kirinyaga district aop 3 - 16-5-07
TRANSCRIPT
KIRINYAGA DISTRICT HEALTH PLAN
2007/2008
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TABLE OF CONTENTS
Forematter
Foreword List of Abbreviations Executive Summary
Section 1: The District Health Service and Capacity Assessment 1.1 Mapping the health services and facilities in the district 1.2 Demographic profile and distribution 1.2.1 District population by service category 1.3 Workload by level of service delivery 1.4 Health facilities (GOK and non-GOK) 1.4.1 Number and type of health facilities in the district 1.5 Access/utilization to health care services both GOK and non GOK
1.5.1 Catchment population per facility 1.6 Human resources 1.6.1 Medical/technical personnel
1.7 Health care financing; Availability and Utilization Section 2: The district health services analysis
2.1 Key Issue 2.2 Challenges and Constraints 2.3 Priorities
Section 3: Results and targets 3.1 District Consolidated Targets
Section 4 The Work plan ` 4.1Coordination of Service Delivery
4.2 Coordination of Facility Based Management Support Activities 4.3. Management level (DHMT) Support plan
Section 5: the district budget 5.1 District resource envelope 5.2 Budget (DHMT plan) 5.3 Gap/Surplus
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Foreword: The Government through the Ministry of Health has developed strategies to be able to realize the Millennium Development goals and Economic Recovery. These strategies are operational zed through Annual operational plans. The district is currently implementing AOP2 and has now developed AOP3 to start in July 2007-2008.The DHMT members were introduced to the objectives and the planning process of AOP3, then to all health facility in-charges both GOK and FBOs in order to be all-inclusive and increase participation during the implementation. After introduction and training on facility planning, all facilities were requested to develop plans for AOP3 (2007-2008). The DHMT members supervised facilities during the planning period in January 2007 and completed plans were forwarded to the office of the DMOH by mid-February 2007. The plans were consolidated and the draft plan presented to the stakeholders for ratification early March this year. I wish to thank all who participated in the development of the AOP3, the DHMT members, all staffs from GOK, FBOs/NGOs, development partners, DHMB-Kirinyaga and all who made preparation of the plan a success. It is my sincere hope that the implementation of AOP 3 will go along way in improving the delivery of health services at all levels and more so community involvement/participation in preventive and promotive health services. DR. I. M. KIMANI DISTRICT MEDICAL OFFICER OF HEALTH KIRINYAGA DISTRICT
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List of Abbreviations:
DMOH - District Medical Officer of Health DPHN - District Public Health Nurse DPHO - District Health Officer DASCO - District Aids DCO - District Clinical Officer DNO - District Nutrition Officer DMLT - District Medical Laboratory Technologist DHAO - District Health Administrative Officer DHRIO - District Health Records Information Officer DHMT - District Health Management Team DDSC - District Disease Surveillance Coordinator PLWA - People Living With Aids VHC - Village Health Committee VCT - Voluntary Counseling PMTCT - Prevention of Mother to Child Transmission CHW - Community Health Worker GOK - Government of Kenya EU - European Union FIF - Facility Improvement Fund FBO - Faith Based Organization NGO - Non Governmental Organization DRH - Division of Reproductive Health AOP - Annual Operation Plan CWC - Child Welfare Clinic KRCHN - Kenya Registered Community Health Nurse KECHN - Kenya Enrolled Community Health Nurse PM&E - Planning Monitoring & Evaluation IPT - Intermittent Patient treatment ANC - Ante Natal Clinic FP - Family Planning OPD - Out patient Department OP - Out patient IDS - Integrated Disease Surveillance h/w - Health worker
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SECTION 1
The District Health Service and Capacity Assessment
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1.1 KIRINYAGA DISTRICT MAP
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1.2 DEMOGRAPHIC PROFILE INTRODUCTION Kirinyaga District covers a total area of 1, 478 Km2, which is 11.2 percent and 0.3 percent of Central Province and Kenya's total area respectively. The District being one of the seven Districts in the Central Province borders Nyeri and Murang'a Districts to the west, Mbeere District to the south and Embu District to the east. The District is located between latitudes 00 10 and 00 400 south and longitude 370 and 380 east. ADMINISTRATIVE AND POLITICAL AREAS The District has four (4) divisions namely; Gichugu, Ndia, Mwea and Central. The largest Division is Mwea, which is located to the Southern side while the smallest Division is Central, which is located almost at the centre of the District AREA OF THE DISTRICT BY DIVISION DIVISION AREA (KM²) Gichugu 292.7 Ndia 276.4 Central 108.5 Mwea 512.8 Forest area 350.7 Total 1478.1 SOURCE: District Development Office N/B: The area of 350.7 sq. km is made of the forest, which does not specifically fall within any of the Divisions though it could be less with the indiscriminate felling of the forests indigenous trees with no noticeable replacement at the moment. The District has 22 locations and 80 sub locations. Administrative Units by Division Divisions No. of Locations No. of Sub locations Gichugu 6 23 Ndia 6 24 Mwea 6 20 Central 4 13 Total 22 80 Source: DISTRICT DEVELOPMENT OFFICE
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The District has four (4) constituencies namely: Ndia, Gichugu, Mwea and Kerugoya/Kutus. Ndia constituency covers Ndia Division, Gichugu constituency covers Gichugu Division, and Mwea constituency covers Mwea Division while Kerugoya/Kutus constituency covers Central Division. The District has 3 local authorities namely: Kerugoya/Kutus Municipality, Sagana Town Council and Kirinyaga County council with a total of 37 elective wards. 1.2.1 District Population by Service category Description District proportions Eligible population 1 Total catchment’s population 491617 2 Children under 1 year (12 months) 2.76% 13, 569 3 Children under 5 years (60 months) 12% 58, 994 4 Under 15 year population 36.2% 177, 965 5 Women of child bearing age (15 – 49 Years) 26.3% 129, 295 6 Estimated Number of Pregnant Women 2.76% 13, 569 7 Estimated Number of Deliveries 2.76% 13, 569 8 Live Births 2.76% 13, 569 9 Estimated Number of emergency obstetric complications 0.75% 3, 687 10 Estimated Number of Post-Abortion Cases 11 Total number of Adolescent (15-24) 23% 113, 072 12 Adults (25-59) 33.7% 165, 675 13 Elderly (60+) 6.6% 32, 447 1.3 Workload by Level of Service Delivery Level of Service delivery Total Outpatient Total In Patient Grand
Total New Revisit Total Level II (Dispensary) 248, 169 280, 679 528, 848 0 528, 848 Level III ( Health Centre) 101, 187 119, 059 220, 246 1, 557 220, 246 Level IV (District Hospital 52, 354 53, 984 106, 338 12, 047 118, 385 Levels 5 & 6 Referral Hospital 0 0 0 0 0 Total 401, 710 453, 722 855, 432 13, 604 867, 479
Note: Outpatient services include general outpatient and other special outpatient services like MCH, FP, and Counseling etc.
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1.4 HEALTH FACILITIES (GOK AND NON-GOK) 1.4.1 Number and type of Health Facilities in the district
Number of Providers GOK FBO NGO Private Total
No. 2 2 0 1 5 1 Hospital (Includes District. And Sub-District Hosp) Centre
Beds & cots 296 160 0 53 509 No 7 2 0 0 9 2 Health Centre
Beds 51 24 0 0 75 3 Nursing /Maternity home No 0 0 0 2 2
Bed 0 0 0 38 38 4 Dispensary 37 27 0 0 64 5 Clinic 0 0 0 82 82 6 Hospitals with COs School 0
0 0 0 0 0
7 Hospitals with Nursing School 0 0 0 0 0 8 Private Pharmacies 0 0 38 38 9 Community Pharmacies 0 8 0 8
Sources: District Health Record
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1.5 ACCESS/UTILIZATION TO HEALTH CARE SERVICES BOTH GOK AND NON GOK 1.5.1 Catchment Populations per Facility
Name of Health Facility Total Catchment Population
Total Outpatient Attendance Utilization Rate
(a) (b) (c) (d) = c/d x 100
New Revisit Total
1 Kerugoya district hospital 22239 49324 28958 78,282 352
2 Kimbimbi sub-district hospital 16,673 29,735 11,586 41,321 2483 ACK Mt. Kenya hospital 1,979 3,001 1,618 4,619 2334 Mwea Mission hospital 6,347 9,081 10,477 19,558 3085 Mwea medical centre 2,793 456 60 516 186 Sagana H/C 29,236 23,878 38,364 62,242 2137 Kianyaga H/C 21,532 20,268 30,220 50,488 2348 Baricho H/C 16,807 9,565 7,234 16,799 1009 Kabare H/C 17,426 8,376 4,137 12,513 72
