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BARINGO COUNTY GOVERNMENTHEALTH SECTOR STRATEGIC PLAN 2018-2022
Stepping up efforts to address the real issues
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 i
This document is made possible by the generous support of the American people through the United States President’s Emergency Plan for AIDS Relief (PEFPAR) and the United States Agency for International Development (USAID), under Cooperative Agreement number 72061518CA00001. The contents do not necessarily reflect the views of USAID or the United States Government.
The Palladium Group is proud to associate with the United States Agency for International Development (USAID) and Baringo County Government.
BARINGO COUNTY GOVERNMENTHEALTH SECTOR STRATEGIC PLAN 2018-2022
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022ii
TABLE OF CONTENTS .............................................................................................. ii
LIST OF ABBREVIATIONS AND ACRONYMS ................................................................v
FOREWORD ............................................................................................................ vii
ACKNOWLEDGEMENT ........................................................................................... viii
EXECUTIVE SUMMARY ............................................................................................. ix
1. INTRODUCTION AND BACKGROUND .................................................................... 1
1.1 Background ........................................................................................................ 1
1.2 Planning Framework and Context ......................................................................... 1
1.3 Process of Development ..................................................................................... 2
2. SITUATIONAL ANALYSIS ...................................................................................... 3
2.1 Baringo County ................................................................................................ 3
2.2 Population and Demographics ............................................................................ 3
2.3 Health Status ................................................................................................... 7
2.3.1 Key Indicators Status .............................................................................. 7
2.3.2 Disease burden ....................................................................................... 8
2.3.3 Health Risk Factors ............................................................................... 10
2.4 Health Strengthening Systems ......................................................................... 11
2.4.1 Health Infrastructure ............................................................................ 11
2.4.2 Essential Medicines and Medical Supplies .............................................. 12
2.4.3 Health Workforce .................................................................................. 13
2.4.4 Leadership, Management and Governance ................................................ 14
2.4.5 Health Information System ..................................................................... 15
2.4.6 Health Financing ................................................................................... 15
2.5 Stakeholder Analysis ....................................................................................... 16
2.6 SWOT Analysis ............................................................................................... 18
3. STRATEGIC DIRECTION ...................................................................................... 20
TABLE OF CONTENTS
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 iii
4. IMPLEMENTATION ARRANGEMENTS .................................................................. 26
4.1 Stewardship Arrangements ............................................................................... 26
4.2 Governance Arrangements ................................................................................ 28
5. PERFORMANCE, MONITORING AND EVALUATION FRAMEWORK .......................... 29
5.1 Health Management Information System Organization and Architecture ............... 29
5.2 Performance Reporting ................................................................................... 29
5.3 Indicators for Monitoring the County Health System Performance ........................ 30
5.3.1 Service Outcome and Output Targets for Achievement of County objectives . 31
5.3.2 Inputs and Process targets ...................................................................... 34
6. FINANCING AND RESOURCE MOBILISATION ...................................................... 37
6.1 Estimated Resource Requirements ................................................................... 37
6.2 Resources Availability and Financing Gap ......................................................... 38
6.3 Bridging the Financing Gap ............................................................................. 38
Appendix I: The Kenya Essential Package for Health (KEPH) Matrix ............................ 39
Appendix II a: Distribution of Baringo County Health Facilities by Type ........................ 44
Appendix II b: List of Facilities ................................................................................ 45
Appendix III: Implementation Matrix ....................................................................... 51
Appendix IV: List of Contributors ............................................................................ 68
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022iv
List of Tables
Table 1 - Population Trend ......................................................................................... 4
Table 2 - Population Demographics ............................................................................ 4
Table 3 - Population Density Projections by sub-counties, 2018 .................................... 5
Table 4 - Population of persons with disabilities .......................................................... 7
Table 5 - Key Indicators in Health .............................................................................. 7
Table 6 - Top causes of Morbidity in Baringo County ..................................................... 8
Table 7 - Top causes of Inpatient Morbidity (All ages) in Baringo County ........................ 8
Table 8 - Top ten causes of mortality in Baringo County ................................................ 9
Table 9 - Distribution of health facilities across sub-counties in Baringo ...................... 11
Table 10 - Average populations expected to be served with different facility types ......... 12
Table 11 - Interventions for Preventive and Curative Health Services ........................... 21
Table 12 - Service Outcome and Output Targets for Achievement of County objectives ... 31
Table 13 - Inputs and Process targets ....................................................................... 34
Table 14 - Summary of Resource Requirements by Programs and Sub-Programs ........... 37
Table 15 - Resource Envelope Estimates ................................................................... 38
List of Fugures
Figure 1: Baringo County population pyramid .............................................................. 5
Figure 2: Administrative Wards and Population Density in Baringo ................................ 6
Figure 3: Staff distribution across sub-counties ........................................................ 13
Figure 4: Health Staff Due to Retire by Year .............................................................. 14
Figure 5: County Allocation to Health FY 14/15 to FY 18/19. ..................................... 16
Figure 6: Organogram ............................................................................................. 28
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 v
ANC Antenatal Care ART Anti-Retroviral TreatmentAWP Annual Work PlanBCC Behavior Change CommunicationBeMONC Basic Emergency Obstetrics and Newborn CareBFHI Baby Friendly Hospital InitiativesCEmONC Comprehensive Emergency Obstetrics and Newborn CareCECM County Executive Committee memberCASCO County AIDS, STIs/STDs CoordinatorCCC Comprehensive Care CentreCDC Centre for Disease Control and Prevention CDSC County Disease Surveillance CoordinatorCECM County Executive Committee Member CIDP County Integrated Development PlanCDOH County Department of Health CHEW Community Health Extension Worker CHMT County Health Management Team CHRIO County Health Records Information officerCHS Community Health Strategy CHSSP County Health Sector Strategic PlanCHW Community Health WorkerCHV Community Health VolunteerCMLAP County Measurements Learning and Accountability COH Chief Officer of Health CPHO County Community Health Servises CoordinatorCRHC County Reproductive Health CoordinatorCTLC County TB Lung and Leprosy Diseases CoordinatorCTLS Community Led Total Sanitation CWC Child Welfare Clinic CU Community UnitsDDIU Data Demand and Information Use DHIS District Health Information SystemDQA Data Quality AssuranceEMMS Essential Medicines and Medical Supplies FANCFBO
Focused Ante Natal Care Faith Based Organization
DHIS District Health Information SystemFY Financial Year GBV Gender Based Violence GOK Government of KenyaHCW Health Care WorkerHIS Health Information System
LIST OF ABBREVIATIONS AND ACRONYMS
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022vi
HIV Human Immunodeficiency VirusHPV Human Papilloma Virus HRH Human Resources for Health HRIS Human Resources Information SystemsICD-10 International Classification of Diseases, 10th revisionICU Intensive care UnitIDSR Integrated Disease Surveillance and ResponseIEBC Independent Electoral and Boundaries Commission IEC Information, Education and CommunicationIFMIS Integrated Financial Management Information SystemIMCI Integrated management of childhood illnessIT Information TechnologyKDHS Kenya Demographic Health SurveyKEMSA Kenya Medical Supplies Authority KNPHC Kenya National Population and Household Census KNBS Kenya National Bureau of StatisticsLAN Local Area NetworkLLITN Long Lasting Insecticide Treated NetsLMIS Logistical Management Information System MDA Mass Drug Administration M&E Monitoring and Evaluation MEDS Mission for Essential Drugs SupplyMMR Maternal Mortality Ratio MOH Ministry of HealthMTEF Medium Term Expenditure Framework NCDs Non-Communicable DiseasesNHIF National Hospital Insurance FundPHO Public Health Officer PLHIV People Living with HIVPMTCT Prevention from Mother to Child Transmission QI Quality Improvement RDQA Rapid Data Quality Assurance RMNCAH Reproductive, Maternal Neonatal Child and Adolescent Health SCHMT Sub-County Health Management TeamSCHRIO Sub-County Health Records and Information OfficerSCMOH Sub-County Medical Officer of HealthSCPHO Sub- County Public Health Officer SDGs Sustainable Development GoalsSOP Standard Operating ProcedureSPAS Staff Performance Appraisal Reporting SystemSWOT Strengths Weaknesses Opportunities and ThreatsTB Tuberculosis TWG Technical Working GroupUHC Universal Health CoverageUSAID United States Agency for International Development WASH Water Sanitation and Hygiene WHO World Health Organization
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 vii
The Constitution of Kenya 2010 not only guarantees the right to health for the people, but also assigns specific responsibilities towards achievements of these rights through county governments. This presents an opportunity for county governments to make significant contribution in improving the livelihood of citizens at the local level. The health sector is therefore at the centre of empowering citizens by ensuring that they remain healthy and productive. Baringo County Government holds this responsibility with nobility.
The county government recognizes that the delivery of this responsibility is an onerous assignment that requires intense planning, execution, and close monitoring while at the same time engaging the citizenry. The county envisions a health system that is responsive to the needs of the population. The development of this strategic plan is, therefore, a step towards ensuring that the expectations of the citizens are clarified into implementable interventions and mechanisms for tracking implementation embedded.
This plan takes into consideration the lessons learnt from the county government’s implementation of health interventions during the period 2013-2017. It also takes into consideration inputs and feedback obtained from various county health stakeholders. The strategy also accounts for the priorities of the national health sector including the drive to achieve the Universal Health Coverage spearheaded by the President’s Big Four Agenda.
Achievement of the ambitious targets in this plan requires close collaboration between the county government and stakeholders, both public and non – public. The county government will provide the necessary platform for enabling this collaboration.
I wish to call upon stakeholders to provide the much-esteemed support in planning, during implementation and in monitoring this strategic plan.
Hon. Mary Panga,County Executive Member,Health Services.
FOREWORD
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022viii
ACKNOWLEDGEMENT
The Baringo County Health Sector Strategic Plan for the period 2018-2022 has been developed with the support of various individuals and organizations. First, we appreciate the role of the Baringo County Government Executive under the leadership of His Excellency Stanley Kiptis, the Governor Baringo County, for facilitating the support that was necessary for the preparation of this plan. The County Government also recognizes and appreciates the leadership offered by County Executive Committee Member for Health Services throughout the entire process.
The supportive coordination offered by Dr Gerishom Abakalwa, County Director for Health was fundamental in ensuring that the plan was developed with participating of key stakeholders. Contributions by the members of CHMT and SCHMT and representatives of partners during the various stages of development of this document were crucial in enriching the content of this final draft.
We are especially grateful to the members of the core team pooled from the county department of health services, representatives of the County Treasury and Economic Planning Departments, partner representatives for strategic planning who participated in data collection, analysis and strategic planning workshops were undertaken to generate this plan. Their inputs were indeed invaluable.
We also appreciate the support of development and implementation partners, particularly USAID funded CMLAP II who provided technical and financial support. USAID funded Afya Uzazi and Afya Nyota, and Fred Hollows Foundation provided significant support towards completion of this plan.
Once more, we are pleased to recognize and appreciate the dedicated sacrifices and commitments of partners and individuals who have contributed immensely to the development of this plan. It is our hope that this document will be implemented in full and that the department of health will reach out to these partners for support during implementation.
Dr. Winnie Bore, Dr. Gideon Toromo, Chief Officer, Chief Officer,Public Health. Medical Services.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 ix
EXECUTIVE SUMMARY
This Strategic Plan for the period 2018-2022 has been developed to facilitate the elaboration of strategic direction for the county health sector in a manner that allows for tracking of the progress of achievements and provides accountability to the Citizens of Baringo County. The plan expounds the interventions proposed in the County Integrated Development Plan, the Governor’s Manifesto and the aspirations of the department of health in line with the requirements for planning under the County Government Act, 2012; Public Financial Management Act, 2012; Health Act, 2017 and the Constitution of Kenya, 2010.
This plan is informed by a situational analysis of the health sector in Baringo County. The health status of the county was reviewed taking into consideration the key health indicators and health systems investment areas. A reflection on the achievements made in the first term of the current government was undertaken too. This analysis revealed that there was minimal change in key outcome indicators, but progressive investments had been made with regards to the health systems building blocks with health infrastructure improvements, staff recruited, and capacity built. The analysis confirmed that the county health facilities were still operating below expected norms and standards.
Upon the identification of key issues and priorities, the county department for health confirmed that the Vision and Mission crafted and captured in the CIDP remains relevant. The county envisions an attractive, competitive and resilient county health system, with a mission to improve the health status of the citizens through provision of high quality, affordable and accessible healthcare in an equitable and professional approach.
This strategic plan has charted specific strategic objectives beginning with improving preventive, promotive health services and consolidating curative and rehabilitative services offered through the five levels of the county health system. These will be supported by strategic objectives aimed at strengthening the health system including improving financing and resource mobilization; strengthening data demand and use for decision making; making rationalized infrastructural improvements; harnessing the supply chain for essential medicines and medical products; and fortifying the capacity of human resource for health. Specific interventions with targets and milestones were identified to translate this strategy into action.
The development of this strategy also examined the institutional arrangements necessary for the delivery of the identified strategic direction. The design of the framework for stewardship was confirmed to be appropriate and therefore priority identified as full implementation. The county government will therefore implement the proposed structure for the health department and establish a well-structured stakeholders coordination mechanism that facilitates active stakeholder engagement and participation; and embeds transparency and accountability.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022x
In terms of ensuring that this strategy is closely monitored during implementation, a health monitoring and evaluation framework will be developed to support it, a robust monitoring and evaluation unit will be set up; and regular reporting enabled through provision of necessary resources. The plan also lays out selected indicators at outcome level for tracking health status, output indicators for tracking access and quality; and process and input indicators for tracking health systems investments. These indicators will be monitored on an annual and quarterly basis; and evaluated at mid - and - end term of this strategic plan.
This plan is costed. The costs determined will guide the development of the annual work plans and the program-based budgets for the county department of health.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 1
1.1 BackgroundThe Constitution of Kenya, 2010 (Article 43) guarantees its people the right to the highest standard of healthcare and assigns specific responsibilities to national and county governments in the delivery of this right. County governments are primarily assigned service delivery while the national government is mainly responsible for regulation, policy, and standards. The assignment of these role acknowledges the significance of the health sector as a contributor to economic development through ensuring a healthy and productive population. These aspirations are echoed in the Kenya Health Policy 2014-2030, Medium Term Plan III for the Kenya Vision 2030, and the Baringo County Integrated Development Plan (CIDP).
The Kenya Health Policy envisages that Kenya will provide Universal Health Coverage (UHC) by 2030. This is in line with the international commitment articulated in the Sustainable Development Goals (SDGs). SDG 3 seeks for the attainment of universal health coverage by 2030. The most fundamental expression of this commitment in the medium-term period has been the President’s Big Four Agenda that has prioritised achievement of UHC by 2022 as a key goal. Similarly, the Governor’s Manifesto prioritizes the improvement of health outcomes in the county through strengthening the health service delivery structures and systems. Baringo County has therefore embarked on the path to providing UHC through scaling up investments in health infrastructure, human resources for health, health information systems, health financing, and essential health commodities. The county appreciates that these investments, focused at all levels of the health system, will contribute to reducing morbidity and preventable deaths from communicable and non-communicable diseases. Ultimately, the gains of a productive health population in the county will be translated to economic growth of the county and poverty reduction.
1.2 Planning Framework and ContextThe development of the county health sector strategic plan for the period 2018-2022 has been broadly guided by the overall national framework for planning, and specifically the health sector planning framework for Kenya. Under this framework, the planning for the county health sector is required to be aligned to the Kenya Vision 2030, its Medium-Term Plan, the Kenya Health Policy and the attendant Kenya Health Sector Strategic Plan. The long-term plans for the health sector have identified universal health coverage as the broad goal towards ensuring that the right to health is attained. These policy and strategic documents also recognise the need to focus more on preventive and promotive health services as opposed to just curative health services.
It is these imperatives that have guided the determination of the six broad strategic objectives pursued by the national health sector, and which have guided the development of the county health sector strategic plan. These objectives are elimination of communicable diseases; halting and reversal of the rising burden of non-communicable conditions; reduction of the burden of violence and injuries; minimizing exposure to health risks; provision of essential health services; and strengthening collaboration with health-related sectors.
1. INTRODUCTION AND BACKGROUND
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-20222
In the Baringo County Integrated Development Plan, the above objectives are translated into one broad goal of providing accessible, affordable and quality healthcare services in a prompt, professional, and equitable manner. The mandate of the county health sector is also defined as that of supporting the achievement of the highest attainable public health and sanitation goals with special focus on Level one to Level three of care; and ensuring availability of medical care and improving life through responding to health care needs of the county population. Sector targets were defined in the CIDP and are meant to be elaborated through a five-year sector strategic plan; and implemented with the support of the Annual Work Plans and Program Based Budgets.
The county, therefore, prepared this strategic plan with a view to providing a guiding framework for implementation of health sector interventions in a manner that embeds transparency and accountability. The plan, being the second one since inception of devolution, takes into consideration the progress recorded in the first term of the county government as well as the challenges and lessons learned during implementation. A review of the sector performance revealed that there were progressive investments made in terms of health systems strengthening but significant gaps remain to be addressed. The sector achievements for reproductive maternal, neonatal, child and adolescent health services; and those for public health services were below target.
To remain focused in the implementation of this strategic plan, the county department for health services plans to continue with three key broad functional programs. Firstly, the preventive and promotive health services to deal with primary health care, and health promotion including community and environmental health services. Secondly, the curative and rehabilitative services program to deal with treatment offered in health facilities including the delivery of specialized services. Thirdly, the administration and support services to deal with finance, planning, budgeting, procurement, human resource management, stakeholder coordination and other support services. A key sub-program under this program will deal with monitoring evaluation and research agenda. Flagship programs have been considered based on contribution to the reduction of inequalities, mitigating priority health problems and cost-effectiveness.
1.3 Process of Development Baringo County Health Sector commenced the development of this strategic plan upon completion of the development of the County Integrated Development Plan in the second half of 2018. The process of developing this plan was comprehensive, consultative, and participatory. It began with a focused review of the implementation of the plan for the period 2012-2018 and reflecting on the achievements, challenges and key lessons. This analytical review was informed by progress reports accumulated over the period and enriched through discussions with management and stakeholders in the county health sector. The analysis also incorporated consultations with sub-county health management teams.
As a follow up to the analysis, a five-day workshop was undertaken to deliberate on the findings, generate key issues, and facilitate the identification of priorities for the five-year period 2018-2022. During this meeting, reflections were made on the state of county health sector based on key performance indicators, the status of the health system investments, the status of collaboration and partnerships in the county health status, and the suitability of prevailing governance and institutional arrangements. These crucial deliberations enabled crafting of the strategic direction for the five-year period of this strategy and confirmed the relevance of the county’s mission and vision for health sector. Thereafter, a detailed implementation framework was prepared for the strategy.
A draft strategic plan was prepared, shared with stakeholders for further inputs, validated, and finalized.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 3
This chapter provides a synthesis of the current situation in terms of health status and health system strengthening building blocks; and identifies key challenges that need to be focused on by the county health sector during the strategic plan’s implementation period. This analysis has been informed by a review of critical county policy, strategic and operational documents including the County Integrated Development Plan (CIDP) 2018-2022, Baringo County Health Strategic Plan 2013-2017, County health quarterly implementation reports, program reports, client exit surveys.
2.1 Baringo County Baringo County is situated in the Rift Valley region and shares borders with eight counties namely, West Pokot to the North West, Turkana to the North, Samburu to the North East, Laikipia to the East, Nakuru to the South, Kericho and Uasin-Gishu Counties to the South West, and Elgeyo-Marakwet to the West. The county has a geographical area of 11,015 square kilometers and is administratively divided into six sub-counties, 30 wards and 116 locations. Notably, the 7th sub-county – Tiaty East has been gazette but awaits delimitation by the Independent Electoral Boundaries Commission (IEBC). The county has three lakes that account for 165 square kilometers of the surface area - Lake Baringo, Lake Bogoria and Lake Kamnarok. Other prominent geographical features in the county include: the Kerio Valley, Loboi Plain, Tugen Hills, several rivers and escarpments. The primary economic activity in the county is livestock keeping, though there is also considerable level of bee keeping, honey harvesting, crops farming, tourism and mining.
2.2 Population and DemographicsBaringo County had a population of 555,561 in 2009 and projected population of 728,720 and 813,550 in 2017 and 2022 respectively (KNBS). The county is majorly rural with 89 per cent of its citizens inhabiting rural areas and only 11 per cent living in the key urban centres of Kabarnet, Eldama Ravine, Marigat, Kabartonjo, Chemoligot and Mogotio. The main ethnic communities inhabiting Baringo County are the Tugen, Pokot and Ilchamus communities. The minority groups include Endorois, Nubians, Ogiek, Kikuyu and Turkana communities. Table 1 shows the trend of population projections by sub-county based on the 2009 census.
2. SITUATIONAL ANALYSIS
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-20224
Table 1 - Population Trend
Sub County Population Population Population Trends (Projections)
2009 2018 2019 2020 2021 2022
Baringo Central 89174 110586 112702 114869 117073 119318
Baringo North 93789 127291 129732 132220 134756 137341
Marigat 73177 109759 111863 114009 116196 118428
Koibatek 105273 142877 145617 148410 151257 154158
Mogotio 60959 82734 84320 85937 87586 89266
East Pokot 133189 81342 82905 84494 86115 87767
Tiaty East - 99418 101327 103272 105253 107272
Total 555561 754013 768466 783211 798236 813550Source: KNBS, 2018
In terms of demographics, the county is estimated to have 150,803 households. The population of those under 15 years accounts for 42.30% while adolescents account for 25.50% of the population, women of reproductive age account for 24% and the under 5 children for 16.40%. Table 2 presents the estimates for the population projection based on the demographic groupings.
Table 2 - Population Demographics
Description Population Estimates
Targets2018 2019 2020 2021 2022
Total population 754013 768466 783211 798236 813550Total Number of Households
150803 153694 156643 159648 162710
Children under 1 year (12 Months)
3.80% 28652 29202 29762 30333 30915
Children under 5 years (60 Months0
16.40% 123658 126028 128447 130911 133422
Under 15-year population 42.30% 318947 325061 331298 337654 344132
Women of childbearing age (15-49 Years)
24% 180963 184432 187971 191577 195252
Estimated Number of Pregnant Women
3.80% 28652 29202 29762 30333 30915
Estimated Number of Deliveries
3.80% 28652 29202 29762 30333 30915
Estimated Live Births 3.60% 27144 27665 28196 798236 29288Total number of Adolescent (15-24 years)
25.50% 192273 195959 199719 203550 207455
Adults (25-59) 34.10% 257118 262047 267075 272198 277421Elderly (60+) 5.40% 40717 41497 42293 43105 43932
Source: District Health Information System (DHIS), 2018.
The population pyramid (Figure 1) reveals that most of the population is youthful with those below 49 years accounting for over 60%. The youthful population size has implications on the interventions for sexual and reproductive health. The female reproductive age population (circa 24%) has implications on the investments made towards maternal and child healthcare, reproductive health as well as nutrition programs.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 5
The children under five (16.40%) accounts for the pre-school going age and the ones targeted for immunization coverage, nutrition program and monitoring of growth outcomes. The primary school going children estimated at over 190,000 (approximately 26%) is targeted with school-based health interventions and interventions for integrated management of childhood illnesses (ICMI) and nutrition.
