Mukuru cbhc proposal june 2012[1]


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Mukuru cbhc proposal june 2012[1]

  1. 1. MUKURU PROMOTION CENTRE PROPOSAL TO ENHANCE ACCESS TO QUALITY & AFFORDABLE COMMUNITY BASED HEALTH CARE FOR THE MUKURU COMMUNITYGeneral Information o Name of Organisation o Mukuru Promotion Centre o Project Title o Enhance Access to Quality & Affordable Community Based Health Care for the Mukuru Community o Project Location o Mukuru slum villages in the Industrial Area, Nairobi o Contact Person o Sr Mary Geason: Tel: 0727 752294 o Contact Information: Physical Address, Postal Address, Phone Number and Email Address o Likoni Road Bypass, opposite Express Kenya, Industrial Area, Nairobi. o P O Box 17837 – 00500. Phone number: 020 2044428. o Email Address: director o Project Timeline o Project Timeline: 2012-2015 o Amount Requested o Ksh 1,500,000 annually for 2012-2015 representing 50% of the required funding o Other donors will be approached to fund the balanceExecutive Summary:Mukuru Promotion Centre is a church based charitable organization that was established by the Sistersof Mercy in 1985. The organization started as a temporary school in the heart of the Mukuru slums andits key objective then was to provide education to the children of Mukuru to get them off the streets.Since its inception, MPC has expanded a great deal and now operates several projects that focus on fourkey areas: Education, Health, Vocational Training, and Social Rehabilitation.MPC’s vision is: In partnership with the Mukuru community, Mukuru Promotion Centre envisions theMukuru community attaining sustainable and holistic human development and self reliance. The overallgoal of all MPC actions in 2012-2015 as specified in our Strategic Plan will be to continue its contributionto the alleviation of the dehumanizing effects of poverty and disease through interventions that lessenthe burden of living and liberate the population to focus on development initiatives.Significance of the Project:Mukuru Informal Settlement: the Mukuru slum lies within Nairobi’s industrial area with an estimatedpopulation of 600,000 people, majority of them being women and children. Most households within thiscommunity are headed by women. Like all other informal settlements in Nairobi the Mukuru slum is 1 13-Jul-12
  2. 2. MUKURU PROMOTION CENTREseverely overcrowded, insecure and lacks basic health and sanitation facilities. An average of 5 to 6people live in a room that measures approximately 3 to 6 square meters. MPC has offered communitybased health services to the community for years, and during the last four years, nearly 60,000 clientsbenefited and nearly 1000 community health workers were trained. The current project aims toenhance access and increase the number of clients to 18000 per year, 66,000 over the four years, 2012 –2015.Problem Statement:Water is purchased from vendors at high costs and is therefore a very scarce resource. Heaps of garbageare a common sight within this area blocking most of the drainage channels. Lack of sanitary facilities todispose human waste and garbage has led to serious environmental and health hazards including highincidence of diseases like typhoid, cholera and diarrhea especially among young children.The majority of the residents are poor, unemployment levels are high (especially the youth). Many workas unskilled casual labourers earning less than $2 a day. As in most developing countries, Kenya faces abig challenge as far as provision of affordable health care for its people is concerned. Quality health careservices are basically only available in private hospitals in Kenya and these facilities are beyond thereach of the informal settlement population. Government facilities within these areas are ill equipped tohandle any serious ailment as they lack personnel, drugs and other medical equipment. The Mukurucommunity members often resort to unregistered pharmacies and quack medics for many of theirhealth care needs. The only alternative are the few faith-based and donor sponsored health carefacilities within the catchment areas. The health services under Mukuru Promotion Centre wereinstigated in response to this dire need.Project Objectives: Objective 1: Increase the number of clients that access the Community Based Health Care Program. Two nurses, assisted by Community Health Workers, provide services in eleven slum villages on a rotating basis.  Increase from 15,000 (2012) to 18,000 (2015) clients per year to benefit from the community based health care program  Reduced mortality rate due to early diagnosis and intervention Objective 2: Increase access to clean water for Mukuru community  3 village communities(approximately 300 households) have better access to clean water annually with the provision of 3 community based water tanks (12 installations, 1,200 households over 4 years)  Reduction in the incidence of preventable diseases  Improved sanitation and general hygiene practices in the client community 2 13-Jul-12
