health strategic plan kenya

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Kenya-Health-Sector-Strategic-Plan(July 2018-June 2023)

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Kenya Health Sector Strategic Plan 2018-2023

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Nursing Council Of Kenya Launches Strategic Plan 2023-2027 For Regulation And Promotion Of Nursing And Midwifery Education And Practice, With ISO Certification

Nairobi (KENYA), March 10, 2023,

The Nursing Council of Kenya launched its Strategic Plan for 2023-2027, which outlines the future direction of nursing and midwifery regulation in the country on Friday March 10, 2023.  The Cabinet Secretary, Ministry of Health, Dr. Susan Nakhumicha, commended the Council for its efforts in regulating nursing and midwifery education and practice in Kenya and acknowledged the critical role that nurses and midwives play in achieving global health obligations and providing essential services to people: "I commend the Nursing Council of Kenya for its commitment to a performance-based management culture, as evidenced by the development of this strategic plan. I also recognize the critical role that nurses and midwives play in achieving global health obligations and providing essential services to people in all settings throughout their lifespans," she said.  Dr. Nakhumicha emphasized the importance of a highly motivated health workforce and committed the Ministry of Health to supporting the Council's strategic objectives. "A highly motivated health workforce is essential for achieving Universal Health Coverage and improving the health outcomes of our citizens. I am pleased to pledge the Ministry of Health's support for the Nursing Council of Kenya's strategic objectives," she stated.  The Nursing Council of Kenya's Strategic Plan for 2023-2027 aims to contribute to meeting or exceeding global health outcome indicators and support the achievement of Universal Health Coverage.  Dr. Nakhumicha acknowledged the importance of the plan in regulating and promoting standards in nursing and midwifery education and practice that inspire public safety and confidence: The Nursing Council of Kenya's Strategic Plan for 2023-2027 envisions a safe and healthier world through regulating and promoting standards in nursing and midwifery education and practice that inspire public safety and confidence. “This plan will contribute to meeting or exceeding global health outcome indicators and support the achievement of Universal Health Coverage,” said the CS.  The Cabinet Secretary also congratulated the Council on its ISO 9001:2015 Quality Management Systems certification, which verifies that its quality management system meets international standards. "I congratulate the Nursing Council of Kenya on its ISO 9001:2015 Quality Management Systems certification. This certification verifies that the Council's quality management system meets international standards and underscores its commitment to excellence." The launch of the Strategic Plan and ISO certification marks an important milestone for the Nursing Council of Kenya and the nursing and midwifery professions in the country. Dr. Nakhumicha emphasized the need for all stakeholders to participate in the implementation process to ensure the success of the plan: "The launch of the Nursing Council of Kenya's Strategic Plan for 2023-2027 and ISO certification marks an important milestone for the nursing and midwifery professions in the country. I call upon all stakeholders to participate in the implementation process to ensure the success of this plan."

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CHW Central

A global resource for and about Community Health Workers

Kenya National Community Health Strategy, 2020-2025

July 31, 2021 By

Authors: Kenya Ministry of Health

In 2006 Kenya adopted a community-based approach (Community Health Strategy), as articulated in the second National Health Sector Strategic Plan (2005-2010), which defined a new approach for health care service delivery to Kenyans. This approach emphasized a more proactive approach of promoting individual and community health to prevent the occurrence of diseases.

The Kenya Community Health Strategy 2020 – 2025 is anchored on an ambitious vision, mission and goal whose realization is envisaged through seven strategic directions:

1. Strengthen management and coordination of community health governance structures at all levels of government and across partners 2. Build a motivated, skilled, equitably distributed community health workforce 3. Increase sustainable financing for community health 4. Strengthen the delivery of integrated comprehensive and high-quality community health services 5. Increase availability, quality, demand and utilization of data 6. Ensure the availability and rational distribution of safe and high-quality commodities and supplies 7. Create a platform for strategic partnership and accountability among stakeholders and sectors at all levels within community health

Link: Kenya National Community Health Strategy, 2020-2025

Resource Topic: Africa , CHW Role , Country Ownership , Policy

Resource Type: FAH

Region: Sub-Saharan Africa (SSA)

Country: Kenya

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HORN Project

Kenya launches one health strategies to control zoonotic diseases.

