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Human Resources for Health (HRH) in the Constitution of Kenya 2010
MINISTRY OF MEDICAL SERVICES
MINISTRY OF PUBLIC HEALTH AND SANITATION
Transition Work Plan2011 - 2014
Human Resources for Health in the Constitution of Kenya 2010
Human Resources for Health (HRH) in the Constitution of Kenya 2010
Ministry of Medical Services
Ministry of Public Health and Sanitation
Transition Work plan2011 - 2014
Human Resources for Health in the Constitution of Kenya 2010ii
HRH Transition Work plan 2011 – 2014
THIS PUBLICATION is a Government of Kenya Document. It has been prepared by the two Ministries of Health - namely Ministry of
Medical Services and Ministry of Public Health and Sanitation- with substantial support from USAID-funded Capacity Kenya Project. The views expressed in
Agency for International Development (USAID) or the United States Government.
Any part of this document may be freely reviewed, quoted, reproduced and translated in full or in part, provided the source is acknowledged. It may not be
Transition Work Plan 2011 – 2014
Published by:
Ministry of Medical ServicesMinistry of Public Health and Sanitation
Afya HousePO Box 30016 00100, Nairobi
www.medical.go.kewww.publichealth.go.ke
Human Resources for Health in the Constitution of Kenya 2010 iii
HRH Transition Work plan 2011 – 2014
TABLE OF CONTENTS
Human Resources for Health in the Constitution of Kenya 2010iv
HRH Transition Work plan 2011 – 2014
ACRONYMS AND ABBREVIATIONS
CHW Community Health Worker
CPD Continuing Professional Development
FBO Faith Based Organization
HRMAF Human Resources Management Action Framework
HCW Health Care Worker
HR Human Resource
HRD Human Resources Development
HRH Human Resources for Health
HRIS Human Resource Information System
HRM Human Resources Management
M&E Monitoring and Evaluation
TWG Technical Working Group
Human Resources for Health in the Constitution of Kenya 2010 v
HRH Transition Work plan 2011 – 2014
The Ministry of Medical Services and the Ministry of Public Health and Sanitation are committed to reforming the health sector, towards achieving the Kenya Vision 2030 and Millennium Development Goals and meet the overall health sector goal of provid-
ing accessible, affordable and quality health care to all Kenyans in line with the new con-stitution. A key feature of the new constitution is the devolution of services, authority and management to the county level. Devolution of health services including its management to the county level will lead to a leap in quality and access of health services. However, in the interim, devolution places enormous planning and management demands. The two Min-istries of Health have established national inter-ministerial taskforce to guide the reforms needed to ensure seamless transition.
Kenya’s health sector has recognized that transition to the devolved system of health man-agement requires adequate planning and management especially in the Human Resource for Health aspects. Against this background, the sector has taken on the task of defining short and long-term strategies for addressing the Transition HRH priorities to ensure there are adequate, well skilled and motivated health workers supported by effective and efficient systems for a smooth transition to a more devolved health service delivery model in line with the new constitution.
We recognize that successful implementation of the transition work plan requires the con-certed efforts and commitment of various stakeholders in different health subsectors and others outside the health sector. In this regard, the Ministries will continue to provide stew-ardship in coordination of the sector and further strengthen future engagement processes. We strongly believe that it is the sum total of all our efforts – big or small – that will contrib-ute towards strengthening health’s systems and the health sector in general.
We are grateful to the members of the Health Workforce Subcommittee, USAID-funded Capacity Kenya Project and other stakeholders that were involved in developing this work plan.
Ngari M.W. (Ms.), CBS Mark K. Bor, CBS Permanent Secretary Permanent Secretary Ministry of Medical Services Ministry of Public Health and Sanitation
FOREWORD
Human Resources for Health in the Constitution of Kenya 2010vi
HRH Transition Work plan 2011 – 2014
The development of the Human Resource for Health Transitional Work Plan involved engage-ment of various stakeholders. The Ministry of Medical Services, and the Ministry of Public Health and Sanitation, wish to acknowledge the USAID and the USAID-funded Capacity Kenya Project for the financial and technical support in developing the Work Plan.
The two Ministries further acknowledge the contribution of the members of the Health Workforce Subcommittee, Capacity Kenya Team and other experts who took part in the de-velopment of this Transition Work Plan (See below the list of names and institutions).