  3. 3. MUKURU PROMOTION CENTRE Objective 3: Reduce incidence of illness and undiagnosed health problems in primary school children  4,500 primary school children benefit annually from regular health checks and follow-up if necessary  450 Early Childhood Education and Development (ECED) children per year are screened for full immunization; nutrition status; birth registration.  Reduced incidence of sick days due to better health: reduce from 9% (2011) to 5% (2015) Objective 4: Improve health of children in the 4 MPC Early Childhood Education and Development (ECED) Centres through education of caregivers  200 care-givers of ECED children (50 per school) attend a training three times per year (once per term), on topics such as how to identify serious illness in children; nutrition; safe water and sanitation; hygiene.  Reduced incidence of preventable diseases in ECED children Objective 5: Increase effectiveness of Health services through capacity building  2 Nurses and 120 Community Health Workers benefit from updates/refresher courses  Health Workers provide up-to-date health information and treatmentProject Implementation and Management Plan: Objective 1: Increase the number of clients that access the Community Based Health Care Program. Two nurses, assisted by Community Health Workers, provide services in eleven slum villages on a rotating basis. Weekly, each of the two nurses, along with the mobile dispensary, visit one of eleven bases in the eight villages in Mukuru Community. They meet with the Community Health workers (who typically live in the village visited) who have mobilized clients who need medical attention, and who are not capable of visiting MPC’s own clinic located on St Catherine’s school compound. The nurses perform a general assessment and if in their opinion the administration of drugs will provide resolution they provide the patient with the medication. If, in their opinion, that the patient needs further medical treatment they arrange with family/friends/neighbours to have the patient transported to the MPC Clinic or to a hospital. Objective 2: Increase access to clean water for Mukuru community In conjunction with the Area Chief and the Village Health Committees (established in 2009/10/11 by MPC) select the most needy villages to receive water tanks. In collaboration with the Village Health Committees locate and install water tanks. Train and facilitate the purchase and sale of water to the local population with the proceeds being used to purchase more water 3 13-Jul-12
  4. 4. MUKURU PROMOTION CENTRE and to upgrade other infrastructure needs within the community as agreed by the community members. In collaboration with the community health workers, village health committees and village authorities, organize monthly “community action days” whereby the community benefits from education on public health issues; clean-ups; proper disposal of waste. Objective 3: Reduce incidence of illness and undiagnosed health problems in primary school children In conjunction with Child Fund Kenya and the District Public Health Office, school medical camps are organized once per term. This activity reaches a total of 4,500 MPC primary school and ECED children who undergo general health checks once per term. The exercise is conducted with partners: the District Public Health Office (DPO) and Child Fund Kenya (CFK). The reach of the total exercise is to 6,000 children in 34 schools in Mukuru. It is conducted with health professionals from MPC, CFK and seconded DPO staff to participate. Children with health problems are referred to appropriate health services for treatment Objective 4: Improve health of children in the 4 MPC ECD Centres 200 care-givers of ECED children (50 per school) will be invited to attend a training three times per year (once per term). The training will be conducted by officials from the Department of Public Health, and the topics covered will empower parents/care-givers to recognize symptoms of serious illness and so seek early treatment. Education on safe water and sanitation will empower them to treat water appropriately before drinking, and ensure safe disposal of human waste, thus reducing the incidence of water-borne diseases. Objective 5: Increase effectiveness of Health services through capacity building The nurses and community health workers, in consultation with MPC, will identify and