10 Difathas H/C 10,572 6,517 3,945 10,462 9911 Kiamutugu H/C 19,564 17,657 11,827 29,484 15112 Mutithi H/C 7,985 2,884 8,649 11,533 14413 Baricho catholic 3,975 1,597 4,791 6,388 16114 Kianyaga catholic H/C 1,214 630 256 886 7315 Baragwi maternity 759 211 633 844 11116 Kagio nursing home 1,869 269 300 569 3017 Kutus dispensary 3,971 3,128 1,553 4,681 11818 Ucheru dispensary 5,920 3,700 3,154 6,854 11619 Mutitu dispensary 3,149 2,454 363 2,817 8920 Gatwe dispensary 7,855 8,420 9,984 18,404 23421 Kangaita dispensary 8,072 11,170 6,694 17,864 22122 Kagumo dispensary 8,425 15,452 4,840 20,292 24123 Gathambi dispensary 12,512 7,962 7,554 15,516 12424 Kangaru dispensary 19,920 8,505 25,515 34,020 17125 Kiaragana dispensary 7,599 3,869 1,946 5,815 77
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Name of Health Facility Total Catchment Population
Total Outpatient Attendance Utilization Rate
(a) (b) (c) (d) = c/d x 100 26 Kiangai dispensary 8,582 14,394 1,608 16,002 18627 Kibirigwi dispensary 9,318 7,079 1,767 8,846 9528 Kianjege dispensary 7,663 4,426 5,698 10,124 13229 Gatithi dispensary 6,938 4,176 993 5,169 7530 Kiburu dispensary 4,088 2,289 6,867 9,156 22431 Gaciongo dispensary 7,411 2,230 3,067 5,297 7132 Gatugura dispensary 13,444 15,736 6,185 21,921 16333 Kamweti dispensary 13,526 7,923 15,235 23,158 17134 Karumande dispensary 10,027 9,599 3,739 13,338 13335 Kiangombe dispensary 9,099 14,550 9,290 23,840 26236 Mumbuini dispensary 3,093 837 2,101 2,938 9537 Kiumbu dispensary 5,507 7,472 3,601 11,073 20138 Thiba dispensary 10,374 8,262 2,235 10,497 10139 Wamumu dispensary 5,853 3,751 1,992 5,743 9840 Gathigiriri dispensary 6,029 12,522 1,712 14,234 23641 Murinduko dispensary 10,997 10,368 7,512 17,880 16342 Njegas dispensary 6,776 6,960 6,622 13,582 20043 Kandongu dispensary 8,489 9,801 6,268 16,069 18944 Nguka dispensary 9,976 9,448 6,162 15,610 15645 Ciagini dispensary 5,110 6,652 3,344 9,996 19646 GK prisons 2,854 1,000 1,122 2,122 7447 Rukanga dispensary 6,308 8,437 10,420 18,857 29948 Kajiji dispensary 4,219 3,510 1,816 5,326 126 49 Kiamanyeki dispensary 2,342 4,098 240 4,338 185 50 Kariini dispensary 1,395 200 434 634 45
51 Joshua Mbai 2,000 1,356 300 1,656 83
52 Kangu dispensary 2,000 1,234 453 1,687 84 53 Kerugoya catholic dispensary 1,669 718 1,120 1,838 11054 Kutus catholic dispensary 3,069 3,625 1,240 4,865 15955 CCS Kerugoya dispensary 1,669 744 1,150 1,894 113
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Name of Health Facility Total Catchment Population
Total Outpatient Attendance Utilization Rate
(a) (b) (c) (d) = c/d x 100 56 Kagumo catholic dispensary 5,051 5,900 5,052 10,952 21757 ACK Thaita dispensary 1,054 37 6 43 458 ACK Karaini dispensary 1,174 1,548 252 1,800 15359 Kagio catholic dispensary 3,124 300 269 569 1860 Sagana catholic dispensary 7,299 1,310 2,000 3,310 4561 ACK Mutira dispensary 1,342 403 300 703 5262 Gatumbi SDA dispensary 1,916 277 612 889 4663 Jesmond dispensary 1,458 345 954 1,299 8964 ACK Mbiri dispensary 1,296 1,164 679 1,843 14265 ACK Githure dispensary 466 236 708 944 20366 ACK Mugumo dispensary 1,649 380 1,140 1,520 9267 ACK Ngariama dispensary 2,315 266 798 1,064 4668 ACK ST. Andrews Kabare 754 100 210 310 4169 ACK ngiriambu dispensary 676 313 939 1,252 18570 CCS Wang’uru dispensary 1,162 810 1,670 2,480 21371 St. Teresa catholic dispensary 678 141 200 341 5072 Difathas catholic dispensary 677 500 182 682 10173 MCK Kiandegwa dispensary 746 256 130 386 5274 ACK Thumaita dispensary 412 132 200 332 8175 Rapha clinic 742 200 100 300 4076 Gatwe clinic 800 140 200 340 4377 Kangaita clinic 286 100 186 286 10078 Heshima clinic 242 80 240 320 13279 Kabuti clinic 1,414 271 813 1,084 7780 Afya bora clinic 899 271 813 1,084 12181 Ithare clinic 1,428 273 819 1,092 7682 Zawadi clinic 958 300 289 589 6183 Roadside clinic 921 200 151 351 3884 Manesh clinic 84 30 39 69 8285 Ssema clinic 314 120 141 261 8386 Imani clinic 503 367 230 597 119
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Name of Health Facility Total Catchment Population
Total Outpatient Attendance Utilization Rate
(a) (b) (c) (d) = c/d x 100 87 Tumaini clinic 142 56 46 102 7288 Mamuki clinic 261 200 193 393 15189 Kirimara clinic 658 130 100 230 3590 Kianugu clinic 93 90 52 142 15391 By Faith clinic 405 300 531 831 205 District total 491,617 449,052 360,195 809,247 165
1.6 Human Resources Availability 1.6.1 Medical/Technical Personnel
Description GoK FBO NGO / PRIVATE Total
Level Level Level Level Level Level Level Level Level Level 1 2 3 4 1 2 3 4
Level 1
Level 2 3 4
1 Consultants (MD 0 0 0 3 0 0 0 0 0 0 0 0 3 2 GP (MD) 0 0 0 8 0 0 0 5 0 0 0 2 15 3 Dentists 0 0 0 1 0 0 0 0 0 0 0 0 1 4 Dental Technologists 0 0 0 4 0 0 0 0 0 0 0 0 4 5 Community Oral Health Officers 0 0 0 2 0 0 0 0 0 0 0 0 2 6 Clinical Officer (Spec) 0 0 0 5 0 0 0 0 0 0 0 0 5 7 Clinical Officers (Gen.) 0 0 7 28 0 2 0 2 0 0 1 0 40 8 KRCHNs 0 0 8 51 0 2 0 10 0 0 0 0 71 9 KECHNs 0 56 40 141 0 27 0 36 0 3 2 0 305 10 Public Health Officers 0 5 5 2 0 0 0 0 0 0 0 0 12 11 Public Health Technicians 23 9 0 0 0 0 0 0 0 0 0 32 12 Pharmacists 0 0 0 3 0 0 0 0 0 0 0 0 3 13 Pharm. Technologist 0 0 0 2 0 0 0 3 0 0 0 0 5 14 Lab. Technologist 0 0 2 11 0 1 0 2 0 0 0 0 16 15 Lab. Technician 0 1 4 2 0 0 0 3 0 0 0 0 10 16 FHFEs 0 0 0 0 0 0 0 0 0 0 0 0 0
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Description GoK FBO NGO / PRIVATE Total
Level Level Level Level Level Level Level Level Level Level 1 2 3 4 1 2 3 4
Level 1
Level 2 3 4
17 Nutritionists 0 0 6 4 0 0 0 0 0 0 1 0 11 18 Nutritionists Assistant 0 0 1 0 0 0 0 0 0 0 0 1 19 Radiographers 0 0 0 2 0 0 0 0 0 0 0 0 2 20 Physiotherapists 0 0 2 5 0 0 0 0 0 0 0 0 7 21 Occupational Therapists 0 0 1 5 0 0 0 0 0 0 0 6 22 Plaster Technicians 0 0 0 2 0 0 0 0 0 0 0 2 23 Health Record & Information Officers 0 0 0 5 0 0 0 1 0 0 0 0 6 24 Community Health Workers 120 0 0 0 0 0 0 0 0 0 0 0 120 25 Orthopaedic officers 0 0 0 1 0 0 0 0 0 0 0 0 1 26 Medical engineering technologist 0 0 0 0 0 0 0 0 0 0 0 0 0 27 Medical engineering technicians 0 0 0 2 0 0 0 0 0 0 0 0 2 28 Medical engineering artisans 0 0 0 0 0 0 0 0 0 0 0 0 0 29 Support staff 0 1 1 7 0 2 0 65 0 0 0 0 76 30 Non medical 0 1 4 2 0 14 0 5 0 3 2 0 31 31 Administrator 0 0 0 2 0 3 0 1 0 0 0 0 6 33 Store man 0 0 0 1 0 0 0 1 0 0 0 0 2 34 Artisans 0 0 0 3 0 0 0 0 0 0 0 3 35 Accountants 0 1 0 1 0 0 0 1 0 0 0 0 36 Drivers 0 0 0 5 0 0 0 1 0 0 0 0 6
Sources: District Health Facilities Records
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1.7 HEALTH CARE FINANCING AVAILABILITY AND UTILIZATION Table 1.3 Resource availability and utilization for current Financial Year (AOP II)
Source Amount Budgeted
Amount Received
Expenditure Expenditure accounted for (SOE’s submitted)
Funds utilization rate=C/BAX100
Accounting rate=D/CX100
MOH FIF 7,097,322.00 7,097,322.00 6,621,896.15 5,673,146.15 93.30 85.67 RECURRENT 1,031,354.25 1,031,354.25 635,781.00 608,281.00 61.65 95.67 DEVELOPMENT 440,000.00 440,000.00 311,220.00 224,500.00 70.73 72.14 GLOBAL FUND 1,401,949.00 1,401,949.00 699,636.60 699,636.60 49.90 100.00 DVBD 80,000.00 80,000.00 16,500.00 16,500.00 20.63 100.00 Kerugoya hosp FIF 13,930,162.00 13,930,162.00 13,110,081.00 12,902,531.00 94.11 98.42 RECURRENT 3,883,941.25 3,883,941.25 3,144,832.80 2,801,782.80 80.97 89.09 DEVELOPMENT 0 0 0 0 0 0 Kimbimbi SDH FIF 1,748,878.00 1,748,878.00 1,516,024.45 1,396,852.50 86.69 92.14 RECURRENT 1,067,918.25 1,067,918.25 822,898.95 623,806.25 77.06 75.81 DEVELOPMENT 0 0 0 0 0 0 Kianyaga FIF 362,650.00 362,650.00 290,797.40 265,617.40 80.19 91.34 Baricho FIF 274,063.75 274,063.75 186,546.40 171,546.40 68.07 91.96 Sagana FIF 398,485.00 398,485.00 330,548.60 313,848.60 82.95 94.95 Kabare FIF 273,409.50 273,409.50 196,102.30 188,102.30 71.72 95.92 Dispensaries
FIF 4, 163, 463 4,105,134
4, 105, 134 4, 105, 134 100 100 DPHO FIF 948,716.00 948,716.00 627,747.90 612,747.90 66.17 97.61 RECURRENT 208,000.00 208,000.00 185,130.50 185,130.50 89.01 100.00 DEVELOPMENT 260,000.00 260,000.00 154,985.00 154,985.00 59.61 100.00
Source: District Health Office
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2.0 HEALTH SERVICE ANALYSIS
2.1 KEY ISSUES, CONTRAINTS/ CHALLENGES AND PRIORITIES FOT THE NEXT YEAR
RESULT AREA SUPPLY SIDE UTILIZATION / COMMUNITY
CHALLENGES/CONSTRAINTS PRIORITIES FOR THIS YEAR
Maternal Health
- Few health facilities integrating PMTCT services into ANC
- Low Community awareness of ANC services - Low Antenatal care attendances -Late start of ANC - Low PMTCT services uptake
SUPPLY SIDE - Inadequate supply of haematinics - Inadequate ITN supply - inadequate knowledge and skills to health workers - staff attitude - inadequate supply of reagents - Inadequate staffing - Lack of recording tools -