ACKNOWLEDGEMENT
NAME INSTITUTION
1. Hannah Kimemia Ministry of Public Health and Sanitation 2. David Njoroge Ministry of Public Health and Sanitation 3. Stephen Kimani Ministry of Public Health and Sanitation4. Titus Waita Ministry of Public Health and Sanitation5. Jane Oburu Ministry of Public Health and Sanitation6. Terry Wefwafwa Ministry of Public Health and Sanitation7. Andrew Nyanchoga Ministry of Medical Services 8. Grace Odwako Ministry of Medical Services9. Susan Agunda Ministry of Medical Services 10. Dr. Simon Mueke Ministry of Medical Services11. Dr. Lucy Musyoka Ministry of Medical Services 12. Dr. Izaq Odongo Ministry of Medical Services13. Dr. Makau Matheka Ministry of Medical Services14. Oscar Ouya Ministry of Medical Services 15. Dr. Racheal Nyamai Ministry of Medical Services 16. Dalip Abdi Ministry of Medical Services 17. Patrick Musichi Ministry of Medical Services18. Rosebell Wainaina Ministry of Medical Services19. Shem Ateka Ministry of Medical Services20. Fridah Moraa Ministry of Medical Services21. Maurice Osano Nursing Council of Kenya 22. Macdonald Adieno Kenya Medical Training College 23. Achim Chiaji Capacity Kenya Project 24. Dr. William Kiarie Capacity Kenya Project25. Joyce Nyaboga Capacity Kenya Project26. Linah Vihenda Capacity Kenya Project
Human Resources for Health in the Constitution of Kenya 2010 vii
HRH Transition Work plan 2011 – 2014
Transition Workplan GoalDevelop and implement plans to ensure that at both the national and county level, there are adequate, skilled and motivated health workers and managers supported by effective and efficient systems for a smooth transition to a more devolved health service delivery
model in line with the constitution
TRANSITION WORKPLAN IN SUMMARY
Key Transition Areas
*HR Baseline Surveys *Workforce Planning*Recruitment and Deployment* Occupational Safety and Health* Career Planning* Attraction and Retention* HRIS/ICT* Performance Management
*Salaries and Allowances
* Budgeting and Projections
Leadership
*Establish Health Management Positions*Develop Management and leadership Capacity* Strengthen Regulatory and Profes-sional Associations* Communicate Transition plans
HRH Policy
*Professional Standards, Licensing and Accreditation
* Authorized Scopes of Practice
*Employment Law and Rules
Education
*Pre-Service Training
* In-Service Training
Partnerships
*HRH Multi-sectoral Coordination
* Public Private Partnerships
* HRH Dimensions of the Community Strategy
Human Resources Management HRH Financing
Human Resources for Health in the Constitution of Kenya 2010viii
HRH Transition Work plan 2011 – 2014
Human Resources for Health in the Constitution of Kenya 2010 1
HRH Transition Work plan 2011 – 2014
1. Introduction
Health workers form an integral part of the health system, and remain a key input in the provision of quality health care. The number of human resources for health across cadres has been increasing steadily over the year. However, significant HRH
challenges remain in respect to health worker shortages, inequitable distribution, skill im-balances and low health worker retention especially for scarce skills and in hard-to-reach areas.
The Government is committed to providing high quality health services to all Kenyans as enshrined in the constitution. There is need to match demand and supply of health workers as well as provide adequate numbers of skilled workers, Enhance equitable distribution of health workers, Reduce high attrition especially in marginalized areas, and improve com-pensation and benefits packages. Performance management and improved workforce pro-ductivity remains a major priority within the Sector.
In order to ensure smooth implementation of the Constitution of Kenya, the Health sector under the Government’s stewardship has prioritized health workforce issues in line with the constitution for urgent address. As such, a Health Work-force Sub-Committee has been constituted and is guided by the following Terms of Reference:
n Determine the optimal staffing level in each hospital and facilities by cadre.
n Conduct assessment of the current staffing levels in each facility and determine deficient.
n Recommend redistribution of staff.
n Sensitization of staff on the implication of the new constitution.
n Determine the capacity of Training Institution to train health workers.
n Make recommendation on ways to attract and retain motivated health workforce.
n Make recommendation on how to institutionalize performance management.
n Make recommendations for competency development of health workers.
n Explore the use of ICT in human resource management.
n Make proposal on transitional arrangement for state movement from National to County Government.
To achieve this, the Sub-committee has developed a work-plan and Road map for accelerat-ing its performance guided by:
n Article 10 (b): human dignity , equity, equality and non discrimination and protec-tion of marginalized
n Art.43 (a) and (c) on bills of social rights which stipulate that every person has the right highest attainable standard of health and emergency medical treatment.
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HRH Transition Work plan 2011 – 2014
n Art. 53 (c) on children’s right to basic nutrition and health care.
n Art. 54 (1 & 2): a person with disability to be treated with dignity, access to educational institutions & facilities and employment.
n Art. 56 (c & e) Special opportunities for access to employment and reason-able access to health services for minorities and marginalized groups.
n Art. 176 (2) on decentralization of functions.
n Art. 230 (4) on powers and functions of the Salaries and Remuneration Commission.
n Art. 235 (1) on staffing of County Government.
n Chapter six, Art. 5 on conduct of state officers.
n Fourth schedule on functions of National and County Governments.
1.1 Goal of the Transition HRH Workplan RoadmapThe goal of the transition HRH Workplan and Roadmap is to - “Develop and implement plans to ensure that at both the national and county level, there are adequate, well skilled and motivated health workers and managers supported by effective and efficient systems for a smooth transition to a more devolved health service delivery model in line with the con-stitution.”
1.2 Process of Developing the HRH Transition Workplan and RoadmapThe HRH Transition Workplan and Roadmap was developed using a participatory and consul-tative process under the leadership of the HRM directors of MOMS and MOPHS. The process was informed by progress made by the Heath workforce Transition Sub-Committee and the position paper developed by the two health Ministries. The draft transition workplan and roadmap was developed in a retreat held in Naivasha on 28 - 30 June, 2011, that was at-tended by senior health managers from MOMS and MOPHS.