attend appropriate seminars/training opportunities to continue to build their capacity to deliver quality health services, education and advice.Staff/ Administration The Program is overseen by the Coordinator of MPC Health Services 2 Home based care nurses o Responsible for the smooth operation of the Home based care program. o Responsible to deliver curative and preventive health care services to the Mukuru community (within the villages) o They are accountable for the drugs and supplies of the service o They will extend their services to the bedridden and those who are unable to reach the Mary Immaculate clinic. o Ensure proper records keeping and submit monthly reports to the in-charge. o Participate in medical camps organized by the department. 4 13-Jul-12
  5. 5. MUKURU PROMOTION CENTRE o Work closely with the trained Community Health workers to offer intensive health education and pioneer in water & sanitation activities in the villages. Community Health Workers – Casual workers – two per day assist the Home based care nurses. They are key personnel to assist in the “community action days”. 1 Driver – part time Duties include: transport the nurses to the various bases within the villages, and drive the mobile dispensary that carries the drugs, lotions and medical supplies. The MPC Project Director- oversees overall program development and operations and plays a key role in establishing and maintaining links with key donors, and other stakeholders. MPC operates centralized Finance, Human Resource and Procurement functions. These functions are all essential components in the project. The Human Resource function will handle Staff recruitment, Training and Development, Remuneration & Welfare while all the financial issues are handled by the Finance Department.Project Partners: Child Fund Kenya works with MPC as a partner in implementing the school health program and ECED program. Government of Kenya provides vaccines, TB drugs, and provides assistance with personnel for School Health program.Project sustainabilityThe Community Based Health Care program has been run almost entirely on donor funds. From 2012,clients are being asked to pay 20/- per visit.MPC needs to constantly establish new partnerships and encourage sponsorship from both local andinternational donors in order ensure continuity of the community based health program.Project Monitoring and Evaluation:Monitoring As indicated above under staff/ administration, the key individual in the monitoring function will be the Health Coordinator. She will work closely with the Project Director / Deputy Director to ensure the smooth running of the health program. The Coordinator will monitor the program daily i.e. ensure that the staff attend to their duties as required. She will ensure that rules and procedures are adhered to, updated records kept and that the program is implemented as planned. The Coordinator will meet the staff on a monthly basis to discuss work progress and discuss challenges and she will be required to report on the same during the monthly Heads of Departments meetings. The Coordinator will submit quarterly reports to the MPC managementEvaluationAt the end of each year, an evaluation will be carried out to measure the success of the program againstthe set targets and goals. In addition, the services offered will also be assessed against emerging or new 5 13-Jul-12
  6. 6. MUKURU PROMOTION CENTREdevelopments in the medical field. The evaluation will involve open discussions with the clientcommunity and other stake holders.Documentation and Sharing Results:The data collected will be analyzed annually, and a report will be prepared and shared with the donorsand other stakeholders. This evaluation report will be utilized by the project implementers to improveon project execution in years that follow. Sharing our results also through: newsletter and AnnualReport. 6 13-Jul-12
  8. 8. MUKURU PROMOTION CENTREProject Budget:STRATEGIC PLAN: 2012-2015 SERVICE AREA: HealthStrategic Thrust: Enhance access to quality and affordable health care.BUDGET 2012-2015 Annual BudgetPersonnel Number Monthly Budget 2012 2013 2014 2015 TotalsNurses 2 60,000 720,000 792,000 871,200 958,320 3,341,520Driver(Half Salary) 1 10,000 120,000 132,000 145,200 159,720 556,920Community Health Workers (4 CHWs everyday @ 250/= Each) 80 20,000 240,000 264,000 290,400 319,440 1,113,840Total Personnel Costs 83 90,000 1,080,000 1,188,000 1,306,800 1,437,480 5,012,280Medicines 60,000 720,000 792,000 871,200 958,320 3,341,520SanitationWater tanks 3 37,500 450,000 495,000 544,500 598,950 2,088,450Installation Costs 3 25,000 300,000 330,000 363,000 399,300 1,392,300Total Sanitation 62,500 750,000 