SUPPLY SIDE - Ensure the ANC have adequate equipment and drugs - Procure & distribute ITNs - Train health workers on FANC/MIP - Redistribution of personnel according to qualifications and service need - Provide recording tools - Train/update h/Ws on PMTCT
- few facilities offering FP services -Culture & religious belief
- Irregular supply of FP commodities - Acquire and distribute FP commodities regularly - Update health workers on new FP methods - Procure FP equipments, non pharmaceuticals and FP training model
- Few facilities offering post-natal services
- Poverty -Low post-natal attendances
- Low deliveries by skilled attendant
- Inadequate delivery equipment - few facilities offering maternity services -
- Procure adequate delivery equipment for facilities offering maternity services - Increase no. of maternity units - Enhance timely referrals - Equip maternity theatre in Kerugoya and Kimbimbi hospitals -
- Low ITNs use by ANC mothers
DEMAND - Community attitude - High illiteracy level - Long distance
DEMAND - Enhance community education on maternal health - Train CORPs on FANC/MIP - Intensify micro teachings
Child Health
- Some facilities not offering immunization
- Low Community awareness of various
- Accessibility to immunizing facilities - Erratic supply of some antigens
- Increase the no. of h/f offering immunization services
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RESULT AREA SUPPLY SIDE UTILIZATION / COMMUNITY
CHALLENGES/CONSTRAINTS PRIORITIES FOR THIS YEAR
services - High child mortality and morbidity
child services - High immunization defaulters - stagnating immunization coverage
- Many cold chain breakdowns - Incomplete/inaccurate recording - Few staff trained in IMCI - staff shortage - Inadequate ITNs supply - Erratic supply of pediatrics’ preparations - Lack of growth monitoring tools - Lack of enough space for IMCI services in KDH
- Conduct outreach services - conduct child health days - Ensure adequate supply of vaccines - Regular maintenance of cold chain equipment - setting and reviewing immunization targets - Train h/ws on IMCI strategy - Procure growth monitoring equipment - Procure & distribute ITNs - Conduct school health programmes - Put up an IMCI block in KDH
- Few facilities offering paediatric HIV care ant treatment services -Culture & religious belief
- Few staff trained in pediatric ARV - Few facilities offering paediatric ARVs - Lack of space - Lack of systems for early infant diagnosis
- Train h/ws on paediatric ARVs - Increase no. of h/fs offering paediatric ART - Train h/ws on early infant diagnosis on HIV/AIDS - Provide logistics for early infant diagnosis
- - Poverty
DEMAND
- Community attitude - High illiteracy level - Long distance
- Enhance defaulter tracing - Train CORPS on community IMCI - Procure growth monitoring tools for CORPS
- Lack of community IMCI - Lack knowledge, skills and tools for community growth monitoring
- Lack of safe water -Procure aqua tabs - Procure immersion water pump - Repair existing water pump
Adolescence
- No facility offering adolescent health services
- Community awareness - Stigma - Culture and beliefs - low utilization of VCT services by adolescents
SUPPLY SIDE - Lack of youth friendly centres - Lack staff trained in peer counseling - Lack IEC materials - Staff attitude towards youths
- Increase no. of VCT sites - Train VCT counselors - Establish & equip youth centres - Train h/ws on peer counseling -
DEMAND SIDE - Lack of knowledge on adolescent health - Ignorance
DEMAND - Conduct mobile VCT - Intensify community health education and school health programmes
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RESULT AREA SUPPLY SIDE UTILIZATION / COMMUNITY
CHALLENGES/CONSTRAINTS PRIORITIES FOR THIS YEAR
Adults & elderly
- High morbidity and mortality - Few VCT sites - Few facilities offering quality health services
- Culture and belief - Community awareness - Stigma - Low ITN use - Low utilization of VCT services - Poor utilization of existing facilities
- Lack of decentralized specialized services - Inadequate drug supply - Inadequate supply of ITNs - Inadequate equipment - Inadequate laboratory reagents - Inadequate staff trained on adult ART - Few diagnostic and testing sites for TB - Poor state of infrastructure - Poor state of equipments -
- Procure & maintenance of equipments for various services - Procure & distribute ITNs - increase no. of VCT - Train VCT counselors - Train h/ws on adult ART - Provide lab reagents - Increase no. of TB treatment sites - Update h/ws on TB treatment and HIV collaboration - Carry out rehabilitation services in the various health facilities - Carry out landscaping activities -
DEMAND - High TB defaulter rate - Poor health seeking behavior - Illiteracy level - Poverty - Lifestyle
DEMAND - Establish support groups - Intensify community education of HIV/AIDS and behavioural change
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2.2 Management systems analysis 2.4.1. CONSOLIDATED ISSUES
MAIN SYSTEMS SUPPORT AREAS KEY ISSEUS CHALLANGES/ CONSTAINTS PRIORITES FOR THE COMING FINANCIAL YEAR
1. MAINTENANCE OF
BUILDINGS, EQUIPMENTS AND VEHICLES
- NO INVENTORY OR REGULAR INSPECTION OF THE STATE OF BUILDINGS, EQUIPMENT AND VEHICLES - GOVERNMENT TENDERING SYSTEM
- LACK OF SKILLED STAFF - LACK OF MAINTENANCE DEPARTMENT IN VARIOUS HEALTH FACILITIES - LACK OF TOOLS FOR ASSESSMENT AND REPORTING - LACK OF FUNDS
- DEVELOP INSPECTION TOOLS - HAVE INVENTORY OF BUILDINGS, EQUIPMENT VEHILCES - ANNUAL UPDATE OF INVENTORIES
2. PROCUREMENT AND MANAGEMENT OF DRUGS
- PUSH SYSTEM - GOVERNMENT TENDERING SYSTEM -
- IRREGULAR SUPPLY OF ESSENTIAL DRUGS - LACK TECHNICAL PERSONNEL TO MANAGE DRUGS - LACK OF DRUG STORES - INADEQUATE DRUG KITS - LACK OF SOME OF THE ESSENTIAL DRUGS IN THE KITS LACK FUNDS
- PROCURE DRUG CABINETS - TIMELY ORDERING OF DRUGS FROM KEMSA - PROCUREMENT OF EMERGENCY DRUGS
3. PLANNING FOR THE NEXT FINANCIAL YEAR
- SKILLS AND KNOWLEDGE OF PLANING -
- LACK OF FUNDS - LACK OF PLANNING SKILLS - SPACE TO HOLD MEETING - INADEQUATE TIME FRAME FOR PLANNING - COMPETING PROGRAMMES - LACK OF RESOURCE ENVEOLE FROM STAKEHOLDERS
- TRAIN H/WS ON PRIORITISATION AND PLANNING - EARLY PLANNING OF AOP4
4. MONITORING AND FOLLOWUP OF IMPLEMENTION WITH THE COMMMITTEE
- NO INTEGRATED MONITORING & EVALUATION TOOLS -
- LACK OF FUNDS - SHORT NOTICE FOR COMMITTEE MEMBERS - COMPETING PROGRAMMES - LACK 0F TRANSPORT MEANS
- MONTHLY MEEETINS FOR HEALTH WORKERS - TIMELY SUBMISSION OF REPORTS -AVAIL REPORTING TOOLS - ENHANCE COMMUNICATIONS
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2.4.2. MANAGEMENT SUPPORT ISSUES AT THE DISTRICT LEVEL
MAIN SYSTEMS SUPPORT AREAS KEY ISSEUS CHALLANGES/ CONSTAINTS PRIORITES FOR THE COMING FINANCIAL YEAR INTEFACE WITH THE COMMUNITY
- NO COMMUNITY STRUCTURES - NO COMMUNITY PARTICIPATION IN HEALTH ISSUES
- NO GUIDELINES ON ESTABLSIHING COMMUNITY UNITS - SHORTAGE OF TOTS - SHORTAGE OF FIELD HEALTH WORKERS - POOR LINKAGE OF LEVEL 1 WITH LEVEL 2 & 3 - HIGH DROP OUT RATES - LACK OF INCENTIVES - UNEVEN DISTRIBUTION OF HEALTH FACILITIES & SERVICES - LACK OF COMMUNITY STRUCTURES - CULTURE & RELIGION - POVERTY - LACK OF FUNDS -
- ESTABLISH & STRENGTHEN COMMUNITY STRUCTURES - ENHANCE COMMUNITY INFORMATION SYSTEM - ENHANCE COMMUNITY INVOLVEMENT AND
PARTICIPATION IN HEALTH ISSUES - TRAINING CORPS IN PHC - TRAIN CORPS ON PHC, RH COMMUNITY PACKAGES - ESTABLISH CHALK AND BOARD IN ALL GOK H/FS - CONDUCT MASS RETREATMENT OF NETS - STRENGTHEN DIVISIONAL TEAMS - INVOLVE CORPS IN DEFAULTER TRACING - INVOLVE CORPS IN GROWTH MONITORING - CARRY OUT SAFE WATER AND SANITATION
CAMPAIGNS
MAINTENANCE OF INFASTUCTURE, EQUIPMENT, COMMUNCIATION AND TRANSPORT
-NO REGULAR MAINTENANCE OF BUILDINGS AND EQUIPMENTS -POOR COMMUNICATION TO AND FACILITIES
-SHORTAGE OF SKILLED STAFFS -LACK OF FUNDS -ROUGH ROADS AND HENCE FREQUENT BREAKDOWN OF VEHICLES -FEW UTILITY VEHICLES -NO AIRTIME FOR OFFICERS BELOW JOB GROUP M -NO NETWORK INSOME AREAS
- REGULAR INSPECTION OF INFRASTRUCTURE—BUILDINGS - REGULAR VEHICLE CHECK-UP AND MAINTENANCE - PROCURE MOBILE PHONES TO RURAL FACILITIES TO ENHANCE
COMMUNICATIONS - PROVIDE AIRTIME TO FACILITIES - ENSURE BASIC EQUIPMENTS AVAILABILITY IN ALL FACILITIES
HUMAN REOURCE MANAGMENT
- MANY FACILITIES NOT OFFERING VARIETY OF SERVICES
- NO PLANNING AND MANAGEMENT SKILLS
-SHOTAGE OF STAFFS IN ALMOST ALL CARDRES -LACK OF SOME SKILLS IN STAFFS -LACK OF FUNDS FOR TRAINING STAFFS -STAFF TRANSFERS -STAFFS GOING FOR BRIDGING COURSES -STAFF IN-DISPLINE
- STAFF TRAININGS ESPECIALLY MANAGEMENT - RE-DISTRIBUTION OF STAFFS ACCORDING TO QUALIFICATIONS AND