21st February 2022 Administrator HORN Kenya 0

On 16 th February 2022, Kenya reached a significant milestone in combating emerging zoonotic diseases by launching three One Health Strategic documents that were developed through multisectoral and multidisciplinary collaborations. This stakeholder engagement and validation process began in 2018 and since 2019 it has been led by Dr. Mark Nanyingi of University of Liverpool , HORN project.  The Government body responsible for the strategies was the Zoonotic Disease Unit (ZDU), with which Nanyingi worked very closely. Technical advice and guidance were sponsored by the Food and Agriculture Organization of the United Nations (FAO) and a range of other partners (including HORN partners the International Livestock Research Institute and University of Nairobi ), and financial support was secured from the USAID Global Health Security Agenda programme.

The three roadmaps are:

• One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya (2021-2025)
• National Strategy for the prevention and control of Anthrax in humans and animals in Kenya (2021-2036)
• National Strategy for the prevention and control of Brucellosis in humans and animals in Kenya (2021-2040).

The One Health strategic plan aims to strengthen the implementation of one health approaches at the national and county levels, strengthen prevention, surveillance, response and control of priority zoonotic diseases in both humans and animals, and promote applied research using the One Health approach.  We expect that some of the HORN Sandpit projects in Kenya will contribute to this evidence gathering through applied research. The Brucellosis and Anthrax control strategies are focused on i) Harmonising the legal and policy frameworks through development and institutionalisation of a one health policy for joint preparedness, surveillance and response plans, and operationalisation of County One Health Units (COHU), ii) Strengthening laboratory capacity for human and animal diagnosis, and iii) Enhancing multisectoral data sharing, communication, coordination, collaboration and partnerships to boost resources allocation.

HORN has played a central role in One Health workforce development in Kenya, through postdoctoral training and by sponsoring individuals through several sandpit projects that promote applied research (e.g. on spatial epidemiology of Anthrax , seropepidemiology of Rift Valley fever , Antimicrobial resistance, Brucellosis diagnosis and COVID-19 epidemiology). The outputs of these studies form part of the body of evidence that continues to guide decision makers in cost effective programmatic implementation of One Health approaches in Kenya. The refurbishment, equipping and repurposing of the One Health lab in Oloitoktok in Kajiado county by HORN will strengthen capacity for human and animal lab diagnosis of zoonoses in Kenya as outlined in the strategies.

Among the One Health leaders who graced the occasion was Prof. Eric Fevre, who is jointly appointed at the International Livestock Research Institute and the University of Liverpool. He is a HORN co-investigator who has been collaborating with ZDU, the national government, and counties in carrying out extensive one health field research to generate data that informs policies that address zoonotic disease burden problems.

Dr. Nanyingi, who continues to provide technical support to the government of Kenya and scientific guidance to the FAO-ECTAD, termed this as a “Trifecta of One Health Success” that creates an opportunity for sustained global north -south collaborations in one health applied and implementation research. Speaking at the national high level strategy launch event attended by FAO,OIE,WHO, CDC, DTRA, USAID and Government representatives in Kenya, Dr. Nanyingi highlighted the need to estimate the cost benefit and effectiveness of one health programming to guide the prudent allocation of scarce resources for optimal disease control that will make Kenya free of Brucellosis and Anthrax by 2040.

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One Health sustainable financing: National investment dialogue underlines why it pays off

The traditional approach to health has often focused on separate silos – human health, animal health, and ecosystem health. However, a growing movement recognizes the interconnectedness of these domains. This concept, known as One Health, emphasizes a collaborative approach to ensure the well-being of all. Investing in One Health initiatives offers a multitude of benefits, as evidenced by compelling cases from Kenya.