825,000 907,500 998,250 3,480,750School Health Checks(Thrice Per Year)Mobilisation Costs 4500 12,500 150,000 165,000 181,500 199,650 696,150Capacity Building1. Nurses Refresher Courses(Twice a year) -Transport 2 100 1,200 1,320 1,452 1,597 5,569 -Refresher course fees 4 1,667 20,000 22,000 24,200 26,620 92,8202. Community Health Workers(Bi-annual) - -Facilitation Fees 4 2,667 32,000 35,200 38,720 42,592 148,512 -Refreshments 120 4,000 48,000 52,800 58,080 63,888 222,768 -Stationery 120 4,000 48,000 52,800 58,080 63,888 222,768 -Transport 120 6,000 72,000 79,200 87,120 95,832 334,1523. Care Givers(Thrice Per Year) - -Transport 200 10,000 120,000 132,000 145,200 159,720 556,920 -Refreshments 200 10,000 120,000 132,000 145,200 159,720 556,920 -Stationery 200 10,000 120,000 132,000 145,200 159,720 556,920Total Capacity Building 48,433 581,200 639,320 703,252 773,577 2,697,349Community Action Days(Once a month) -Garbage bags 200 1,000 1,100 1,210 1,331 1,464 5,105 -Refreshments 40 4,000 4,400 4,840 5,324 5,856 20,420 -Mobilization 40 6,000 6,600 7,260 7,986 8,785 30,631Total Community Action 11,000 12,100 13,310 14,641 16,105 56,156Other Costs -Fuel and Vehicle Maintenance 10,000 120,000 132,000 145,200 159,720 556,920 -Stationery 5,000 60,000 66,000 72,600 79,860 278,460 -Airtime 2,000 24,000 26,400 29,040 31,944 111,384Total Other Costs 17,000 204,000 224,400 246,840 271,524 946,764Total Costs 301,433 3,497,300 3,847,030 4,231,733 4,654,906 16,230,969Allow 10% Administration Costs 30,143 349,730 384,703 423,173 465,490 1,623,097Total Project Costs 331,576 3,847,030 4,231,733 4,654,906 5,120,396 17,854,066Community Contribution 14400 24,000 288,000 432,000 576,000 720,000 2,016,000 8 13-Jul-12
  9. 9. MUKURU PROMOTION CENTREProject Deficit 307,576 3,559,030 3,799,733 4,078,906 4,400,396 15,838,066 9 13-Jul-12
  10. 10. MUKURU PROMOTION CENTRE 10 13-Jul-12
  11. 11. MUKURU PROMOTION CENTRE.Additional Information:2. Mukuru Promotion Centre is also involved in other health services, with partners as follows: 1. CHILD SURVIVAL PROGRAM (Funded by partner, Medicines for Humanity) Intervention Area: Clinical Services For Children And Pregnant Women Goals: i. Identify and treat 420 children under 5yrs; 165 children 6-12yrs; 85 children 13-18 yrs. Total of 670 children per month; 8,000 per year ii. Identify and provide antenatal services to 40 pregnant women per month; 480 per year. 1. Intervention Area: Improving Effectiveness Of Community Health Services Goal: 60 Caregivers receive training monthly; 60 pregnant women receive training quarterly; 240 Community Health Workers undertake refresher courses Totals: 720 Caregivers, 240 pregnant women and 960 CHWs trained in a year Topics: Child and maternal health, community health monitoring, growth and development of the child. 1 Consultant Pediatrician: (Part time). 1 Nurse 1 Data Clerk 1 Cleaner (full time) - His key responsibility is to ensure that the clinic facility and the surrounding grounds are kept clean and orderly. He will ensure proper disposal of clinical waste. 2. GENERAL CLINIC SERVICES: PREVENTIVE AND CURATIVE HEALTH Increase the number of clients that access the Mary Immaculate Clinic for preventive and curative health services Objective 1.1: 100 clients daily, benefit from general preventive and curative health services. Most common diseases are treated, e.g. Respiratory tract infections; diarrhea; malaria; skin infections; parasitic worms; sexually transmitted diseases 11 13-Jul-12
  12. 12. MUKURU PROMOTION CENTRE Objective 1.2: Facilitate referrals i.e. to ensure that, cases that cannot be handled at the clinic are referred to appropriate health facilities for further intervention. Objective 1.3: 300 clients per year benefit from testing and treatment at the Tuberculosis (TB) clinic at the centre. 3. VOLUNTARY COUNSELLING AND TESTING FOR HIV (Funded by St Elizabeth School of Community Health and Social Work, Slovakia). Goals i. 2,500 clients per year receive Voluntary Counseling and Testing for HIV. ii. 175 clients per year referred to a Comprehensive Care Clinic for ongoing treatment iii. Conduct HIV/Aids prevention sensitization activities 4. NUTRITION PROGRAM (Funded by St Elizabeth School of Community Health and Social Work and in collaboration with the Kenya Ministry of Health) Goal: 100 malnourished children under five are stabilized per yearAnticipated Outcome or Results from above programs:  Reduced infant mortality rates  Less cases of malnourished children.  Increase in the incidence of healthy new- born children  Reduction in still births and other complications during delivery for the mothers.   Increase in the number of people who know their HIV status 12 13-Jul-12