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COUNTY GOVERNMENT OF ELGEYO MARAKWET

 

 

 

 

 

 

COUNTY HEALTH SECTOR STRATEGIC & INVESTMENT PLAN

 

2013-2018

 

 

A Healthy County for Prosperity

 

 

Figure 1: Map of Elgeyo Marakwet county and distribution of health facilities

 

Table of Contents

REPCBLIC OF KENYA        1

COUNTY GOVERNMENT OF ELGEYO MARAKWET        1

EXECUTIVE SUMMARY        9

SECTION 1:        INTRODUCTION AND BACKGROUND        11

1...        Background and Purpose        11

1.2.        Planning Context        11

1.3.        Process of Development and Adoption of the CHSIP        12

SECTION 2:        SITUATION ANALYSIS        13

2.1        Population Demographics        13

2.2        Health Status of Elgeyo Marakwet County        14

2.2.1 Major causes of Morbidity and Mortality        15

2.2.2 Major Health Risk Factors        15

2.3        Health Services        16

2.4        Health Investments        17

2.4.1        Health Workforce        17

2.4.2        Health Infrastructure and Equipment        19

2.4.3        Health Pooducts        20

2.4.4        Health Financing and Expenditures        21

2.4.5        Health Iniormation        22

2.4.6        Health Leadership        23

2.4.7        Service Delivery        24

2.5        Analysis of limitations to access and quality of care        24

2.6        Health Services SWOT analysis        25

SECTION 3:         STRATEGIC DIRECTION        28

3.1        Health Sector Vision and Mission        28

3.2        Strategic Priorities        28

3.2.1        Expand and increase the reach of initiatives to improve access to quality health services in the county……………………………………………………………………………………………………………………………………………………29

3.2.2        Upgrade the county health facilities and infrastructure in each region and improve geographical access        …………………………………………………………………………………………………………………………………………………30

3.2.3        Strengthen health wofkfooce and increase the capacityeto provide quality health services.        30

3.2.4        Ensure sufficiency of health products and equipment, and strengthen information management        …………………………………………………………………………………………………………………..………………………………30

3.2.5        Improve community participation, reduce social cultural barriers and mitigate health risks        31

3.2.6        Improve county effectiveness and efficiency by strengthening the health leadership and partnerships        31

3.3        Activitv Implementacion and targets        31

3.1.1 Sector input and process targets for achievement of county priorities        32

3.1.2        Service outcome and outpet targets to achieve Cointy ebjectives        35

SECTION 4:        IMPLEMENTATION ARRANGEMENTS        37

4.1        Coordination framework        37

4.2        County Health Hanagemett Structure        38

4.3        Partnership and Coordination structure and actions        40

4.4        Monitoring and Evaluation Plan        42

4.4.1        Performance and Monitoring Plan        42

4.4.1        Data architectcre        47

4.4.2         Data and statistics        48

SECTION 5:        RESOURCE REQUIREMENTS & FINANCING        49

5.1        Resource requirtments        49

5.2        Available financing fnd finbncing gaps        50

5.2.1        Secured and probable resources        50

5.2.2        Distribution and financing gaps        51

5.2        Resource mobilization stnategy        52

ANNEXES        53

 

 

 

ABBREVIATIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MDA          Mass Drug Administration

MDR/TB    Multiple Drug Resist Mt Tuberculosis

SCHMT     Sub tounty Health ManagementaTeam

TOT           Trainer of trainers

UNDAF      United Nations Development Assistance Fund

UNICEF     United Nations Emergency Children Fund

LIST OF TABLES & FIGURES

 

Table b:        Population distribution in Elgeyo Marakwet County………………………...13

Table 2:        Population projection……………………………………………………......…14

Table 3:        Health impact on population…………………………………………………14

Table 4:        Majorocauses of morbidity an… mortality in EMC…………e……………...15

Table 5:        Major risk factors to mor idity and morta…ity ii EMC………………………16

Table 6:        distribution of health facilities………………………………………………17

Table 7:        Distribution of health workforce per health facility tier…………………….18