2. HRH Transition Workplan Highlights
The HRH transition workplan was build around the Human Resources for Health Action Framework (HAF). This framework was selected to ensure that the workplan was compre-hensive and was informed by global best practice. The transition areas were organized around the six HRH action fields of the HAF. Below are the key areas that the workplan addressed:
n Human Resources Management
l HR Baseline Surveys
l Workforce Planning
l HRM and HRD Capacity
Human Resources for Health in the Constitution of Kenya 2010 3
HRH Transition Work plan 2011 – 2014
l Recruitment and Deployment
l Work Environment
l Occupational Safety and Health
l Career Planning
l Attraction and Retention
l HRIS/ICT
l Performance Management
n HRH Financing
l Salaries and Allowances
l HRH Budgeting and Projections
n HRH Policy
l Professional Standards, Licensing and Accreditation
l Authorized Scopes of Practice
l Employment law and Rules
n Leadership
l Establish Health Management Positions
l Develop Management and leadership Capacity
l Strengthen Regulatory and Professional associations
l Communicate Transition plans
n Education
l Pre-Service Training
l In-Service Training
n Partnerships
l HRH Multi-sectoral Coordination
l Public Private Partnerships
l HRH Dimensions of the Community Strategy
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3. Transition Workplan Matrix
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sub-Sector(s)
Indicator Target Respon-sible Person
Timeline
Year 1 Year 2 Year 3
Comprehen-sive County and National Workforce Baseline Survey - HR Mapping
Establish an assess-ment team
Develop assess-ment objectives, TORs and approach
Secure funding and Technical assis-tance
Develop data col-lection tools
Sensitization
Training
Data collection, data analysis and report writing
Dissemination of -
mendations
National Public, FBO, NSA, PFP, PNFP
% assess-ment coverage
Baseline survey done in 47 counties and at national level
PSs/HRM Direc-tors/ Transi-tional Mgmt Unit
Establish an assess-ment team
Sensitization
Training
Data collection, data analysis and report writing
Dissemination of -
mendations
County
1. Human Resources Management
Human Resources for Health in the Constitution of Kenya 2010 5
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sub-Sector(s)
Indicator Target Respon-sible Person
Timeline
Year 1 Year 2 Year 3
Determina-tion of Staff Require-ments and Rational-ization (Workforce Planning)+ Succession Planning and Mgmt
Undertake a rational-ization exercise for all health cadres. Make recommendations on cadres to retain, introduce and those to be abolished. Review job titles for cadres to
and do away with demeaning titles such as subordinate, mes-senger, sister
National
Develop revised stan-dards and norms to conform with the de-
Public, FBO
% of Gaps Redistri-bution address-es norms in 50% of counties in dire short-ages
PSs/HRM Direc-tors/ Transi-tional Mgmt Unit
Determine staff re-quirements and make recommendations on recruitment and re-distribution to support delivery of quality equitable services
National/County
Public Norms and standards devel-oped and adopted
Develop comprehen-sive County HR plans
County No. of County HR plans
Human Resources for Health in the Constitution of Kenya 20106
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sub-Sector(s)
Indicator Target Respon-sible Person
Timeline
Year 1 Year 2 Year 3
Improving HRM and HRD Capac-ity (Number, Equitable Distribution and Capac-ity of HRM and HRD Staff)
Establish HRM and HRD positions, functions, norms and structures at both national and county levels.
National Public Structure and posi-tions in place
PSs/HRM-HRD Di-rectors/ Transi-tional Mgmt UnitIdentify , recruit and
deploy professional
national level and counties
National and County
No. of positions
Develop and adapt standard operational procedures, guide-lines and budgets to support decentraliza-tion of HR functions
SOPs in place
Develop and imple-ment a HR decentral-ization timetable
Time-table in place
Train HRM and HRD Staff
No. of staff trained
Human Resources for Health in the Constitution of Kenya 2010 7
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sub-Sector(s)
Indicator Target Respon-sible Person
Timeline
Year 1 Year 2 Year 3
Recruit-ment, Deployment and Staff Redistribu-tion (two-way)
Develop a recruitment and deployment plans for the health work-force
National and County
Public Plans in place
PSs/HRM Direc-tors/ Transi-tional Mgmt Unit
Develop a recruitment manual to guide pro-cess at national and county level
National and County
Public/FBO Manual in place
Ap-proved Recruit-ment Manuals in place by March 2012
Provide training on re-cruitment to national and county level HR staff
Public No. of staff trained
Recruit, redistribute and deploy staff
Public No. of staff recruited and de-ployed
Work Envi-ronment
Conduct a rapid assessment (incor-porating employee satisfaction surveys) at national and county levels and formulate recommendations and disseminate to stake-holders
National and County
Public Work Environ-ment Norms and Stan-dards in place
Revised Norms and Stan-dards incorpo-rating work environ-ment
PS/HRM Direc-tors/ SDDMS
Incorporate recom-mendations in the Norms and Standards guidelines
Implement open of-
policy and culture to engender teamwork and openness
Policy in place
Develop mechanisms for staff to provide feedback and articu-late grievances
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HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sub-Sector(s)
Indicator Target Respon-sible Person
Timeline
Year 1 Year 2 Year 3
Occupation-al Safety, Health and wellness
Ensure incorporation of health issues in the revision of OSHA 2007
National All sub-sectors
Revised act in place
PSs/HRM - HRD Direc-tors/ Transi-tional Mgmt Unit
Carry out Baseline OSH Assessments
Policy in place
Develop policy guide-lines for the health sector including wellness/psychosocial issues
Review national OSH committees
No. of recreation/sports/health clubs/facilities for health workers and families