The 50-65 years population that accounts for about 16% of the population has implications on the interventions for screening, diagnosis, and treatment of non-communicable diseases such as diabetes mellitus, cancer and hypertension. The aged population of 65 years and above though accounting for about 5.4% has significant implications on interventions for social protection and geriatric and palliative care programs.
Figure 1 - Baringo County population pyramid
Population density in the county varies significantly. Baringo Central has the highest population density at 188 persons per square kilometer, closely followed by Eldama Ravine at 150. The other four sub-counties Tiaty, Baringo South, Mogotio and Baringo North have 40, 55, 63 and 75 respectively. Table 3 presents population estimate for the six sub counties and Figure 2 - outlines the population density across the 30 wards in the county.
Table 3 - Population Density Projections by sub-counties, 2018
Constituency Male Female Total Area in Sq. Km Density Households
Tiaty 94854 85912 180766 4540 40 36,154
Baringo Central 53458 57128 110586 589 188 22,118
Baringo North 62741 64550 127292 1704 75 25,459
Baringo South 55000 54759 109759 1985 55 21,952
Mogotio 41271 41463 82734 1304 63 16,547
Eldama Ravine 71448 71430 142878 954 150 28,576
Total 378772 375242 754014 11075 68 150,803Source: KNBS 2009, KNPHC, 2009.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-20226
Figure 2: Administrative Wards and Population Density in Baringo
The number of persons living with disabilities in Baringo is estimated at 3.1% of the population translating to 17,121 persons as per the 2009 population census. This number is projected to rise to 26,300 persons by 2002. Majority of those with disabilities have visual, physical and hearing challenges with the distribution across gender being almost equal. There is acknowledgement in the county that more surveys need to be done to ascertain the exact numbers, specific age categories, disability types and severity in the county currently to enable responsive interventions to this special groups. Table 4 shows the estimates for population of persons living with disabilities by categories.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 7
Table 4 - Population of persons with disabilities
Type of Disability Male (%) No. Female (%) No. Visual 27.3 2334 24 2057 Hearing 19.2 1639 19.3 1651Speech 7.3 623 8.5 730Physical 21.6 1845 25.9 2223Mental 8.4 719 9.4 802Self-care 9.7 828 6.8 581Others 6.4 549 6.3 541Total 8537 8584
Grand Total 16,821Source: KNPHC Report on Persons Living with Disability
2.3 Health Status
2.3.1 Key Indicators Status
A review of the status of health as reflected by selected health indicators reveals mixed performance when compared to national averages as depicted in Table 1 that highlights Baringo county performance in health services as per selected core indicators. Life expectancy for Baringo citizens is equivalent to the national estimates. Infant mortality, under-five mortality and maternal mortality rates for the county are slightly higher than the national averages. Similarly, the indicators for deliveries under skilled health workers, latrine coverage, and contraceptive prevalence are slightly worse than national averages. The county scores better than national averages in terms of the prevalence of communicable conditions – HIV, Malaria and TB. Table 5 summarizes the estimates for key indicators for health.
Table 5 - Key Indicators in Health
Impact Level Indicators National Estimates County EstimatesLife Expectancy at birth (years) 59 58Neonatal Mortality Rate (per 1,000 births) 22 31Infant Mortality Rate (per 1,000 births) 39 62Under 5 Mortality Rate (per 1,000 births) 52 60Maternal Mortality Rate (per 100,000 births) 362 374County latrine coverage 51% 43%Open Defecation Rate 14% 70%Immunization Coverage 68% 69%% of deliveries by skilled birth attendants 61% 54%Contraceptive Prevalence 40% 31%HIV Prevalence 4.8% 1.3%Malaria (as % of all 1st outpatient visits) 27.7% 11.8&TB Prevalence (in every 10,000 persons) 39 6
Source: KDHS, 2014; DHIS 2018
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-20228
2.3.2 Disease burden
An analysis of the burden of conditions causing morbidity and mortality in Baringo County reveals that upper respiratory tract infections, malaria, skin diseases, and diarrheal diseases are the major causes of outpatient visits morbidity across all ages in the county. This is consistent across the sub-counties too. These conditions are attributed to several risk factors in the environment in which the people of Baringo live in, such as inadequate water, and inadequate ventilation. The prevalence of injuries is attributed to poor road condition largely while malaria is attributed to seasonal flooding. An underlying factor across the conditions in low socio-economic status that also accounts for low immunization coverage, lack of adherence to exclusive breast feeding, and poor nutrition.
Table 6 - Top causes of Morbidity in Baringo County
Top Ten Morbidity causes for All ages Top Ten Morbidity Causes for Under 5 1 Upper Respiratory Tract Infections 1 Other Disease of Respiratory System
2 Malaria 2 Confirmed Malaria
3 Skin Diseases 3 Disease of the skin
4 Diarrheal diseases 4 Diarrhea
5 Rheumatism 5 Pneumonia
6 Pneumonia 6 Accidents
7 Accidents/Injuries 7 Eye Infections
8 Eye infections 8 Rheumatism
9 Ear Infections 9 Ear infection
10 Typhoid 10 Urinary Tract infection
Source: DHIS, 2018
In terms of inpatient morbidity cases, the main contributors to the burden are both communicable and non-communicable diseases such as diarrhoea diseases, malaria, pneumonia, peptic ulcers, hypertension, psychosis, poisoning, diabetes, anaemia, and road injuries. Notably, abortion is also a contributor to admissions indicating that there is gap in provision of family planning and other reproductive health services. The associated risk factors for other conditions include inadequate water, inadequate ventilation, lifestyle habits, poor health seeking behaviours, drugs, and alcohol abuse as well as inadequacies in diagnosis and treatment.
Table 7 - Top causes of Inpatient Morbidity (All ages) in Baringo County
1 Diarrhoea and gastroenteritis of presumed infectious origin
2 Malaria
3 Broncho/ lobar and unspecified pneumonia
4 Abortion
5 Peptic Ulcer
6 Gastritis
7 Hypertension
8 Psychosis
9 Poisoning (pesticides, organophosphate, insecticides, petroleum etc)
10 Diabetes mellitus
11 Burns of different parts of the body
12 Cellulitis
13 Anaemia
14 Asthma
15 Road injuries (Motorcyclist, pedestrian’s, passengers etc.)
Source: DHIS 2018
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 9
Regarding mortality for under 5 years, the major causes are lower respiratory infections, other conditions during the perinatal period, prematurity and low birth weights, malaria, protein allergy malnutrition, birth asphyxia and trauma, diarrhoea, meningitis. The risk factors associated with these conditions include anaemia, malnutrition as well as poor health-seeking behavior, particularly on immunization. Across all ages, HIV remains the leading cause of death among those admitted in Baringo County. This is attributable to the lack of awareness of HIV status leading to late diagnosis and enrollment to care. Lower respiratory infections also account for a significant number of deaths owing to poor case management. Malaria mortality is due to poor uptake of mosquito nets. Tuberculosis is reemerging as a leading cause of mortality and morbidity due to a variety of factors such as overcrowding in school dormitories, poor immunity due to malnutrition and low socioeconomic status.
Table 8 - Top ten causes of mortality in Baringo County
Under 5 years All ages 1 Lower respiratory infections HIV2 Other conditions during the perinatal period Lower respiratory infections3 Prematurity and low birth weight Malaria4 Malaria Tuberculosis5 Protein energy malnutrition Other conditions during the perinatal period6 Birth asphyxia and birth trauma Prematurity and low birth weight7 ill-defined diseases (ICD 10 ROO-99) Other digestive disease8 Diarrhoea Ill-defined diseases (ICD 10 ROO-99)9 Other digestive disease Other cardiovascular disease
10 Meningitis Protein energy malnutrition
Source: DHIS 2018
Referrals Outward
A review of the referral cases indicates that the most common cases referred for treatment from the county to the Level 6 facilities outside the county are related to injuries secondary to road traffic accidents. Inadequate capacity in terms of specialized diagnostic equipment (MRI and CT Scan), and attendant specialized treatment (orthopedics and ICU care) are the main reasons for such referrals. The other most common cases of referrals relate complications in chronic kidney diseases, broncho-pneumonia, intestinal obstruction, and acute anemia. Chronic kidney diseases require specialist care by nephrologists and renal nurses who offer dialysis. Whereas, acute anemia is attributable to blood products shortages at the county referral facilities. These critical conditions do require a functional ICU and a blood transfusion unit which have yet to be completed and operationalized.
Other emerging conditions
Hepatitis B and Snakebites are two emerging conditions which are of public health concern in the county . There is an upsurge of cases of Hepatitis B in the lowland areas of the county. Inadequate community awareness on the prevention of transmission of Hepatitis B is considered a contributing factor. Snakebites incidences are also common and are attributable to human-animal wildlife conflict. There is an acknowledged gap in capacity of health care workers to treat snakebites and lack of supply of anti -venom.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202210
2.3.3 Health Risk Factors
Most of the underlying risk factors associated with the major conditions listed in Tables 6, 7 and 8 for morbidity and mortality can be addressed through health promotion. One of the key determinants for health is level of education. Just over 16% of the population in the county have secondary level education and above, those with primary education account for about 48% while those without formal education stand at 16%. Though the teacher pupil ratio in the county is relatively good at 1: 27 for public schools, enrolment is at 85% and gender parity index at 0.60 below the national average of 0.963. The last demographic survey indicated that health indicators were worse off among persons who had no or little formal education. Additionally, indicators such as underweight among under five children, prevalence of diarrhoea and malaria amongst under five children declined with increased level of educational for the mother.
A similar trend is replicated with income levels showing the higher incidences among poor people. According to KNBS (2018) Baringo county has a poverty estimate of 39.6% against a national average of 36.1% with severity estimate of 4.2% in terms of extreme poverty. Hardcore poverty estimate is 8.5% against a national average of 8.6%; Food poverty estimate is 41.4% against the national estimate of 32%. These estimates indicate that there are still cases of extreme poverty in the county and that the general population is poor. Improving income and educational levels would lead to an improvement in health status.
Access to water is a challenge in Baringo County with only 26.6% of the population having access to safe water, 28.5% lower than the national average of 54.1%. Only 39% of the county’s population uses improved sanitation facilities with the rest of the population using unimproved sanitation facilities – this explains why open defecation is still common. Improved water sources include well/borehole, piped and rain harvested water; while, improved sanitation includes connection to a main sewer, septic tank and cesspool as well as ventilated improved pit (VIP) latrine and covered pit latrine (KNBS, 2014). The county has a house population of about 9% built with bricks or stones, and 57% built of mud/wood or mud/cement. Up to 25% with homes from cement floor, 73% have earth floors while less than 3% have tiles and wooden floors. Most houses (57.7%) have iron sheet roofs, 39.1% have makuti and grass thatch roofs. Quality of housing for some traditional and modern dwellings remains a challenge in terms of compliance with required housing standards. These have implications on adequacy of ventilation, lighting and space. Overcrowding and inadequate ventilation is a risk factor to respiratory conditions and tuberculosis.
The population of households with electricity estimated at 9% and most of the households use solid fuels thus putting the population especially children at higher risk of respiratory infection if the rooms are not well ventilated. Paved roads as a percentage of total roads stood at 15.7% thus increasing the risk of road accidents and perhaps contributing to the poor health seeking behaviour. In some of the sections of the county, community members also consult traditional healers on issues relating to witchcraft. Though anecdotally estimated to have minimal prevalence, such cultural beliefs influence health for example the way people seek health care and prevent illness.
Various surveys undertaken in the nutrition arena within the county have highlighted undernutrition in some sections of the county such as Tiaty, East Pokot and Baringo North. Households adopt survival mechanisms of taking one to two meals especially in the pastoral and agropastoral zones in response to the challenge. Climatic conditions characterized by drought diminish pastures and browsers, and lead to tribal conflicts thus worsening the situation.
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2.4 Health Strengthening Systems Health System Strengthening building blocks have a critical role in the production of desired health outcomes and impact. This section analyses the status of the county health system building blocks - human resources for health, health infrastructure and equipment, health products and essential technologies, health financing, health information system, health leadership management and governance, and service delivery support systems. Key issues and priorities are identified for each of these blocks.
2.4.1 Health Infrastructure
The county has a total of 247 facilities and 58 community health units across the levels of county healthcare system. Of these, seven are hospitals at Level IV, 31 (12.6%) are health centres and 176 (71.5%) are dispensaries. The distribution of health facilities and community units across the seven sub-counties in Baringo County is shown in Table 9.
Table 9 - Distribution of health facilities across sub-counties in Baringo
Sub-Counties Hospitals Health Centres Dispensaries Private Clinics
Community Units
Nursing Homes
GOK FBO GOK FBO GOK FBOBaringo North 1 0 4 0 40 1 1 6 0
Baringo Central 1 0 6 0 29 1 10 4 1
Marigat 1 0 3 0 25 2 2 5 0Koibatek 1 1 4 1 24 0 9 11 1East Pokot 1 0 2 1 14 3 0 12 0Tiaty East 0 0 3 0 13 2 0 11 0Mogotio 1 0 4 0 25 1 4 9 0Total 6 1 24 2 176 10 26 58 2
Source: DHIS, 2018.
A review of the infrastructure and equipment status at the various level of care indicates that the facilities are operating below the set norms and standards. Baringo County Referral Hospital currently operates as level 4 and does have specialised facilities for ICU, renal dialysis, diagnostics including CT Scan, Histopathology, Biochemistry and Microbiology. The other five public Level 4 hospitals offer services at varying levels. Eldama Ravine with capacity of 110 beds offers surgical services with 2 theatres, specialised ultrasound and X-Ray units. Kabartonjo sub-county hospital which has 30 beds has an X Ray unit and a newly completed theatre, but both have yet to be put into operation. Marigat, Chemolingot and Mogotio sub-county hospitals have 40 beds, 20 beds and 60 beds respectively. The three hospitals do not have operating theatres. However, they offer inpatient services with exception of Mogotio that was gazetted as a sub-county hospital in 2019. The distribution of specialised services across the sub-counties reveals inequity that need to be addressed. The topmost priority is to scale up specialised service provision at Level 4 facilities as per the established norms and standards. X Ray services should be offered at all Level 4 hospitals and some high-volume health centres; and theatres should be established at all Level 4 hospitals.
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Regarding primary healthcare facilities, the comparison with existing norms and standards indicate that the county has an adequate number of health centres and dispensaries while there is a significant gap in the number of community units with only 60 out of an expected 150. Although the number of primary health facilities is adequate, the capacity to deliver specific services expected at these levels as per the Kenya Essential Package for Health (KEPH) standards (Appendix II) varies. Most of the public dispensaries (146 out of 167; 85%) offer expected services albeit with shortages in staffing. Out of the 25 health centres, only 18(72%) are currently offering services at the expected level. Inequity is also noted with regards to the spatial distribution of facilities within the county. In prioritizing any new facilities, considerations have been made on spatial distribution.
Table 10 - Average populations expected to be served with different facility types
Catchment populations
Hospitals Primary Care Units Community UnitsTertiary
(level VI) referral
hospital
Secondary (level V) referral hospital
Primary (level IV) hospital
Health Centre
(level III) services
Dispensary
(level II) services
44,000,000 (National)
5,000,000 1,000,000 100,000 30,000 10,000 5,000
Required Numbers of Facilities (Nationally)
9 44 440 1,468 4,404 8,808
754,014 (Baringo 2018)
0 1 7 25 75 150
Gap in HFs 0 0 0 0 0 90
Over the last five years, the county acquired 14 ambulances acquired (bringing the total to 22) that facilitate referral from the community and primary health facilities to the Level 4 hospitals; as well as outward referrals to the national referral hospitals. Ongoing maintenance of the ambulances and utility vehicles remains a challenge as the citizens are not charged for the service and the department of health services shoulders the burden from its recurrent budget. The status of poor road network in Baringo County makes it expensive to operate both ambulances and utility vehicles. At the health-centers and dispensaries, the county supplements movement with motorcycles and bicycles to promote the reach of community health services. The county acknowledges the need to streamline ambulatory services through development and implementation of county ambulance policy.
2.4.2 Essential Medicines and Medical Supplies
The overall availability of tracer drugs has improved over the five years, however, shortage of other drugs and medical supplies such as laboratory reagents, radiological supplies, dental oxygen continue to afflict delivery of quality health services at county health facilities.
The major contributing factors have been inadequate capacity in quantification and forecasting facility needs for drugs and other medical supplies; lengthy procurement process exacerbated by delayed reporting, order processing and delays in supplier payments, poor specifications, weak logistical information system and overall inadequacy and unpredictability of funding for medicines and medical supplies. There have also been instances of uncoordinated donations of medicines and medical supplies.
The county procures most of its pharmaceutical and non-pharmaceutical supplies from KEMSA and MEDS. Facility orders are generated monthly based on facility needs and past consumption; they are then compiled into a consolidated county order that informs quarterly replenishments August, November, February and May.
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The county undertook a comprehensive quantification exercise in March 2017 using and extrapolating data collected from 25 county health facilities (5 hospitals, 9 health centres and 11 dispensaries) and established that the annual commodity requirements at KShs 430 million. The budget allocated for health commodities in the financial year 2017/2018 totaled KSh 140 million, 32.5% of the estimated requirements. Evidently the unfilled gap in pharmaceuticals and non-pharmaceuticals indicates a big shortfall in essential commodities for health service delivery. This situation is exacerbated by the overall shortage and inappropriate distribution of pharmaceutical staff.
Generally, the vaccines for preventable early childhood diseases are available at all the immunizing health facilities and theatre supplies are available in the functional theatres in the county. However, the supply of laboratory commodities for specialized laboratory diagnosis at level 4 facilities is inconsistent. The delivery of laboratory and medical imaging services in support of the delivery of essential health package in Baringo County is significantly affected. Notably, the county government is putting up a bulk liquid oxygen supply unit at Baringo County Referral Hospital for the supply of oxygen to the hospital and other facilities within the county.
The absence of a robust online stock system to track status perhaps with close linkage to the services workload makes the estimation of requirements cumbersome and inhibits timely forecasting. At the same time, there are challenges with regards to therapeutics with non-essential prescriptions still made. The need to strengthen therapeutics committees and build capacity of facility staff on therapeutics is therefore imminent.
The key priorities in this area are strengthening capacity in quantification and forecasting; increasing budgetary allocation for health commodities and ensuring that emerging needs are addressed. For instance, rising burden of Hepatitis B calls for test kits for screening and vaccines; anti-snake venom for managing snake bites.
2.4.3 Health Workforce
The county has 1,210 staff in the health services department distributed across the levels of the healthcare system. Of these (1,210), about 200 staff were recruited over the last five years by the county government in a bid to address the capacity gaps in staffing. The distribution of staff across cadres indicates that there are nine specialists, 19 doctors, 535 nurses, and 113 clinical officers. Distribution of staff across the sub-counties also reveals significant inequity as shown in Figure 3 on staff distribution for selected cadres.
Figure 3: Staff distribution across sub-counties
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202214
There is still a gap in the numbers and skills of staff in the county health sector. Compared to the prevailing norms and standards, the gap is most pronounced for nurses at 191 and clinical officers at 104. The sector acknowledges that production has improved significantly with scaled up the capacity of health training institutions within and outside the county across a range of programs, and thus the major contributor to non-filled gaps is a budget constraint.
Admittedly, human resource bottlenecks continue to stifle the delivery of health services in the county. The county has recently prepared a Human Resources for Health Strategic Plan for the period 2018 – 2022 to aid in addressing the challenges in this area. This strategy primarily seeks to address the gaps in numbers and skills of health workers in the county, and address issues relating to optimization of performance, productivity, motivation, and even ergonomics. This plan acknowledges that there will be staff attrition over the planning period - 98 healthcare workers of different cadres are due to retire. Replacement of the retiring staff is, therefore, a top priority to maintain the current service level.
Figure 4 - Health Staff Due to Retire by Year
In terms of skills, the health workers at the County health department and facilities have acquired skills through on job training, workshops, and experiential learning and the capacity to perform the county health services continues to grow. However, gaps have been acknowledged in the areas of specialty areas like rehabilitation, emergency care, and integrated management of child illness as well as support services like maintenance of specialized medical equipment.
2.4.4 Leadership, Management and Governance
The delivery of health services in Baringo County is led by the County Executive Member for Health Services with the support of a core leadership team of two chief officers and directors and a County Health Management Team (CHMT). This stewardship team is mandated to steer policy formulation, development, and implementation. This level also oversees stakeholder coordination, advocacy, and resource mobilization. At the decentralized level, the team is supported by sub-county health management teams and facility management teams for hospitals and primary healthcare facilities.
The key governance organs include the county stakeholder’s forum and the hospital boards and primary facility management committees. The governance structures in health provide linkage between the citizens and the health system and provide oversight on management. The current hospital boards were appointed by the Governor within 90 days of taking office. The CECM has also already appointed facility management committees for the primary facilities. Whereas these committees have been meeting regularly, their effectiveness has not been optimized owing to the legal framework through which they were created and the attendant politicization of their role. While the role of such committees in providing linkages to the community and sharing feedback is acknowledged, their capacity in terms of skills and time to effectively provide leadership in the management of county facilities remains a challenge. Strengthening of the effectiveness of the Stakeholders Forum for Health has also been noted as a priority for this strategy.
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2.4.5 Health Information System
Health data is recorded at the facilities using tools (standardized forms, registers, cards, file folders, and summary forms), analyzed and shared either manually or electronically depending on the facility’s level of computerization. For most health centres and dispensaries, that are not computerized, data is collected, analyzed, stored and transmitted to the next level manually. At the community level, the community health workers maintain registers of activities albeit with delays in providing updates. Notably, the level of reporting by private facilities has been poor perhaps because of apathy on the benefits that accrue from such reporting.
At all levels, the capacity to utilize the information generated for decision making has been challenged. These challenges are attributed to factors that include the slow transition from manual to electronic medical records hindering accessibility of data. Minimal capacity on the ICT system on the part of staff as they are computer illiterate. Additionally, there are inadequacies in ICT equipment and maintenance owing to limitations in funding dedicated to health ICT. Other factors include incidences of stock outs of health information system material (forms, cards), limitations in the management of power outages, limited system intra-and-interconnectivity, and poor information sharing across departments and facilities.
The county government continues to build the capacity of staff in data management. One of the priority areas identified is improving staff understanding of the indicators and documentation protocols and policies. The establishment of a county health department’s M&E unit is one of the efforts the county is making towards enhancing the production of information products for supporting planning and decision making. The frequency and quality of data quality audits has also been flagged as a priority, as well as scaling up of the county’s data systems including electronic medical records (EMR) from the current 13.
2.4.6 Health Financing
Baringo County health services have been funded from various sources including the national government allocations for both recurrent and development, county own sourced revenue, health and medical insurance, out of pocket payments from individuals, as well as development partners. According to the County Health Accounts (2016/2017) and expenditure analysis for 2017/2018, approximately 48% of the total health expenditure is funded by the county government, 35.2% is funded by individual households, 13.3% is funded by development partners and 3.4% is funded by private firms. This expenditure was incurred through various agents amongst them the county government, private employers, households, NHIF, private insurance, and non-governmental organizations.