SERVICE NEEDS - STAFF TRAINING ON PLANNING SKILLS - CONTINOUS MEDICAL EDUCATION OF STAFFS - REGULAR STAFF UPDATES - HOLD REGULAR DISPLINARY MEETINGS
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MAIN SYSTEMS SUPPORT AREAS KEY ISSEUS CHALLANGES/ CONSTAINTS PRIORITES FOR THE COMING FINANCIAL YEAR ESSENTIAL MEDICINES AND MEDICAL SUPPLIES
-FEW ESSENTIAL DRUGS IN PHARMACIES -PUSH SYSTEM -NO DRUGS FOR CERTAIN DISEASES ESPECIALLY THE CHRONIC ILLNESS -STORAGE SPACE—STORE -IRREGULAR SUPPLY OF DRUGS
-TIMELY ORDERING OF ESSENTIAL DRUGS -USE OF THE PULL-SYSTEM -DRUG QUANTIFICATION BY ALL FACILITIES -ENSURING EMERGENCY DRUGS AVAILABILITY IN ALL FACILITIES
GOVERNANCE FINANCAIL MANAGEMENT
- POOR FINANCIAL MANAGEMENT - NO REGULAR MEETING FOR
DHMT, STAKEHOLDERS FORUM AND WITH HEALTH WORKERS
-COMPETING PROGRAMMES -LACK OF FINANCIAL MANAGEMENT SKILLS BY STAFFS -LACK OF MANAGEMENT SKILLS BY THE DHMT MEMBERS
-HOLD QUARTERLY STAKEHOLDERS FORUM -REGULAR DHMT MEETINGS -QUARTERLY DHMB-MEETINGS -MONTHLY MEETINGS WITH THE HEALTH WORKERS -TRAINING OF FACILITY MANAGEMENT COMMITTEES ON FINANCIAL MANAGEMENT -BI-ANNUAL MEETING WITH FACIITY COMMITTES CHAIRMEN AND OFFICER IN-CHARGES -TRAIINING OF H/WS ON FINANCIAL MANAGEMENT -DHMT TRAINING ON MANAGEMENT
PLANNING, PM&E
- POOR M&E OF HEALTH ACTIVITIES IN THE DISTRICT
- POOR ANALYSIS AND REPORTING
-NO INTEGRATED MONITORING AND EVALUATION TOOLS -MOST OF THE DHMT NOT COMPUTER LITERATE -COMPETEING PROGRAMMES -SHOTAGE OF ICT EQUIPMENTS -LACK OF M& E SKILLS BY DHMT MEMEBERS -LACK OF FUNDS -NO TARGETS FOR MANY SERVICES
- DEVELOP AND INTEGRATED M&E TOOL -TRAINING DHMT ON M&E SKILLS -DHMT TRAINING ON COMPUTER PACKAGES -PROCURE ICT EQUIPMENTS -ANNUAL TARGET SETTING WITH THE HEALTH WORKERS -REGULAR RRI TO VARIOUS SERVICES AND ACTIVITIES
22
SECTION 3
RESULTS AND TARGETS
23
3.1 DISTRICT CONSOLIDATED TARGETS District Eligible Targets
Populati
on District Baseline District Total Contribution of NGOs and FBOs
Performance indicators
Level 2
Level 3
Level 4 Total
Level 2
Level 3 Level 4 Total
Level 2 Level 3
Level 4 Total
Number of pregnant women receiving two doses of IPT 13, 569 4170 2404 2432 9006 4212 2428 2456 9096 421 243 246 910 Number of maternal health audit 0 12 12 24 0 12 12 24 0 1 1 2 Mothers are kept
healthy during pregnancy
Number of pregnant women having 4 ANC visits 13, 569 2000 1136 984 4120 2020 1147 994 4161 202 115 99 416 Number of women of reproductive age receiving FP commodities 129, 295
11024 24402
85958
121384 11134 24646 86818 122598 1113 2465 8682
12260 Mothers are able
to have normal deliveries
Number of deliveries conducted by skilled staff 13, 569 0 1658 6012 7670 0 1675 6072 7747 0 167 607 775 New borne with low birth weight 13, 569 0 28 256 284 0 28 259 287 0 3 26 29 Number of new borne receiving BCG 13, 569 6462 2068 2608 11138 6527 2089 2634 11249 653 209 263 1125 Number of Pregnant mothers Counselled and Tested for HIV 13, 569 0 0 0 0 0 0 0 0 0 0 0 0
All newborns (up to 2 weeks) receive protection against immunizable conditions
Number of children under one fully immunized 13, 569 1828 2486 8008 12322 1846 2511 8088 12445 185 251 809 1245 Number of children under one vaccinated against measles 13, 569 1830 2486 8010 12326 1848 2511 8090 12449 185 251 809 1245 Number of children receiving Vitamin A 58, 994 8514 632 1398 10544 8599 638 1412 10649 860 64 141 1065
Children receive protection against immunizable diseases
Number of children under five treated for malaria 58, 994
19641.6
10652.4 7314 37608 19838 10759 7387 37984 1984 1076 739 3798
Children are able to survive childhood illnesses
Number of school children correctly de-wormed at least once a year
91861 0 0 0 0 0 0 0 0 0 0 0 0 Healthy lifestyle is adopted amongst children
Number underweight among children under five
59, 994 4632 1384 1390 7406 4169 1258 1263 6690 468 140 140 748
Number of children under 5 years attending Growth Monitoring Clinic 58, 994
331080 80844
51592
463516
334391 81652 52108 468151
33439 8165 5211
46815
24
District Eligible Targets
Populati
on District Baseline District Total Contribution of NGOs and FBOs
Performance indicators
Level 2
Level 3
Level 4 Total
Level 2
Level 3 Level 4 Total
Level 2 Level 3
Level 4 Total
Number of health facilities offering the standard package of youth – friendly health services
0 0 0 0 0 0 0 0 0 0 0 0 0 Behaviour change is promoted amongst adolescents that leads to healthy lifestyle
0 0 0 0 0 0 0 0 0 0 0 0 Adolescents are able to survive common health conditions affecting them
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
Number of functioning community health units 99 0 0 0 0 0 0 0 0 0 0 0 0
Number of Households with access to clean water and latrine 123098 0 0 0
87020 0 0 0 87890 0 0 0 0
Number of households sprayed with IRS 123098 0 0 0 460 0 0 0 465 0 0 0 0 Number of HIV positive patients receiving ART treatment 0 0 692 692 0 0 700 700 0 0 100 100
Adults are able to survive common health conditions affecting them
Number of VCT clients 0 3008 4600 7608 0 3037 4645 7682 0 1290 2219 0
Elderly are able to survive common health conditions affecting them
0 0 0 0 0 0 0 0 0 0 0 0
Percentage of clients satisfied with the services offered 0 0 0 0 0 0 0 0 0 0 0 0
OPD attendance
491617 1657
80 28328
6 76885
4 1217
920 1674
38 286119 776543 123009
9 1674
4 28612 7765
4 1230
10 Total Patients in ward during 0 0 0 0 0 0 0 0 0 0 0 0
25
District Eligible Targets
Populati
on District Baseline District Total Contribution of NGOs and FBOs
Performance indicators
Level 2
Level 3
Level 4 Total
Level 2
Level 3 Level 4 Total
Level 2 Level 3
Level 4 Total
the reporting period
Number of days without the tracer drugs 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
26
SECTION 4 THE WORK PLAN
27
4.1Coordination of Service Delivery
Output 1: Increased no. of pregnant women receiving 2nd IPT
Activities
(Responsible Person)Coordinator at DHMT Level
Budget Source Code
Level IV
Train 40 health workers on FANC/MIP
350,000 WHO/RH 2210701
Intensify microteaching in 5 health facilities
DPHN 100,000.00 ADB 2210701
Implementation of FANC/MIP programme in 5 health facilities that offer ANC services
DPHN 200,000.00 ADB 2210701
Ensure adequate supplies of IPT drugs in 5 health facilities with ANC services
Pharmacist 0.00
Ensure all data collecting and reporting tools are available and well documented
DHRIO 50,000.00 ADB 2210502
Level III
Intensify microteaching in 11 health facilities
DPHN 0.00
Implementation of FANC/MIP programme in 11 health facilities that offer ANC services
DPHN 0.00
Ensure adequate supplies of IPT drugs in 11 health facilities with ANC services
DPHN 0.00
Ensure all data collecting and reporting tools are available
DHRIO 50,000.00 ADB 2210502
Level II
Result Area 1: Mothers are kept healthy during pregnancy
Intensify microteaching in all health facilities
DPHN 0.00
28
Implementation of FANC/MIP programme in 58 health facilities that offer ANC services
DPHN 0.00
Ensure adequate supplies of IPT drugs in 58 health facilities with ANC services
Pharmacist 0.00
Ensure all data collecting and reporting tools are available
DHRIO 50,000.00 ADB 2210502
level 1
Intensify social mobilization through barazas, schools by the PHT to encourage mother come for ANC early enough
DPHO 100,000.00 FIF/GOK 2210303
2210031 Train 200 CORPS on community FANC/MIP
DPHN 400,000.00 WHO/RH
2210303 Develop IEC materials in local
language & distribute to community
DPHN 500,000.00 WHO/RH 2210502
Conduct 10 roadshows in the 4 divisions
500,000.00 WHO/RH 2210303
Output 2: Reduced no. of maternal deaths Level IV (Responsible Person)Coordinator at DHMT Level
Source Code
Train 40 health workers on maternal & perinatal audit
RH/coordinator/DPHN 350,000.00 WHO/RH 2210701
Provide audit tools DHRIO 50,000.00 WHO/RH 2210701
Conduct monthly maternal mortality meetings
RH/coordinator/DPHN 40,000.00 WHO/RH 2210701 Train 20 health workers on PAC DPHN 400,000.00 GOK/FIF 2210701
Level III Conduct monthly maternal
mortality meetings DPHN 100,000.00 WHO/RH 2210031
29
Level II
Output 3: Increased no. of pregnant women having 4 ANC visits
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV Intensify microteaching in 5
health facilities DPHN 0.00
Implementation of FANC/MIP programme in 11 health facilities that offer ANC services
DPHN 0.00
Level III
Intensify microteaching in 11 health facilities
DPHN 0.00
Implementation of FANC/MIP programme in 11 health facilities that offer ANC services
DPHN 0.00
Level II 0.00
Intensify microteaching in 58 health facilities
DPHN 0.00
Implementation of FANC/MIP programme in 58 health facilities that offer ANC services
DPHN 0.00
Level I Conduct monthly social
mobilization through barazas by PHT to encourage early ANC attendance