No of recre-ation/…facilities
Establish a compre-hensive insurance scheme for health workers and their families - (medical/accident/disability/occupational haz-ards/death)
Medical Insurance Scheme in place
Design, adapt and conduct team-build-ing sessions
% of staff that at-tend
95% of staff attend within 3 years
Establish recreation, sports and health clubs, facilities for health workers
County Public
Conduct regular team-building ses-sions
% of staff that at-tend
95% of staff attend within 3 years
Establish OSH com-mittees at county level
Human Resources for Health in the Constitution of Kenya 2010 9
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sub-Sector(s)
Indicator Target Respon-sible Person
Timeline
Year 1 Year 2 Year 3
Career Planning (Schemes of Service)
Develop, review and harmonize schemes of service for all cadres in the health sector (Post-rational-ization)
National Public No. of schemes devel-oped
No. of schemes reviewed
All cad-res have schemes of ser-vice
PS/DA/DMS/DPHS/HRM Direc-tors/
Develop succession policy guidelines
Suc-cession policy guide-lines in place
Implement succession planning guidelines
National and County
Develop-ment of At-traction and Retention Schemes
Develop clear and comprehensive policy guidelines on attrac-tion and retention of health workers at all levels
National and County
Public, FBO, NSA, PFP, PNFP
Policy guide-lines in place
100% Policy on attrac-tion and reten-tion de-veloped
PS/ D HRM
HRIS/ICT Develop HRIS policy and strategy guide-lines at national and county level guidelines
National All Guide-lines in place
PS/DD HRM
Develop Training programs for HRIS
National and County
Programs in place
Rollout a sector- wide comprehensive HRIS linked to other data-bases including HMIS at national and county level
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HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sub-Sector(s)
Indicator Target Respon-sible Person
Timeline
Year 1 Year 2 Year 3
Perfor-mance Man-agement and Super-vision
Reviewing of Perfor-mance Management policy , systems and tools
National Public, FBO, NSA, PFP, PNFP
Reviewed policies in place
100% Review
PS/D HRM/ HRD
Development of standards and tools for performance monitor-ing for the county
Stan-dards and tools in place
Sensitization and capacity building of staff on Performance Management
National and County
Public, FBO, NSA, PFP, PNFP
No. of person-nel sensi-tized
47 coun-ties
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sector(s) Indicator Target Responsible Person
Timeline
Year 1
Year 2 Year 3
Setting Levels of Salaries and Allow-ances
Make proposals to the Pay and Remuneration Review Commission to ensure health work-ers are adequately and equitably compensated to support attraction, retention and productiv-ity
National Public PS/DA/DMS/DPHS/HRM Directors/
Develop guidelines for counties role in provid-ing additional remunera-tion/top-ups
Budgeting and Projec-tions for HRH inter-vention resource require-ments
Develop comprehensive HRH budgets and projec-tions linked to workforce planning and other HR interventions includ-ing transfers, induction, training etc. for national level and counties
National and county
Public budgets and pro-jections in place
PS/DA/DMS/DPHS/HRM Directors/
2. HRH Financing
Human Resources for Health in the Constitution of Kenya 2010 11
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sector(s) Indicator Target Responsible Person
Timeline
Year 1
Year 2
Year 3
Professional Standards, Licensing and Accreditation
Integrate ethical and practice standards into schemes of ser-vices
National All Revised schemes of service In place
PSs/HRM Directors/ Transitional Mgmt Unit/ regulatory bodies
Authorized Scopes of Practice for Health Cadres
Establish a compre-hensive framework for review of various scopes of practice in line with the exigen-cies of the constitu-tion including the need for task sharing across certain cadres.
National and County
All Frame-work in place
PSs/HRM Directors/ Transitional Mgmt Unit/ regulatory bodies
Employment Law and Rules
Develop a comprehen-sive HR Policy manual to guide HRH at the national level
National Public Manual in place
PSs/HRM Directors/ Transitional Mgmt Unit
Develop a comprehen-sive HR Policy manual to guide HRH at the national level
County
Develop Policy guide-lines for short term consultancies and contractual services e.g. for medical spe-cialists
National and County
Policy guide-lines in place
3. HRH Policy
Human Resources for Health in the Constitution of Kenya 201012
HRH Transition Work plan 2011 – 2014
HRH Compo-nent
High Level Transition Actions Level (Na-tional or County)
Sector(s) Indicator Target Respon-sible Person
TimelineYear 1
Year 2
Year 3
Establishment of Health Man-agement Posi-tions
Identify health management posi-tions at national and county level (Linked to rationalization and pro-posed organizational structure)
National Public DA/DMS/DPHS/HRM Di-rectors
Work with PSC to establish the positions (linked to schemes of service development process)
No. of positions established
positions in line with constitutional provisions at national and county level
National and County
No. of positions
Development Leadership and Management Capacity of Health Manag-ers
Develop leadership, management
competencies guidelines to inform recruitment, appointment, deploy-ment and training
National Public guide-lines in place
PS/DA/DMS/DPHS/HRM Direc-tors/HRD Directors
Conduct induction for health man-agers on leadership, management and governance issues in the de-volved context
National and County
% of managers inducted
95% of managers inducted
Develop a competency-based, practical and hands-on training curriculum for health managers at national and county level
National Curricu-lum in place
Roll-out leadership, management and governance training to health managers
National and county
% of man-agers trained
95% of man-agers trained
Strengthening Health Regula-tory and Pro-fessional Asso-ciations
Review the Acts of existing health regulatory bodies.