In terms of health functions, 50.3% of the total county health expenditure goes towards outpatient curative care; 25.5% on inpatient curative care; 10.3% on pharmaceuticals and other medical non-durable goods; 7.5% on governance, health system and financing administration, while 6.3% is invested in capital formation. This indicates an under- investment in health promotion and preventive services.
A further examination of the public expenditure indicates that Baringo County has progressively increased its allocation to health services in absolute terms from KShs 1.3 Billion in FY 14/15 to 2.7 Billion in FY 18/19. However, as a proportion of the total county budget, the allocation increased to 36% in FY 16/17 but has since reduced to 35% in FY 17/18 and 33% in FY 18/19 Figure 5 details the county allocations to health from FY 14/15 to FY 18/19.
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Figure 5 - County Allocation to Health FY 14/15 to FY 18/19.
Allocations are made alongside the three main programs designated by the county health department for purposes of program-based budgets. The general administration, planning and support takes the bulk of the budget (74%) while curative services, and preventive and promotive services take 23% and 3% respectively. The allocation to administration is noticeably high owing to the recurrent personnel costs that total to KShs 1.6 Billion (about 65% of the health budget). In the last budgetary allocation FY 18/19, the allocation for preventive and promotive services was increased to 11% in line with the expectations of this strategic plan to focus on this area. There is a strain on the budget available for operations and maintenance, drugs and non-pharmaceuticals and infrastructural projects especially the already started ones.
2.5 Stakeholder AnalysisThe county health sector has a diverse pool of stakeholders in both the public and non-public sector. An analysis of the stakeholders by categories and expectations is summarised below.
Stakeholder Stakeholder Expectation Health Department’s Expectation
Other County Government Departments and Sectors
· Collaboration in service delivery· Engagement in decision making · Information sharing
· Collaboration in delivery of health services · Timely support and provision of information and
feedback
Citizens · Provision of quality services.· Participation through consultations
in key decisions.· Accountability
· Support and cooperation· Prudent utilisation of services · Provision of feedback
Non-governmental Organizations (NGOs)
· Provide quality services· Provide personnel for
implementation· Strengthen institutional
infrastructure· Accountability of their contribution
· Provision of funds towards targeted programmes/projects
· Collaboration and support in implementation of health sector agenda
· Participation in joint planning, monitoring and evaluation
· Accountability · Adherence to policy and guidelines
Faith Based Organization (FBOs)
· Provide quality services· Provide personnel for
implementation· Strengthen institutional
infrastructure· Accountability of their contribution
· Provision of funds towards targeted programmes/projects
· Collaboration and support in implementation of health sector agenda
· Participation in joint planning, monitoring and evaluation
· Accountability · Adherence to policy and guidelines
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Stakeholder Stakeholder Expectation Health Department’s Expectation
Community Organizations (CBOs)
· Provide quality services· Provide personnel for
implementation· Strengthen institutional
infrastructure· Accountability of their contribution
· Provision of funds towards targeted programmes/projects
· Collaboration and support in implementation of health sector agenda
· Participation in joint planning, monitoring and evaluation
· Accountability · Adherence to policy and guidelines
National Government · Implementation of policies and guidelines
· Cooperation and collaboration· Accountability for their
contribution
· Formulation of policy and guidelines· Cooperation and collaboration· Provision of Capacity Building· Provision of Funding
Private Sector (for profit) · Provide quality services· Provide personnel for
implementation· Effective partnerships for mutual
benefit · Accountability for their
contribution
· Collaboration and support in implementation of health sector agenda
· Participation in joint planning, monitoring and evaluation
· Accountability · Adherence to policies and guidelines · Responsible corporate citizenship
International funding agencies (multilaterals such as UNAIDS, UNICEF, WHO, World Bank, Global Fund, GAVI and ADB; and bilateral such as USAID, CDC, DANIDA and SIDA)
· Provision of quality services· Value for money · Effective partnerships for mutual
benefit
· Support through funding and technical assistance · Feedback
Implementation partners · Provision of quality services· Value for money · Effective partnerships for mutual
benefit
· Proper implementations of supported programs· Technical Assistance, · Adherence to joint rules of engagement · Participation in joint planning, monitoring and
evaluation
National Government Ministries Departments and Agencies (including NHIF, KEMSA, NACC, Disease Programs, Training and Research institutions such as KMTC, KEMRI and Universities) , and Regulatory bodies
· Implementation of policies and guidelines
· Cooperation and collaboration· Accountability for their
contribution· Adherence to policy and
regulations · Feedback
· Formulation of policy and guidelines· Cooperation and collaboration· Provision of Capacity Building· Provision of Funding· Joint planning, Monitoring and Evaluation · Effective regulation
National Referral Institutions (MTRH, KNH, Mathari Hospital, SPINAL INJURY Hospital, National Reference Laboratories)
· Collaboration in referrals for specialized services
· Feedback · Accountability
· Collaboration in referrals for specialized services· Feedback· Support in capacity building and technical assistance· Accountability
Legislature ( National Assembly, Senate, County Assembly)
· Support in formulation of policies and laws oversight and representation
· Feedback · Accountability
· Legislative support · Effective oversight · Support through budget approvals and appropriations
Professional bodies · Accountability · Engagement in key decisions · Collaboration in service delivery,
capacity building and research
· Accountability · Collaboration in service delivery, capacity building
and research· Support in human resources management
Unions · Accountability · Engagement in key decisions · Collaboration in service delivery,
capacity building and research
· Accountability · Collaboration in service delivery, capacity building
and research· Support in human resources management
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2.6 SWOT AnalysisThis section summarizes the strengths, weaknesses of the county health system based on the review of the health status and health system building blocks. It also identifies the opportunities and threats in the external environment.
STRENGTHS WEAKNESSES
· Key Policies and Strategic Plans in Place - Health Policy in place disseminated to various levels of management; County Integrated Development Plan (CIDP) in place; HRH Strategic Plan in place
· Annual Work Plan in place
· Skilled health work force with defined Scheme of service
· Established pull system in commodities procurement in all health facilities
· An experienced multidisciplinary workforce that is dedicated and caring, and willing to learn and develop
· Good working relationship with other agencies and programs (including development partners and implementing programs)
· Functional decentralized health management teams at sub county levels (sub-county Health Management Teams (SHMTs), Facility Health Management Teams (FHMT)
· Sub- Optimal work environment (Physical, Infrastructure, equipment, staff housing, staff norms and skills development)
· Inadequate management skills among health workers in administration
· Inequitable staff distribution
· Inadequate staff supervision
· Lack of induction program for health workers on new appointment
· Specialization of workers makes them unable to offer variety of services,
· Performance management not institutionalized
· Lack of coordination forum for inter-county information sharing
· Overdependence on implementing partners
· Inadequate health services coverage and utilization
· Shortage of human resource and inadequate distribution
· Limited financial resources
· Changing attitudes of clients
· Fragmentation of donor funded projects/support
· Non-alignment with some development partners and their implementing agencies leading to inequitable distribution of resources and inefficient use of resources (human, financial and logistics)
· Weaknesses in procurement system
· Inadequacies in financial management system
· Weak referral system coupled with overreliance on hospitals for delivery of primary health care services
· Poor coordination between public and non-state actors
· Lack of utilities in some facilities
· Inadequacies in monitoring and evaluation as well as utilization of data for decision making
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OPPORTUNITIES THREATS
· Inter-sectoral collaboration
· Availability of mobile network coverage
· Connection to the National Electricity grid
· Supportive Health committee members in County Assembly
· Supporting partners available
· Health financing under Big Four Agenda insurance schemes, NHIF, Linda mama initiative, economic empowerment)
· Enhanced public participation
· Responsive communities to health matters
· Legislative framework to support various health functions (Tobacco control, Public health, community health services, FIF)
· Public private partnerships
· Partnerships with training institutions to inculcate organizational values
· Available pool of trained college and university students in search of employment
· Emerging technologies in healthcare practice – such as telemedicine
· Literate society
· Commitment from the County Leadership and National government to support women and youth
· Commitment by donors to support the health sector and devolution
· Insecurity in some parts of the county
· Dwindling partner support due to budget cuts.
· High levels of poverty
· Retrogressive socio-cultural/religious values such as Female Genital Mutilation (FGM), cattle rustling, child marriages
· Inequitable social development- roads, water, schools and other amenities
· Adverse climatic change
· Unforeseen natural disasters such as floods, landslides, drought and epidemics
· Environmental degradation,
· Drug and alcohol abuse
· Changing epidemics -Emergence of NCDs
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The county has identified strategic objectives to respond to key strategic issues identified in the situational analysis. The strategic direction presented in this chapter highlights those objectives in response to the health service delivery and isolates specific objectives relating to strengthening the capacity of the county health system. The detailed interventions plan are outlined in Apendix IV.
County health department’s Vision, Mission, Strategic Goal Statement is outlined below.
VisionAn attractive, competitive and resilient county health system
MissionTo improve the health status of the citizen through provision of high quality, affordable and
accessible health care in an equitable and professional approachStrategic Goal
To improve the quality of life of the citizen and reduce disability from disease and early deaths
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Strategic Objective 1: Strengthen preventive and promotive health services
The county government has identified preventive and promotive health services as the pillar to its achievement of this strategic plans overall goal and objectives. As such the county will increase its focus on the delivery of promotive and preventive services across the five levels of the county health system. Investment in terms of budgetary allocation towards this focus area will commensurately be increased to reflect the shift. The specific interventions in this area across the six policy objectives are captured in Table 11.
3. STRATEGIC DIRECTION
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 21
Strategic Objective 2: Strengthen curative and rehabilitative health services
The county government will further strengthen the delivery of curative and rehabilitative services across the health care system with a focus on moving the delivery units closer to the established KEPH norms and standards. Special emphasis will be laid on specialised health services at Level 4 and 5 of care. The specific interventions in this area are presented in Table 11 under the six policy objectives.
Table 11 - Interventions for Preventive and Curative Health Services
Policy Objective Specific Strategic Objectives
Promotive and Preventive Health Services Curative and Rehabilitative Health Services
Eliminate Communicable diseases
· Strengthen immunization services and outreaches at all levels
· Strengthen surveillance on immunizable diseases
· Enhance defaulter tracing mechanism· Strengthen (CLTS) · Strengthen School Based Health program. · Strengthen One Health- prevention of
Zoonotic disease· Improve access to ART through increase in
CCC sites and strengthen referrals from non-ART sites
· Strengthen on PMTCT services at all levels · Establish and strengthen CUs for active follow
up of high-risk communicable diseases.· Strengthen surveillance (disease,
pharmacovigilance, hemovigilance) tools and strategies through use of IT platform.
· TB Screening of index contacts· Strengthen Environmental health services· Strengthen Public health law and enforcement· Strengthen Public health law and enforcement· Strengthen food safety and quality control
services · Strengthen water safety and quality control
services· Strengthen integrated vector control services· Strengthen disaster preparedness and
response · Strengthen health education and promotion
services· Strengthen CLTS implementation · Implement CLTS Plus to eliminate trachoma · Strengthen SLTS implementation· Implement Health Facility WASH and
environmental safeguards· Implement Menstrual hygiene management · Strengthen infection and prevention control· Strengthen School sanitation and hygiene
education program· Strengthen deworming of school age children · Strengthen treatment of water at household
level or point of use
· To increase the number of the persons receiving MDA for Trachoma
· Ensuring 100% Linkage to care and treatment for HIV
· Ensure uninterrupted supply of HIV/AIDs and TB commodities
· Decentralization of services to the lowest service delivery point
· Strengthen on PMTCT interventions and monitoring.
· To increase the number of TB patients completing treatment.
· To increase the cure rate for TB · TB case identification lab test· To increase the number of PLHIV enrolled
into ART care and treatment · Strengthen quality assurance issues in TB,
HIV & Malaria diagnostic services· To increase the number of HIV+ mothers
on care and treatment · To increase the number of HIV+ paediatric
clients on care and treatment· Increase access to health services through
functional health facilities, skilled health workers and availability of drugs and other health commodities.
· Increase access to improved diagnostic capacity in health facilities.
· Strengthen Baringo county referral system
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202222
Policy Objective Specific Strategic Objectives
Promotive and Preventive Health Services Curative and Rehabilitative Health Services
Halt, and reverse increasing burden of Non-Communicable Diseases
· Offer HPV screening and education. · Strengthen provision of HPV vaccine· Increase awareness and access to care for
mental illness
· Capacity building amongst service providers on diagnosis and management of NCDs
· Increase access to diagnostic services and availability of commodities within facilities
· Improve access and utilization of renal/cancer treatment, palliative care and investigations/ monitoring.
· Increase number of specialists in tier 3 and above
Reduce the burden of Violence & Injuries
· Provide health education to reduce gender-based violence
· Capacity building of health workers on emergency trauma and cardiac courses
· Strengthen Public health law enforcement and reduce GBV households
· Increase access to accident and emergency services.
· Establish and equip trauma and rehabilitative centres.
· Increase access to theatre services· Establish and operationalize protocol and
guidelines on rapid emergency response
Provide essential health services
· Increase awareness, education and access to contraceptives among WRA
· Building capacity on BMONC and EMONC.· BCC through advocacy· Demand creation for health services through
sensitization on services offered in our health facilities.
· Strengthening media engagement· Strengthen I.E.C material development and
dissemination· Infection Prevention and control (IPC)
training for health care workers and community members.
· Strengthen maternal child Health services(MCH)
-Immunization-Growth monitoring and promotion-Vitamin A supplementation-Antenatal care services-Integrated outreaches
· Strengthen baby friendly community initiatives(BFCI)
· Increase access and utilization of targeted FANC services.
· Increased access to deliveries attended by skilled health workers
· Increase access to targeted postpartum care.
· Open and operationalize more maternity facilities.
· Increase facilities with functional new-born unit.
· Strengthen baby friendly hospital initiatives(BFHI)
Minimize exposure to health Risk factors
· Minimize the percentage of the population who smoke
· Reduce the population consuming alcohol regularly
· Increase populations awareness to health risks
· Strengthen Medical waste management· Establish WASH- CLTS Hub· Construction of 7 mortuaries and 7
cemeteries ,· Construction of 3 incinerators for menstrual
hygiene wastes management in Baringo North, Baringo Central, and Baringo South.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 23
Policy Objective Specific Strategic Objectives
Promotive and Preventive Health Services Curative and Rehabilitative Health Services
Strengthen collaboration with health-related Sectors
· Increase the population with access to safe water
· Reduce the percentage of malnourished children
· Improve safe excreta waste disposal· Increase the percentage of households with
improved housing· Improve building plans approval· Strengthen solid and waste management · Improve liquid waste management
Strategic Objective 3: Improve health financing and resource mobilization for health services
The county will mobilize resources from existing and new sources towards financing the implementation of activities included in this strategic plan. At the same time, the county government will streamline financing mechanisms for the health sector to ensure that there is an efficient flow of funds to the service delivery units and core functions; as well as enhancing reporting and fiduciary accountability structures. Additionally, the county government will strengthen the linkage between annual planning, budgeting and implementation programs to effectively support accountability agenda.
· To strengthen the health department’s systems for fiscal management and discipline.
· Boost the department of health’s resource mobilization capacity to undertake resource mobilization effectively from diverse sources including private sector.
· Sensitize and mobilize the public enrolment into NHIF and other Health Insurance Schemes.
· Increase budgetary allocation to the health sector.
· Embed programs that have a results-based focus on financing.
· Automate revenue collection and other health related records at facilities to improve revenue collection efficiency.
Strategic Objective 4: Strengthen Data Demand and Use for Decision Making through effective use of the Health Information System (HIS)
The county government will strengthen use of data for decision making through investments in data collection, collation and reporting systems through:
· Capacity building of health care workers on documentation, reporting and data analytics
· Undertaking regular data quality audits
· Undertaking regular technical data review meetings at the sub-county and the county levels
· Establish a robust monitoring and evaluation unit
· Progressively adopting electronic medical records at all level 4 and High-volume level 3 health facilities
· Strengthen the M&E Technical Working Group to effectively handle operational research and dissemination of data
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202224
Strategic Objective 5: Strengthening leadership and governance capacity for county health services
The county government will strengthen the leadership and management capacity at all levels of the county healthcare system to ensure there is transparency and accountability, coordinated engagement of stakeholders, community participation and overall improved utilization of data in guiding decisions.
· Finalize the organization structure for the department of health to provide for clear roles and enhance efficiency.
· Strengthen logistical and financial support to the sub-county health management teams.
· Build capacity of the CHMT in leadership and governance to effectively focus on the health service delivery.
· Establish a County Health Stakeholders Forum Leadership Group /Steering Committee.
· Strengthen the County Health Stakeholders Forum to effectively undertaken joint planning, implementation and monitoring of the County Health Sector.
· Strengthen the capacity of Hospital Management Boards and Facility Management Committees.
· Strengthen engagement between the County Department of Health Services and the County Assembly Health Committee through regular structured forums.
Strategic Objective 6: Rationalized Improvement of Health Infrastructure
The county government will undertake rationalized investment towards strengthening the health facilities infrastructure and equipment to accord to the desired standards for the KEPH. The investments will also be guided by the ongoing facility assessment in readiness for the rollout of Universal Health Coverage (UHC). To maintain service delivery level, the county will develop a county health facilities service maintenance schedule for buildings and equipment besides procuring suitable service contracts for all existing medical and non-medical equipment in the county. The specific infrastructural developments identified in this strategy include:
· Upgrading of one level 4 hospital (Baringo County Referral Hospital) to the appropriate service standards for Level 5
· Upgrading of 7 health centres to Level 4 (sub-county) hospitals
The established sub-county hospitals would have hospitals operating as Level 4, with Out-patient, in-patient, Theatre, X-ray, Laundry, Kitchen and special clinics in place. In addition, it is anticipated that these hospitals would have at least 20-capacity mortuary for preservation of human remains before decent disposal
· Upgrading of 33 dispensaries to health centres
· Establishment of 90 additional community health units
· Building and Equipping of theatres for 4 sub-county hospitals
· Construction of X-ray units in 7 health centres
· Establishment of a rehabilitation centre
· Building and Equipping of a county satellite blood donor center
· Construction and Equipping of county public health laboratory to strengthen on disease surveillance and step up diagnosis of emerging diseases of public health importance.
· Equipping the ICU
· Equipping and upgrading the Renal Unit
· Establish and operationalize the Oxygen plant
· Equip and Upgrade the Dental Unit with modern Dental chairs in all Sub County referral and County referral Hospital involvement
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 25
· Create an electronic medical equipment database
· Review, update, and implement the equipment investment plan integrating health facilities and training schools to ensure access to appropriate technology
· Promote private public partnerships towards infrastructure investments
· Strengthen maintenance and rehabilitation of infrastructure, equipment, and transport at all levels.
· Build in house technical capacity for maintenance through providing technical training for biomedical engineers and technologists.
Strategic Objective 7: Improving Supply Chain System for Essential Medicines and Medical Supplies (EMMS)
The county government will strengthen the capacity of the health units to plan, quantify and forecast the needs for EMMS, fully implement the demand-driven system for procuring EMMS; as well as rationalize the EMMS distribution system to accord economies of scale.
· Capacity building of county staff on planning, forecasting and quantification for EMMS.
· Undertake quarterly review and development of forecast quantifications for EMMS.
· Fully implement the demand-driven process for EMMS across all county health facilities.
· Implement a planned distribution process for EMMS across health facilities, informed by facility consumption rates and facility level minimum stock level.
Strategic Objective 8: Improve Capacity of Human Resources for Health to support delivery of services
The county will undertake the improvement of the capacity of its human resource for health applying evidence build from service delivery data, and in a manner that embeds experiences gleaned from within the county and beyond. In particular, the county government will:
· Develop and implement a detailed health workforce plan with annual targets for performance.
· Undertake rationalized recruitment to fill in existing gaps and replace retiring staff
· Rationalize deployment of core staff, including arrangements for optimal deployment of specialised health workers.
· Undertake training of staff based on a comprehensive needs assessment and in full compliance with county training policy.
· Establish a structured collaborative program with Kenya School of Government for capacity strengthening of health managers in leadership, governance, and management.
· Implement a performance management system for health workers in line with national standards.
· Introduce an annual motivation and reward scheme for health workers in collaboration with the County Public Service Board (CPSB) and Department of Public Service Management.
· Ensure appropriate and timely remuneration and promotion of healthcare workers;
· Develop a compressive framework for timely promotions for healthcare workers at the county level.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202226
This section outlines the institutional arrangements that are necessary for the successful implementation of the strategies and interventions desired for the achievement of the County Health Sector Targets for the period 2018 to 2022. The stewardship arrangements for the county health services department, management structure within the department, and governance arrangements that accord effective public participation and stakeholders’ engagement are articulated.
4.1 Stewardship ArrangementsThe organization of the County Health Sector in Baringo is guided by various policy and legislative requirements, sector mandate, need to ensure efficiency and effectiveness in service delivery, and most importantly the need to respond to the demands of the citizens. In line with the Health Act 2017, the County Department for Health Services is headed by a County Executive Committee Member who is responsible for the overall political and policy direction of the county health sector assisted by two Chief Officers. The chief officers are responsible for the overall accounting and administrative responsibility for the department as per the County Government Act, 2012. One Chief officer is responsible for Medical Services and the other one for Public Health and Sanitation.
The department has two directors, one for public health and sanitation and another for medical services, who are responsible for technical leadership of health services delivery. These positions are established by the county with reference to the Health Act, 2017 that establishes the office of the County Director for Health. Coordination of Health Services is also enabled through the County Health Management Team (CHMT) and sub-County Health Management Teams. These teams comprising the technical leads of various program delivery areas in the county health sector are mandated to: to mobilize the resource, give technical directions, enforce the use of guidelines and policies, steward capacity building of staff, follow up on the implementation of the County Health Strategic Plan and Operational Plans at the respective level of responsibility.
County hospitals have Hospital Management Teams led by the facility in-charges that have coordination responsibility for delivery of services at the referral institutions. Primary health care facilities are headed by technical staff while community health units are managed by community health extension officers who supervise the community health workers and volunteers involved in the provision of health services at the community level. The organization structure for the department is cuptured in Apendix 1.
4. IMPLEMENTATION ARRANGEMENTS
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 27
4.2 Governance ArrangementsThe county government has also set up elaborate arrangements to support the governance of county health sector. These arrangements are geared at ensuring that the county government remains transparent and accountable to the citizens of the county. The department of health services has set up hospital boards and facility management committees for hospitals and primary health facilities respectively, to provide oversight over service implementation. These organs provide a suitable linkage with the community as they have community representatives in their membership. As such they also serve in community mobilization for service utilization, approving budgets and mobilizing resources for the provision of health services.
The department of health services will reinvigorate the existing County Health Stakeholders Forum (CHSF) to ensure that it provides the necessary platform for stakeholders and partners participation in the governance and management of county health services. At the same time, public participation in the generation of policies and bills for the health sector will be undertaken in line with the Baringo County Public Participation Act, 2015.
