HEALTH SECTOR STRATEGIC PLAN 2018-2022

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

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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

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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.


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


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.


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.


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.


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


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


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.


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.


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.


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.


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


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.


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.


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)









Stakeholder Stakeholder Expectation Health Department’s Expectation

Community Organizations (CBOs)








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



· 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


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


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


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


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




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.




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


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


· 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.


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


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.


ORGA

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Figu

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: Org

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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


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.


5.3.

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9Yr

. 220

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020

Yr. 3

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/202

1Yr

. 420

21/2

022

Yr. 5

2022

/202

3

HEA

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INPU

T AN

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S IN

VEST

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Serv

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mun

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% o

f out

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s 10

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#

of n

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s pe

r 10

,000

pop

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7.1

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89

10

% o

f elig

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sta

ff w

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unde

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PD

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%

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f attr

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0

00

00

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as

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spec

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annu

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ta

5010

0

% o

f hea

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with

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ees

100%

10

0%

100%

10

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10

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10

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10

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ns

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data

10

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10

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10

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lth In

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of s

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r qu

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ts p

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and

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ated

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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

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s su

bmitt

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timel

y, c

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and

accu

rate

in

form

atio

nN

o da

ta

100%

100%

100%

100%

100%


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




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




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


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


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


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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✓


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

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


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

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✓


Appendix II a: Distribution of Baringo County Health Facilities by Type


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



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



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



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



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



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


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


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


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


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


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


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


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

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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


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

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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


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


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


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


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


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


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


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


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


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


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

Documents

HEALTH SECTOR STRATEGIC PLAN 2018-2022