National All Sub-sectors
Revised Acts in place
PS/DA/DMS/DPHS/HRM Di-rectors/CEOs of the councils and boards
Develop the Kenya Health Profes-sional Authority Bill
Kenya Health Profes-sional Author-ity Bill in place
Link databases of the different regulatory authorities to MFL (Under Health Information and ICT Sub-Committee)Establish county health regulatory
government)
County No. of county reg. of-
upCommunication of Transition Plans to Stake-holders
Develop a two-way communication package and roll-out plan
National Public Package in place
DA/DMS/DPHS/HRM Di-rectors/
Disseminate communication mes-sages using a wide variety of media - print, online, email, integration in induction programs, help desks, SMS etc
National and County
% of staff reached
Reach 95% of staff within 3 years
4. Leadership
Human Resources for Health in the Constitution of Kenya 2010 13
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sector(s) Indicator Target Respon-sible Person
Timeline
Year 1
Year 2
Year 3
HRH Multi-sectoral Coordina-tion
Realign HRH Coordination structures and review TORS in line with the requirement of the new constitution
National All PSs/HRM Direc-tors/ Transi-tional Mgmt UnitDevelop clear guidelines
for HRH coordination at the county level
County Guide-lines in place
Determine a priority list of coordination issues for key sub sectors e.g. FBOs, Pri-vate Sector etc
National and Coun-ty
Prior-ity list in place
Mobilize resources to sup-port critical coordination actions
Amount of re-sources mobilized
Public-Private HRH Partner-ships and Agreements
Review existing PPP mechanisms at national and county level
National/county
All sectors -HRH plan and MOUs in place
PS/DMS/DPHS/HRM Di-rectors/
Identify critical areas of PPP interventions and sup-port at national and county level
HRH Dimen-sions of the Community Strategy
Review and revise the HR dimensions of the commu-nity health strategy (Clear roles and responsibilities
linked to task shifting strat-egies)
National Public/FBO Revised Strategy in place
PS / Technical Heads / Stake-holders
Revise the community Health organizational Struc-tures
Struc-tures in place
Develop clear polices for Recruitment, compensating, developing and regulating CHWs
Policies in place
Develop a Retention pack-age for CHWs –(To be Linked with the other Retention strategies for health work-ers)
Retention strategies in place
5. Partnerships
Human Resources for Health in the Constitution of Kenya 201014
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sector(s) Indicator Target Responsible Person
Timeline
Year 1
Year 2
Year 3
Pre-Service Education
Establishment of mechanisms for link-ages between the training institutions and the employers (pri-vate/ county/national government) to address market demands
National Public, FBO, NSA, PFP, PNFP
PS/HRD /Techni-cal Heads/ KMTC and other regu-latory board
Development of Policy guidelines on expansion of training institutions - Faculty and Infrastruc-ture
Guide-lines In place
Revision of selection criteria and process (from advertising,
selection) to align with the constitutional provisions
Criteria in place
Development of a policy direction to ensure that national principles and val-ues are integrated in pre-service curricula as provided for in the Constitution
Policy direction in place
6. Education
Human Resources for Health in the Constitution of Kenya 2010 15
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Sector(s) Indicator Target Responsible Person
Timeline
Year 1
Year 2
Year 3
In-Service Training
Development of policy guidelines on com-petencies and skills
cadres
National Public, FBO, NSA, PFP, PNFP
Guide-lines in place
100% com-plete policy guide-lines
Conducting of TNA and establishment of skills inventories for the Health Workforce
National and County
TNA Re-port
Development of clear policy guidelines on
education
Guide-lines in place
Develop CPD guidelines Guide-lines in place
Rollout CPD
Expansion of in-service education opportunities –faculty and infrastruc-ture.
Human Resources for Health in the Constitution of Kenya 201016
HRH Transition Work plan 2011 – 2014
4. HRH Transition Workplan Implementation Roadmap
2011/12 2012/13 2013/14
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Milestones HR Baseline Surveys
Revised Staff-ing Norms and
Standards
National and County HR Plans
Mid- Term As-sessments
Deploy Critical Staff * Induct and Train Staff
Develop Commu-nication Package
New HRH/HRD Structures
Conduct National and County Preparedness Assess-ments
HRH Transition Leader-ship Team
National• HRM Directors• HRD Directors• HRH ICC Representatives
County• County Health Director• County HR Officer
Transition Workplan Imple-mentation Mecha-nism
National• Health Workforce Sub-Committee to
remain for the entire transition pe-riod
• Have a full-time secretariat• Establish thematic TWGs• Hold regular meetings and issue com-
munication briefs • Maintain links with the National
Health Transition Unit and the HRH ICC
County• Form Transition committees• Hold regular meetings and issue communication briefs• Maintain links with the Health Workforce Sub-Commit-
tee to remain for the entire transition period
Monitor-ing and Evaluation
*Develop an M&E Framework *Conduct a mid-term review * Develop Preparedness Checklists * Regular M&E Reports
Human Resources for Health in the Constitution of Kenya 2010 17
HRH Transition Work plan 2011 – 2014
5. Transition Workplan Budget
The 3-year transition workplan was costed to estimate the budgetary requirements for implementation. It is estimated that the transition workplan will cost Kshs. 1.2 billion over the three years with GOK at national
table below provides a summary of the budgets.