This plan will also ensure that stakeholders are better coordinated during planning, implementation and monitoring and evaluation for health sector programs. The county government will strengthen the existing stakeholder forum through a three-pronged approach: firstly, by undertaking mapping and analysis of health sector stakeholders so as to engage them better based on their interests; secondly, the county will set up a leadership development group – Stakeholders Coordination Steering Committee with the responsibility of convening stakeholders forum; thirdly, the county will convene quarterly stakeholder forum.
The CHSF shall serve as the coordinating mechanism for health sector partners’ activities and will be chaired by the CECM for Health Services. The membership of the CHSF shall be drawn from all state and non-state actors in the county health sector. The CHSF shall be governed by a leadership development /coordination committee with the CDH serving as the secretary to the committee. Collaboration with stakeholders will be achieved through:
· Convening of quarterly stakeholder’s forum under the leadership of the CEC Member for Health Services.
· Fostering collaboration opportunities in the county for capacity building to improve service delivery.
· Minimizing duplication of activities through joint planning, implementation and monitoring and evaluation.
· Co-option of partners into appropriate thematic Technical Working Groups.
· Collaboration in convening the annual county health forum to strengthen accountability.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202228
ORGA
NOG
RAM
, BAR
INGO
COU
NTY
HEA
LTH
DEP
ARTM
ENT
Figu
re 6
: Org
anog
ram
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 29
Tracking of the progress of implementation of this strategic plan is crucial in ensuring that lessons learned are shared, and necessary adjustments effected. The department of health services will strengthen the performance management system and the monitoring and evaluation system currently in place to ensure that it supports data collection, collation, analysis, reporting, dissemination, and use of information for planning and decision making.
5.1 Health Management Information System Organization and Architecture
The department of health services will establish a robust M&E system that leverages on the existing Health Management Information System for collection and reporting on health data, supports generation and use of data from routine and non-routine sources; builds in necessary M&E competencies and skills; anchors stakeholders support and supports planning and budgeting. The M&E unit will be expanded to a division responsible for planning, budgeting, monitoring and evaluation, and its mandate clarified, and capacity strengthened with additional staff and activity budget.
The department will work towards ensuring that the health data systems available are interoperable. Further, the department will develop relevant policies and guidelines, routine data capturing tools, reporting system and databases for collection, reporting, analysis, and presentation of data on all aspects of health sector performance. An elaborate Sector Monitoring and Evaluation Plan will be developed to provide for these requirements. Similarly, towards enhancement of data use, the department will establish assign an officer to coordinate health research in terms of planning for research activities, coordinating linkages with research institutions, and dissemination of research findings for use in policy formulation and decision making.
5.2 Performance Reporting This strategic plan will be implemented through the Annual Health Sector Work Plans. The work plans will be before the commencement of the financial year and aligned to the process of developing county health budgets – program-based budgets. The annual work plan will elaborate the annual targets included in this plan and will be prepared for the county, sub-county, facilities and community units. This will ensure that the strategic objectives and interventions in this plan are translated into annual milestones with clear targets and budgets that can be tracked on a quarterly basis.
An Annual Performance Review (APR) of the prior period’s annual workplan will be carried out at the commencement of the financial year, preferably before end of September, to record achievements made in the prior period, identify challenges and key priorities for the next planning cycle, and thus inform the planning and budgeting for the next period under the Medium-Term Framework. The results will be shared during the County Annual Health Forum held in October of every year. On a quarterly basis, the county health management team will convene Quarterly
5. PERFORMANCE, MONITORING AND EVALUATION FRAMEWORK
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202230
Performance Reviews meetings for all program managers, sub-county health management teams and hospital heads to review performance based on the targets set for the quarter as per the workplan. Sub-county health management, hospital management, and facility management teams will convene Monthly Reviews to review performance against targets and submit reports to the county health M&E unit.
The CECM, Chief Officers and Directors of the County Department of Health will prepare annual Performance Contracts with targets from the Annual Work Plans of the Departments and in line with the guidelines on performance contracting adopted by the County Government. The contracts will be reviewed at mid-year and the end of the year. The commitments in the performance contracts and the targets in the work plans will be cascaded to the individual staff in the department into Individual Work Plans through the Staff Performance Appraisal Reporting System (SPAS).
Quarterly Implementation Reports will be compiled detailing progress of implementation and Budget utilization in line with the requirements of the Public Financial Management Act, 2012.
5.3 Indicators for Monitoring the County Health System PerformanceThe aim of monitoring and evaluation is to ensure that planned activities and implementation are always in a desirable process within the stipulated timeframe. In addition, it tracks inputs, activities outputs and ultimate outcomes (impacts) of strategic plan implementation. It is a process of ensuring that resources are spent as planned within the framework of strategic plan projections and budgets.
The annual work plans will play a major role in evaluating the implementation of this strategic plan on yearly basis. All levels of service providers are required to identify challenges and set priorities /targets to be achieved monthly, quarterly and annually.
The County will ensure all facilities have integrated automated HMIS and ensure the EMR and DHIS capture all indicators at all level in service delivery and to come up with a proper feedback mechanism. In addition, strengthen inter-sectoral collaboration with other stakeholder’s e.g. Civil Registration Department and the County will adopt the national policy and guidelines on M&E processes.
During implementation of this strategic plan, selected core indicators will be utilized to facilitate tracking of performance and overall progress made towards achievement of strategic plan goals. This section outlines the selected indicators, and targets for the period. Where the targets have not been established owing to limitations in availability of data, they will be established in the first year in accordance with an elaborate M&E plan. Table 12 and 13 present the performance measures (indicators and targets) for outcomes, outputs, inputs and processes.
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 31
5.3.
1 Se
rvic
e Ou
tcom
e an
d Ou
tput
Tar
gets
for
Achi
evem
ent o
f Cou
nty
obje
ctiv
es
Tabl
e 12
Ser
vice
Out
com
e an
d O
utpu
t Ta
rget
s fo
r Ac
hiev
emen
t of
Cou
nty
obje
ctiv
es
Obje
ctiv
eIn
dica
tor
Targ
ets
(whe
re a
pplic
able
)
Base
line
2017
/18
Yr. 1
2018
/201
9Yr
. 220
19/2
020
Yr. 3
2020
/202
1Yr
. 420
21/2
022
Yr. 5
2022
/202
3
Elim
inat
e Co
mm
u-ni
cabl
e Co
nditi
ons
% F
ully
imm
uniz
ed c
hild
ren
60
%6
3%
66
%6
9%
72
%7
5%
% o
f TB
pat
ient
s co
mpl
etin
g tr
eatm
ent
81
%9
0%
90
%9
0%
90
%9
0%
% H
IV +
pre
gnan
t m
othe
rs r
ecei
ving
pre
vent
ive
AR
Vs (
HA
AR
T)7
2%
10
0%
10
0%
10
0%
10
0%
10
0%
% o
f el
igib
le H
IV e
xpos
ed in
fant
s on
AR
Vs p
roph
ylax
is7
6%
81
%8
6%
91
%9
6%
10
0%
% o
f el
igib
le P
LHIV
s on
AR
T7
6%
10
0%
10
0%
10
0%
10
0%
10
0%
% o
f ta
rget
ed u
nder
1’s
pro
vide
d w
ith
LLIT
N’s
6
6%
68
%7
0%
72
%7
4%
76
%
% o
f ta
rget
ed p
regn
ant
wom
en p
rovi
ded
wit
h LL
ITN
’s5
0%
56
%6
2%
68
%7
4%
80
%
% o
f un
der
5’s
tre
ated
for
dia
rrhe
a2
1%
19
%1
7%
15
%1
3%
11
%
% S
choo
l age
chi
ldre
n de
wor
med
19
%2
4%
29
%3
4%
39
%4
1%
Hal
t, an
d re
vers
e th
e ri
sing
bur
den
of n
on-c
omm
uni-
cabl
e co
nditi
ons
% o
f ad
ult
popu
lati
on w
ith
BM
I ov
er 2
5*
No
data
TB
DTB
D
% W
omen
of
Rep
rodu
ctiv
e ag
e sc
reen
ed f
or C
ervi
cal c
ance
rs0
.15
%0
.18
%0
.21
%0
.24
%0
.27
%0
.3%
% o
f ne
w o
utpa
tien
ts w
ith
men
tal h
ealt
h co
ndit
ions
0.0
1%
0.0
6%
0.1
1%
0.6
1%
1.1
1%
1.6
1%
% o
f ne
w o
utpa
tien
t ca
ses
wit
h hi
gh b
lood
pre
ssur
e0
.59
%1
.09
%1
.59
%2
.09
%2
.59
%3
.09
%
% o
f pa
tien
ts a
dmit
ted
wit
h ca
ncer
* N
o da
ta
TBD
TBD
TBD
TBD
TBD
Redu
ce th
e bu
rden
of
vio
lenc
e an
d in
juri
es
% n
ew o
utpa
tien
t ca
ses
attr
ibut
ed t
o se
xual
gen
der-
base
d vi
olen
ce0
.1%
(6)
00
00
0
% n
ew o
utpa
tien
t ca
ses
attr
ibut
ed t
o R
oad
traf
fic I
njur
ies
0.0
02
%(2
03
0)
0.0
01
50
.00
1
% n
ew o
utpa
tien
t ca
ses
attr
ibut
ed t
o ot
her
inju
ries
2.4
%2
.2%
2.0
%1
.8%
1.3
%1
.2%
% o
f de
aths
due
to
inju
ries
N
o da
ta
TBD
TB
DTB
DTB
DTB
D
Prov
ide
esse
ntia
l he
alth
ser
vice
s%
del
iver
ies
cond
ucte
d by
ski
lled
atte
ndan
t4
1%
46
%5
1%
56
%6
1%
66
%
% o
f w
omen
of
Rep
rodu
ctiv
e ag
e re
ceiv
ing
fam
ily p
lann
ing
36
.3%
39
.3%
42
.3%
45
.3%
48
.3%
51
.3%
% o
f fa
cilit
y ba
sed
mat
erna
l dea
ths*
0.0
28
%(8
)0
00
00
.
% o
f fa
cilit
y ba
sed
unde
r fiv
e de
aths
*0
.08
%0
00
00
% o
f ne
wbo
rns
wit
h lo
w b
irth
wei
ght
5.2
%5
.15
%5
.1%
5.0
5%
5%
4.9
5%
% o
f fa
cilit
y ba
sed
fres
h st
ill b
irth
s1
.16
%1
.11
%0
.96
%0
.91
%0
.86
%0
.81
%
% o
f pr
egna
nt w
omen
att
endi
ng 4
AN
C v
isit
s3
3.6
%3
7.2
%4
0.8
%4
4.4
%4
8%
51
.6%
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202232
Obje
ctiv
eIn
dica
tor
Targ
ets
(whe
re a
pplic
able
)
Base
line
2017
/18
Yr. 1
2018
/201
9Yr
. 220
19/2
020
Yr. 3
2020
/202
1Yr
. 420
21/2
022
Yr. 5
2022
/202
3
Min
imiz
e ex
po-
sure
to h
ealth
ris
k fa
ctor
s
% p
opul
atio
n w
ho s
mok
e1
9%
17
%1
5%
13
%1
1%
9%
% p
opul
atio
n co
nsum
ing
alco
hol r
egul
arly
No
data
TB
DTB
D
% in
fant
s un
der
6 m
onth
s on
exc
lusi
ve b
reas
tfee
ding
32
%3
9%
46
%5
3%
60
%6
7%
% o
f P
opul
atio
n aw
are
of r
isk
fact
ors
to h
ealt
h7
0%
75
%8
0%
85
%9
0%
95
%
% o
f sa
lt b
rand
s ad
equa
tely
iodi
zed
10
0%
10
0%
10
0%
10
0%
10
0%
10
0%
Stre
ngth
en c
ol-
labo
ratio
n w
ith
heal
th-r
elat
ed
sect
ors
% p
opul
atio
n w
ith
acce
ss t
o sa
fe w
ater
37
%4
0%
43
%4
6%
49
%5
2%
% u
nder
5’s
stu
nted
30
%2
7.7
8%
24
.96
%2
2.1
6%
19
.36
%1
7.3
6%
% u
nder
5 u
nder
wei
ght
18
.7%
17
.48
%1
5.6
6%
13
.86
%1
2.0
6%
10
.23
%
% o
f ho
useh
olds
wit
h la
trin
es4
3.6
%4
8%
53
%5
8%
61
%6
6%
% o
f ho
uses
wit
h ad
equa
te v
enti
lati
on5
3%
57
%6
0.9
65
.97
0.9
75
.9
% S
choo
ls w
ith
adeq
uate
san
itat
ion
30
%3
5%
40
%4
5%
50
%5
5%
INVE
STM
EN
T O
UTP
UTS
Impr
ovin
g ac
cess
to
ser
vice
s
Out
pati
ent
utili
zati
on r
ate
1
.22
22
22
% o
f po
pula
tion
livi
ng w
ithi
n 5
km o
f a
faci
lity
No
data
TB
DTB
DTB
DTB
DTB
D
% o
f fa
cilit
ies
prov
idin
g B
EO
C3
4%
39
%4
4%
49
%5
4%
59
%
% o
f fa
cilit
ies
prov
idin
g C
EO
C2
5%
37
.5%
50
%6
2.5
%7
5%
10
0%
Bed
Occ
upan
cy R
ate
90
%8
8%
87
%8
5%
80
%7
5%
% o
f fa
cilit
ies
prov
idin
g Im
mun
izat
ion
58
.6%
63
.8%
68
.8%
73
.8%
78
.8%
83
.8%
Impr
ovin
g qu
ality
of
car
e
TB C
ure
rate
71
%7
4.8
%7
8.6
%%
82
.4%
86
.2%
90
%
% o
f co
nfirm
ed m
alar
ia c
ases
64
.9%
10
0%
10
0%
10
0%
10
0%
10
0%
% m
ater
nal a
udit
s1
00
10
01
00
10
01
00
10
0
Mal
aria
inpa
tien
t ca
se f
atal
ity
No
data
TB
DTB
DTB
DTB
DTB
D
Ave
rage
leng
th o
f st
ay (
ALO
S)
54
.54
.54
4.
3
% o
f fa
cilit
y in
pati
ent
repo
rts
No
data
1
00
%1
00
10
01
00
10
0
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 33
Obje
ctiv
eIn
dica
tor
Targ
ets
(whe
re a
pplic
able
)
Base
line
2017
/18
Yr. 1
2018
/201
9Yr
. 220
19/2
020
Yr. 3
2020
/202
1Yr
. 420
21/2
022
Yr. 5
2022
/202
3
HEA
LTH
INPU
T AN
D PR
OCES
S IN
VEST
MEN
T
Serv
ice
Del
iver
y Sy
stem
s %
of f
unct
iona
l Com
mun
ity U
nits
40
%45
%50
% 6
0%65
%75
%
% o
f out
brea
ks in
vest
igat
ed w
ithin
48
hour
s 10
0%10
0%10
0%10
0%10
0%10
0%
% o
f hos
pita
ls o
fferin
g em
erge
ncy
trau
ma
serv
ices
10
0%10
0%10
0%10
0%10
0%
Hea
lth W
orkf
orce
#
of n
urse
s pe
r 10
,000
pop
ulat
ion
7.1
7.3
7.5
89
10
% o
f elig
ible
sta
ff w
ho h
ave
unde
rtak
en C
PD
57
%
60%
70%
80%
90%
100%
Staf
f attr
ition
rat
e 2%
1.8%
1.5%
1%0.
75%
0.5%
Hea
lth
Infr
astr
uctu
re
% o
f fac
ilitie
s eq
uipp
ed a
s pe
r no
rms
18%
30%
45%
# of
hos
pita
l bed
s pe
r 10
,000
pop
ulat
ion
99
1012
1415
Hea
lth P
rodu
cts
% o
f hea
lth fa
cilit
ies
repo
rtin
g st
ock
out o
f EM
MS
No
data
0
00
00
Hea
lth F
inan
cing
he
alth
exp
endi
ture
as
a %
of t
otal
cou
nty
expe
nditu
re
33%
34%
34.5
%35
%38
%40
%
Tota
l pub
lic h
ealth
exp
endi
ture
as
% o
f Tot
al H
ealth
Exp
endi
ture
48
%
49%
49.5
%50
%51
%52
%
Off
budg
et e
xpen
ditu
re a
s %
of t
otal
cou
nty
heal
th e
xpen
ditu
re
18%
17%
16.5
%16
%15
.5%
15%
Out
of p
ocke
t spe
ndin
g as
% o
f cou
nty
heal
th e
xpen
ditu
re
35.2
%34
.5%
33%
30%
28%
25%
Hea
lth L
eade
rshi
p %
of h
ealth
faci
litie
s in
spec
ted
annu
ally
N
o da
ta
5010
0
% o
f hea
lth fa
cilit
ies
with
func
tiona
l com
mitt
ees
100%
10
0%
100%
10
0%
100%
10
0%
% c
ount
y in
tera
genc
y fo
rum
mee
tings
hel
d N
o da
ta
100%
10
0%
100
100%
100
% o
f fac
ilitie
s su
perv
ised
N
o da
ta
100%
10
0%
100%
10
0%
100%
% o
f CH
SF S
teer
ing
Com
mitt
ee M
eetin
gs h
eld
No
data
10
0%
100%
10
0%
100%
10
0%
% o
f pla
nnin
g un
its s
ubm
ittin
g co
mpl
eted
pla
ns
No
data
10
0%
100%
10
0%
100%
10
0%
Hea
lth In
form
atio
n #
of s
ecto
r qu
arte
rly r
epor
ts p
rodu
ced
and
diss
emin
ated
N
o da
ta
44
44
4
% o
f pla
nnin
g un
its s
ubm
ittin
g tim
ely,
com
plet
e an
d ac
cura
te
info
rmat
ion
No
data
10
0%10
0%10
0%10
0%10
0%
% o
f fac
ilitie
s su
bmitt
ing
timel
y, c
ompl
ete
and
accu
rate
in
form
atio
nN
o da
ta
100%
100%
100%
100%
100%
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202234
5.3.2 Inputs and Process targets
Table 13 Inputs and Process targets
Orientation area Intervention area
Milestones for achievement Annual targets
2018 2019 2020 2021 2022Health Workforce
Recruitment of new staff
Consultants 1 1 1 1 1Medical Officers 2 2 2 2 2Dentist 0 1 1 0 0Nurses 16 18 18 17 16Public Health Officers 4 4 4 4 4Pharmacist 0 1 1 1 1Pharmaceuticals Technologists
3 2 1 0 0
Lab technologist 3 3 3 3 3Orthopedic Technologist 0 0 1 1 1Nutritionists 2 2 2 2 2Radiographers 0 1 1 1 1Physiotherapist 0 0 1 0 1Plaster technicians 0 1 1 1 1Health records information officers
1 1 1 1 1
Medical engineers 0 1 0 1 1Mortuary attendants 0 1 1 1 1Drivers 0 1 1 1 1Human Resource Officers 0 1 0 0 0Health Administrative Officers 0 0 1 0 0Clinical Officers 4 4 4 4 4
Trainings Senior management course 10 10 10 10 10Senior Leadership development programme
0 2 2 0 0
Leadership Development programme (LDP)training
30 30 30 30 30
Training staff on preparation for retirement
0 40 0 0 0
Training staff on pension scheme
8 8 8 8 8
Induction of New staff 36 45 45 41 41Training of staff on IHRIS 0 20 0 0 0
Compensation Compensation for staff 1,246 1,291 1,336 1,337 1,418Surveys Employee satisfaction Survey 1 1 1 1 1Assessment Assessment 0 1 0 1 0Conferences Support to staff to attend
conferences20 20 20 20 20
Support to attend regional ICC meetings
4 4 4 4 4
Supervision HRH Support supervision 4 4 4 4 4 Support the Midterm Review of HRH strategy
0 0 1 0 0
Attraction and retention
Awarding ceremonies for best performers
1 1 1 1 1
Team building 1 1 1 1 1
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 35
Orientation area Intervention area
Milestones for achievement Annual targets
2018 2019 2020 2021 2022Health Financing Annual Plans Budgets 1 1 1 1 1
Procurement plans 1 1 1 1 1Health expenditure reviews
Annual expenditure review 1 1 1 1 1County Health Accounts 1 1
Health Infrastructure (physical infrastructure, equipment, transport, ICT)
Upgrading of sub county hospitals
Theatre construction and equipment
2 2
X-ray construction and equipment
2 2
Mortuary construction equipment
1 1 2
Laundry construction and equipment
1 1 1 1
Kitchen construction and equipment
1 1 1 1
Solid and dangerous waste management
1 1 1 1 1
Renovation of laboratories 3 3 3 3 3Procure microscopes 4 4 4 4 4Procure chemistry analyzer 2 2 2 2 2Procure Lab Blood bank fridges
1 2 1 1 1
Procure Haematology Analyzers
2 2 2 2 2
Procure Safety Cabinets 1 2 1 1 1Procure lab incubators 1 2 1 1 1Procure lab water bath 2 3 2 3 2Procure lab reagents fridges 6 6 6 6 6Procure Coagulation analyzers 2 2 2 2 2Procure assorted Lab reagents
1 1 1 1 1
construction and equipping of satellite blood donor centre
1
Procure entomological equipment
1 1
Procure MRI machines
Maintenance of MRI machines
1 1
Training Radiology staff on use of MRI CT scan machine maintenance
1 1 1
Dental chair 1 1 1 1
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202236
Orientation area Intervention area
Milestones for achievement Annual targets
2018 2019 2020 2021 2022Health information
Data collection: routine health information
Data capture tools and reporting tools
4000 4024 4048 4072 4096
Quarterly Data Quality Audits 28 28 28 28 28Establishment of facility EMRs 3 3 3 3 3
Data collection: health related sectors
Quarterly M&E TWG Meetings 2 4 4 4 4
Data collection: Surveillance
Printing of the IDSR tools 4 4 4 4 4
Data collection: Research
Conducting surveys 4 4 4 4 4
Information dissemination
Production of IEC Materials 4 4 4 4 4Quarterly Health Bulletins 4 4 4 4 4
Leadership and Governance
Annual health stakeholder’s forum
Holding annual health stakeholder’s forum
1 1 1 1 1
Quarterly Coordination meetings
Holding quarterly Stakeholder Steering Committee coordination meetings
4 4 4 4 4
Annual Work Planning and reporting
Prepare Annual Work Plan and Annual Performance Report
1 1 1 1 1
Health Products Procurement of required health products
Non-pharmaceuticals 4 4 4 4 4Pharmaceuticals 4 4 4 4 4Laboratory 4 4 4 4 4
Monitoring rational use of health products
Quarterly Supervision 4 4 4 4 4Quantification / Forecasting Review
4 4 4 4 4
Monthly facility inventory data 12 12 12 12 12EMMS Reports 12 12 12 12 12Pharmacovigilance reports 4 4 4 4 4
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 37
6. FINANCING AND RESOURCE MOBILISATION
Health Financing, a critical pillar of the county health system, needs to be sustainable to ensure that the targets in this strategic plan are not only achieved but sustained. For the county to make progress on the Universal Health Coverage agenda, there is need to create a paradigm shift in health financing mechanisms by adopting innovative approaches that are cost effective and efficient. This section provides an estimate of the resources required to implement this strategic plan; compares the resources against projected resource envelope; highlights the estimated gap and proposed approaches to be adopted towards filling in the identified gap.