The Government of Kenya with FAO hosted a One Health Investment Dialogue which brought together over 50 representatives from government, the AU, private sector, civil society organizations, academia and development, members of the Quadripartite collaboration (FAO, UNEP, WHO and WOAH), partners together. The Dialogue presented five priority investment opportunities for One Health in agrifood systems transformation, spanning epidemio-surveillance, laboratory services, value chains, workforce capacity development, and technology and innovation. This approach is rooted in the One Health principle of an interdisciplinary strategy, where various stakeholders collaborate, communicate, and create synergies. Aspects of human, animal and ecosystem health systems may serve as weakest links, because as developments happens, and urbanization and agricultural production expands, so do health risks.

"The successful dialogue in Kenya is a perfect example of the power of collaboration in One Health. By bringing together government, civil society, the private sector, and other stakeholders, we were able to identify and prioritize key investment opportunities that benefit human, animal, and ecosystem health. This collaborative approach, coupled with strong leadership from the Kenyan government, paves the way for a more sustainable future for Kenya and a model for other countries to follow."  Said Charles Bebay, FAO Regional Manager.

One of the major challenges in implementing One Health is the fragmentation of health-related data. In Kenya, for instance, a lack of coordinated data collection system and sharing across sectors like public health, agriculture, and environment hinders effective disease surveillance, lab diagnostics and prevents sectoral workforce’ joint response. A One Health approach highlights multiple benefits including the importance of initiatives that supports clear data-sharing frameworks and technological solutions like real-time disease outbreak data capture tools.

Kenya's proposed solution focuses on building a comprehensive, unified One Health surveillance, lab and workforce network, using technologies and innovation. This collaborative effort leverages existing structures like the Zoonotic Disease Unit, other national platforms, and County One Health Units and other One Health stakeholders, (including CSOs and the private sector), and has the potential to significantly improve outbreak detection and response. Early identification of threats like rabies, brucellosis, and anthrax, right from the community level, allows for quicker containment measures, protecting public health and minimizing the burden on healthcare systems.

Another Kenyan investment case highlights the power of technology in One Health. A proposed investment in an Animal Identification and Traceability System (ANITRAC) utilizes Radio Frequency Identification (RFID) tags, sensors, and blockchain technology. This not only enhances food safety by tracking animal products and identifying contamination sources along specific value chains, but also bolsters economic development. By meeting stringent traceability requirements, ANITRAC can open doors to international markets for Kenyan beef, fostering growth in the agricultural sector and can benefit sector such as dairy and food safety requirements. 

In his closing remarks, Dr Pius Mutuku, Division of Disease Surveillance at the Kenya Ministry of Health underlined, “One Health is a core competency in field epidemiology, forming a key part of the curriculum for county and national officers. Moving forward, we hope to create more synergies and increase collaborative investments, especially as these discussions have come at a critical and strategic time for the Republic of Kenya, including for its budget cycle.”

Next steps include further dialogue led by the Government of Kenya, supported by FAO, collaboration, leading on from discussions with development partners and potential investors. This includes the EU, USAID, Germany, the UK, International Development Banks and Private Sector representatives, some of whom expressed keen interest in particular investment cases matched to their own priorities.

The One Health Investment Dialogue is a critical piece in the jigsaw of One Health initiatives. By fostering sustainable financing for One Health opportunities that enhance collaboration, break down data silos, and leverage technology, such investments in Kenya can generate an average return of USD10 for per USD1 invested. 

Read more https://www.fao.org/one-health/en

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Githinji Gitahi: Developing resilient health systems for universal coverage

Githinji gitahi talks to gary humphreys about the value of cross-sectoral collaboration and health system assessment in the drive towards universal health coverage (uhc)..

Q: You grew up in a small rural village in Kenya, the child of farmers. How did that upbringing inform your world view and career choices?

A: It made me acutely aware of the challenges faced by certain communities in accessing quality health care. And I would say that a desire to make a difference in the lives of people, particularly those who find themselves marginalized or excluded, has guided me in most of the projects I have worked on – certainly the work I do with Amref.