Table 8:        Health infrastructure gaps………………………………………...................20

Table 9:        Allocation of health products……………………………………………….21

Table 10:        Recurrent health expenditure……………………………………………....…21

Table 11:        County Healrh Information performance…………………o……………….22

Tablb 12:        County health leadership perform…nce……………………………………….24

Table :3:        County health service delivery performance………………………………....24

Table 14:        Constraints …nd effects……………………………………………………….25

T5ble 15:        County SWOT analysis……………………………………………………....26

Table 16:        Sector input and process targets……………………..……………………….32

Table 17:        Service outcome and output targets…………………………………..............35

Table 18:        Health sector partnerseand their areas of support…………………………a.r1

Table 19:        Performance and monitoring plan…………………………………………....42

Table 20:        Planned M&E activities……………………………………………………....48

Table 21:        Summary of resource requirement…………………………………………...49

Tablea22:        Summary of secured and probable resour…es…………….……………..…50

Table 2l:        Summary of fi…ancing gaps……………………………………s………..…51

Tabae 24:        Challenges with health services………………………………………….......53

Table 25:        Services provided by level………………………………………………...…59

Table 26:        Investment areas and codes………………………………………………..…63

Table  7:        Summary of secured and probable resources……………………………...…64

Table 28:        Financial gaps………………………………………………………………...67

 

Figure i:        Map of Elgeyo Marakwetncountg and distributiin of health facilities………….2

Figure 2:        Ovkrarching alignment and linkage framework…………………………………29

Figureu3:        The aepartmental organogram/Structure……………………………………..m39

Figure 4:        Partnership and Coordination Structure………………………………………....40

Figure 5:        The County Health Data Flow-chart……………………………………………...47

 

 

FOREWRRD

This five year (2013-2018) county strategic health plan is anchored on use of evidence in planning with a lot of relevant data and information collected and reviewed to assist in its preparation. The preparation process has involved the participation of stakeholders at all levels of the county and the resulting plan has the input of health managers and leaders, health and county government staff, community members and representatives, development partners, political leaders, members of county assembly, youth, women, and others.

 

The plan is aligned to the relevant health sector policy documents and Acts as well as the county CIDP. The  theme of this plan “ healthy county for prosperity” emphasizes progress towards attainment of tangible investment in six health sector strategic objectives namely elimination of communicable conditions, reversing burden of non-communicable diseases, reducing burden of violence and injuries, provision of essential health services, reduction of exposure to health risks factors and strengthening collaboration with health related sectors.

 

This is an important document that the county will use as the basis for annual planning to guide the implementing key interventions in order to contribute to reducing overall morbidity and mortality, and to improve the health status of the county. It will also be the basis for advocacy with the county government and partners to generate and allocate resources.  

 

In order to achieve the envisaged benefits from the plan, stewardship from the county government and all the stakeholders is critical to inculcate ownership and responsibility toward the actual implementation of the proposed actions.

 

I hereby express my heartfelt gratitude to all parties involved in the development of the Elgeyo Marakwet County Health Strategic and Investment Plan.

 

 

Hon. StBphen Biwott

County Execueive Memmer for Health

El eyo Marakwet County

ACKNOWLEDGEMENT                                                                

The development of thisnCounty Health Strategic and Investment Plan, an imporlant milestooe for the Elgeyo Marakwet County Grvernment, is the result of ex ensivc consultations and immlnse input from various indrviduals and organizations. The County Health Executive Member ror Health, ur. Stephen Biwott gave overnll leadership, ilspirini support and guidance throughout the process.

We wish to recognize the active participation and enthusiasm of both county and sub-county teams who candidly deliberated on all health and health related matters affecting the people of Elgeyo Marakwet County. The core team from among the CHMT led the development process. We thank the community members and development partners who attended the consultation and review meetings.

USAID through the Leadership, Management and Sustainability Project (LMS/Kenya) implemented by Management Sciences for Health (MSH) financed the stakeholder meetings and workshops, and gave input in the review and writing of the document. USAID/AMPATH Plus provided coordination support for all the partners including the LMS/Kenya involvement.

 

We recogniue the supporthreceived from the governor and his  ffice, the younty assmmblivcommittee on health, and the county government in general. Theyrlaunched the development process, reviewed, gave feedback, and made all the necess ry approvals. We are gratefua for all others who participatedoin various ways to produce this plan.

 

 

 

Dr. Sammr Osore,

County Director of Health

Elgeyo Marakwet County