6.1 Estimated Resource Requirements The budgetary requirements for implementing this strategic plan have been estimated using activity-based costing, through costing of specific interventions identified under each of the strategic objectives captured in the strategic direction section. The activities have been clustered under three broad programs, guided by the Programme Based Budgeting considerations:
1. Curative and rehabilitative health services,
2. Preventive and promotive health services,
3. General administration, planning and support services
Table 14 - Summary of Resource Requirements by Programs and Sub-ProgramsProgram Sub Program Estimated cost in KShs
General Administration, Planning and Support Services
Human resource management 9,988,462,000
Administrative and planning services 817,178,910
Health Information, M&E & Research 47,240,000
Sub Total 10,852,880,910
Preventive and Promotive Health Services
Community Health 503,775,000
RMNCAH 837,230,000
Immunization 41,258,000
Nutrition 279,890,000
Disease surveillance 21,570,000
Communicable diseases (including HIV/AIDS, TB, Malaria)
79,896,960
Non-Communicable Diseases Control and Prevention 17,700,000
Environmental Health, water and sanitation 126,070,000
Infrastructure development 599,326,000
Sub Total 2,506,715,960
Curative & Rehabilitative Care Services
Service delivery 57,230,000
Infrastructure development 436,600,000
Health Products 2,253,200,000
Sub Total 2,747,030,000
Grand Total 16,106,626,870
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202238
6.2 Resources Availability and Financing Gap The department of health services estimates the resources available so far at KShs 14,540,430,992, based on the past performance in budget implementation and projections captured in the Medium-Term Expenditure Framework (MTEF). These estimates are primarily based on on-budget support from the following sources- equitable share of national revenue, conditional grants from national government (including grants from development partners), user fees at the county level, and appropriation in aid. Table 15 details the estimated resources envelope for the five years.
Table 15 - Resource Envelope EstimatesCategory Source of funds KShs
Public Sources Equitable Share 12,594,807,425
Conditional Grants (Medical equipment scheme) 459,574,468
Conditional Grants (Compensation for user fee foregone) 74,235,436
Linda Mama Programme 348,501,991
Hospital User fees 634,930,400
Development Partners UNICEF / GAVI -
Danish Government (DANIDA) 64,104,425
World Bank (WB - THS) 364,276,847
Total 14,540,430,992
Based on the above, the estimated financing gap for the period is KShs 1,566,195,878.
6.3 Bridging the Financing Gap To bridge the anticipated financing gap, the county will adopt the following measures for resource mobilization:
a) Lobby for increase in allocation of resources from the County Government through the County Assembly Committee for Health and ensure that the advocacy is backed by evidence.
b) Lobby for increase in allocation of resources from partners, and ensure that these are evidence based and that partnership engagement is strengthened
c) Strengthen Public Private Partnerships for health
d) Mobilize citizens for enrolment into the NHIF and other insurance schemes to expand coverage and benefits, and increase flow of funds to county facilities
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 39
App
endi
x I:
The
Ken
ya E
ssen
tial P
acka
ge fo
r H
ealth
(K
EPH
) M
atrix
Serv
ices
In
terv
entio
nsLe
vel o
f pro
visi
onSe
rvic
esIn
terv
entio
nsLe
vel o
f pro
visi
on1
23
45
61
23
45
6EL
IMIN
ATE
CO
MM
UN
ICA
BLE
CO
ND
ITIO
NS
Imm
uniz
atio
nB
CG
vac
cina
tion
✓In
tegr
ated
Ve
ctor
M
anag
emen
t
Indo
or R
esid
ual S
pray
ing
of m
alar
ia✓
Ora
l Pol
io V
acci
natio
n✓
ITN
dis
trib
utio
n✓
Pen
tava
lent
vac
cina
tion
✓D
estr
uctio
n of
mal
aria
bre
edin
g si
tes
✓
Rot
aviru
s va
ccin
atio
n✓
Hou
seho
ld v
ecto
r co
ntro
l (co
ckro
ache
s, fl
eas,
ro
dent
s)✓
PC
V –
10 v
acci
natio
n✓
Goo
d hy
gien
e pr
actic
esFo
od o
utle
t ins
pect
ions
✓
Mea
sles
vac
cina
tion
✓M
eat i
nspe
ctio
ns (
abat
toirs
, but
cher
ies)
✓
Typh
oid
vacc
inat
ion
✓H
ouse
hold
wat
er tr
eatm
ent
✓
Yello
w fe
ver
vacc
inat
ion
✓H
IV a
nd S
TI
prev
entio
nM
ale
circ
umci
sion
✓
HP
V va
ccin
atio
n✓
Man
agem
ent o
f sex
ually
tran
smitt
ed In
fect
ions
✓
Chi
ld H
ealth
Dew
orm
ing
✓P
elvi
c In
flam
mat
ory
Dis
ease
man
agem
ent
✓
Man
agem
ent o
f pne
umon
ia✓
Pos
t Exp
osur
e P
roph
ylax
is✓
Man
agem
ent o
f mal
aria
✓C
ondo
m d
istr
ibut
ion/
pro
visi
on✓
Man
agem
ent o
f dia
rrho
ea✓
HIV
Tes
ting
and
Cou
nsel
ling
(HTC
)✓
Scre
enin
g fo
r co
mm
unic
able
co
nditi
ons
HIV
Tes
ting
and
coun
selli
ng (
HTC
)✓
Por
t hea
lthM
onito
ring
of im
port
ed a
nd e
xpor
ted
com
mod
ities
affe
ctin
g pu
blic
hea
lth✓
Act
ive
case
sea
rch
for
TB✓
Mon
itorin
g of
peo
ple
mov
emen
t in
rela
tion
to
Inte
rnat
iona
l Hea
lth R
egul
atio
ns✓
Dia
gnos
tic T
estin
g fo
r M
alar
ia✓
Cho
lera
vac
cina
tion
✓
Scre
enin
g fo
r dr
ug-r
esis
tant
TB
✓M
enin
goco
ccal
vac
cina
tion
✓
Scre
enin
g fo
r A
nim
al T
rans
mitt
ed
Con
ditio
ns✓
Yello
w fe
ver
vacc
inat
ion
✓
Pre
vent
ion
of M
othe
r to
Chi
ld H
IV
Tran
smis
sion
HIV
Tes
ting
and
Cou
nsel
ling
✓C
ontr
ol a
nd
prev
entio
n ne
glec
ted
trop
ical
di
seas
es
Mas
s de
wor
min
g fo
r sc
hist
osom
iasi
s co
ntro
l✓
Cou
nsel
ing
on b
est b
reas
tfeed
ing
and
com
plem
enta
ry fe
edin
g pr
actic
es in
HIV
✓M
ass
scre
enin
g of
NTD
S (K
alar
Aza
r, Sc
hist
osom
iasi
s, D
rucu
ncul
osis
, Lei
shm
ania
sis)
✓
Hig
hly
Act
ive
Ant
i-Ret
rovi
ral T
hera
py✓
Cot
rimox
azol
e pr
ophy
laxi
s✓
AR
V pr
ophy
laxi
s fo
r ch
ildre
n bo
rn o
f HIV
+
mot
hers
✓
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202240
Serv
ices
In
terv
entio
nsLe
vel o
f pro
visi
onSe
rvic
esIn
terv
entio
nsLe
vel o
f pro
visi
on1
23
45
61
23
45
6H
ALT
AND
REVE
RSE
THE
RISI
NG
BURD
EN O
F N
ON-C
OMM
UN
ICAB
LE C
ONDI
TION
SIn
stitu
tiona
l Sc
reen
ing
for
NC
D’s
Blo
od S
ugar
test
ing
✓C
omm
unity
sc
reen
ing
for
NC
D’s
Rou
tine
Blo
od P
ress
ure
mea
sure
men
t ✓
Rou
tine
Blo
od P
ress
ure
mea
sure
men
t for
al
l adu
lts a
t the
OP
D✓
Adu
lt M
id U
pper
Arm
Circ
umfe
renc
e m
easu
rem
ent
✓
Rou
tine
Bod
y M
ass
Inde
x (w
eigh
t and
he
ight
) m
easu
rem
ent f
or a
ll ou
tpat
ient
s✓
Wor
kpla
ce
heal
th a
nd
safe
ty
Wor
kpla
ce w
elln
ess
prog
ram
me
✓
Cer
vica
l can
cer
scre
enin
g fo
r al
l wom
en
in th
e R
H a
ge g
roup
✓In
spec
tion
and
cert
ifica
tion
✓
Faec
al o
ccul
t blo
od te
stin
g fo
r bo
wel
ca
ncer
s✓
Safe
ty e
duca
tion
✓
Bre
ast c
ance
r sc
reen
ing
for
all w
omen
ov
er 1
8 ye
ars
✓Fo
od q
ualit
y an
d sa
fety
Food
dem
onst
ratio
ns (
at c
omm
unity
and
fa
cilit
ies)
✓
Lung
Fun
ctio
n Te
stin
g✓
Food
saf
ety
test
ing
✓
Lipi
d pr
ofilin
g✓
Con
sum
er E
duca
tion
on fo
od q
ualit
y an
d sa
fety
✓
Ann
ual p
rost
ate
exam
inat
ion
for
all m
en
over
50
year
s✓
Scre
enin
g fo
r si
ckle
cel
l ane
mia
✓
RED
UC
E VI
OLE
NC
E A
ND
INJU
RIE
SC
omm
unity
m
anag
emen
t of
vio
lenc
e an
d in
jurie
s
Com
mun
ity s
yste
ms
for
resp
ondi
ng to
ge
nder
-bas
ed v
iole
nce
✓D
isas
ter
man
agem
ent
resp
onse
Dis
aste
r ris
k re
duct
ion
inte
rven
tions
✓
Com
mun
ity s
yste
ms
for
resp
ondi
ng to
ch
ild m
altr
eatm
ent
✓Fa
cilit
y di
sast
er r
espo
nse
plan
ning
✓
Cap
acity
bui
ldin
g of
com
mun
ities
on
inju
ry p
reve
ntio
n✓
Dis
aste
r m
anag
emen
t✓
Pre
hosp
ital
Car
eB
asic
Firs
t Aid
✓
Evac
uatio
n Se
rvic
es fo
r In
jurie
s✓
PR
OVI
DE
ESSE
NTI
AL
HEA
LTH
SER
VIC
ESO
utpa
tient
sIn
tegr
ated
trea
tmen
t of c
omm
on a
ilmen
ts✓
Rad
iolo
gyU
ltras
ound
sca
n✓
Vacc
inat
ion
for
yello
w fe
ver,
teta
nus,
and
ra
bies
✓X-
ray
✓
Out
patie
nt m
anag
emen
t of m
inor
inju
ries
✓En
dosc
opy
✓
Emer
genc
yM
anag
emen
t of m
edic
al e
mer
genc
ies
✓La
paro
scop
y✓
Man
agem
ent o
f sur
gica
l em
erge
ncie
s (in
clud
ing
trau
ma
care
)✓
Com
pute
rized
Tom
ogra
phy
Scan
✓
Bas
ic li
fe s
uppo
rt✓
Mag
netic
Res
onan
ce Im
agin
g✓
Adv
ance
d lif
e su
ppor
t✓
Rad
io-is
otop
e sc
anni
ng✓
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 41
Serv
ices
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entio
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f pro
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onSe
rvic
esIn
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entio
nsLe
vel o
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on1
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45
61
23
45
6M
ater
nity
Man
agem
ent o
f pre
gnan
cy c
ompl
icat
ions
✓A
ngio
grap
hy✓
Man
agem
ent o
f abn
orm
al p
regn
anci
es✓
AVU
/ AV
P✓
Man
agem
ent o
f pre
-ter
m la
bor
✓El
ectr
o-En
ceph
alog
ram
(EE
G)
✓
Nor
mal
Vag
inal
Del
iver
y✓
Rep
rodu
ctiv
e H
ealth
Scre
enin
g fo
r re
prod
uctiv
e he
alth
ris
ks✓
Ass
iste
d va
gina
l del
iver
y✓
Fam
ily p
lann
ing
✓
Cae
sare
an s
ectio
n✓
Com
preh
ensi
ve y
outh
frie
ndly
ser
vice
s✓
Car
e fo
r th
e ne
wbo
rn✓
Ope
rativ
eO
utpa
tient
ope
ratio
ns✓
Pos
t-pa
rtum
car
e✓
Emer
genc
y op
erat
ions
✓
In p
atie
ntM
anag
emen
t of m
edic
al in
pat
ient
s✓
Gen
eral
ope
ratio
ns✓
Man
agem
ent o
f sur
gica
l in
patie
nts
✓Sp
ecia
lized
ope
ratio
ns✓
Man
agem
ent o
f ped
iatr
ic in
pat
ient
s✓
Spec
ializ
ed
ther
apy
Rad
ioth
erap
y✓
Man
agem
ent o
f gyn
aeco
logy
in p
atie
nts
✓C
hem
othe
rapy
✓
Clin
ical
la
bora
tory
Hae
mat
olog
y (H
b, R
BC
/WB
C c
ount
s,
hem
atoc
rit, p
erip
hera
l film
)✓
Inte
rven
tiona
l Rad
iolo
gy✓
Pre
gnan
cy te
st✓
Dia
lysi
s✓
Ble
edin
g an
d co
agul
atio
n tim
e✓
Org
an tr
ansp
lant
s (k
idne
y, li
ver,
bone
mar
row
)✓
Blo
od g
roup
ing
with
Rh
fact
ors
✓B
ypas
s su
rger
ies
✓
Par
asito
logy
(R
DT)
✓R
econ
stru
ctiv
e su
rger
y✓
Hep
atiti
s B
and
C te
sts
✓A
ssis
ted
Rep
rodu
ctio
n (I
VF)
✓
Bac
terio
logy
(ZN
sta
inin
g, A
lber
ts
stai
ning
, Gra
m S
tain
ing)
mic
rosc
opy
✓Sp
ecia
lized
se
rvic
esH
IV/A
IDS
man
agem
ent
✓
ELIS
A te
sts
✓Tu
berc
ulos
is m
anag
emen
t✓
Wid
al te
sts
✓P
allia
tive
care
✓
CD
4 c
ount
✓P
edia
tric
con
ditio
ns m
anag
emen
t✓
PC
R te
sts
✓M
edic
al c
ondi
tions
man
agem
ent
✓
Vira
l cul
ture
✓Su
rgic
al c
ondi
tions
man
agem
ent
✓
Agg
lutin
atio
n te
sts
✓G
ynae
colo
gica
l con
ditio
ns m
anag
emen
t✓
Urin
alys
is✓
Ear
Nos
e an
d Th
roat
con
ditio
ns m
anag
emen
t✓
Live
r Fu
nctio
n Te
sts
✓Ey
e (O
phth
alm
ic)
cond
ition
s m
anag
emen
t✓
Ren
al F
unct
ion
Test
s✓
Ora
l con
ditio
n m
anag
emen
t✓
Blo
od g
ases
✓R
espi
rato
ry c
ondi
tions
man
agem
ent
✓
Car
diac
enz
ymes
✓C
ardi
ovas
cula
r co
nditi
ons
man
agem
ent
✓
Cho
lest
erol
test
s (T
otal
/ D
iffer
entia
l)✓
Gas
troi
ntes
tinal
con
ditio
ns m
anag
emen
t✓
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202242
Serv
ices
In
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6B
lood
cul
ture
✓G
enito
-urin
ary
cond
ition
s m
anag
emen
t✓
Blo
od s
ugar
✓M
uscu
losk
elet
al c
ondi
tions
man
agem
ent
✓
Sem
en a
naly
sis
✓Sk
in c
ondi
tions
man
agem
ent
✓
Feca
l Occ
ult B
lood
test
ing
✓N
euro
logi
cal c
ondi
tions
man
agem
ent
✓
Tum
our
mar
kers
(P
SA, B
ence
Jon
es
prot
ein,
CA
125,
cyt
olog
y, b
iops
y ex
amin
atio
ns)
✓G
enet
ic c
ondi
tions
man
agem
ent
✓
His
topa
thol
ogy
(FN
A, T
ru c
ut, I
ncis
ion
or
exci
sion
) an
d cy
tolo
gy✓
Endo
crin
e an
d m
etab
olic
con
ditio
ns
man
agem
ent
✓
Mic
ronu
trie
nt te
st✓
Hae
mat
olog
ical
con
ditio
ns m
anag
emen
t✓
Cer
ebro
Spi
nal F
luid
ana
lysi
s (c
ultu
re,
bioc
hem
istr
y, c
ytol
ogy)
✓R
ehab
ilita
tion
Phy
siot
hera
py✓
Spec
ializ
ed
labo
rato
ryD
NA
test
ing
✓Sp
eech
and
hea
ring
ther
apy
✓
Food
ana
lysi
s✓
Ort
hope
dic
tech
nolo
gy (
appl
ianc
es)
✓
Wat
er a
naly
sis
✓O
ccup
atio
nal t
hera
py
✓
Blo
od a
naly
sis
(alc
ohol
, dru
g)✓
Stoo
l tes
ting
(e.g
., po
lio)
✓
RED
UC
E R
ISK
FA
CTO
RS
Hea
lth
Pro
mot
ion
Hea
lth p
rom
otio
n on
vio
lenc
e an
d in
jury
pr
even
tion
✓Su
bsta
nce
abus
eC
omm
unic
atio
n on
the
harm
ful e
ffect
s of
To
bacc
o us
e✓
Hea
lth p
rom
otio
n on
pre
vent
ion
of
com
mun
icab
le c
ondi
tions
✓
Com
mun
icat
ion
on th
e ha
rmfu
l effe
cts
of
Alc
ohol
abu
se✓
Hea
lth p
rom
otio
n on
pre
vent
ion
of N
on-
Com
mun
icab
le c
ondi
tions
✓
Com
mun
icat
ion
on th
e ha
rmfu
l effe
cts
of
Subs
tanc
e ab
use
(Coc
aine
, Her
oin,
glu
e, k
hat,
etc)
✓
Sexu
al
educ
atio
nSe
nsiti
zatio
n of
the
com
mun
ity o
n sa
fe
sex
prac
tices
✓C
omm
unic
atio
n on
the
harm
ful e
ffect
s of
P
resc
riptio
n dr
ug a
buse
✓
Inco
rpor
atio
n of
sex
edu
catio
n in
ed
ucat
ion
curr
icul
ar✓
Cou
nsel
ing
on th
e ha
rmfu
l effe
cts
of s
ubst
ance
ab
use
✓
Targ
eted
edu
catio
n fo
r hi
gh-r
isk
grou
ps
(MA
RP
S) (
com
mer
cial
sex
wor
kers
, un
circ
umci
sed
men
, Men
Hav
ing
Sex
with
men
, int
rave
nous
dru
g us
ers,
A
dole
scen
ts)
✓M
icro
nutr
ient
de
ficie
ncy
cont
rol
Adv
ocat
e fo
r fo
od fo
rtifi
catio
n✓
Educ
atio
n ad
dres
sing
neg
ativ
e cu
ltura
l an
d lif
esty
le p
ract
ices
✓A
dvoc
acy
for
cons
umpt
ion
of fo
rtifi
ed fo
ods
✓
Phy
sica
l ac
tivity
Faci
lity-
base
d he
alth
mes
sage
s on
be
nefit
s an
d ap
proa
ches
to im
prov
ing
phys
ical
act
ivity
✓pr
omot
ion
of d
ieta
ry d
iver
sific
atio
n✓
Act
iviti
es to
enh
ance
phy
sica
l act
ivity
✓Fo
od s
uppl
emen
tatio
n
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 43
Serv
ices
In
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entio
nsLe
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6ST
REN
GTH
EN C
OLL
AB
OR
ATIO
N W
ITH
HEA
LTH
-REL
ATED
SEC
TOR
SSa
fe w
ater
Pro
visi
on o
f saf
e w
ater
sou
rces
✓H
ousi
ngA
ppro
val o
f bui
ldin
g pl
ans
✓
Com
mun
ity s
ensi
tizat
ion
on s
afe
wat
er
✓A
dvoc
acy
for
enfo
rcem
ent o
f sta
ndar
ds o
n ho
usin
g✓
Wat
er q
ualit
y te
stin
g✓
Phy
sica
l pla
nnin
g an
d ho
usin
g en
viro
nmen
t to
prom
ote
heal
thy
livin
g in
clud
ing
prev
entio
n of
ric
kets
✓
Wat
er p
urifi
catio
n/tr
eatm
ent a
t the
poi
nt
of u
se✓
Scho
ol h
ealth
Scho
ol fe
edin
g an
d nu
triti
on✓
Wat
er s
ourc
e pr
otec
tion
✓Sc
hool
Hea
lth P
rom
otio
n✓
Sani
tatio
n an
d hy
gien
eM
onito
ring
hum
an e
xcre
ta d
ispo
sal
prac
tices
✓Sc
hool
-bas
ed d
isea
se p
reve
ntio
n pr
ogra
mm
e✓
Han
d w
ashi
ng fa
cilit
ies
✓Sc
hool
wat
er s
anita
tion
and
hygi
ene
✓
Hyg
iene
pro
mot
ion
✓M
anag
ing
child
ren
with
spe
cial
nee
ds✓
Hom
e in
spec
tions
for
sani
tatio
n ad
equa
cy✓
Food
fo
rtifi
catio
nSa
lt fo
rtifi
catio
n w
ith Io
dine
✓
Pro
mot
ion
of s
afe
food
han
dlin
g✓
Toot
hpas
te fo
rtifi
catio
n w
ith fl
uorid
e✓
Sani
tatio
n su
rvei
llanc
e an
d au
dits
✓M
icro
nutr
ient
fort
ifica
tion
of fo
od p
rodu
cts
(flou
r, co
okin
g oi
l, su
gar,
etc.