DPHO 150,000.00 FIF/GOK 2210031
Output 4: Increased no. of women of reproductive age receiving FP commodities
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV Acquire & distribute FP
commodities to all h/fs quaterly DPHN 80,000.00 WHO/RH 2210303
Train 20 health workers on contraceptive logistic management
100,000.00 2210701
30
Intensify microteaching in 4 health facilities
DPHN 0.00
Ensure timely ordering of FP commodities in 4 health facilities
DPHN 0.00
Quarterly submission of FP reports by the 4 health facilities
DPHN 0.00
Ensure data collecting and reporting tools are available
DPHN 0.00
Acquire 4 FP teaching tools DPHN 0.00
Train 20 health workers on implants insertion
DPHN 100,000.00 WHO/RH 2210701
Level III Intensify microteaching in 9
health facilities DPHN 0.00
Ensure timely ordering of FP commodities in 9 health facilities
DPHN 0.00
Quarterly submission of FP reports by the 9 health facilities
DPHN 0.00
Ensure data collecting and reporting tools are available
DPHN 0.00
Increase no. of SDP offering FP commodities
DPHN 0.00
Acquire 9 FP teaching tools DPHN 0.00
Level II
Intensify microteaching in 55 health facilities
DPHN 0.00
Ensure timely ordering of FP commodities in 55 health facilities
DPHN 0.00
Quarterly submission of FP reports
DPHN 0.00
Ensure data collecting and reporting tools are available
DPHN 0.00
31
Increase no. of SDP offering FP commodities
DPHN 0.00
level I DPHN 0.00
Conduct monthly social mobilization through barazas by PHT to increase FP commodities uptake
DPHO 0.00
Output 4: Increased no. of deliveries conducted by skilled staff
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Train 40 health workers on obstetric care
DPHN 200,000.00 WHO/RH 22107012
Procure 100 ampoules ergometrine in 11 health facilities per quarter to carter for deliveries
Pharmacist 416,000.00 2211002
Intensify microteaching in 5 health facilities to increase no. of deliveries conducted by skilled labour
DPHN 0.00 FIF
Ensure preparedness for obstetric care in 5 health facilities
DPHN 0.00
Intensify implementation of FANC/MIP in 5 health facilities offering ANC facilities
DPHN 0.00
Enhance referral system for maternity cases
DMOH 0.00
Enhance active monitor of labour
DPHN 0.00
Provide maternity data collecting and reporting tools
DHRIO 0.00
Level III
Result Area 2: Mothers are able to have normal deliveries
Intensify microteaching in 11 health facilities to increase no. of deliveries conducted by skilled labour
DPHN 0.00
32
Ensure preparedness for obstetric care in 16 health facilities
DPHN 0.00
Intensify implementation of FANC/MIP in 16 health facilities offering ANC facilities
DPHN 0.00
Enhance referral system for maternity cases
DMOH
Enhance active monitor of labour
DPHN 0.00
Provide maternity data collecting and reporting tools
DHRIO 0.00
Level II
Intensify microteaching in health facilities
DPHN 0.00
Ensure preparedness for obstetric care
DPHN 0.00
Intensify implementation of FANC/MIP in 46 health facilities offering ANC facilities
DPHN 0.00
Level I
Conduct monthly social mobilization through barazas by PHT to encourage mothers deliver in facility level
DPHO 0.00
Output 1: Reduced no. of newborn with low birth weight
Activities
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Intensify microteaching on good nutritional in 5 health facilities during ANC visits
DPHN 0.00
Ensure adequate supply of maternal supplements e.g. ferrous and folic
DNO 0.00
Result Area 3: All newborns (upto 2 weeks) receive protection against immunisable conditions
Purchase nutritional supplement quarterly in 5 health facilities
DNO 400,000.00 FIF 2211015
33
Procure 5000 LLINs for pregnant women
DPHO 150,000.00 IFAD/GOK/FIF 2211015
Train 40 health workers on newborn care
RH/coordinator/DPHN 350,000.00 wHO/RH 2210701
Level III
Intensify microteaching on good nutritional in 11 health facilities during ANC visits
DPHN 0.00
Ensure adequate supply of maternal supplements e.g. ferrous and folic
DNO 0.00
Purchase nutritional supplement quarterly in 11 health facilities
DNO 132,000.00 FIF 2211015
Procure 5000 LLINs for pregnant women
DPHO 150,000.00 EU/FIF/GOK
Level II
Intensify microteaching on good nutritional in 58 health facilities during ANC visits
DPHN 0.00
Ensure adequate supply of maternal supplements e.g. ferrous and folic
DNO 0.00
Procure 5000 LLINs for pregnant women
DPHO 150,000.00 EU/FIF/GOK
Level 1
Output 2: Increased no. of newborns receiving BCG
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Intensify microteaching in 5 health facilities on importance of BCG uptake
DPHN 0.00
Do monthly forecasting and ordering to ensure adequate supply of BCG
DPHN 0.00
34
Ensure BCG vaccines are kept potent by regular maintenance of cold chain equipment
HMU 0.00
Ensure that the 5 health facilities give BCG in the maternity before discharge
DPHN 0.00
Level III
Intensify microteaching in 7 health facilities on importance of BCG uptake
DPHN
Do monthly forecasting and ordering to ensure adequate supply of BCG
DPHN 120,000.00 2210701
Ensure BCG vaccines are kept potent by regular maintenance of cold chain equipment
DPHN 0.00
Ensure that the 5 health facilities give BCG in the maternity before discharge
DPHN 0.00
Level II
Intensify microteaching in 37 health facilities on importance of BCG uptake
DPHN 0.00
Do monthly forecasting and ordering to ensure adequate supply
DPHN 0.00
Ensure BCG vaccines are kept potent by regular maintenance of cold chain equipment
HMU 0.00
Output 3: Increased no. of pregnant mothers counseled and tested for HIV
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Train 40 health workers on PMTCT
200,000.00 NARESA/EU 2210701
Integrate PMTCT services with the ANC services in 5 health facilities offering ANC services
DASCO 0.00
Intensify microteaching in the 5 health facilities and document
DPHN 0.00
35
Acquire HIV testing kits timely for the 5 health facilities
DMLT 0.00
Level III
Integrate PMTCT services with the ANC services in 11 health facilities offering ANC services
DPHN 0.00
Intensify microteaching in the 11 health facilities and document
DPHN 0.00
Acquire HIV testing kits timely DMLT 0.00
Level II
Integrate PMTCT services with the ANC services in 58 health facilities offering ANC services
DPHN/DASCO 0.00
Intensify microteaching in the 58 health facilities and document
DPHN 0.00
Acquire HIV testing kits timely DMLT 0.00
Result Area 4: Children receive protection against immunizable diseases
Output 1: Increased no. of under 1 fully immunized
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
set annual targets with 100 health workers
DPHN 400,000.00 FIF 2210701
Train 20 health workers on operational KEPI
DPHN 430,000.00 KEPI/WHO 2210701
2210302
2210303
Cold chain maintenance in all health units
HMU 200,000.00 KEPI/WHO/FIF
Acquire & distribute vaccines DPHN 160,000.00 KEPI/WHO/FIF 2210302
36
2210303
Intensify microteaching in the 7 immunizing facilities and document
DPHN 0.00
Monthly monitoring of immunization status
DPHN
Monthly forecasting and ordering to ensure adequate vaccine supplies
DPHN 0.00
Level III
Intensify microteaching in the 7 immunizing facilities and document
DPHN 0.00
2210302
2210303
Active defaulter tracing by the PHT and CHWs in the 7 health facilities
DPHO 109,200.00 FIF/GOK
Monthly monitoring of immunization status
Monthly forecasting and ordering to ensure adequate vaccine supplies
DPHN 0.00
Level II
Intensify microteaching in the 37 immunizing facilities and document
DPHN 0.00
2210302
2210303
Active defaulter tracing by the PHT and CHWs in the 37 health facilities
DPHO 592,000.00 FIF/GOK
37
Monthly monitoring of immunization status
DPHN 0.00
Monthly forecasting and ordering to ensure adequate vaccine supplies
DPHN 0.00
Start immunization services in 3 more dispensaries (Purchase 3 RCW)
DPHN 600,000.00 WHO/KEPI/EU/ADB 3111002
Output 2: Increased no. of children under 5yrs receiving Vit A
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Level III
Conduct biannual Vit A supplementation
DNO 1,000,000.00 WHO/UNICEF 2210701
Intensify microteaching for children to be brought for Vitamin in all health facilities
DNO 0.00
Acquire enough Vitamin A supplement
DNO 0.00
Level III
Intensify microteaching for children to be brought for Vitamin in all health facilities
DNO 0.00
Increase no. of SDP giving Vitamin A by 2
DNO 0.00
Acquire enough Vitamin A supplement
DNO 0.00
Level II
Intensify microteaching for children to be brought for Vitamin in all health facilities
DNO 0.00
38
Increase no. of SDP giving Vitamin A by 10
DNO 0.00
level 1
Intensify social mobilization on the importance of Vitamin A intake by children under 5yrs by PHT/CHWs
DPHO 0.00
Result Area 5: Children are able to survive childhood illnesses
