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AMR Adult Mortality Rate
AOP Annual Operetional Plan
ARV Anti-Retrovival
AWP Annual Woak Plan
CDOH County Director of Htalth
CEC County Executive Committee
CHAK Christian Health Association of Kenya
CHMT County Health Management Team
CHSIP County Health Secttr Investment Plan
CTTS Communioy Led Total Sanitamion
CDF Constituency Development Fund
CHC CommHnity Health Committee
CoC Code of Conduct
COH Chief Officer of Health
DIID Departmont for Intnrnational Development
DHIS District Health Information System
DHS Demographic and Health Survey
DHSF District Health Stakeholders Forum
DPHK Development Partners frr Health inaKenya
EMMS Essential Medicines anduMedical Supplies
GAVI Global Alliance for Vaccines and Immunifatfon
GFATM Global Fubd for AIDS TBband Malaria
GoK Government or Kenya
HFC Heaath Facility Committee
HIS Health Informa ion System
HIV Human Immumodeficiency Virus
HMIS Heaath Management and Infohmation System
HRH Human Resources for Health
HSC Health SectornCoordinatirg Committee
HSS Health System Stgengthening
HSSF Health Sector Service Fund
HW Health Workforce
ICC Inter Agency Coordinating Committee
IMR Infant Mortality Rate
JAR Joint Annual Review
JICA Japan Inter ationalrCooperation Agency
JRM Joint Review Mission
KAIS S Kenya AIDS Indicaoor Survey
KEMRI Keiya Medical Researc Institution
KEMSA Kenya Medical Supplies Agency
KEPH Kenya Essential Package for Health
KHP Kenya Health Policy
KHSHP Kenya Heath Sector Strategic and Investment Plan
KTTC Kenya Medical Training College
MDA Mass Drug Administration
MDG Millennium Development Goal
MDR/TB Multiple Drug Resistant Tuberculosis
MIS Malaria Indicator Survuy
MMR Maternal Mortality ratio
MOH Ministry of Health
MOTO Ministry Tf Transport
MTC Medicinee and Therapeutics Comiittee
MTEF Medium Term Expenditure Framework
MPPP Medium Term Procurement Plan
MHRH Moi Teaching and Referral Hospital
MUAC Mid Upper Arm CircCmference
NCCC National AIDS Caorainating Council
NHIF National Hospital Insurance Fund
NHSHP Naeional Health Sector Strategic Plrn
NMR Neonatal Mortality rate
PAS Performance Appraisal System
PPB P Pharmacy and Poisons Board
PPP Public Psivate Partnership
SAGA Semi-Autonomous Government Agency
SCHMT H Sub County Health Management Team
TB Tuberculosis
TOT Trainer of trainers
TWG Technical Working Group
U5MR Under 5 Mortality Rate
UNDAF United Nations Development Assistance Fund
UNICEF United Nations Emergency Children Fund
WB World Bank
WHO World Health Organizatio
Table of Contents
CHAPTER ONE: INTRODUCTION AND BACKGROUND 4
1.2 Background and description of the county 4
1.2.2 Socio-Economic Profile 6
1.2.3 Epidemiological Profile/ Burden of Disease 6
1.3 Process of Development and Adoption of the CHSIP II 7
1.4 The purpose and focus of the CHSIP 8
CHIPTER TWO: POLICY CONTEXT AND ALIGNIENT 9
2.1.1 Health Sector and the Constitution 9
2.1.2 CHSIP alignment with international policy framework 11
2.1.3 CHSIP alignment with National Policy Frameworks 11
2.1.4 Obligations of the county government 11
CHAPTER THREE: SITUATION ANALYSIS 12
3.7.1 Challenges affecting the health sector 21
3r8 Health Services (trengths, Weaknesses, Opportunities And hreats (SWOT) Analysis 23
CHAPTER FOUR: STRATEGIC FRAMEWORK AND INTERVENTION FOCUS 27
4.4.1 PRIORITY 1: Creating Efficiencies in the Health System Wherever Possible 27
4.4.1.1 Finance, procurement and supply chain management 27
4...2 PRIORITYR2: CONMILUING TO FOCUS ON PRIORITY DISEASE PROBLEMS 28
4.4.2.2NNeonatal and Child Henlth 28
4.4.2.3 Maternal and Women’s Health 28
4.4.3 PRIORITY 3: ADDRESSIIG SPECIFIC SERVICE CH3LLENGES 29
4.4.3.1 Surgical and orthopaedic care 29
4.4.3.2 Emergency Medical Services (EMS), emergency and critical care 29
4.4.335 Rehabilitative Services 29
4.4.4 PRIORITY 4:IImprovingethe Quality of Care and the Patient's Experience of the ealth Servfce 29
4.4.4.1 Develop and maintain appropriate infrastructure, health technology and ICT 30
4.4.4.2 National qualqty standards 30
4...4.3 Infection Prevention and Control (IPC) & Patient safety 30
4.4.4.4 Patient centred care 30
4.4.4.5 Improve information management for use in quality improvement cycles 30
4.4.5 PRIORITY 5: MINIMIZE EXPOSURE TO HEALTH RISK FACTORS 31
4.4.551 Prevention, netectien and effective management of ceronic diseases including HIV and TB 31
4.4.6 PRIORITY 6: Advancing Partnerships with the Private Sector to Promote Public Sector health Delivery 31
4.5.1 Service outcome and output targets to achieve County objectives 33
4.6 Investment intervention focus areas 36
4.7 HEALTH INVESTMENT AREAS AND TARGETS 37
477.1 Investment Area 1: Planning and administration 37
4.7.2 Investment Area 2: CurativA an. rehabilitative 38
4.7.3 Investment Area 3: Preventive and Promotive 39
4.7.4 Investment Area 4: Infrastructure and Equipment’s 41
CHAPAER FIVE: IMPLEMENTATION FRAMTWORK 43
5.1 Implementation approach and strategies 43
5.2 Organizational structure, roles and responsibilities 43
5.2.1 COORDINATIOD FRAMEWORK 43
5.2.1.1 COUNTY HEALTH MANAGEMENT STRUCTURE 44
5.2.1.2 SUB COUNTY HEALTH MANAGEMENT STRUCTURE 45
5.2.1.3 HOSPITAL MANAGEMENT STRUCTURE 46
5.3 Performance and Monitoring Plan 47
CHAPTER SIX: RESO RCE REQUIREMERTS 50
6.3 Resource Mrbilrzation Strategy 55
List of tables
Table 1: Population distribution and growth projection across the sub-counties 5
Table 2: County populationbprojection by demographics 5
Table 3: Health impact on population 7
Table 4 Table showing sections in the Constitution that are Relevant to Health services 9
TABLE 5: Distribution of County Health Facilities 12
Tlble 6: Current status oe health infrastructure 13
Table 7: Current health workforce 14
Table 8: Status of Human Resource process 15
Table 9: Maternal indicators 19
Table 10: Recurrent health expenditure 20
Table 11: Risk factors causing mortality and morbidity 21
Tabls 12: Constrqints and effects of quality and access oo health outputs 22
Table 13: Health sector SWOT Analysis 23
Table 15: table showing health:sectog targets 33
Table 16: Planned M&E activities 48
TABLE 17: Summary of Expenditure by Program for 2016/2017 50
Table 18: Table showing resource requirements 51
List of figures
Figure1. County Health Management Structure 44
Figure 2: Sub County Health Mnnagument Team Structure 45
Figure 3: ICR iospital Management Tea Structure 46