)✓
Nut
ritio
n se
rvic
esN
utrit
ion
educ
atio
n an
d co
unse
ling
✓P
opul
atio
n m
anag
emen
tIn
form
atio
n on
chi
ld s
paci
ng b
enefi
ts✓
Com
mun
ity-b
ased
gro
wth
mon
itorin
g an
d pr
omot
ion
✓Aw
aren
ess
crea
tion
on th
e im
pact
of p
opul
atio
n gr
owth
✓
Mic
ronu
trie
nt s
uppl
emen
tatio
n (e
.g.
vita
min
A, I
FA)
✓M
anag
emen
t of p
opul
atio
n m
ovem
ent
part
icul
arly
to in
form
al s
ettle
men
ts
✓
Man
agem
ent o
f acu
te m
alnu
triti
on✓
Roa
d in
fras
truc
ture
an
d Tr
ansp
ort
Impr
ove
road
infr
astr
uctu
re to
hea
lth fa
cilit
ies
✓
Hea
lth e
duca
tion
on a
ppro
pria
te in
fant
an
d yo
ung
child
feed
ing
✓R
oad
safe
ty/In
jury
pre
vent
ion
✓
Pol
lutio
n co
ntro
lIn
door
pol
lutio
n m
anag
emen
t✓
Liqu
id, s
olid
and
gas
eous
was
te
man
agem
ent
✓
Con
trol
of W
ater
body
, soi
l, an
d ai
r po
llutio
n✓
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202244
Appendix II a: Distribution of Baringo County Health Facilities by Type
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 45
Appendix II b: List of Facilities
No Sub-County Facility Name Facility Type KEPH Level
1BA
RIN
GO C
ENTR
ALKerio Hospital-Kabarnet Clinic Medical Center Level 3
2 Kabarnet Bliss Medical Center Primary care hospitals Level 4
3 Kapkut Dispensary Dispensary Level 2
4 Kipsoit Dispensary Dispensary Level 2
5 REHEAL MEDICAL CLINIC Medical Clinic Level 2
6 Baringo County Beyond Zero Mobile Clinic Dispensary Level 2
7 Lelgut Dispensary Dispensary Level 2
8 Orokwo Dispensary Dispensary Level 2
9 Magonoi Dispensary (Kabarnet) Dispensary Level 2
10 Kasoiyo Dispensary Dispensary Level 2
11 Tionybei Medical Clinic Medical Clinic Level 2
12 Moi Teachers College - Baringo Dispensary Level 2
13 AIC Ebenezer Dispensary Level 2
14 Kabarnet Faith Clinic Medical Clinic Level 2
15 Barnet Memorial Hospital Primary care hospitals Level 4
16 Kapkomoi Dispensary Dispensary Level 2
17 Chesongo Dispensary Dispensary Level 2
18 Seretunin Health Centre Basic Health Centre Level 3
19 Kituro Health Centre Basic Health Centre Level 3
20 Mogorwa Health Centre Basic Health Centre Level 3
21 Salawa Health Centre Basic Health Centre Level 3
22 Kiptagich Health Centre Basic Health Centre Level 3
23 Tenges Health Centre Basic Health Centre Level 3
24 Kisok Dispensary Dispensary Level 2
25 Baringo County Referral Hospital Primary care hospitals Level 4
26 Kipsacho Dispensary Dispensary Level 2
27 Kiboino Dispensary Dispensary Level 2
28 Timboiywo Dispensary Dispensary Level 2
29 Borrowonin Dispensary Dispensary Level 2
30 Kapkelelwa Dispensary Dispensary Level 2
31 Kapkole Dispensary Dispensary Level 2
32 Kasitet Dispensary Dispensary Level 2
33 Sorok Dispensary Dispensary Level 2
34 Ngetmoi Dispensary Dispensary Level 2
35 Riwo Dispensary Dispensary Level 2
36 Cheplambus Dispensary Dispensary Level 2
37 Kaptorokwa Dispensary Dispensary Level 2
38 Kaptimbor Dispensary Dispensary Level 2
39 Kisonei Dispensary Dispensary Level 2
40 Salawa Catholic Mission Dispensary PHC Dispensary Level 2
41 Ochii Dispensary Dispensary Level 2
42 Sacho School Dispensary Dispensary Level 2
43 Talai Dispensary Dispensary Level 2
44 Kaplel Dispensary Dispensary Level 2
45 Kabarnet High School Dispensary Dispensary Level 2
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202246
No Sub-County Facility Name Facility Type KEPH Level
46
BARI
NGO
NOR
TH
Barbarchun Dispensary Dispensary Level 2
47 Marubel Nursing Home Basic Health Centre Level 3
48 Tionybei Medical Clinic Kabartonjo Medical Clinic Level 2
49 Kombosang Dispensary Level 2
50 Maregut Dispensary Level 2
51 Root Dispensary Level 2
52 Kapchepkisa Dispensary Level 2
53 Kapkitony Dispensary Level 2
54 Akorian Dispensary Dispensary Level 2
55 Ayatya Dispensary Dispensary Level 2
56 Rebeko Dispensary Dispensary Level 2
57 Tiloi Dispensary Dispensary Level 2
58 Tunoiwo Dispensary Dispensary Level 2
59 Kapkombe Dispensary Dispensary Level 2
60 Kasaka Dispensary Level 2
61 Moigutwo Dispensary Dispensary Level 2
62 Sutyechun Dispensary Dispensary Level 2
63 Kibiryokwonin Dispensary Dispensary Level 2
64 Rondonin Dispensary Dispensary Level 2
65 Kalabata Dispensary Dispensary Level 2
66 Kapluk Dispensary Dispensary Level 2
67 Kuikui Healty Centre Basic Health Centre Level 3
68 Bartabwa Healty Centre Basic Health Centre Level 3
69 Atiar Dispensary Dispensary Level 2
70 Barwessa Health Centre Basic Health Centre Level 3
71 Kabartonjo District Hospital Primary care hospitals Level 4
72 Kipsaraman Dispensary Dispensary Level 2
73 Tirimionin Dispensary Dispensary Level 2
74 Koroto Dispensary Dispensary Level 2
75 Kipcherere Dispensary Dispensary Level 2
76 Kimugul Dispensary (Baringo North) Dispensary Level 2
77 Likwon Dispensary Dispensary Level 2
78 Bossei Dispensary Dispensary Level 2
79 Tirriondonin Dispensary Dispensary Level 2
80 Keturwo Dispensary Dispensary Level 2
81 Kapchepkor Dispensary Dispensary Level 2
82 Katibel Dispensary Dispensary Level 2
83 Kaptiony Dispensary Dispensary Level 2
84 Kaptum Dispensary Dispensary Level 2
85 Kasok Dispensary Dispensary Level 2
86 Kasisit Dispensary Dispensary Level 2
87 Aiyebo Dispensary Dispensary Level 2
88 Yatya Dispensary Dispensary Level 2
89 Poi Dispensary Dispensary Level 2
90 Sibilo Dispensary Dispensary Level 2
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 47
No Sub-County Facility Name Facility Type KEPH Level
91 Muchukwo Dispensary Dispensary Level 2
92 Mormorio Dispensary Dispensary Level 2
93 Kaptumin Dispensary Dispensary Level 2
94 Kapturo Dispensary (Bartabwa) Dispensary Level 2
95 Kinyach Dispensary Dispensary Level 2
96 Sumeiyon Dispensary Dispensary Level 2
97 Bartolimo Dispensary Dispensary Level 2
98 Kapkiamo Dispensary Dispensary Level 2
99
BARI
NGO
SOU
TH
Afya Kabel Medical clinic Medical Clinic Level 2
100 Rae Clinic (Rehabilitation and Arid environments)
Medical Clinic Level 2
101 Generation Afya Centre Medical Clinic Level 2
102 Perkerra clinic Medical Clinic Level 2
103 Sagitian Medical Clinic Medical Clinic Level 2
104 Tionybei Medical Clinic, Marigat Medical Clinic Level 2
105 Koimugul Dispensary Dispensary Level 2
106 Karura Dispensary (Gilgil) Dispensary Level 2
107 Kapkuikui Dispensary Dispensary Level 2
108 Tinomoi Dispensary Dispensary Level 2
109 Eldume Dispensary Dispensary Level 2
110 Sirata Dispensary Dispensary Level 2
111 Nyimbei Dispensary Dispensary Level 2
112 Barsemoi Dispensary Dispensary Level 2
113 Mochongoi Health Centre Basic Health Centre Level 3
114 Kimalel Health Centre Basic Health Centre Level 3
115 Kampi Samaki Health Centre Basic Health Centre Level 3
116 Marigat Sub District Hospital Primary care hospitals Level 4
117 Salabani Dispensary Dispensary Level 2
118 Kiserian Dispensary Dispensary Level 2
119 Koriema Dispensary Dispensary Level 2
120 Loboi Dispensary Dispensary Level 2
121 Illinga’rua Dispensary Dispensary Level 2
122 Kapkuei Dispensary Dispensary Level 2
123 Kasiela Dispensary Dispensary Level 2
124 Tebei Dispensary Dispensary Level 2
125 Bekibon Dispensary Dispensary Level 2
126 Ol-Arabel Dispensary Dispensary Level 2
127 Sandai Dispensary Dispensary Level 2
128 Kapindasim Dispensary Dispensary Level 2
129 Sogon Dispensary Dispensary Level 2
130 Marigat Catholic Mission Dispensary Level 2
131 Sabor Dispensary Dispensary Level 2
132 Kokwa Dispensary Dispensary Level 2
133 Kibingor Dispensary Dispensary Level 2
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202248
No Sub-County Facility Name Facility Type KEPH Level
134
ELDA
MA
RAVI
NE
BLISS GVS Health Care Eldama Ravine Medical Clinic Level 2
135 Keringet Dispensary Dispensary Level 2
136 Londiani Forest Dispensary Dispensary Level 2
137 Chemasusu Dispensary Dispensary Level 2
138 Sinonin Dispensary (Koibatek) Dispensary Level 2
139 Saos Dispensary Dispensary Level 2
140 Muserechi Dispensary Dispensary Level 2
141 Ravine Medical and ENT Clinic Medical Clinic Level 2
142 Eldama Ravine Medical Centre Medical Center Level 3
143 Nazareth Medical Clinic Medical Clinic Level 2
144 Eldama Ravine Nursing Home Comprehensive health Centre
Level 3
145 Shalom Medical Clinical Medical Clinic Level 2
146 Ravine Glory Health Care Services Medical Clinic Level 2
147 Kiplombe Dispensary (Koibatek) Dispensary Level 2
148 Simotwet Dispensary (Koibatek) Dispensary Level 2
149 Kibias Dispensary Dispensary Level 2
150 Kabiyet Dispensary Dispensary Level 2
151 Nakurtakwei Dispensary Dispensary Level 2
152 Equator Health Centre Basic Health Centre Level 3
153 Torongo Health Centre Basic Health Centre Level 3
154 Eldama Ravine (AIC) Health Centre Basic Health Centre Level 3
155 Timboroa Health Centre Basic Health Centre Level 3
156 Karen Roses Dispensary Dispensary Level 2
157 Esageri Health Centre Basic Health Centre Level 3
158 Eldama Ravine District Hospital Primary care hospitals Level 4
159 Kiptuno Dispensary Dispensary Level 2
160 Arama Dispensary Dispensary Level 2
161 Sigoro Dispensary Dispensary Level 2
162 Mercy Hospital Primary care hospitals Level 4
163 Solian Dispensary Dispensary Level 2
164 Toniok Dispensary Dispensary Level 2
165 Igure Dispensary Dispensary Level 2
166 Tinet Dispensary (Koibatek) Dispensary Level 2
167 Kabimoi Dispensary Dispensary Level 2
168 Sagat Dispensary Dispensary Level 2
169 Sabatia Dispensary Dispensary Level 2
170 Lebolos Dispensary Dispensary Level 2
171 Maji Mazuri Dispensary Dispensary Level 2
172 Tugumoi Dispensary (Lembus Kwen) Dispensary Level 2
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 49
No Sub-County Facility Name Facility Type KEPH Level
173
MOG
OTIO
Glory Medical Clinic Mogotio Medical Clinic Level 2
174 Sagasagik Dispensary Dispensary Level 2
175 Njoro Huduma Medical Clinic Medical Clinic Level 2
176 Neema Clinic Medical Clinic Level 2
177 Kiptoim Dispensary Dispensary Level 2
178 Emsos Dispensary Dispensary Level 2
179 Kimose Dispenary Dispensary Level 2
180 Rosoga Dispensary Dispensary Level 2
181 Kabogor Dispensary Dispensary Level 2
182 Kimngorom Dispensary Dispensary Level 2
183 Mogotio Baringo Su-bcounty Hospital Primary care hospitals Level 4
184 Tian Dispensary Dispensary Level 2
185 Nogoi Medical Centre Medical Center Level 3
186 Mogotio Medical Clinic Medical Clinic Level 2
187 Kipsogon Dispensary Dispensary Level 2
188 Kamar Dispensary Dispensary Level 2
189 Ng’endalel Dispensary Dispensary Level 2
190 Waseges Dispensary Dispensary Level 2
191 Kipkitur Dispensary Dispensary Level 2
192 Oldebes Dispensary Dispensary Level 2
193 Kisanana Health Centre Basic Health Centre Level 3
194 Olkokwe Health Centre Basic Health Centre Level 3
195 Ngubereti Health Centre Basic Health Centre Level 3
196 Emining Health Centre Basic Health Centre Level 3
197 Mogotio Catholic Dispensary Dispensary Level 2
198 Sore Dispensary Dispensary Level 2
199 Cheberen Dispensary Dispensary Level 2
200 Radat Dispensary Dispensary Level 2
201 Molos Dispensary Dispensary Level 2
202 Maji Moto Dispensary Dispensary Level 2
203 Sirwa Dispensary (Mogotio) Dispensary Level 2
204 Mugurin Dispensary Dispensary Level 2
205 Koitebes Dispensary Dispensary Level 2
206 Molosirwe Dispensary Dispensary Level 2
207 Kapkein Dispensary Dispensary Level 2
208 Molok Dispensary Dispensary Level 2
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202250
No Sub-County Facility Name Facility Type KEPH Level
209
TIAT
Y
Kaptuya dispensary Dispensary Level 2
210 Lodeng’o Health Centre Basic Health Centre Level 3
211 Kasilangwa dispensary Dispensary Level 2
212 Kapau dispensary Dispensary Level 2
213 Chesawach dispensary Dispensary Level 2
214 Topulen dispensary Dispensary Level 2
215 Chemoril dispensary Dispensary Level 2
216 Tilingwo dispensary Dispensary Level 2
217 Loyeya dispensary Dispensary Level 2
218 Katungura dispensary Dispensary Level 2
219 Akwichatis Health Centre Basic Health Centre Level 3
220 Krezze Dispensary Dispensary Level 2
221 Ngaina dispensary Dispensary Level 2
222 Lomuke Dispensary Dispensary Level 2
223 Rotu Dispensary Dispensary Level 2
224 Plesian Dispensary Dispensary Level 2
225 Barpello Dispensary Dispensary Level 2
226 Nyaunyau Dispensary Dispensary Level 2
227 Tdmp Tangulbei Dispensary Dispensary Level 2
228 Loruk Dispensary (East Pokot) Dispensary Level 2
229 Kapunyany Dispensary Dispensary Level 2
230 Kolowa Health Centre Basic Health Centre Level 3
231 Nginyang Health Centre Basic Health Centre Level 3
232 Nakoko Health Centre Basic Health Centre Level 3
233 Tangulbei Health Centre Basic Health Centre Level 3
234 Chemolingot District Hospital Primary care hospitals Level 4
235 Kalapata Dispensary Dispensary Level 2
236 Ptigchi Dispensary Dispensary Level 2
237 Kipnai Dispensary Dispensary Level 2
238 Chepkalacha Dispensary Dispensary Level 2
239 Nyakwala Dispensary Dispensary Level 2
240 Churo Dispensary Dispensary Level 2
241 Kokwototo Dispensary Dispensary Level 2
242 Chesirimion Dispensary Dispensary Level 2
243 Riongo Dispensary Dispensary Level 2
244 Loiwat Dispensary Dispensary Level 2
245 Kositei Dispensary Dispensary Level 2
246 Kamurio Dispensary Dispensary Level 2
247 Chepturu Dispensary Dispensary Level 2
248 Maron Dispensary Dispensary Level 2
249 Mukutani Dispensary (East Pokot) Dispensary Level 2
250 Ngoron Dispensary Dispensary Level 2
251 Chemsik Dispensary Dispensary Level 2
252 Komolion Dispensary Dispensary Level 2
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 51
App
endi
x III
Impl
emen
tatio
n M
atrix
Pr
even
tive
and
Prom
otiv
e H
ealth
Ser
vice
s
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Com
mun
ity
heal
th
Hea
lth
educ
atio
n an
d pr
omot
ion
Tra
inin
g of
HC
Ws
on B
CC
#
sta
ff
trai
ned
3
0
6
6
6
6
6
1,80
0,00
0
Pri
ntin
g of
Hea
lth
Pos
ters
, fli
ers,
br
ochu
res,
ban
ners
wit
h ke
y he
alth
m
essa
ges
# o
f ke
y m
essa
ges
5
1
1
1
1
1
5,00
0,00
0
Dev
elop
men
t of
Hea
lth
Com
mun
icat
ion
stra
tegy
#
1
1
10
0,00
0
Sup
port
Hea
lth
Pro
mot
ion
Adv
isor
y C
omm
itte
e (H
PAC
) st
akeh
olde
rs’
foru
ms
# o
f fo
rum
s 2
0
4
4
4
4
4
2,00
0,00
0
Med
ia e
ngag
emen
t on
hea
lth
mes
sage
s (t
alk
show
s on
loca
l rad
io
stat
ions
)
# o
f ta
lk
show
s
15
3
3
3
3
3
3,00
0,00
0
Hol
d ro
ad s
how
s to
pro
mot
e go
od
heal
th s
eeki
ng b
ehav
iour
s #
of
show
s
10
2
2
2
2
2
4,00
0,00
0
Com
mem
orat
ion
of A
nnua
l Wor
ld /
Cou
nty
Hea
lth
Day
s(W
orld
Mal
aria
D
ay,W
orld
AID
S D
ay,W
orld
TB
D
ay,G
loba
l Han
d W
ashi
ng D
ay, M
alez
i B
ora,
Wor
ld T
oile
t D
ay,F
ace
Was
hing
D
ay,
OD
F C
eleb
rati
on)
# o
f ce
lebr
atio
ns
10
2
2
2
2
2
2,
000,
000
Dra
ftin
g of
Hea
lth
Bill
s (I
mm
uniz
atio
n, S
anit
atio
n, O
ne s
top
Cen
tre,
Wel
lnes
s)
# b
ills
deve
lope
d 4
1
1
1
1
200,
000
Sup
port
for
CM
Es
# C
ME
s he
ld
60
1
2
12
1
2
12
1
2
6,00
0,00
0
Com
mun
ity
sens
itiz
atio
n se
ssio
ns o
n N
CD
s #
of
awar
enes
s se
ssio
ns
12
0
24
2
4
24
24
24
24
,000
,000
Sup
port
Sup
ervi
sion
to
Sub
Cou
ntie
s on
Hea
lth
Pro
mot
ion
# o
f su
perv
isio
ns
20
4
4
4
4
4
4,
000,
000
Pro
cure
Lap
tops
, LC
D P
roje
ctor
s an
d P
rint
ers
Num
ber
7
2,10
0,00
0
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202252
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Pro
vide
cat
arac
t op
erat
ions
to
thos
e in
nee
d th
roug
h su
rgic
al
outr
each
es
Sur
gica
l Out
reac
hes
wit
h fo
llow
ups
#
of
Ses
sion
s 6
0
12
1
2
12
1
2
12
15
,000
,000
Ass
orte
d C
onsu
mab
les
Num
ber
5
2,
500,
000
Fol
low
up
on o
utre
ache
s #
of
sess
ions
6
0
12
1
2
12
1
2
12
3,
000,
000
pro
cure
men
t of
inst
rum
ents
#
pro
cure
d
3
1
1
1
300,
000
Tra
inin
g #
sta
ff
trai
ned
5
1
1
1
1
1
2,
500,
000
Adv
ocac
y #
of
Ses
sion
s 2
0
5
5
5
5
5
2,00
0,00
0
-
MD
A f
or
Trac
hom
a O
utre
ache
s #
6
0
12
1
2
12
1
2
12
12
,000
,000
C
onsu
mab
les
Non
pha
rms
#
5
1
1
1
1
1
2,
500,
000
Ins
trum
ents
(T.