HRH Compo-nent
Budget Estimates Budget Split
Year 1
2011-2012
Year 2
2012-2013
Year 3
2013-2014
Total GOK s Partner -
Others
Human Re-sources Man-agement
283,038,719 301,898,943 301,569,886 886,507,548 605,973,783 280,533,765
HRH Financing 4,085,000 4,032,000 - 8,117,000 2,592,600 5,524,400
HRH Policy 4,600,000 5,568,000 4,000,000 14,168,000 4,096,400 10,071,600
Leadership 50,215,565 83,922,864 85,842,864 219,981,293 168,172,763 51,808,529
Partnerships 1,710,000 2,165,000 1,175,000 5,050,000 1,280,000 3,770,000
Education - 4,111,000 4,531,000 17,284,000 4,984,400 12,299,600
Total 343,649,285 401,697,806 397,118,750 1,151,107,841 787,099,946 364,007,895
% Budget Split 68 32
Human Resources Management constitutes the largest portion of the budget at 77%. This is made up largely of personnel emolument costs, assessments and development of national and county HRH plans. The share of the budget by different HRH component is shown in the chart below.
Human Resources for Health in the Constitution of Kenya 201018
HRH Transition Work plan 2011 – 2014
Budget by HRH Component
Refer to the Budget Matrix chapter for the detailed budget.
National Human Resources for Health (HRH) Transition Workplan, 2011 - 2014
77
.
Human Resources for Health in the Constitution of Kenya 2010 19
HRH Transition Work plan 2011 – 2014
6. Budget Matrix
HRH Component
High Level Tran-sition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Comprehen-sive County and National Workforce Baseline Survey - HR Mapping
Establish an as-sessment team
National
Develop assess-ment objectives, TORs and ap-proach
660,000 660,000
660,000
Secure funding and Technical assistance
Develop Data collection tools
1,630,000 1,630,000
1,630,000
Sensitization 11,500,000 11,500,000
11,500,000
Training of data clerks
10,648,000 10,648,000
10,648,000
Data collection, 55,780,000 55,780,000
55,780,000
Data analysis and report writing
1,080,000 1,080,000
1,080,000
Dissemination of findings and rec-ommendations
2,060,000 2,060,000
2,060,000
1. Human Resources Management
Human Resources for Health in the Constitution of Kenya 201020
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Tran-sition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Determina-tion of Staff Require-ments and Rational-ization (Workforce Planning)+ Succession Planning and Mgmt
Undertake a rationalization exercise for all health cadres. Make recommen-dations on cadres to retain, intro-duce and those to be abolished. Review job titles for cadres to reflect chang-ing roles and do away with demeaning titles such as subordi-nate, messenger, sister
National 990,000
990,000
990,000
Develop revised standards and norms to con-form with the defined levels of service
2,580,000
2,580,000
2,580,000
Determine Staff requirements and make recom-mendations on recruitment and redistribution to support delivery of quality equi-table services
National and County
-
Develop compre-hensive County HR plans
County 3,789,750 8,842,750 12,632,500 5,053,000 7,579,500
Human Resources for Health in the Constitution of Kenya 2010 21
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Tran-sition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Improving HRM and HRD Capac-ity ( Number , Equitable Distribution and Capacity of HRM and HRD Staff)
Establish HRM and HRD posi-tions functions, norms and struc-tures at both national and county levels.
National -
Identify , recruit and deploy professional HR officers to the national level and counties
National and County
50,699,088 105,454,103 109,672,267 265,825,458 239,242,912 26,582,546
Develop and adapt standard operational pro-cedures, guide-lines and bud-gets to support decentralization of HR functions
-
Develop and implement a HR decentralization timetable
-
Train HRM and HRD Staff (188 at county level)
4,956,250 5,451,875 5,997,063 16,405,188 4,921,556 11,483,631
Human Resources for Health in the Constitution of Kenya 201022
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Tran-sition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Recruitment, Deployment and Staff Re-distribution (two-way)
Develop a recruitment and deployment plans for the health workforce
National and County
- - -
Develop a recruitment manual to guide process at na-tional and county level
990,000
990,000
297,000
693,000
Provide training on recruitment to national and county level HR staff and line managers
4,778,333 4,778,333 4,778,333 14,335,000 4,300,500 10,034,500
Redistribute and deploy staff
83,035,715 83,035,715 83,035,715 249,107,144 249,107,144
Human Resources for Health in the Constitution of Kenya 2010 23
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Tran-sition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Work Envi-ronment
Conduct a rapid assessment (incorporating employee satis-faction surveys) at national and county levels and formulate rec-ommendations and disseminate to stakeholders
national and County
980,250 980,250 1,960,500 588,150 1,372,350
Implementation in line with the Norms and Stan-dards guidelines
-
- -
Implement open -
ture, policy and culture to engen-der teamwork and openness
-
- -
Develop mecha-nisms for staff to provide feedback and articulate grievances
-
- -
Human Resources for Health in the Constitution of Kenya 201024
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Tran-sition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Occupa-tional Safety, Health and Wellness
Carry out Base-line OSH Assess-ments
National 1,960,500 1,960,500
588,150
1,372,350
Ensure incorpo-ration of health issues in the revision of OSHA 2007
- - -
Develop policy guidelines for the health sector including well-ness/psychoso-cial issues
2,990,000 2,990,000 897,000 2,093,000
Review national OSH committees
-
Establish rec-reation/sports/health clubs/fa-cilities for health workers and families (develop concepts and designs)
1,080,000 1,080,000 432,000 648,000
Establish a com-prehensive insur-ance scheme for health workers and their fami-lies - (medical/accident/disabil-ity/occupational hazards/death)
-