Q: What is Amref’s core mission?

A: To catalyse and drive community-led and people-centred primary health-care systems development, while also addressing the social determinants of health. We are the largest Africa-based international health development organization, and deliver health services and training to over 30 million people across the continent annually. Tackling access issues is reflected in all our work going right back to 1957 when the Flying Doctors of East Africa first brought health services to remote communities.

Q: You have held positions of responsibility across companies and organizations in quite different sectors. How has that experience informed the work you do with Amref, particularly regarding UHC?

A: Well, I started out as a clinician, but I very quickly became interested in what was causing the diseases and conditions of my patients. That led me to look outside the walls of the clinic to explore what have come to be known as the social determinants of health. I’d go out into the community and into people’s workplaces to try to understand the risks they faced. Early on in my career I also became very interested in how we, as a hospital, were meeting the needs of the communities we served. That steered me towards management roles, and eventually into hospital administration. I also worked in the health insurance arm of a health service provider, which gave me insights into the financing aspects of health service provision and got me thinking about how to make sure that essential health services were affordable to people paying low premiums.

Q: You later worked with Glaxo SmithKline (GSK) in marketing and product management roles. What lessons did you learn there?

A: Principally, I learned about essential medicines from the manufacturer’s side of the fence and developed an understanding of the marketplace. However, I also worked on access there and, during my tenure, the company developed a high-volume low-margin pricing policy. Between 2001 and 2007 there were price reductions of up to 70% in some products, including essential medicines like antibiotics.

But I’d like to stress the value of multisectoral experience in developing collaborative approaches to tackling public health challenges. A lot of the work we do at Amref involves bringing people together, often people from different disciplines with different missions and imperatives. Having worked in different roles in different sectors I think helps me see the opportunities for collaboration and has also given me the tools to enable it. At GSK, for example, I worked on bridging research and clinical practice for better patient outcomes and served as a liaison between scientists, regulators and consumers. At Smile Train International, I focused on developing partnerships and programmes to provide corrective surgery for children with cleft lips and palates. One of the main challenges we faced with Smile Train was over-reliance on short-term, donor-driven medical missions. To address that issue, we focused on partnering with local hospitals and medical institutions to facilitate the training of local surgeons, building local capacity in countries such as the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Nigeria and Uganda.

Lack of transportation was another big challenge. The annual surveys we did revealed that some patients had to travel up to1000 kilometres, and often required overnight accommodation. That finding really brought home to me the fact that access challenges exist outside the physical health facilities and, as a result, our health system assessments started to be more holistic, incorporating indicators such as availability of transportation and even societal permissions, such as husbands allowing wives to bring their children for treatments.

A: You mention health system assessment. What part does that play in your work at Amref?

A: Health system assessment, in the sense of taking a view of the whole, is obviously key. Without it, there is a tendency to fall into the kind of silo thinking that has hampered health system development in the past. This is often attributed to approaches taken by vertical programmes, but I would say that the policy positions developed under the MDGs (millennium development goals) also played a role. As many of your readers will remember, the MDGs focused on just eight goals, including three specific health goals: reducing child mortality, improving maternal health and combating HIV, malaria, and other diseases. When I joined Amref in 2015, the organization had a very vertical strategy in alignment with those goals. With the transition from the MDGs to the SDGs (sustainable development goals) it has become vital to consider the big picture and the connections between elements previously considered distinct, such as nutrition and climate change, to take just one example. Seeing the need for a shift in thinking, I attended a course on strategic perspectives for non-profit management at Harvard which helped me develop a more holistic, integrated approach, aligning with the UHC agenda. I also read  Health, Wealth, and the Origins of Inequality  by Angus Deaton, a book which profoundly influenced my understanding of UHC and equity, not least because of its insights regarding the way better data and a deeper understanding of the determinants of health can help frame more effective health and economic policies. These insights were pivotal in shaping Amref’s new five-year strategy that is focused on strengthening community health systems and increasing access to primary health care, but also prioritizes improving the livelihoods of women and young people and improving the social and structural conditions that impact health outcomes.