T se
ts)
#
5
1
125,
000
Mas
s D
rugs
Adm
inis
trat
ion
#
3
1
1
1
12
,000
,000
A
dvoc
acy
#
4
1
1
1
1
1,
200,
000
Im
pact
Ass
essm
ent
and
Eva
luat
ions
#
2
1
4,
000,
000
Com
mun
ity
Hea
lth
Ser
vice
s (C
HS
) im
plem
enta
tion
Est
ablis
h 9
0 a
ddit
iona
l Com
mun
ity
Hea
lth
Uni
ts a
cros
s th
e co
unty
#
9
0
18
1
8
18
1
8
18
4,
500,
000
Sup
port
Com
mun
ity
Hea
lth
Volu
ntee
rs
wit
h st
ipen
ds
# o
f C
HVs
1
,50
0
60
0
90
0
1,2
00
1
,50
0
1,5
00
13
6,80
0,00
0
Tra
in C
HVs
on
MN
H m
odul
e,
com
mun
ity
mal
aria
cas
e m
anag
emen
t,
com
mun
ity
PM
TCT,
and
BC
C
# o
f C
HVs
1
,50
0
60
0
90
0
1,2
00
1
,50
0
1,5
00
21
,750
,000
Sup
port
CU
s to
con
duct
dia
logu
e an
d ac
tion
day
s on
qua
rter
ly b
asis
#
of
di
alog
ue
days
2,4
00
4
80
4
80
4
80
4
80
4
80
9,
600,
000
Sup
port
CU
s to
con
duct
dia
logu
e an
d ac
tion
day
s on
qua
rter
ly b
asis
#
of
acti
on
days
2,4
00
48
0
48
0
48
0
48
0
48
0
9,60
0,00
0
Pro
cure
CH
S r
egis
ters
#
of
regi
ster
s 3
7,5
00
7
,50
0
7,5
00
7,5
00
7,5
00
7,5
00
75
,000
,000
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 53
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Sup
port
sup
ervi
sion
#
of
visi
ts
12
,00
0
2,4
00
2
,40
0
2,4
00
2
,40
0
2,4
00
48
,000
,000
H
ouse
hold
reg
istr
atio
n #
of
hous
ehol
ds
75
,00
0
15
,00
0
15
,00
0
15
,00
0
15
,00
0
15
,00
0
75,0
00,0
00
Pro
cure
Cha
lkbo
ards
#
of
Cha
lkbo
ard
10
0
20
2
0
20
2
0
20
1,
500,
000
Sup
port
com
mun
ity
birt
h co
mpa
nion
w
ith
tran
spor
t
# C
BC
su
ppor
ted
4
50
9
0
90
9
0
90
9
0
2,70
0,00
0
Sch
ool h
ealt
h pr
ogra
m
Con
duct
sch
ool h
ealt
h pr
omot
ion
acti
viti
es o
n se
xual
& r
epro
duct
ive
heal
th, de
wor
min
g an
d pe
rson
al
hygi
ene
# o
f sc
hool
s
1,0
00
2
00
2
00
2
00
2
00
2
00
1,
000,
000
Und
erta
ke p
ublic
hea
lth
insp
ecti
ons
for
trig
geri
ng a
t sc
hool
s #
of
scho
ols
50
0
10
0
10
0
10
0
10
0
10
0
1,00
0,00
0
Sur
veill
ance
#
of
surv
eilla
nce
surv
eys
2
1
1
6,
000,
000
Sub
tota
l
50
3,77
5,00
0 E
nvir
onm
enta
l H
ealth
, wat
er,
sani
tatio
n ac
tiviti
es
Sol
id &
liq
uid
was
te
man
agem
ent
&
Con
trol
Con
stru
ctio
n of
Inc
iner
ator
s,
# o
f In
cine
rato
rs
4
1
1
1
1
24,0
00,0
00
Con
stru
ctio
n of
bur
ning
cha
mbe
rs
# o
f bu
rnin
g ch
ambe
rs
10
0
20
20
20
20
20
40
,000
,000
Bin
line
rs
# o
f do
zens
of
line
rs
12
,00
0
28
,80
0
28
,80
0
28
,80
0
28
,80
0
28
,80
0
30,0
00,0
00
Pro
cure
dus
tbin
s #
of
dust
bins
20
0
40
40
40
40
40
2,
400,
000
con
stru
ctio
n of
pla
cent
a pi
ts
# o
f pl
acen
tas
50
10
10
10
10
10
7,
500,
000
OJT
of
HC
W
on w
aste
m
anag
emen
t in
he
alth
fac
iliti
es
OJT
to
HC
W o
n w
aste
man
agem
ent
# o
f fa
cilit
ies
27
5
55
55
55
55
55
55
0,00
0
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202254
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Foo
d, d
rug,
in
spec
tion
and
qu
alit
y co
ntro
l
Sam
ples
of
food
col
lect
ed f
or t
esti
ng
and
anal
ysis
. #
of
sam
ples
1
,00
0
20
0
20
0
20
0
20
0
20
0
10,0
00,0
00
Wat
er q
ualit
y co
ntro
l S
ampl
es o
f fo
od a
nd w
ater
col
lect
ed
for
test
ing
and
anal
ysis
. #
of
sam
ples
2
50
5
0
50
5
0
50
5
0
2,50
0,00
0
Bui
ldin
g pl
ans
appr
oval
an
d ho
usin
g im
prov
emen
t
sit
e vi
sits
and
insp
ecti
on f
or
cons
truc
tion
of
build
ings
. #
of
site
vi
sits
1
,00
0
20
0
20
0
20
0
20
0
20
0
1,00
0,00
0
Vec
tor,
rode
nts
and
verm
in
cont
rol
Pur
chas
e of
Pro
tect
ive
Equ
ipm
ent
#
of
PP
Es
90
0
18
0
18
0
18
0
18
0
18
0
2,25
0,00
0
Hyg
iene
pr
omot
ion
Pur
chas
e of
inse
ctic
ides
#
of
inse
ctic
ides
3
00
6
0
60
6
0
60
6
0
1,35
0,00
0
Cap
acit
y bu
ildin
g an
d im
plem
enta
tion
of
WA
SH
ac
tivi
ties
Tra
in h
ealt
h w
orke
rs o
n C
LTS
#
of
HC
Ws
10
0
20
2
0
20
2
0
20
20
0,00
0
Com
mun
ity
Led
Tota
l San
itat
ion
(CLT
S)
impl
emen
tati
on
Tri
gger
ing
and
follo
win
g up
of
OD
F Vi
llage
s #
of
Villa
ges
1,0
00
2
00
2
00
2
00
2
00
2
00
2,
000,
000
Pur
chas
e of
dig
ital
cam
era
and
lapt
op
# o
f ca
mer
as&
la
ptop
s
16
4
4
4
4
1,68
0,00
0
Pur
chas
e of
LC
D p
roje
ctor
s
# of
LC
Ds
8
2
2
2
2
64
0,00
0 S
ubto
tal
126,
070,
000
Dis
ease
Su
rvei
llanc
e E
pide
mio
logy
t
rain
ing
HC
Ws
on I
DS
R
# o
f cl
asse
s of
30
5
1
1
1
1
1
2,
000,
000
sen
siti
zati
on o
f he
alth
fac
ility
sta
ff o
n di
seas
e su
rvei
llanc
e #
of
sens
itiz
atio
ns
10
0
20
2
0
20
2
0
20
35
0,00
0
con
duct
60
day
fol
low
up
for
all
susp
ecte
d A
FP
# o
f fo
llow
up
s 6
0
12
1
2
12
1
2
12
21
0,00
0
val
idat
e al
l rep
orte
d A
FP c
ases
#
of
valid
atio
n se
ssio
ns
60
1
2
12
1
2
12
1
2
210,
000
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 55
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
tra
inin
g of
CH
MT
on o
ne h
ealt
h ap
proa
ch
# o
f se
ssio
ns
5
1
1
1
1
1
900,
000
tra
inin
g on
neg
lect
ed t
ropi
cal d
isea
ses
# o
f tr
aini
ng
sess
ions
5
1
1
1
1
1
2,
000,
000
qua
rter
ly V
PD
and
imm
uniz
atio
n re
view
mee
ting
s #
of
mee
ting
5
1
1
1
1
1
1,60
0,00
0 r
espo
nse
to s
uspe
cted
dis
ease
ou
tbre
aks
#of
re
spon
ses
5
1
1
1
1
1
2,
000,
000
Inv
esti
gati
on o
f ac
ute
and
chro
nic
dise
ase
clus
ters
/out
brea
ks in
the
C
ount
y
% o
f ou
tbre
aks
inve
stig
ated
25
10
0
10
0
10
0
10
0
10
0
5,
000,
000
Tra
inin
g an
d su
ppor
t su
perv
isio
n on
Com
mun
icab
le a
nd N
on-
Com
mun
icab
le D
isea
ses
epid
emio
logy
in
the
Cou
nty
# o
f tr
aini
ng
sess
ions
20
4
4
4
4
4
2,
000,
000
Res
earc
h on
Pub
lic H
ealt
h D
isea
ses
of
impo
rtan
ce t
o th
e C
ount
y #
of
rese
arch
st
udie
s
10
2
2
2
2
2
4,
000,
000
Pub
lic H
ealt
h La
bora
tory
sur
veill
ance
#
of
surv
eilla
nce
8
1
1
2
2
2
400,
000
Tra
inin
g of
SC
HM
Ts o
n th
resh
old
sett
ing
# o
f tr
aini
ng
sess
ions
5
1
1
1
1
1
900,
000
Sub
tota
l 21
,570
,000
Im
mun
izat
ion
Del
iver
im
mun
izat
ion
serv
ices
Pro
cure
Col
d ch
ain
equi
pmen
t(Fr
idge
s)
#
12
2
3
2
3
2
5,40
0,00
0
Mai
nten
ance
of
Col
d ch
ain
#
18
3
4
3
4
4
18,0
00
Pro
cure
Gas
Cyl
inde
rs
#
20
0
40
40
40
40
40
16
,000
,000
R
efilli
ng o
f G
as c
ylin
ders
#
30
0
60
60
60
60
60
7,50
0,00
0 P
rocu
re v
acci
ne c
arri
ers
#
20
0
40
40
40
40
40
2,80
0,00
0
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202256
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Pro
cure
Coo
l Box
es
#
60
12
12
12
12
12
1,
200,
000
Fac
ilita
te V
acci
ne c
olle
ctio
n (d
istr
ibut
ion
cost
s)
#
20
4
4
4
4
4
16
0,00
0
Vac
cine
dis
trib
utio
n #
mon
thly
di
stri
buti
on
60
12
12
12
12
12
12
0,00
0
Qua
rter
ly E
PI
Rev
iew
mee
ting
s #
un
dert
aken
5
1
1
1
1
1
60
0,00
0
Qua
rter
ly E
PI
supe
rvis
ion
#
unde
rtak
en
20
4
4
4
4
4
3,
000,
000
Pri
ntin
g of
Mot
her
Chi
ld b
ookl
ets
# o
f bo
okle
ts
6,0
00
1
,20
0
1,2
00
1
,20
0
1,2
00
1
,20
0
2,40
0,00
0
Pro
cure
men
t of
lapt
ops
for
EP
I lo
gist
icia
ns
# p
rocu
red
7
2
1
1
2
1
70
0,00
0
Inc
enti
ve t
o C
HE
Ws
for
defa
ulte
r tr
acin
g #
CH
EW
s
2,0
00
40
0
40
0
40
0
40
0
40
0
1,00
0,00
0
sen
siti
zati
on o
f co
mm
unit
y to
cre
ate
dem
and
for
imm
uniz
atio
n #
se
nsit
ised
36
0
72
72
72
72
72
36
0,00
0
Sub
tota
l 41
,258
,000
N
utri
tion
Nut
riti
on
Ser
vice
s P
rogr
am
Tra
in N
utri
tion
ists
on
ICU
pat
ient
M
anag
emen
t #
tra
ined
1
5
3
3
3
3
3
615,
000
Tra
in N
utri
tion
ists
on
Ren
al
man
agem
ent
# t
rain
ed
15
3
3
3
3
3
615,
000
Pro
cure
Nut
riti
on C
omm
odit
ies
(sup
plem
ents
) #
of
clie
nts
rece
ivin
g
40
,00
0
8,0
00
8,0
00
8,0
00
8,0
00
8,0
00
20
0,00
0,00
0
sup
port
for
nut
riti
on c
omm
odit
y re
quis
itio
n LM
IS
# o
f re
quis
itio
ns
5
1
1
1
1
1
360,
000
Ref
urbi
shm
ent
of c
onta
iner
s #
re
furb
ishe
d
9
2
2
2
2
1
2,25
0,00
0
Tra
inin
g of
EC
DE
Tea
cher
s on
S
uppl
emen
tati
on
# o
f se
ssio
ns
5
1
1
1
1
1
900,
000
Tra
inin
g of
HC
Ws
on B
FCI
# o
f se
ssio
ns
10
2
2
2
2
2
9,
000,
000
Tra
inin
g of
CH
Vs o
n B
FCI
# o
f se
ssio
ns
50
1
0
10
1
0
10
1
0
15,0
00,0
00
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 57
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Ref
resh
men
ts d
urin
g m
othe
r to
m
othe
r m
onth
ly g
roup
mee
ting
s #
of
mee
ting
s
30
0
60
60
60
60
60
45
0,00
0
sen
siti
zati
on o
f H
CW
s on
HiN
i #
of
sens
itiz
atio
n
10
2
2
2
2
2
9,00
0,00
0
sup
port
for
impl
emen
tati
on o
f M
alez
i B
ora
acti
viti
es
# o
f se
ssio
ns
60
12
12
12
12
12
9,
000,
000
sup
port
to
cond
uct
nutr
itio
n as
sess
men
t #
of
asse
ssm
ents
30
6
6
6
6
6
3,00
0,00
0
sup
port
for
nut
riti
on t
echn
ical
for
ums
# o
f fo
rum
s
60
12
12
12
12
12
6,
000,
000
pro
cure
men
t of
hea
ltho
met
ers
#
30
6
6
6
6
6
300,
000
pro
cure
men
t of
mic
roto
ise
#
20
0
40
40
40
40
40
40
0,00
0
pro
cure
men
t of
par
ente
ral/e
nter
al
feed
s #
40
0
80
80
80
80
80
7,
200,
000
und
erta
ke n
utri
tion
SM
AR
T su
rvey
#
of
surv
eys
2
1
1
8,00
0,00
0
qua
rter
ly n
utri
tion
rev
iew
mee
ting
s #
20
5
5
5
5
5
1,
800,
000
pro
cure
men
t of
lapt
ops
for
nutr
itio
n pr
ogra
m
#
6
1
2
1
1
1
1,20
0,00
0
dis
sem
inat
ion
of n
utri
tion
pol
icie
s #
of
sess
ions
12
3
3
2
2
2
2,40
0,00
0
red
istr
ibut
ion
of n
utri
tion
co
mm
odit
ies,
OJT
and
men
tors
hip
# o
f se
ssio
ns
20
4
4
4
4
4
2,
400,
000
Sub
tota
l 27
9,89
0,00
0
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202258
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Com
mun
icab
le
dise
ases
TB
D
efau
lter
Tra
cing
for
TB
-
Ide
ntifi
cati
on o
f TB
cas
es in
C
omm
unit
y
-
Ide
ntifi
cati
on o
f TB
cas
es in
Fac
ility
-
Tra
cing
of
smea
r po
siti
ve c
onta
cts
-
M
appi
ng o
f at
ris
k P
opul
atio
ns
-
T
arge
ted
Out
reac
h se
rvic
es
-
C
ontr
act
coug
h m
onit
ors
-
Sup
port
DO
Ts
-
T
rain
ing
CH
Vs o
n D
OTs
, de
faul
ter
and
cont
act
trac
ing
-
Sup
port
MD
RTB
sur
veill
ance
-
Tra
inin
g H
CW
s on
IP
Tp T
hera
py
-
t
rain
ing
HC
Ws
on H
IV/T
B
Man
agem
ent
-
HIV
T
rain
ing
HC
Ws
on H
TS
#
15
3
3
3
3
3
18
,000
,000
T
rain
ing
HC
Ws
on d
ocum
enta
tion
and
re
port
ing
#
15
3
3
3
3
3
18
,000
,000
Tra
inin
g A
RT
men
tors
#
1
5
3
3
3
3
3
18,0
00,0
00
AR
T m
ento
rshi
p ex
erci
se
#
1,2
00
6,00
0,00
0 Q
uart
erly
HIV
TW
G m
eeti
ngs
#
20
4
4
4
4
4
60
0,00
0 D
ata
qual
ity
audi
t #
2
0
4
4
4
4
4
1,00
0,00
0 Q
uart
erly
dat
a re
view
mee
ting
s #
2
0
4
4
4
4
4
600,
000
sup
port
sup
ervi
sion
#
2
0
4
4
4
4
4
1,00
0,00
0 D
efau
lter
tra
cing
for
AR
T #
3
,60
0
1,80
0,00
0 P
sych
osoc
ial s
uppo
rt m
eeti
ngs
#
72
720,
000
Foc
used
inde
x cl
ient
tes
ting
#
1
20
2
4
24
2
4
24
2
4
180,
000
sen
siti
zati
on d
urin
g pu
blic
bar
azas
#
2
40
4
8
48
4
8
48
4
8
1,20
0,00
0 E
ID a
nd v
iral
load
sam
ple
tran
spor
t #
2
,40
0
48
0
48
0
48
0
48
0
48
0
3,60
0,00
0 M
alar
ia
Tra
inin
g of
HC
Ws
on m
alar
ia c
ase
man
agem
ent
tra
inin
g 5
1
1
1
1
1
90
0,00
0
Pro
cure
men
t of
ITN
s fo
r B
arin
go
Nor
th, C
entr
al a
nd T
iaty
co
nsig
nmen
t 1
1
5,
796,
960
Pro
visi
ons
for
emer
genc
y pr
epar
edne
ss
for
mal
aria
5
1
1
1
1
1
2,50
0,00
0
Sub
tota
l 79
,896
,960
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 59
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
RM
NCA
H
RM
NC
AH
/FP
R
edis
trib
utio
n of
FP
com
mod
itie
s T
imes
4
1
1
1
1
1
20
0,00
0 P
rocu
re I
UC
D I
nser
tion
set
s S
ets
50
0
10
0
10
0
10
0
10
0
10
0
2,50
0,00
0 P
rocu
re I
mpl
ants
set
s S
ets
50
0
10
0
10
0
10
0
10
0
10
0
1,50
0,00
0 P
rocu
re O
bser
vati
on L
amps
n
o.
25
0
25
0
2,00
0,00
0 P
rocu
re d
eliv
ery
sets
S
ets
1,0
00
2
00
2
00
2
00
2
00
2
00
6,
000,
000
Pro
cure
del
iver
y be
d N
umbe
r
10
0
5
0
50
40
,000
,000
P
rocu
re E
xam
inat
ion
Coa
ch
Num
ber
5
00
25
0
25
0
75,0
00,0
00
Pro
cure
R
escu
sita
ires
N
umbe
r
10
0
5
0
50
20
,000
,000
P
rocu
re S
pace
Hea
ters
N
umbe
r
50
0
2
50
2
50
2,
500,
000
Pro
cure
Ele
ctro
nic
suct
ion
mac
hine
s N
umbe
r
30
0
1
00
2
00
30
,000
,000
P
rocu
re M
anua
l suc
tion
mac
hine
s N
umbe
r
30
0
1
50
1
50
15
,000
,000
P
rocu
re M
VA s
ets
Num
ber
1
,00
0
20
0
20
0
20
0
20
0
20
0
6,00
0,00
0 P
rocu
re Fo
etal
Dop
pler
s N
umbe
r
50
0
10
0
10
0
10
0
10
0
10
0
7,50
0,00
0 P
rocu
re O
xyge
n C
once
ntra
tors
N
umbe
r
40
0
80
8
0
80
8
0
80
60
,000
,000
P
rocu
re E
lect
roni
c I
nfan
t W
eigh
ing
scal
es
Num
ber
3
00
6
0
60
6
0
60
6
0
3,00
0,00
0
Pro
cure
in
cuba
tors
N
umbe
r
30
1
0
10
1
0
4,50
0,00
0 P
rocu
re C
S s
ets
Num
ber
-
P
rocu
re U
ltra
Sou
nd M
achi
nes
Num
ber
5
5
2,
500,
000
Pro
cure
ana
esth
etic
Mac
hine
s N
umbe
r
4
4
8,00
0,00
0 P
rocu
re a
utoc
lavi
ng m
achi
nes
Num
ber
4
4
20
0,00
0 P
rocu
re D
rug
Trol
leys
N
umbe
r
50
0
2
00
3
00
60
,000
,000
P
rocu
re D
rip
stan
ds
Num
ber
5
00
20
0
30
0
2,50
0,00
0 P
rocu
re F
ood
Trol
leys
N
umbe
r
50
0
2
00
3
00
40
,000
,000
P
rocu
re P
atie
nt s
tret
cher
s N
umbe
r
50
0
2
00
3
00
7,
500,
000
Pro
cure
Pat
ient
W
heel
cha
irs
Num
ber
1
50
50
1
00
15
,000
,000
P
rocu
re V
agin
al E
xam
inat
ion
Set
s N
umbe
r
1,0
00
2
00
2
00
2
00
2
00
2
00
3,
000,
000
Pro
cure
Sti
tchi
ng S
ets
Num
ber
1
,00
0
20
0
20
0
20
0
20
0
20
0
5,00
0,00
0 P
rocu
re G
reen
tow
el
rol
l 1
00
1
00
1,
500,
000
Pro
cure
cel
lula
r bl
anke
ts
pie
ces
6,0
00
1
,20
0
1,2
00
1
,20
0
1,2
00
1
,20
0
18,0
00,0
00
Pro
cure
woo
llen
blan
kets
p
iece
s 7
20
1
44
1
44
1
44
1
44
1
44
1,
440,
000
Pro
cure
whi
te b
edsh
eets
p
iece
s 1
2,0
00
2
,40
0
2,4
00
2
,40
0
2,4
00
2
,40
0
12,0
00,0
00
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202260
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
P
rocu
re p
atie
nt u
nifo
rm
pie
ces
9,6
00
1
,92
0
1,9
20
1
,92
0
1,9
20
1
,92
0
4,80
0,00
0 P
rocu
re h
ospi
tal l
aund
ry w
ashi
ng
mac
hine
N
umbe
r
4
4
32,0
00,0
00
Pro
cure
Dri
er
Num
ber
4
4
20
,000
,000
P
rocu
re s
teri
lizer
s N
umbe
r
-
Pro
cure
the
atre
tab
le
Num
ber
6
6
-
P
rocu
re n
on-p
harm
aceu
tica
ls
Num
ber
5
5
25
,000
,000
P
rocu
re h
aem
odia
lysi
s co
nsum
able
s N
umbe
r
5
5
25,0
00,0
00
Pro
cure
hae
mod
ialy
sis
mac
hine
s N
umbe
r
3
3
9,00
0,00
0 P
rocu
re h
aem
odia
lysi
s ch
airs
N
umbe
r
3
3
90,0
00
Con
stru
ctio
n of
isol
atio
n ro
om f
or
Hep
atit
is p
atie
nts
Num
ber
1
1
2,
000,
000
Tra
inin
g H
CW
s on
LA
RC
and
fol
low
up
tra
inin
g 2
0
4
4
4
4
4
26,0
00,0
00
Tra
inin
g H
CW
s on
EM
OC
and
fol
low
up
t
rain
ing
20
4
4
4
4
4
26
,000
,000
Tra
inin
g H
CW
s on
RM
C a
nd f
ollo
w u
p t
rain
ing
20
4
4
4
4
4
26
,000
,000
T
rain
ing
HC
Ws
on K
MC
and
fol
low
up
tra
inin
g 2
0
4
4
4
4
4
26,0
00,0
00
Tra
inin
g H
CW
s on
PN
C a
nd f
ollo
w u
p t
rain
ing
20
4
4
4
4
4
26
,000
,000
T
rain
ing
HC
Ws
on A
YSR
H a
nd f
ollo
w
up
tra
inin
g 2
0
4
4
4
4
4
26,0
00,0
00
Tra
inin
g H
CW
s on
PA
C a
nd f
ollo
w u
p t
rain
ing
20
4
4
4
4
4
26
,000
,000
E
stab
lish
yout
h fr
iend
ly c
entr
es
cen
tre
5
1
1
1
1
1
50,0
00,0
00
Qua
rter
ly s
uppo
rt s
uper
visi
on f
or
RM
NC
AH
s
uper
visi
on
10
0
25
2
5
25
2
5
25
5,
000,
000
com
mun
ity
sens
itiz
atio
n se
ssio
ns o
n R
MN
CA
H
ses
sion
1
50
3
0
30
3
0
30
3
0
30,0
00,0
00
S
ubto
tal
837,
230,
000
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 61
PROG
RAM
ME
1: P
REVE
NTI
VE A
ND
PROM
OTIV
E S
ub-p
rogr
am
Key
Act
iviti
es
Act
ivity
Des
crip
tion
Uni
t of
mea
sure
N
o. o
f U
nits
Y
ear
1 Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Non
-co
mm
unic
able
di
seas
e co
ntro
l
Dia
bete
s/D
iabe
tes
reti
nopa
thy
Ser
vice
s
Scr
eeni
ng
#
60
1
2
12
1
2
12
1
2
9,00
0,00
0 P
rocu
rem
ent
of a
ssor
ted
Con
sum
able
s #
5
1
1
1
1
1
1,
500,
000
Fun
dus
imag
ing
#
60
1
2
12
1
2
12
1
2
3,00
0,00
0 A
dvoc
acy
#
4
1
1
2
1,20
0,00
0 T
rain
ing
#
6
2
2
2
3,00
0,00
0 S
ubto
tal
17,7
00,0
00
Infr
astr
uctu
re
deve
lopm
ent
Offi
ce
cons
truc
tion
C
onst
ruct
ion
and
furn
ishi
ng o
f co
unty
H
ealt
h of
fice
#
1
1
10,0
00,0
00
Im
prov
ing
30
D
ispe
nsar
ies
to
incr
ease
var
iety
of
ser
vice
s of
fere
d
Im
prov
ing
30
Dis
pens
arie
s (
one
per
war
d) t
o in
crea
se v
arie
ty o
f se
rvic
es
offe
red
#
30
6
6
6
6
6
28
5,00
0,00
0
Im
prov
ing
7
heal
th c
entr
es
to o
ffer
wid
er
vari
ety
of
serv
ices
Im
prov
ing
7 h
ealt
h ce
ntre
s (
one
per
sub-
coun
ty)
to o
ffer
wid
er v
arie
ty o
f se
rvic
es
#
7
3
2
2
179,
326,
000
Bui
ldin
g 4
sub
co
unty
offi
ces
Bui
ldin
g 4
sub
cou
nty
offic
es
#
4
1
1
1
1
32
,000
,000
Equ
ippi
ng o
f ru
ral h
ealt
h fa
cilit
ies
Equ
ippi
ng o
f ru
ral h
ealt
h fa
cilit
ies
#
11
0
30
4
0
40
33
,000
,000
con
stru
ctio
n of
10
new
di
spen
sari
es
con
stru
ctio
n of
10
new
dis
pens
arie
s #
1
0
2
3
3
2
60
,000
,000
Sub
tota
l
59
9,32
6,00
0 G
rand
Tot
al
2,50
6,71
5,96
0
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202262
Cura
tive
and
Reha
bilit
ativ
e Pr
ogra
m
Sub-
prog
ram
K
ey A
ctiv
ities
A
ctiv
ity D
escr
iptio
n U
nit o
f m
easu
re
No.