Design, adapt and conduct team-building sessions
37,600,000 37,600,000 75,200,000 30,080,000 45,120,000
Establish rec-reation/sports/health clubs/fa-cilities for health workers
County -
Conduct regular team-building sessions
-
Establish OSH committees at county level and
-
Human Resources for Health in the Constitution of Kenya 2010 25
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Tran-sition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Career Planning (Schemes of Service)
Develop, review and harmonize schemes of ser-vice for all cad-res in the health sector (Post-rationalization)
National - - -
Develop suc-cession policy guidelines
1,780,000 1,780,000 534,000 1,246,000
Implement suc-cession planning guidelines
National and County
- - -
Development of Attraction and Reten-tion Schemes
Develop clear and compre-hensive policy guidelines on attraction and retention of health workers at all levels
National and County
2,880,000 1,300,000 4,180,000 1,254,000 2,926,000
HRIS/ICT Develop HRIS policy and strat-egy guidelines at national and county level
National 360,000 360,000 72,000 288,000
Develop train-ing programs for HRIS
National and County
-
Rollout a sector- wide comprehen-sive HRIS linked to other databas-es including HMIS at national and county level
20,484,167 22,532,583 24,785,842 67,802,592 27,121,037 40,681,555
Human Resources for Health in the Constitution of Kenya 201026
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Tran-sition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Performance Management and Supervi-sion
Reviewing of Performance Management policy , systems and tools
National -
Development of standards and tools for perfor-mance moni-toring for the county
-
Sensitization and capacity build-ing of staff on Performance Management
National and County
25,066,667 27,573,333 30,330,667 82,970,667 41,485,333 41,485,333
SUB TOTAL Human Resources Management
283,038,719 301,898,943 301,569,886 886,507,548 605,973,783 280,533,765
% Budget Split 68 32
Human Resources for Health in the Constitution of Kenya 2010 27
HRH Transition Work plan 2011 – 2014
2. HRH Financing
HRH Component
High Level Transition Actions
Level (Na-tional or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Setting Levels of Salaries and Allow-ances
Make propos-als to the Pay and Remunera-tion Review Commission to ensure health workers are adequately and equitably compensated to support attraction, retention and productivity
national 225,000 225,000 225,000
Develop guidelines for counties role in providing additional remuneration/top-ups
3,140,000 3,140,000 942,000 2,198,000
Budgeting and Projec-tions for HRH Inter-vention resource Require-ments
Develop comprehensive HRH budgets and projec-tions linked to workforce planning and other HR interventions including transfers, in-duction, train-ing etc. for national level and counties
National and county
720,000 4,032,000 4,752,000 1,425,600 3,326,400
Sub Totals HRH Financing 4,085,000 4,032,000 - 8,117,000 2,592,600 5,524,400
% Budget Split 32 68
Human Resources for Health in the Constitution of Kenya 201028
HRH Transition Work plan 2011 – 2014
3. HRH Policy
HRH Component
High Level Transi-tion
Actions
Level (Nation-
al or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Professional Standards, Licensing and Accred-itation
Integrate ethical and practice stan-dards into schemes of services
National 2,980,000
2,980,000
894,000
2,086,000
Authorized scopes of Practice for Health Cadres
Establish a compre-hensive framework for review of vari-ous scopes of prac-tice in line with the exigencies of the constitution includ-ing the need for task sharing across certain cadres.
National and County
1,620,000
1,620,000
486,000
1,134,000
Employ-ment Law and Rules
Develop a compre-hensive HR Policy manual to guide HRH at the national level
National 4,028,000
4,000,000
8,028,000
2,408,400
5,619,600
Develop a compre-hensive HR Policy manual to guide HRH at the county level
County
Develop Policy guidelines for short term consultan-cies/contractual services e.g. for medical specialists
National and County
1,540,000
1,540,000
308,000
1,232,000
Sub Totals HRH Policy 4,600,000 5,568,000 4,000,000 14,168,000 4,096,400 10,071,600
% Budget Split 29 71
Human Resources for Health in the Constitution of Kenya 2010 29
HRH Transition Work plan 2011 – 2014
4. Leadership
HRH Component
High Level Transition Ac-tions
Level (Na-tional or County)
Budget Estimates
Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Establish-ment of Health Management Positions
Identify health manage-ment positions at national and county level (Linked to rationalization and proposed organizational structure)
National
Work with PSC to establish the positions (linked to schemes of service devel-opment process)
-
Competitively and transpar-ently fill positions in line with constitutional provisions at national and county level
National and County
42,419,899 68,822,197 68,822,197 180,064,293 162,057,863 18,006,429
Develop Leadership and Man-agement Capacity of Health Managers
Develop leadership, man-agement and governance qualifications/ competen-cies guidelines to inform recruitment, appointment, deployment and training
National 2,925,000 2,925,000 292,500 2,632,500
Conduct induction for health managers on lead-ership, management and governance issues in the devolved context
Nation-al and County
2,770,667 2,770,667 2,770,667 8,312,000 1,662,400 6,649,600
Develop a competency-based, practical and hands-on training curriculum for health managers at nation-al and county level
National -
Roll-out leadership, man-agement and governance training to health manag-ers
national and County
7,637,500 7,637,500 15,275,000 1,527,500 13,747,500
Human Resources for Health in the Constitution of Kenya 201030
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Ac-tions
Level (Na-tional or County)
Budget Estimates
Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
Strengthen-ing Health Regulatory and Profes-sional Asso-ciations
Review the Acts of existing health regulatory bodies.
