

Little or no progress made 0

Good progress made (Partial Implementation) 5

Action fully and successfully implemented 10





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Transition Work Plan 2011 - 2014 - REPUBLIC OF KENYA · support from USAID-funded Capacity Kenya...

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