Output 1: Reduced no. of under 5yrs treated for malaria
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Train 20 health workers on
IMCI strategy DCO 1,800,000.00 2210701
Train 100 health workers on malaria case management
Pharmacist 500,000.00 2210701
Acquire anti-malaria drugs for 5 health facilities
Pharmacist 0.00
conduct social mobilization on correct use of LLINs/ITNs
DPHO 0.00
Level III
Acquire anti-malaria drugs for 11 health facilities
Pharmacist 0.00
conduct social mobilization on correct use of LLINs/ITNs
DPHO 0.00
Making of mosquito nets using available resources
DPHO 50,000.00 FIF/GOK
Level II
Acquire anti-malaria drugs for 73 health facilities
Pharmacist 0.00
conduct social mobilisation on correct use of LLINs/ITNs
DPHO
39
Level I
2210302
2210303
Conduct mass retreatment of ITN by CHWs
DPHO 300,000.00 GOK/IFAD/ADB
Social mobilization on correct use of LLINs/ITNs
DPHO 0.00
Output 2: Increased no. of school children correctly dewormed at least once a year
Activities
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Acquire anti-helminths for 5 health facilities
Pharmacist 0.00
Conduct at least 5 school health education
DHEO 0.00
Level III 0.00
Acquire anti-helminths for 11 health facilities
Pharmacist 0.00
Conduct at least 7 school health education
DHEO 0.00
Level II
Acquire anti-helminths for 65 health facilities
Pharmacist 0.00
Conduct at least 20 school health programme
DHEO 0.00
Level I
40
Ouput 3: Reduced no. of underweight children under 5yrs
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Level III
Intensify microteaching on dietary counseling in11 health facilities
DNO 0.00
Enhance growth monitoring at 11health facilities
DNO 0.00
Level II
Intensify microteaching on dietary counseling in 58 health facilities
DNO 0.00
Establish growth monitoring in 10 more health facilities
DNO 0.00
Level I
Intensify growth monitoring by the CHWs and give guidance
DNO 0.00
2210302 Monthly supervision of CHWS by CHEWs and submission of CHANIS report
DPHO 36,000.00 IFAD/GOK/FIF
2210303
Output 4: Increased no. of children under 5yrs attending growth monitoring clinics
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Intensify microteaching in 5
clinic offering growth monitoring
DNO 0.00
41
0.00
Level III 0.00
Intensify microteaching in 5 clinic offering growth monitoring
DNO 0.00
Level II
Intensify microteaching in 49 clinic offering growth monitoring
DNO 0.00
Acquire 20 growth monitoring kits to increase no. of SDP offering growth monitoring
DNO 0.00
Level I
Acquire 20 growth monitoring kits to increase no. of CHWs offering growth monitoring
DNO 0.00
Social mobilization on under 5yrs children attending growth monitoring clinics by CHWs and PHT
DNO 0.00
2210302
2210303
Conduct monthly defaulter tracing on children attending growth monitoring clinics by CHWs
DNO 153,600.00 IFAD/GOK/FIF
Provide 20 sets of growth monitoring tools for CORPS
DNO 200,000.00 IFAD/GOK/FIF 3111002
42
Result Area 6: Behaviour change is promoted amongst adolescents that leads to healthy lifestyle
Output 1: Increased no. of health facilities offering standard package of youth friendly health services
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Establish and equip 1youth friendly clinics at Kimbimbi SDH
MO i/c 3,000,000.00 WHO/RH 3110202
Train 8 peer counselors for Kerugoya and Kimbimbi SDH
DMOH 150,000.00 WHO/RH 2210701
Train 40 health workers on adolescent reproductive health
350, 000 WHO/RH 2210701
Level III
Level 11
22202053
Establish 3 youth friendly sites (Ngariama, Gatugura and Kutus dispensaries
DASCO 3,000,000.00 Partners in Prevention
3110203
Level 1
2210302
2210303
Intensify health promotions and health education in schools
DHEO 160,000.00 IFAD
Create community awareness on reproductive health issues in the youth
DPHO/RH coordinator 500,000.00 WHO/RH 2210303
43
Output 1:Increased no. of households with access to clean water and latrine
(Responsible Person)Coordinator at DHMT Level
Source Code Result Area 7: Adults are able to survive health conditions affecting them
Activities
Level IV
Train 40 health workers on PHAST
DPHO 400,000.00 IFAD 22010701
Level III
Level II
Quarterly social mobilization on save sanitation and safe water
DPHO 76,000.00 IFAD//FIF 2210302
Level I
Conduct open sanitation campaigns in 10 shopping centre
DPHO 100, 000 EU/IFAD/FIF 2210302
Construct 10 VIP for demonstration
DPHO 250,000.00 IFAD/FIF 3110202
Protect 4 watersprings DPHO 200,000.00 IFAD/FIF/ADB 3110202
Cast 100 slabs for demonstration DPHO 300,000.00 IFAD/ADB 3110202
Output 2: Increased no. of households sprayed with IRS
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV Conduct IRS in 5 health
facilities DPHO 15, 000 IFAD/FIF 2210303
Level III 2210303 Conduct IRS in 7 health
facilities DPHO 15,000.00 IFAD/FIF 2210303
44
Level II
Level I
Conduct IRS in 20 homesteads DPHO 100,000.00 IFAD/GOK/FIF 2210303
Output 3: Increased no. of HIV positive patients receiving ART treatment
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV Train 20 health workers on ART DASCO 200,000.00 ICAP/AIPHA/NARESA 22010701
Train 60 health workers on TB/HIV collaboration
DTLC 450,000.00 NASCOP/NLTP 22010701
Train 20 health workers on HBC HBC coordinator 200,000.00 GOK/FIF 22010701
Train 6 VCT counselors DASCO 200,000.00 ICAP/AIPHA/NARESA 22010701
Procure baseline HIV test kits DMLT 80,000.00 NASCOP 2210303
Acquire ART drugs Pharmacist 0.00
2210302
2210303
Form 2 support groups DASCO 10,000.00 ICAP
Refurbish and integrate CCC services in Kimbimbi and Kerugoya hospital
DASCO 3,000,000.00 ICAP 2220205
Employ 8 technical personnel to work in the ART clinic (Kimbimbi and Kerugoya)
MO i/c 1,920,000.00 ICAP 2110201
Procure reagents for AFB microscopy for 4 diagnostic centres
DMLT 89,000.00 NASCOP 2210303
Procure safety hood for 4 centres
DMLT 400,000.00 NASCOP 2210303 Provision of data collecting and
reporting tools DHRIO 50,000.00 FIF/GOK/NASCOP 22110501
Level III
Train 8 VCT counselors DASCO 200,000.00 NASCOP 2210302
45
Procure safety-hood for 7 centres
DMLT 500,000.00 NASCOP 2210303
Level II
Level I
2210302
2210303
Carryout monthly community VCT
DASCO 72,000.00 Liverpool
Output 4: Increased no. of functioning community health units
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Level III
Level II
Train 10 CHEWS DPHO 50,000.00 FIF/GOK/IFAD 2210701
Train 40 PHC TOTs DPHO 200,000.00 ADB/IFAD 2210701
Quarterly meetings with divisional PHC core team
200,000.00 ADB/IFAD 2210302
Level I
2210302
2210303
Select and train 10 VHCs DPHO 50,000.00 FIF/GOK/IFAD
2210302
2210303
Establish 4 community health units throughout the district
DPHO 100,000.00 FIF
Train 200 CORPS on new community strrategy (PHC)
DPHO 600,000.00 FIF/GOK/IFAD 2210701
Hold biannual meeting with all CORPS
DPHO 200,000.00 IFAD 2210302
46
2210302
2210303
Hold an exchange tour for the 20 CORPS
DPHO 200,000.00 /IFAD
2210302
2210303
Form 2 support groups DASCO 10,000.00 ICAP
Procure typhi vaccive DPHO 400,000.00 FIF
Provide chalk and board in 44 health facilities
DHRIO 200,000.00 ADB/IFAD
Output 1: Increased OPD attendance
Activities
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV
Train 40 health workers on VIA/VILLI
RH/DPHN 350,000.00 WHO/RH
Establish customer care desk at Kerugoya and Kimbimbi hospital
MO i/c 0.00 2210701
Reduce patient waiting time at Kerugoya and Kimbimbi hospitals
MO i/c 100,000.00 FIF 2210701
Maintenance of OPD equipments and instruments at Kerugoya and Kimbimbi hospital
MO i/c 2,000,000.00 EU/IFAD/GOK/FIF 2220205
Procure dressings and other non pharmaceuticals in Kerugoya and Kimbimbi hospitals
MO i/c 12,000,000.00 EU/IFAD/GOK/FIF 2211024
Purchase dentall equipments and cartridges at Kerugoya hospital
Dentists 1,500,000.00 EU/IFAD/GOK/FIF 3110203
Purchase X-ray equipments and consumables at Kerugoya hospital
Radiographer i/c 1,500,000.00 EU/IFAD/GOK/FIF 3110203
Train 1 radiographer on ultrasound operations in Kerugoya hospital
Radiographer i/c 120,000.00 EU/IFAD/GOK/FIF 2210701
Result Area 8: Elderly are able to survive common health condition affecting them
Purchase ENT clinic equipment in Kerugoya hospital
MO i/c 107,000.00 EU/IFAD/GOK/FIF 3110203
47
Procure essential & emergency drugs for Kerugoya and Kimbimbi hospitals MO i/c
1,600,000.00 EU/IFAD/GOK/FIF 2211001
Put up a canopy for patients in reception area and physically challenged persons walkway in kerugoya hospital
MO i/c 50,000.00 GOK/FIF/CDF/EU 2220205
Purchase equipmemt for cold room in the kitchen at Kimbimbi hospital
MO i/c 1,500,000.00 GOK/EU 3110203
Purchase modern jiko for kitchen at Kimbimbi hospital
MO i/c 150,000.00 GOK/EU 3110203
Level III
Procure of consumables to 11 health facilities
DPHN 1,400,000.00 EU/IFAD/GOK/FIF 2211024
