Kenya Chw Plan
Upcoming SlideShare
Loading in...5
×
 

Kenya Chw Plan

on

  • 6,302 views

CORE Group Fall Meeting 2010. Kenya Essential Package for Health (KEPH)-Community Strategy. Lessons

CORE Group Fall Meeting 2010. Kenya Essential Package for Health (KEPH)-Community Strategy. Lessons
from Kenya. Plan

Statistics

Views

Total Views
6,302
Views on SlideShare
6,302
Embed Views
0

Actions

Likes
2
Downloads
58
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • The context of CHWs in Kenya was similar to most: Various CHW Cadres, Various Sub specialties, Various Abilities, All non-paid, only career path limited to hired as assistant to certified private provider or support staff to government clinic
  • KEPH introduces an additional level of governance at sub-location level
  • Community Strategy better than what there was previously. However the failure to include care groups a missed opportunity.

Kenya Chw Plan Kenya Chw Plan Presentation Transcript

  • Kenya Essential Package for Health (KEPH)-Community Strategy Core Fall Meeting September 15, 2010 Lessons from Kenya
  • Ministry of Public Health and Sanitation: Essential Health Package
    • Kenya’s second National Health Sector Strategic Plan (NHSSP II – 2005–2010) defined a new approach to the way the sector will deliver health care services to Kenyans – the Kenya Essential Package for Health (KEPH).
    • KEPH introduced six life-cycle cohorts and six service delivery levels.
    • One of the key innovations of KEPH is the recognition and introduction of level 1 service, which are aimed at empowering Kenyan households and communities to take charge of improving their own health.
  • KEPH: Life Cycle Cohorts and Levels of Care
    • § Pregnancy and the newborn (up to 2 weeks of
    • age)
    • § Early childhood ( 2 weeks to 5 years)
    • § Late childhood (6–12 years)
    • § Youth and adolescence (13–24 years)
    • § Adulthood (25–59 years)
    • § Elderly (60+ years)
    Tertiary Hospital Secondary Hospital Primary Hospital Health Center/ Maternity Homes Dispensary/ Clinics Community: Village/ Household/ Families/ Individuals
  • The KEPH Community Strategy Approach
    • Establishing a level 1 care unit (CU) to serve a local population of 5,000-10,000 people with a CHC.
    • Instituting a cadre of well trained Community Health workers (CHWs) who will each provide level 1 service ( for all cohorts) to 20 households.
    • Supporting every 25 CHWs with a Community Health Extension Worker (CHEW). (NEW PAID STAFF)
    • Ensuring that the recruitment and management of CHWs is carried out by village and facility health committees.
    • Strengthening health facility–community linkages through LEVEL ONE SERVICES
  • Kenya Administrative Structure at District level COMUNITY UNIT LEVEL FACILITY LEVEL SUB-LOCATION 2 VILL VILL VILL VILL VILL VILL SUB-LOCATION 1 VILL VILL VILL VILL VHC LEVEL VILL VILL VILL VILL VILL VILL SUB-LOCATION 3 DISTRICT LOCATION 2 LOCATION 5 DIVISION 1 DIVISION 2 DIVISION 4 LOCATION 1 LOCATION 4 LOCATION 12 LOCATION 3 DIVISION 3 VILL VILL VILL VILL SUB- LOCATION 36 VILL
  • Comparison before and after Community Strategy in Kilifi District AFTER COMMUNITY STRATEGY: 36 Paid CHEWs, 36 CHCs, 900 unpaid CHWs in 367 Villages and 367 VHC BEFORE COMMUNITY STRATEGY: 14 Paid PHTs, 1555 unpaid CHWs in 367 Villages and 367 VHC Sublocation: 36 Each sublocation to be managed by a CHC facilitated by a resident CHEW. Allows for Sub-locational /CHC Decision Making Currently 14 CHEWs available (1 for 3 CUs). Sublocation: 36 Previously Kilifi had 14 PHTs who were later called CHEWs No CHC. PHTs worked directly with FHC/VHC Villages: 367 Each village has VHC and this allows for VHC Decision making Villages: 367 Each village has VHC and this allows for VHC Decision making Households: 54,000 900 CHWs reaching 18,000 or 33% of households but addressing all 6 cohorts Households: 54,000 Caregroups: 1314 (in 331 villages) 1555 CHWs reaching 100% of households but addressing WRA and U5 issues
  • Major Differences/Threats
    • CHEWs: The project had 14 PHTs staffing 12 facilities within the 4 divisions. So essentially there were 14 CHEWs alongside project front-line staff. For a population of 300,000 KEPH recommends at least 36 CHEWs.
    • CHWs in KEPH will reach about 33% of households which they will have selected from the entire community . It is not clear what equity criteria would be employed in selecting these households. Also CHIS limited to 33% of the households would not provide a complete picture.
    • CHWs in CS will provide polyvalent services directed as 6 cohorts unlike in KID-CARE. The technical training required will also be superior.
    • FHCs will continue to operate at the facility level may do more dispensary management. CHCs will usurp/re-inforce FHC role of governance
    • CS will have no care groups at the homestead and household level unlike KIDCARE. This will result to “unsupported” CHW led efforts at this level which could lead to burn-out. For example decision making using local data will be limited to CHW and this could affect local action.CHW retention may become a major issue.
  • The preceding slides were presented at the CORE Group 2010 Fall Meeting Washington, DC To see similar presentations, please visit: www.coregroup.org/resources/meetingreports