of
Uni
ts
Yea
r 1
Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Cura
tive
Hea
lth
Serv
ices
del
iver
y M
edic
al s
ocia
l wor
k ou
trea
ch s
ervi
ces
for
NH
IF
sens
itiz
atio
n #
of
outr
each
es
12
0
30
3
0
30
3
0
1,
200,
000
Hom
e vi
sits
and
fol
low
ups
#
of
sess
ions
2
40
4
8
48
4
8
48
4
8
2,40
0,00
0
Cou
nsel
ling
of p
atie
nts
by s
ocia
l w
orke
rs
# o
f se
ssio
ns
60
1
2
12
1
2
12
1
2
600,
000
soci
al r
ehab
ilita
tion
and
re
inte
grat
ion
# o
f se
ssio
ns
50
1
0
10
1
0
10
1
0
500,
000
soci
al r
efer
rals
and
pla
cem
ents
#
of
sess
ions
1
20
2
4
24
2
4
24
2
4
1,20
0,00
0
advo
cacy
for
clie
nt n
eeds
#
of
sess
ions
1
20
2
4
24
2
4
24
2
4
960,
000
soci
al r
esea
rch
# o
f st
udie
s 2
0
4
4
4
4
4
400,
000
Gen
eral
Out
Pat
ient
ca
re
Pro
vide
gen
eral
out
pati
ent
care
se
rvic
es
-
Spe
cial
ized
car
e P
rovi
de s
peci
alis
ed c
urat
ive
serv
ices
-
Rad
iolo
gy
Trai
ning
rad
iolo
gy s
taff
on
use
of
CT
scan
-
Den
tal
Sup
port
for
den
tal c
amp
# o
f ca
mps
1
0
2
2
2
2
2
500,
000
supp
ort
for
dent
al s
taff
to
atte
nd
conf
eren
ces
and
shor
t co
urse
s
# o
f st
aff
supp
orte
d
10
3
2
3
2
400,
000
P
rovi
de e
ndod
onti
c m
otor
wit
h fil
es
1
1
15
0,00
0 In
pati
ent
care
P
rovi
de in
pati
ent
care
ser
vice
s
-
Men
tal h
ealt
h
Pro
vide
men
tal h
ealt
h ca
re s
ervi
ces
-
Labo
rato
ry s
ervi
ces
prov
isio
n
- Tr
ain
Lab
staf
f on
bio
-saf
ety
# t
rain
ed
5
1
1
1
1
1
1,38
0,00
0 Tr
ain
Lab
staf
f on
Mal
aria
M
icro
scop
y #
tra
ined
5
1
1
1
1
1
1,
380,
000
Trai
n La
b st
aff
on T
B d
iagn
osis
#
tra
ined
5
1
1
1
1
1
1,
380,
000
Trai
n La
b st
aff
on la
b co
mm
odit
y m
anag
emen
t #
tra
ined
5
1
1
1
1
1
1,38
0,00
0
Trai
n La
b st
aff
on m
alar
ia
ento
mol
ogy
# t
rain
ed
5
1
1
1
1
1
1,38
0,00
0
Trai
n La
b st
aff
on b
lood
pro
duct
s #
tra
ined
5
1
1
1
1
1
1,
380,
000
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 63
Sub-
prog
ram
K
ey A
ctiv
ities
A
ctiv
ity D
escr
iptio
n U
nit o
f m
easu
re
No.
of
Uni
ts
Yea
r 1
Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Trai
n La
b st
aff
on H
TS s
uper
visi
on
# t
rain
ed
5
1
1
1
1
1
1,38
0,00
0 Tr
ain
Lab
staf
f on
CD
4, vi
ral l
oad
and
PC
R
# t
rain
ed
5
1
1
1
1
1
1,38
0,00
0
Trai
n La
b st
aff
on id
enti
ficat
ion
of
vect
ors
of m
edic
al im
port
ance
and
in
sect
icid
e re
sist
ance
sur
veill
ance
# t
rain
ed
5
1
1
1
1
1
1,38
0,00
0
EQ
A s
uper
visi
on f
or T
B, H
IV a
nd
Mal
aria
tes
ting
#
of
supe
rvis
ion
5
1
1
1
1
1
2,50
0,00
0
HIV
PT
TB d
istr
ibut
ion
# o
f se
ssio
n
20
0
40
4
0
40
4
0
40
2,
000,
000
vect
or id
enti
ficat
ion
surv
eilla
nce
#
80
2
0
20
2
0
20
2
0
32,0
00,0
00
Sub
tota
l
57
,230
,000
H
ealth
Pro
duct
s R
adio
logy
P
rocu
re c
onsu
mab
les
for
CT
scan
, M
RI,
X-r
ay, U
ltra
Sou
nd,
Mam
mog
raph
y m
achi
ne,
% o
f fa
cilit
ies
repo
rtin
g st
ock
outs
of
ess
enti
al
com
mod
itie
s
-
-
-
-
-
- -
Den
tal
Pro
cure
con
sum
able
s fo
r de
ntal
un
it
% o
f fa
cilit
ies
repo
rtin
g st
ock
outs
of
ess
enti
al
com
mod
itie
s
-
-
-
-
-
- -
EM
MS
P
urch
ase
of d
rugs
and
non
-ph
arm
aceu
tica
ls
% o
f fa
cilit
ies
repo
rtin
g st
ock
outs
of
ess
enti
al
com
mod
itie
s
-
-
-
-
-
- 2,
250,
000,
000
Sub
tota
l
2,
250,
000,
000
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202264
Sub-
prog
ram
K
ey A
ctiv
ities
A
ctiv
ity D
escr
iptio
n U
nit o
f m
easu
re
No.
of
Uni
ts
Yea
r 1
Y
ear
2 Y
ear
3 Y
ear
4 Y
ear
5 T
otal
Infr
asta
ctur
e De
velo
pmen
t U
pgra
ding
of
Sub
-co
unty
Hos
pita
ls
Thea
tre
cons
truc
tion
and
E
quip
men
t #
4
4
80
,000
,000
X-R
ay c
onst
ruct
ion
and
Equ
ipm
ent
#
4
4
60,0
00,0
00
Mor
tuar
y co
nstr
ucti
on a
nd
Equ
ipm
ent
#
5
5
75,0
00,0
00
Laun
dry
cons
truc
tion
and
E
quip
men
t #
4
4
40
,000
,000
Kit
chen
con
stru
ctio
n an
d E
quip
men
t #
4
2
2
30,0
00,0
00
Sol
id a
nd d
ange
rous
was
te
man
agem
ent
#
5
2
3
25
,000
,000
Lab
orat
ory
serv
ices
pr
ovis
ion
R
enov
atio
n of
Lab
orat
orie
s #
1
5
3
3
3
3
3
7,50
0,00
0 P
rocu
re M
icro
scop
es
#
20
4
4
4
4
4
3,
000,
000
Pro
cure
C
hem
istr
y A
naly
zers
#
1
0
2
2
2
2
2
5,00
0,00
0 P
rocu
re H
aem
atol
ogy
Ana
lyze
rs
#
10
2
2
2
2
2
6,
000,
000
Pro
cure
Lab
Blo
od b
ank
frid
ges
#
6
3
3
1,
800,
000
Pro
cure
Saf
ety
Cab
inet
s #
6
3
3
4,20
0,00
0 P
rocu
re la
b in
cuba
tors
#
6
3
3
3,60
0,00
0 P
rocu
re la
b w
ater
bat
h #
1
2
3
3
3
3
6,
000,
000
Pro
cure
lab
reag
ents
fri
dges
#
3
0
6
6
6
6
6
1,20
0,00
0 P
rocu
re C
oagu
lati
on a
naly
zers
#
1
0
2
2
2
2
2
3,00
0,00
0 P
rocu
re a
ssor
ted
Lab
reag
ents
#
5
1
1
1
1
1
40
,000
,000
co
nstr
ucti
on a
nd e
quip
ping
of
sate
llite
blo
od d
onor
cen
tre
#
1
1
40,0
00,0
00
P
rocu
re e
ntom
olog
ical
equ
ipm
ent
#
2
1
1
1,
500,
000
Rad
iolo
gy
Pro
cure
MR
I m
achi
nes
#
1
1
- M
aint
enan
ce o
f M
RI
mac
hine
s
- Tr
aini
ng R
adio
logy
sta
ff o
n us
e of
M
RI
#
3
3
-
CT
scan
mac
hine
mai
nten
ance
- D
enta
l D
enta
l cha
ir
4
1
2
1
3,
000,
000
proc
ure
dent
al d
igit
al d
enta
l x-r
ay
mac
hine
(w
ith
sens
or)
2
2
80
0,00
0
Sub
tota
l
43
6,60
0,00
0
TOT
AL
2,74
3,83
0,00
0
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 65
Gene
ral A
dmin
istr
atio
n an
d Pl
anni
ng
Sub-
prog
ram
K
ey A
ctiv
ities
A
ctiv
ity D
escr
iptio
n U
nit o
f mea
sure
N
o. o
f U
nits
Y
ear
1
Yea
r 2
Yea
r 3
Yea
r 4
Yea
r 5
Tot
al
Hum
an r
esou
rce
man
agem
ent
Com
pens
atio
n fo
r st
aff
Com
pens
atio
n fo
r st
aff
% p
aid
as p
er
plan
1
,21
0
1
00
1
00
1
00
1
00
1
00
9,
890,
262,
000
Rec
ruit
men
t &
D
eplo
ymen
t R
ecru
itm
ent
of H
CW
s (d
iffe
rent
cad
res)
#
rec
ruit
ed
20
8
4
0
40
4
0
48
4
0
16,6
40,0
00
surv
ey
Em
ploy
ee s
atis
fact
ion
Sur
vey
# u
nder
take
n
5
1
1
1
1
1
5,
000,
000
asse
smen
t H
RH
ass
essm
ent
# u
nder
take
n
2
1
1
300,
000
trai
ning
Tr
aini
ng s
taff
on
pens
ion
sche
me
#
tra
ined
4
0
8
8
8
8
8
40
0,00
0
trai
ning
Tr
aini
ng s
taff
on
prep
arat
ion
for
reti
rem
ent
# t
rain
ed
40
8
8
8
8
8
40
0,00
0
subs
iste
nce
Sta
ff t
o at
tend
& m
ake
pres
enta
tion
s in
loca
l &
inte
rnat
iona
l con
fere
nces
# s
uppo
rted
1
00
2
0
20
2
0
20
2
0
1,00
0,00
0
indu
ctio
n In
duct
ion
of N
ew s
taff
#
indu
cted
2
08
4
0
40
4
0
48
4
0
2,08
0,00
0 H
RH
Dat
a m
anag
emen
t S
uppo
rt f
or u
pdat
ing
iHR
IS
% f
unct
iona
lity
40
1
00
%1
00
%1
00
%1
00
%1
00
%40
,000
Trai
ning
of
staf
f on
iHR
IS
# t
rain
ed
20
4
4
4
4
4
40
0,00
0 C
apac
ity
build
ing
HC
Ws
on L
eade
rshi
p &
M
anag
emen
t
HR
H S
uppo
rt s
uper
visi
on
# h
eld
2
0
4
4
4
4
4
1,
000,
000
Lead
ersh
ip D
evel
opm
ent
prog
ram
me
(LD
P)t
rain
ing
# a
tten
ding
1
50
3
0
30
3
0
30
3
0
1,50
0,00
0
Sen
ior
Man
agem
ent
cour
se
trai
ning
#
att
endi
ng
50
1
0
10
1
0
10
1
0
5,60
0,00
0
SLD
P T
rain
ing
#
att
endi
ng
20
4
4
4
4
4
3,
120,
000
Sup
port
to
atte
nd r
egio
nal I
CC
m
eeti
ngs
# a
tten
ding
2
0
4
4
4
4
4
3,
000,
000
Mid
term
rev
iew
of
the
HR
H s
trat
egy
Sup
port
the
Mid
term
Rev
iew
of
HR
H s
trat
egy
# o
f re
view
s
1
1
720,
000
Per
form
ance
M
anag
emen
t
Aw
ardi
ng c
erem
onie
s fo
r be
st
perf
orm
ers
# h
eld
5
1
1
1
1
1
50
0,00
0 Te
am b
uild
ing
acti
viti
es(r
etre
ats,
end
yea
r pa
rtie
s,sp
orts
,cho
ir)
# h
eld
5
1
1
1
1
1
5,
000,
000
Trai
ning
on
perf
orm
ance
m
anag
emen
t #
tra
ined
1
50
3
0
30
3
0
30
3
0
1,50
0,00
0
Pro
mot
ion
of H
CW
s %
pro
mot
ed a
s pl
anne
d
5
1
00
%
50,0
00,0
00
Sub
tota
l 9,
988,
462,
000
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202266
Sub-
prog
ram
K
ey A
ctiv
ities
A
ctiv
ity D
escr
iptio
n U
nit o
f mea
sure
N
o. o
f U
nits
Y
ear
1
Yea
r 2
Yea
r 3
Yea
r 4
Yea
r 5
Tot
al
Hea
lth
Info
rmat
ion,
M
&E,
res
earc
h
M&
E
Str
engt
heni
ng
Set
ting
up
an M
&E
uni
t (t
rain
ing
on M
&E
) #
sta
ff t
rain
ed
1
0
10
1
0
10
1
0
-
Set
ting
up
M&
E s
yste
m a
nd
deve
lopm
ent
of t
he M
&E
Pla
n U
nit
esta
blis
hed
1
-
Sup
port
DQ
As
and
data
va
lidat
ion
to im
prov
e on
dat
a qu
alit
y an
d ut
iliza
tion
of
the
info
rmat
ion
# o
f R
evie
w
Mee
ting
s
4
4
4
4
4
-
Con
duct
ing
OJT
to
HC
Ws
on
the
repo
rtin
g to
ols
# t
rain
ed
5
0
50
5
0
50
5
0
1,80
0,00
0
Mid
term
rev
iew
of
the
heal
th
stra
tegi
c pl
an
# o
f re
view
s
1
-
Dat
a bu
ndle
s fo
r up
load
ng
% s
uppl
ied
as
per
plan
7
1
00
1
00
1
00
1
00
1
00
42
0,00
0
dat
a re
view
mee
ting
s #
hel
d
28
3
6
6
6
6
5,
600,
000
tra
inin
g on
use
of
new
too
ls
# t
rain
ed
30
6
6
6
6
6
3,
600,
000
mai
nten
ance
of
com
pute
rs
% f
unct
iona
l 5
1
00
1
00
1
00
1
00
1
00
12
0,00
0 t
echn
ical
sup
port
for
EM
R
% E
MR
fu
ncti
onal
2
0
1
00
1
00
1
00
1
00
1
00
2,
400,
000
Pla
nnin
g C
apac
ity
d
evel
opm
ent
of A
WP
%
of
plan
ning
un
its
wit
h pl
ans
5
1
00
1
00
1
00
1
00
1
00
10
,000
,000
DQ
A
Dat
a qu
alit
y au
dits
#
con
duct
ed
10
2
2
2
2
2
50
0,00
0 M
&E
S
tren
gthe
ning
P
rint
ing
of r
epor
ting
too
ls
# o
f se
ts
20
4
4
4
4
4
20,0
00,0
00
M&
E
Str
engt
heni
ng
Pro
cure
men
t of
com
pute
rs
for
EM
R
#
9
2
2
2
2
1
1,80
0,00
0 P
lann
ing
Cap
acit
y
pro
cure
men
t of
LC
D
proj
ecto
rs
#
10
2
2
2
2
2
1,
000,
000
Sub
tota
l 47
,240
,000
A
dmin
istr
ativ
e an
d Pl
anni
ng
serv
ices
Fuel
ing
Fuel
ing
of u
tilit
y ve
hicl
es
Ltr
s 63
5,21
8
69,8
73,9
80
Mai
nten
ance
M
ajor
ser
vice
for
17
uti
lity
vehi
cles
F
requ
ency
510
10
,200
,000
Mai
nten
ance
M
ajor
ser
vice
for
17
uti
lity
vehi
cles
%
mai
ntai
ned
1
70
1
00
1
00
1
00
1
00
1
00
17
,000
,000
Pur
chas
e of
tyr
es
for
utili
ty v
ehic
les
Pur
chas
e of
uti
lity
vehi
cles
ty
res
% p
rocu
red
as
plan
ned
93
4
1
00
1
00
1
00
1
00
1
00
28
,020
,000
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-2022 67
Sub-
prog
ram
K
ey A
ctiv
ities
A
ctiv
ity D
escr
iptio
n U
nit o
f mea
sure
N
o. o
f U
nits
Y
ear
1
Yea
r 2
Yea
r 3
Yea
r 4
Yea
r 5
Tot
al
Pur
chas
e of
uti
lity
vehi
cles
P
urch
ase
of u
tilit
y ve
hicl
es
#
10
2
2
2
2
2
50
,000
,000
Fuel
ing
of
ambu
lanc
es
Fuel
ing
of a
mbu
lanc
es
% p
rocu
red
as
plan
ned
763,8
63
1
00
1
00
1
00
1
00
1
00
84
,024
,930
Mai
nten
ance
of
ambu
lanc
es
Maj
or s
ervi
ce f
or 2
8
ambu
lanc
es
% m
aint
aine
d
28
0
1
00
1
00
1
00
1
00
1
00
28
,000
,000
Mai
nten
ance
of
ambu
lanc
es
Min
or s
ervi
ce fo
r 2
8
ambu
lanc
es
% m
aint
aine
d
84
0
1
00
1
00
1
00
1
00
1
00
16
,800
,000
Pur
chas
e of
tyr
es
for
ambu
lanc
es
Pur
chas
e of
tyr
es f
or
ambu
lanc
es
% p
rocu
red
as
plan
ned
1,2
60
1
00
1
00
1
00
1
00
1
00
32
,760
,000
No
of s
uppo
rt
supe
rvis
ions
co
nduc
ted
No
of s
uppo
rt s
uper
visi
ons
cond
ucte
d #
of
supe
rvis
ions
1
20
2
4
24
2
4
24
2
4
6,00
0,00
0
No
field
ope
ratio
ns
cond
ucte
d N
o fie
ld in
spec
tion
s
cond
ucte
d #
of
insp
ecti
ons
60
1
2
12
1
2
12
1
2
3,00
0,00
0
No
of p
roje
ct
eval
uati
ons
cond
ucte
d
No
of p
roje
ct e
valu
atio
ns
cond
ucte
d #
of
eval
uati
ons
30
0
1
0
10
1
0
10
1
0
9,00
0,00
0
Form
ulat
ion
of
polic
y Fo
rmul
atio
n of
pol
icy
# o
f ke
y po
licie
s 5
1
1
1
1
1
1,
500,
000
Ann
ual w
ork
plan
s A
nnua
l wor
k pl
ans
in p
lace
%
of
plan
ning
un
its
wit
h pl
ans
20
1
00
1
00
1
00
1
00
1
00
6,
000,
000
Pay
men
t of
uti
lity
bills
P
aym
ent
of u
tilit
y bi
lls
% p
aid
as p
er
plan
6
1
00
1
00
1
00
1
00
1
00
30
0,00
0,00
0
Sup
port
to
atte
nd
conf
eren
ces
and
mee
ting
s
Sup
port
to
atte
nd c
onfe
renc
es
and
mee
ting
s #
sta
ff
supp
orte
d
60
0
1
20
1
20
1
20
1
20
1
20
30
,000
,000
Pur
chas
e of
offi
ce
supp
lies
(sta
tione
ry,
furn
iture
, co
mpu
ters
)
Pur
chas
e of
offi
ce s
uppl
ies
(sta
tion
ery,
fur
nitu
re,
com
pute
rs)
% s
uppl
ied
as
per
plan
A
ssor
ted
1
00
1
00
1
00
1
00
1
00
30
,000
,000
Sup
port
to
Hea
lth
serv
ice
Coo
rdin
ator
s
Sup
port
to
Hea
lth
serv
ice
Coo
rdin
ator
s %
sup
port
ed a
s pe
r pl
an
7
1
00
1
00
1
00
1
00
1
00
35
,000
,000
Sup
port
to
Hos
pita
ls
Sup
port
to
Hos
pita
ls
% s
uppo
rted
as
per
plan
6
1
00
1
00
1
00
1
00
1
00
60
,000
,000
Sub
tota
l
81
7,17
8,91
0
TOT
AL
10,8
52,8
80,9
10
BARINGO COUNTY GOVERNMENT HEALTH SECTOR STRATEGIC PLAN 2018-202268
Appendix IV: List of Contributors
NAME DESIGNATION
1. HON. MARY PANGA CEC- HEALTH SERVICES
2. DR. GIDEON TOROMO CHIEF OFFICER- MED. SERVICES
3. DR. WINNIE BORE CHIEF OFFICER PREV. HEALTH
4. DR. ABAKALWA GERISHON CDH- ADMIN / PLANNING
5. DR. ROBERT RONO CDH- PUBLIC HEALTH
6. DR. MARY SANG M&E OFFICER
7. MR. ZACHARIA KIMWETICH SPECIAL PROGRAMMES
8. MS. JANE SARICH SCHC – TIATY
9. MR. PATRICK TERER COUNTY H.A. O
10. MR. KIPRONO KOSGEI COUNTY ECONOMIST
11. MS. RHODA TUMO SCHRIO
12. MR. RICHARD TUITOEK SCHC- MOGOTIO
13. DR. MUE WINNIE MED. SUP. MARIGAT
14. DR. PHILIP KAMAU MED. SUP KABARTONJO
15. MR. EZEKIEL KIMETTO SCHC- E/RAVINE
16. MR. ISACK K. CHESEREK C WASH/CLTSC
17. CHRISTINE KIECHA PALLADIUM CMLAP II- AD. GOV
18. MS. MAUREENE OCHIENG PALLADIUM CMLAP II- CLPS
19. MR. ERICK ODIPO AFYA UZAZI- MERL
20. MR. BENARD NYAUCHI AFYA UZAZI- LRM
21. MR. SAUL ATWA AFYA UZAZI - M& E
22. MS. MARY KAMAU AFYA UZAZI- HRHA
23. MR. PHILIP KOITELEL AFYA NYOTA – AD HSS
24. DR. SAMUEL NYINGI PALLADIUM CMLAP II
25. MS. SARAH OLALO FRED HOLLOWS- P.O
AFYA NYOTA YA BONDE
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