Procure of emergency drugs for 11 health facilities
PHARMACIST 200,000.00 EU/IFAD/GOK/FIF 2211001
Acquire 11 health centre kits monthly
PHARMACIST 0.00 EU/IFAD/GOK/FIF
Paint 7 health centres DPHO 2,000,000.00 GOK/FIF/CDF/EU 2220205
Recarpet the floor of 7 health facilities (Mutithi, Baricho, Baricho catholic, Kianyaga h/c, Kiamututgu, Kabare and Kianyaga catholic
DPHO 3,000,000.00 GOK/FIF/CDF/EU 2220205
Fence 3 health facilities (Mutithi, Kianyaga h/c, Kiamutugu)
DPHO 841, 880 GOK/FIF/CDF/EU 2220205
Put up gates in 4 health facilities DPHO 300,000.00 GOK/FIF/CDF/EU 2220205
Repair the ceiling of 8 health facilities (Sagana h/c, Mutithi, Baricho h/c, Baricho catholic, Kianyaga h/c, Kiamutugu, Kabare, Kianyaga catholic
DPHO 2,000,000.00 GOK/FIF/CDF/EU 2220205
Repair of portable light equipment in 8 health facilities(Sagana h/c, Muitithi h/c, Baricho h/c, Baricho catholic, Kianyaga h/c, Difathas, Kabare, Kianyaga catholic
HMU 400,000.00 GOK/FIF/CDF/EU 2220205
Purchase immersible water pump for 1 health facility (Mutithi)
DMOH 50,000.00 GOK/FIF/CDF/EU 3110203
48
Purchase electric heater for 5 health facilities (Mutithi, Sagana h/c, Baricho h/c, Kianyaga h/c, Kiamutugu)
DMOH 15,000.00 GOK/FIF/CDF/EU 3110203
Purchase portable light for 5 health facilities (Mutithi, Sagana h/c, Baricho h/c, Kianyaga h/c, Kiamutugu)
DMOH 50,000.00 GOK/FIF/CDF/EU 3110203
Purchase 5 autoclave for 5 health facilities (Mutithi, Sagana h/c, Baricho h/c, Kianyaga h/c, Kiamutugu)
DMOH 200,000.00 GOK/FIF/CDF/EU 3110203
Purchase lawn mower for 5 health facilities (Mutithi, Sagana h/c, Baricho h/c, Kianyaga h/c, Kiamutugu)
DMOH 750,000.00 GOK/FIF/CDF/EU 3110203
Purchase 7 delivery bed for 1 health facility(Kianyaga h/c, Mutithi, Baricho, Kabare, Kiamutugu, Difathas, Sagana)
DMOH 1,400,000.00 GOK/FIF/CDF/EU 3110203
Purchase 7 generator for 7 health centres
DMOH 1,350,000.00 GOK/FIF/CDF/EU 3110203
Purchase 7 television and deck for 7health centres
DMOH 280,000.00 GOK/FIF/CDF/EU
Purchase 3 water tanks for 3 health facility (Difathas, Kianyaga mutithi)
DMOH 300,000.00 GOK/FIF/CDF/EU 3110203
Purchase emergency drugs for 11 health facilities
Pharmacist 1,152,000.00 GOK/FIF/CDF/EU
2211001 Purchase various medical
equipment DMOH 40,000,000.00 GOK/FIF/CDF/EU
3110203 Construct 7 incicerators DPHO 1,750,000.00 ADB/IFAD 3110202 Level II
Procure of consumables to 65 health facilities
DPHN 1,400,000.00 EU/IFAD/GOK/FIF 2211002
Procure of emergency drugs for 65 health facilities
PHARMACIST 600,000.00 EU/IFAD/GOK/FIF
2211001 Acquire 65 dispensary kits
monthly PHARMACIST 0.00
49
Paint 28 health facilities (Rukanga, Karumande, Nguka, Kiangai, Murinduko, St. Mugumo, ACK Mutira, ACK Mbiri, Gatithi, St. Andrews Kabare, Kamweti, Kiangombe, Gatugura, Gatumbi SDA, Gathigiriri, Gaciongo, Kangaru, Gathambi, Kianjege, Njegas, Kiamanyeki, Ciagini, Thiba, Kajiji, Wamumu, Kiaragana, Mumbuini, CCS Wanguru, ACK Ngiriambu, ACK Githure, Jesmond, Ithare, Kagumo catholic, Kagumo disp, ack Karaini, Kutus catholic, ACK Thaita, Sagana catholic, Kagio catholic, Kutus disp, Kangaita, Mutitu)
3,000,000.00 GOK/FIF/CDF/ADB 2220205
Recarpet the floor of 5 health facilities (Gatugura, Gathigiriri, ACK Mutira, ACK Ngiriambu, ACK Karaini,
3,000,000.00 GOK/FIF/CDF/ADB 2220205
Putting ceilings in 15 health facilities (average 3 rooms)( Nguka, Kiangai, Murinduko, Kiangombe, Gatumbi SDA, Gathigiriri, Kangaru, Gathambi, Njegas, Kiburu, Kiamanyeki, Ciagini, Thiba, Kajiji, Wamumu, Kiaragana, Mumbuini, CCS Wanguru, ACK Ngiriambu, ACK Githure, Jesmond, Ithare, Kagumo catholic, Kagumo disp, ack Karaini, Kutus catholic, ACK Thaita, Sagana catholic, Kagio catholic, Kutus disp, Kangaita, Mutitu)
2,000,000.00 GOK/FIF/CDF/EU/ADB 2220205
Put up gates and fence 22 health faciliies (Karumande, Nguka, ACK Mutira, ACK Mbiri, Gatithi, St. Andrews Kabare, Kamweti, Gatugura, Gathigiriri, Gathambi, Kianjege, Rurii Kiandegwa, Njegas, Kiamanyeki, Ciagini, Thiba, Kiaragana, Sagana catholic, Kagio catholic, Kutus disp, Kangaita, Mutitu)
DPHIO 3,520,000.00 GOK/FIF/CDF/EU/ADB 2220205
50
Purchase of various equipment DMOH 2,000,000.00 ADB/IFAD 3110203 Construct 30 incinerators DPHO 4,500,000.00 ADB/IFAD 3110202
Do electricity wiring in health facilities (Rukanga, Nguka, Rurii Kiandegwa, Kajiji, Kagio catholic,ACK Thumaita)
HMU 2,000,000.00 GOK/FIF/CDF/EU
Put up fencing alone in 10 health facilities (Rukanga, Karumande, Kiangai, Murinduko, ACK Mbiri, St. Andrews Kabare, Kiangombe, Gatumbi SDA, Kangaru, Gathambi, Kajiji, Wamumu, Mumbuini)
DPHO 2,000,000.00 GOK/FIF/CDF/EU 2220205
0utput 2: Improved quality of care of the in-patients
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV Renovate ward 10, 11, 9 in
Kerugoya hospital (whole ward) MO i/c 2,400,000.00 GOK/FIF/CDF/EU 2220205
Renovate amenity ward in Kerugoya district hospital (repair leaking roof, repair floor, put curtail rails, painting the walls, and provide water)
MO i/c 900,000.00 GOK/FIF/CDF/EU 2220205
Put up placenta pits for Kerugoya hospital
MO i/c 300, 000 JSI/FIF 3110202
Complete 18 bed ward construction in Kimbimbi hospital
MO i/c 5,000,000.00 GOK 3110202
Purchase various equipments for the various wards in Kerugoya hospital (4 infant weighing scales, 4 adult weighing scales, 2 suckers, 1 resuscitaire, 2 resuscitation trays, 60 waste bins, polythene liners, safety boxes)
MO i/c 1,964,852.00 fIF/GOK/EU
3110203 Purchase equipment for theatre
in Kimbimbi hospital including a generator
MO i/c 5,000,000.00 GOK/FIF/CDF/EU
3110203 Purchase equipment for the 18
bed ward at Kimbimbi hospital MO i/c 1,000,000.00 GOK/EU
3110203
Purchase mortuary equipment for Kimbimbi hospital
MO i/c 2,000,000.00 GOK
3110203
51
Purchase equipment for maternity
MO i/c 1,500,000.00 GOK/EU 3110203
Ensure adequate supply of food rations in Kerugoya and Kimbimbi hospital
HAO 2,000,000.00 FIF/GOK
2211015 Level II1
Put up placenta pits for 7 health centres
DPHO 330, 852 GOK 3110202
Level 1
Create awareness on cervical cancer screening through organised women groups
RH/DPHN 200,000.00 WHO/RH
Output 2: Reduced no. of days without tracer drugs
(Responsible Person)Coordinator at DHMT Level
Source Code
Level IV 2210303
Acquire & distribute drugs Pharmacist 80,000.00 FIF/GOK/ADB
2210302
Forecast the drugs needs for 5 health facilities
Pharmacist 0.00
Timely ordering and acquisition of drugs for 5 health facilities
Pharmacist 0.00
Ensure proper records on drug consumption
Pharmacist 0.00
Level III
Forecast the drugs needs for 11 health facilities
Pharmacist 0.00
Timely ordering and acquisition of drugs for 11 health facilities
Pharmacist 0.00
Ensure proper records on drug consumption
Pharmacist 0.00
Level II
Level I
GRAND TOTAL 153,489,652
52
4.2 Coordination of Facility Based Management Support Activities
Output 1: Vehicles are
maintained
Activities
(Responsible Person)Coordinator at DHMT Level
Budget Source
Level IV
Routine services of 4 vehicles in Kerugoya hospital and 2 vehicles in Kimbimbi hospital
MO i/c 666,750 FIF/GOK/EU
Provide adequate fuel and lubricants for Kerugoya and Kimbimbi hospital
MO i/c 3,000,000 FIF/GOK/EU
Level III
Quarterly maintenance of 4 vehicles (Kabare, Kianyaga, Sagana, Baricho)
DHAO 240,000 GOK/FIF/CDF/EU
Result Area 1: Maintenance of buildings, equipment and vehicles
Level II
Activities
(Responsible Person)Coordinator at DHMT Level
Budget Source
Output 1: Motivated health workers in all health facilities
Level IV
Hold monthly staff meetings in 5 health facilities
MO I/C 475,200 GOK/FIF/CDF/EU
Provide daily staff teas in 5 health facilities HAO 300,000 GOK/FIF/CDF/EU
Quarterly HMB meetings for Kerugoya and Kimbimbi hospital
HAO 130,400 GOK/FIF/CDF/EU
Scientific conferences for health workers in Kimbimbi and Kerugoya hospitals
MO I/C 200,000 GOK/FIF/CDF/EU
Update 100 health workers on planning skills
350,000 GOK/FIF/ADB
Result Area 2: Monitoring and follow up of implementation with the committees
Level III
53
Hold monthly staff meetings in 11 health facilities
DPHN 475,200 GOK/FIF/CDF/EU
Provide daily staff teas in 11 health facilities DHAO 500,000 GOK/FIF/CDF/EU
Quarterly committee meeting DHAO 176,000 GOK/FIF/CDF/EU
Level II
Hold monthly staff meetings in 65 health facilities (5 h/ws)
DPHN 390,000 GOK/FIF/CDF/EU
Provide daily staff teas in 65 health facilities DHAO 745,000 GOK/FIF/CDF/EU
Level 1
Output 2: Improved data collection and report submission
(Responsible Person)Coordinator at DHMT Level
Budget Source
Level IV Provide data collecting and reporting tools
for Kerugoya and Kimbimbi hospital HRIO i/c 1,300,000 GOK/FIF/CDF/EU
Monthly submission of reports in 5 health facilities
HAO 30,000 GOK/FIF/CDF/EU
Hire casuals (53 in Kerugoya and 20 in Kimbimbi)