Q: How does Amref approach health system assessment?

A: We have developed our own approach, drawing on different methods and resources, including the World Health Organization's Service Access and Coverage (SAC) index, which aims to provide a clear, quantifiable measure of how effectively health services are being delivered and accessed by populations. However, it is important to point out that you can only assess what you can see – what you have data on. In Kenya, the data gathered by community health workers and posted on what we refer to as Community Health Blackboards at health facilities have been extremely helpful, highlighting gaps in vaccination, antenatal care and affordability. Data compiled by the Ministry of Health have also been useful, revealing for example, that only one person in five in Kenya had health insurance in 2017.

Q: To what extent do the countries that Amref works with make use of health system assessment?

A: Significant assessment data and evidence are available country by country – such as the United Republic of Tanzania’s data on facility financial autonomy, which revealed that facilities lacking financial autonomy struggle to provide quality care; or the data collected by Rwanda through its Imihigo initiative. However, challenges remain with regard to overall health system assessment in most countries.

Q: Did the COVID-19 pandemic raise awareness of the need to assess capacity gaps and shortfalls in service provision?

A: COVID-19 highlighted the shortcomings of the health systems, particularly in regard to vaccine distribution and oxygen provision. However, although there was a brief response to the situation, including an attempt to capture and compile information, things have since returned to ‘normal’, which is to say to underfunded systems which fail to meet the real needs of people, many of whom work in the informal sector.

Q: What needs to change to address these issues?

A: Several things, but one is the perennial issue of underfunding. In my role as co-chair of the UHC 2030 Steering Committee, I’ve witnessed the global push for countries to move towards UHC and it could not have been stronger. However, despite the progress in some countries, the drive towards UHC continues to be hampered by the limited resources made available. In Africa, for example, per capita expenditure on health reaches, at best, 50 United States dollars per capita, with many countries below that. This is in stark contrast with the thousands of dollars per capita spent in high-income countries. So there is clearly a need for greater resource mobilization but also a need to maximize the impact of the resources we have, starting with the provision of a limited range of services for the most vulnerable, providing a broader range of services as more resources become available. At Amref, we are assisting governments in learning how to make the most of their limited resources by purchasing health services strategically, to get more health for the money in the absence of more money for health. Rwanda has been particularly proactive in this area for some time, identifying the very poor and subsidizing them, integrating funds from the Global Fund into their health insurance plans, and maintaining a unified health financing strategy. Ethiopia, despite struggles with its community-based insurance system, has shifted focus to reducing disease severity by deploying community health extension workers, and establishing health posts to serve more people before their conditions worsen. Similar initiatives are seen in Malawi and Kenya, where there are efforts to support health system assistance through health insurance subsidies.

Q: How optimistic are you that the UHC 2030 targets will be met in the countries in which Amref works?

A: As assessed in the recent  WHO Results Report  for 2023, the world is off-track to meet the target of 1 billion more people benefiting from universal health coverage by 2025 and to meet the related sustainable development goals by 2030. The countries Amref works with are likely to be a part of that trend. Moving the needle on UHC requires leadership but it also requires governance structures that transcend electoral cycles. Implementing coherent UHC policies requires decades, while electoral cycles typically run for four or five years, disrupting long-term implementation and support. While Amref will continue to support its members in the certainty of making gains in certain areas, unless this short-term planning changes, they will continue to struggle.

This piece was originally published on WHO Bulletin .

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CLOSING GAPS IN DEVOLVED HEALTH SERVICE DELIVERY FOR SELECT COUNTIES

The “Closing Gaps in Devolved Health Service Delivery for Select Counties” is a five-year project funded by USAID. The project seeks to deepen devolution by strengthening health systems for more accountable and better-financed county health services. The project focuses on addressing key challenges in devolved health governance across three critical areas:

• Financing and efficiency in spending.
• Oversight and accountability mechanisms.
• Alignment of health policies between national and county governments, as well as among county governments.