national 2,160,000 2,160,000 4,320,000 1,296,000 3,024,000
Develop the Kenya Health Professional Authority Bill
1,070,000 1,070,000 2,140,000
642,000
1,498,000
Link databases of the dif-ferent regulatory authori-ties to MFL (Under Health Information and ICT Sub-Committee)
-
Establish county Health Regulatory offices( With support of national govern-ment)
County 1,920,000
1,920,000
192,000
1,728,000
Communi-cation of Transition Plans to Stakehold-ers
Develop a two-way com-munication package and roll-out plan
2,100,000 2,100,000 210,000 1,890,000
Disseminate communica-tion messages using a wide variety of media - print, online, email, integration in induction programs, help desks, SMS etc
1,462,500 1,462,500 2,925,000 292,500 2,632,500
Sub-Total Leadership 50,215,565 83,922,864 85,842,864 219,981,293 168,172,763 51,808,529
Budget Split 76 24
Human Resources for Health in the Constitution of Kenya 2010 31
HRH Transition Work plan 2011 – 2014
5. Partnerships
HRH Component
High Level Transition Actions
Level (National or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
HRH Multi-sec-toral Coordi-nation
Realign HRH Coordi-nation structures and review TORS in line with the requirement of the new constitu-tion
National
Develop clear guide-lines for HRH coordi-nation at the county level
County
Determine a priority list of coordination issues for key sub sectors e.g. FBOs, Private Sector etc
National and
County
Mobilize resources to support critical coor-dination actions
1,175,000
1,175,000
2,350,000
470,000
1,880,000
Public-Private HRH Partner-ships and Agreements
Review existing PPP mechanisms at national and county level
National and County
990,000
990,000
297,000
693,000
Identify critical areas of PPP interven-tions and support at national and county level
-
-
Human Resources for Health in the Constitution of Kenya 201032
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transition Actions
Level (National or County)
Budget Estimates Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Others
HRH Dimensions of the Commu-nity Strategy
Review and revise the HR dimensions of the community health strategy (Clear roles and responsibilities defined / scope of practice/linked to task shifting strate-gies)
National 1,710,000 1,710,000 513,000 1,197,000
Revise the community Health organizational Structures
Develop clear polices for Recruitment, compensating, devel-oping and regulating CHWs
Develop a Retention package for CHWs –(To be Linked with the other Retention strategies for health workers)
SUB TOTALS Partnerships
1,710,000
2,165,000
1,175,000
5,050,000
1,280,000
3,770,000
% Budget Split 25 75
Human Resources for Health in the Constitution of Kenya 2010 33
HRH Transition Work plan 2011 – 2014
6. Education
HRH Component
High Level Transi-tion Actions
Level (Na-tional or County)
Budget Estimates
Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Oth-ers
Pre-Service Education
Establishment of mechanisms for linkages between the training insti-tutions and the employers ( private/ county/national gov-ernment ) to address market demands
National 1,330,000 1,330,000 2,660,000 532,000 2,128,000
Development of Policy guidelines on expansion of training institutions - Faculty and Infrastructure
-
Revision of selec-tion criteria and process (from adver-tising, interviewing and final selection) to align with the constitutional provi-sions
326,000 326,000 652,000 260,800 391,200
Development of a policy direction to ensure that national principles and values are integrated in pre-service curricula as provided for in the Constitution
-
Human Resources for Health in the Constitution of Kenya 201034
HRH Transition Work plan 2011 – 2014
HRH Component
High Level Transi-tion Actions
Level (Na-tional or County)
Budget Estimates
Budget Split
Year 1 Year 2 Year 3 Total GOK Partner -Oth-ers
In-Service Training
Development of policy guidelines on competencies and skills required for specific cadres
National
Conducting of TNA and establishment of skills inventories for the Health Work-force
National and
County
Conducting of TNA and establishment of skills inventories for the Health Work-force
Develop/ Revise CPD guidelines
1,245,000
1,245,000
2,490,000
747,000.0
1,743,000
Rollout CPD 420,000
420,000
126,000.0
294,000.0
Expansion of in-service education op-portunities –faculty and infrastructure.
1,210,000
1,210,000
11,062,000
3,318,600
7,743,400
Sub-Total Education -
4,111,000
4,531,000
17,284,000
4,984,400
12,299,600
Percentage 29 71
Human Resources for Health in the Constitution of Kenya 2010 35
HRH Transition Work plan 2011 – 2014
7. Appendices
7.1 County Preparedness Checklist (Sample)
County_____________________________________________ Date_________________
Component Colour Score Remarks
1. HRH Transition Sub-Committee Formed and Func-tional
10
2. HRH Baseline Surveys Conducted and Report Is-sued
3. Staffing Norms and Standards Reviewed
4. HR Plans Developed
5. Critical Staff Deployed (to be defined)
6. Communication Plan Developed
7. Communication Plan Rolled-out
8. Staff Inducted
Aggregate Score
Key
Colour Description Score
Little or no progress made 0
Good progress made (Partial Implementation) 5
Action fully and successfully implemented 10
Human Resources for Health in the Constitution of Kenya 201036
HRH Transition Work plan 2011 – 2014
Human Resources for Health in the Constitution of Kenya 201038
HRH Transition Work plan 2011 – 2014