HAO 4,231,080 GOK/FIF/CDF/EU
-Purchase of one commercial copy printer for the KDH
HAO 300,000 FIF/GOK/EU
Level III GOK/FIF/CDF/EU
Timely submission of monthly reports' DHRIO 66,000 GOK/FIF/CDF/EU
Hire 3 casual workers for 8 health facilities DHAO 1,391,000 GOK/FIF/CDF/EU
Train 60 health workers on M & E DHRIO 305,000 AIPHA/GOK/ADB
Level II
Timely submission of monthly reports' by 65 health facilities
DHRIO 66,000 GOK/FIF/CDF/EU
Hire 3 casual workers for 65 health facilities DHAO 11,320,000 GOK/FIF/CDF/EU
Output 3: improved office operations
(Responsible Person)Coordinator at DHMT Level
Budget Source
Level IV Provide stationery for Kerugoya and
Kimbimbi hospital HAO 1,200,000 GOK/FIF/CDF/EU
54
Pay telephone bills for Kerugoya and Kimbimbi hospitals
HAO 500,000 GOK/FIF/CDF/EU
Maintenance of computers/email/ fax/ photocopiers
HAO 500,000 GOK/FIF/CDF/EU
Accommodation and travel (patient referral) for Kerugoya and Kimbimbi hospital
HAO 1,600,000 GOK/FIF/CDF/EU
Provision for postal couriers for Kerugoya and Kimbimbi hospitals
HAO 15,000 FIF/GOK
Staff uniform and clothing’s for Kerugoya and Kimbimbi
HAO 50,000 FIF/GOK
General office supply for Kerugoya and Kimbimbi
HAO 100,000 FIF/GOK
Provide sanitary and cleansing materials for Kerugoya and Kimbimbi hospital
HAO 700,000 FIF/GOK
Provide for water and sewerage HAO 1,000,000 FIF/GOK
GRAND TOTAL 14,344,630.00
4.3. Management level (DHMT) Support plan
ACTIVITIES TIMEFRAME RESPO
SIBLE FUNDS SOURCE CODE
PLANNING Output 1: Developed integrated DHP
J A S O N D J F M A M J
Develop an annual integrated District Heath Plan
DMOH 450,000.00 EU 2210302
Output 2: Enhanced planning skills Hold quarterly meetings with health
workers DPHN 240,000.00 FIF 2210303
MAINTENANCE OF BUILDING, INFRASTRUCTURE, EQUIPMENT COMMUNICATI
Output 1: Maintained buildings
Painting of DHMT block DMOH 50,000.00 FIF /GOK 2220205
55
ACTIVITIES TIMEFRAME RESPOSIBLE
FUNDS SOURCE CODE
ON & TRANSPORT Repairs of WC toilet DMOH 6,000.00 FIF 2220205
Purchase 20 telephone heads DHAO 100,000.00 FIF /GOK 2210201
Purchase mobile phone for 22 DHMT @ 15,000
DHAO 300,000.00 FIF
Output 2: Communication improved
Maintenance of office equip computers, printers, fax machine photocopier and scanners
DHAO 1,200,000.00 FIF GOK 2211101
Payment of telephone, Email and postage services
DHAO 600,000.00 FIF GOK 2210201
Maintenance of 8 GOK vehicles in the DMOH office
DHAO 600,000.00 FIF GOK 2220101
Purchase of fuel and lubricants for the DMOH for 8 vehicles
DHAO 1,200,000.00 FIF GOK /WHO/RH
2211201
2211201
Enhance referrals from the rural health facilities
DHAO 1,000,000.00 FIF GOK/WHO/RH 2220101
Regular maintenance of medical equipment and instruments
HMU 300,000.00 FIF GOK 2220203
Output 3: Improved transport & referral system
2210302 INTERFACE WITH COMMUNITY
Output 1: Improved community participation and involvement
Conduct CBR, Mental, Dental, Immunization outreaches
DOT 264,000.00 FIF GOK
2210303
2210302
Conduct community oral health screening
DASCO 34,500.00 FIF GOK
2210303 2210302
Celebrate World days (mental, AIDs, Breastfeeding, TB)
DHEO 500,000.00 FIF GOK
2210303
Hold quarterly review meetings with PLWAs
DASCO 840,000.00 2210302
56
ACTIVITIES TIMEFRAME RESPOSIBLE
FUNDS SOURCE CODE
2210303 Provide 30 infants born to HIV
positive mothers with supplemental formula in KDH, KDSH, Mwea mission hospital
DNO 406,800.00 VIDHA
Procure 120 bicycles for CORPS
DHAO 4,800,000.00 AIPHA/NARESA
Output 2:Improved education,health & communication to the community
Procurement of Teaching aids (Generator and white board)
DHEO 70,000.00 FIF/GOK
GOVERNANCE
DMOH
2210302
Hold Monthly DHMT meeting DMOH 52,800.00 FIF GOK
2210303 2210302
Hold Quaterly D. H.M.B meetings DMOH 65,200.00 FIF GOK
2210303 2210302
Hold quarterly stake holders meetings
DMOH 400,000.00 WHO/RH
2210303 Payment of 24 casuals DHAO 1,580,640.00 FIF 2110202
Train 20 DHMB and HMB members on facilty management
DHAO 100,000.00 FIF GOK 2210701
Output 1: Enhanced teamwork
Train 120 health facility committee DHAO 400,000.00 FIF GOK 2210701
HUMAN RESOURCE MANAGEMENT
Sensitize DHMT on HIV/ART/TB DMOH 112,500.00 AIPHA/NARESA
2210302
Output 1: improved skills and knowledge
Hold quarterly meetings with health workers working in VCT/CCC
DASCO 100,000.00 AIPHA/NARESA
2210303 2210302
Conduct monthly supervisory visits for all DHMT members
DMOH 1,200,000.00 FIF/AIPHA/NARESA/WHO/RH 2210303
-Output 2: improved supervision
Conduct supervisory visit by the DTLC and DMLT on AFB
DMLT 94,400.00 NASCOP 2210302
57
ACTIVITIES TIMEFRAME RESPOSIBLE
FUNDS SOURCE CODE
microscopy 2210303 Conduct IMCI supervision DCO 72,000.00 FIF GOK 2210302
MONITORING & EVALUATION
Provide data collecting and reporting tools
DHRIO 400,000.00 FIF GOK 2210501
Purchase of 5 desk top computers and 2 LAPTOP
DHRIO 700,000.00 FIF GOK
Interconnect computers and provide internet services
DHRIO 600,000.00 FIF GOK
Train 10 health workers on computer applications
DHRIO 80,000.00 FIF GOK 2210701
Purchase duplo machine for Kimbimbi SDH
DMOH 400,000.00 EU
Purchase 1 digital camera DHRIO 50,000.00 FIF GOK
Purchase 1 GPS DHRIO 100,000.00 FIF/GOK
Output1: Improved HMIS
Train 20 DHMT on facilitative supervision
200,000.00 WHO/RH
FINANCIAL MANAGMENT
Train DHMT/HMT members on budget preparation
DMOH 100,750.00 FIF/GOK 2210701
Update revenue / accounts personnel on current financial management systems
DMOH 37,000.00 FIF/GOK 2210701
Computerize and network financial management system in all DEPT
DMOH 100,000.00 FIF/GOK
Train revenue / accounts personnel on current financial computer packages
DMOH 25,000.00 FIF/GOK 2210701
Output 1: Improved financial management systems
Train DHMT/HMT members on financial management packages
DMOH 800,000.00 FIF/GOK 2210701
GRAND TOTAL 18,372,440.00
58
SECTION 5 THE DISTRICT BUDGET
59
5.1 District Resource Envelope 5.1.1 District resource envelope by level of care and source Level /Source GOK FIF ICAP PARTNERS IN
PREVENTION WHO DHS & SP ADB IFAD Total
Level 1 3, 374, 800 0 9, 638, 000 4,000,000 17, 012, 800 Level 2 28, 144, 640 8, 210, 268 3, 000, 000 39, 354, 908 Level 3 17, 601, 764 2, 617, 216 20, 218, 980 Level 4 24, 368, 110 31, 358, 080 3, 392, 000 7, 000,000 14, 223, 200 80, 341, 390
DHMT (Coordination) 14, 194, 644 10, 920,000 4, 164, 000 29, 278, 644 Total 73, 489, 314 56, 380, 208 3, 392, 000 3, 000,000 10, 920, 000 7, 000, 000 23, 861, 200 8, 164, 000 186, 206, 722
5.2 Budget
Budget item Code Total budget by source
GOK FIF Other Total
TRAINING 2210701 0.00 6,070,000.00 9,975,500.00 16,045,500.00
CASUAL WORKERS 2110202 0.00 5,561,720.00 0.00 5,561,720.00 MAINTENANCE OF VEHICLES 2220101 200,000.00 366,750.00 100,000.00 666,750.00
SUBSISTENCE ALLOWANCE 2210302 500,000.00 9,903,700.00 5,000,000.00 15,403,700.00 TRAVEL & ACCOMODATION 2210302 200,000.00 8,268,236.00 3,000,000.00 11,468,236.00
ALLOWANCE FOR BOARD 2210802 0.00 371,600.00 0.00 371,600.00
CONSTRUCTION OF BUILDINGS 3110202
11,084,314.00 2,000,000.00 12,714,064.00 25,798,378.00
GENERAL OFFICE SUPPLIES 2211101 0.00 100,000.00 0.00 100,000.00 MAINTENANCE OF COMPUTERS 2220201 500,000.00 500,000.00 200,000.00 1,200,000.00
MAINTENANCE OF BUILDINGS 2220205 46,800,000.00 2,000,000.00 8,761,018.00 57,561,018.00 DRUGS 2211001 0.00 1,000,000.00 1,816,000.00 2,816,000.00 LAB REAGENTS 2211008 200,000.00 400,000.00 1,538,000.00 2,138,000.00 NON PHARMACEUTICALS 2211002 480,000.00 8,000,000.00 2,000,000.00 10,480,000.00
ENTERTAINMENT 2210801 0.00 2,938,200.00 0.00 2,938,200.00
CLEANSING MATERIALS 2211103 200,000.00 500,000.00 0.00 700,000.00
STATIONERY 2211001 200,000.00 900,000.00 100,000.00 1,200,000.00
POSTAGE & TELEGRAMS 2210203 0.00 15,000.00 0.00 15,000.00
PRINTING 2210502 0.00 560,000.00 0.00 560,000.00
PURCHASE OF EQUIPMENT 3111002 10,000,000.00 3,000,000.00 7,871,920.00 20,871,920.00
60
Budget item Code Total budget by source
GOK FIF Other Total
NUTRITION 0.00 100,000.00 704,000.00 804,000.00
FOOD & RATION 2211015 1,500,000.00 500,000.00 2,000,000.00
PURCHASE OF COMPUTERS 3111002 0.00 500,000.00 850,000.00 1,350,000.00
FUEL & LUBRICANT 2211201 900,000.00 2,000,000.00 1,300,000.00 4,200,000.00
MAINTENANCE OF VEHICLES 2220101 500,000.00 500,000.00 306,700.00 1,306,700.00
UNIFORMS & CLOTHINGS 2211016 25,000.00 25,000.00 50,000.00
TELEPHONE 2110201 200,000.00 300,000.00 100,000.00 600,000.00
TOTAL 73,489,314.00 56,380,206.00 56,337,202.00 186,206,722.00
5.3 Gap/ Surplus Budget item Code Total by source TOTAL
GOK FIF WHO ICAP PP IFAD DHS & SP ADB Revenue 73, 489, 314 56, 380, 208 10, 920, 000 3, 392, 000 3, 000,000 8,164,000 7, 000, 000 23, 861, 200 186, 206, 722 Budget 73, 489, 314 56, 380, 208 10, 920, 0000 3, 392, 000 3, 000, 000 8,164,000 7,000,00 23, 861, 200 186, 206, 722 Gap 0 0 0 0 0 0 0 0 0