Dr. Samuel Mwenda of the Christian Health Association of Kenya discusses the unique holistic aspect of church-based health systems, how public-private partnerships function in Kenya to deliver healthcare, and challenges faced by faith-based health services.

1. FBOs Health System in Kenya;
commitment to quality & equity in access,
complimenting MOH in service delivery,
training of health workers and
commodity supply chain
Presentation to CCIH 2015 Annual Conference by
Samuel Mwenda, General Secretary,
Christian Health Association of Kenya (CHAK)

2. Presentation outline
•Introduction to CHAK and FBO health network in Kenya
•Reality of two-extreme ends of FBO health systems
•MEDS the FBO pharmaceutical supply chain in Kenya
•The Africa Christian Health Associations Platform (ACHAP)
•Public-private-partnership framework
•CHAK strategies in health systems strengthening
•Challenges faced by Faith based health services

3. A success story of a Resilient Health System; KIJABE MISSION HOSPITAL
teaching & referral hospital celebrating 100 years last month by opening
a new 100 Bed Paediatric Neurosurgery Teaching & Referral unit

4. Fragile health systems and loss of opportunity
• FBOs have lost many lower level health facilities which have closed
down due to lack of funding; Why?
• Loss of Donor subsidies
• No Government funding
• Poor communities served who have no or limited means of paying for medical
services
• Increased cost of health service delivery inputs
• Difficult and challenging environment
• This represents lost opportunity for communities previously served by
these health facilities

5. The unique wholistic system of Church Health Services

6. The Faith Based Health Network in Kenya
• CHAK is a national FBO network of the Protestant Churches’ health
facilities, programmes and Medical Training Colleges and
Universities.
• CHAK core functions include; advocacy, health service delivery,
capacity building, health systems strengthening, partnerships &
networking and HIV& AIDS programmes.
• CHAK collaborates closely with the Catholic Health Commission of
Kenya which coordinates the Catholic health facilities - within the
framework of the Church Health Services Coordinating Committee.
• The FBOs in Kenya (Christians & Muslims) have a partnership
framework (MoU) with Ministry of Health that guides partnership
engagement, support and accountability. Partnership is coordinated
through the Faith Based Health Services Coordinating Committee
• FBOs are recognized as key stakeholders in the Health sector since
they contribute about 30% of the health coverage

7. FBO Health network in Kenya -
total = 1,025
 80 Hospitals
 26 Referral Hospitals in 23 Counties (49%)
 11 Doctors Internship Training Hospitals
 4 provide Post Graduate Residency programs
 135 Health Centers
 692 Dispensaries
 90 CBHC programs
 28 Medical Training Colleges
 7 Universities offering Medical programs
 Medical Outreach programs operated from existing
health facilities
 Programs for special needs; disabled, deaf, blind,
mentally challenged, drug rehabilitation etc

8. CHAK Vision, Mission & Goal
Foundation: Rev 22:1-2: “On either side f the River stood the tree of life…… and the leaves of the Tree were for the
healing of the Nation”
Promote access to
quality health care
Vision
Efficient and high quality
health care that is
accessible, equitable,
affordable and sustainable
to the glory of God
To facilitate member health
units in their provision of
quality healthcare services
through advocacy, health
systems strengthening,
networking and innovative
health programmes
Mission
Goal

9. Strategic Directions / core functions :
Revised Strategic Plan 2011 - 2016
1. Health services delivery
2. HIV&AIDS programmes
3. Health systems strengthening including Medical Equipment
Programme
4. Governance and accountability
5. Research, advocacy and communication
6. Health care financing and sustainability
7. Human Resources for Health (HRH)
8. Grants management
9. Total quality management & patient safety
10. Engagement with devolved county health system

10. Health Commodities Supply Chain; Mission for Essential Drugs and
Supplies (MEDS) www.meds.or.ke - established in 1986
• MEDS is a partnership
trust of CHAK and the
Kenya Conference of
Catholic Bishops whose
• Mission is “to provide
reliable, quality and
affordable essential drugs,
medical supplies, training
and other pharmaceutical
services guided by
Christian and Professional
values.

11. MEDS 3 core functions
1. Supply Chain function: to provide reliable, quality and
affordable medical commodities within Kenya and beyond.
The functions include sourcing medical and non-pharmaceutical
products locally and internationally, warehousing, quality control, sale &
distribution in a system that ensures equity of access
2. Capacity Building/Training function: to improve the quality of
patient care through promoting rational drug use and effective
health commodities management
3. Quality Control Laboratory: to ensure quality assurance
mechanism for quality products through it’s WHO prequalified
Medicines Quality Control Laboratory
11

12. MEDS Systems & Services
Wharehouse with excess capacity
Medicines Quality Control Laboratory
12

13. Regional and country level
partnerships

14. Africa Christian Health Associations Platform
• The Africa Christian Health Associations Platform
(ACHAP) was established in 2007 through the inspiration
and support of the World Council of Churches to
facilitate joint advocacy, networking, partnerships and
capacity building of Christian Health Associations and
other Church Health Networks in Africa.
www.africachap.org
• ACHAP brings together 31 Christian Health Associations
and other Church Health Networks from 26 countries of
Sub-Saharan Africa and the Secretariat is hosted by
CHAK in Nairobi, Kenya..
• Registered in Kenya as an international Faith Based NGO
with mandate in Africa and Secretariat is hosted by
CHAK in Nairobi
• Has established an Advisory Team to help advise and
better connect with partners in the north www.africachap.org

15. ACHAP Vision, Mission & membership
Vision
“Health and Healing for all
in Africa”
Mission
“ACHAP supports Church
related health
associations and
organizations to work and
advocate for health for all
in Africa, guided by
equity, justice and human
dignity”.

16. Biennial conferences provide opportunity for joint learning, advocacy
strategy and global policy dissemination
(7th ACHAP Biennial Conference Feb 2015-Nairobi, Kenya on “Universal Health Coverage”)

17. Public-Private-Partnership framework
• Due to their significant contribution FBO health services are
recognized by Government as key stakeholders in the
implementation of the national health sector strategic plans.
• A partnership framework or MoU between government and the
FBO national networks (CHAK, KCCB & SUPKEM) was developed in
2009 that defines roles and obligations and through which
government provides structured support on HRH and essential
health commodities. FBOs have initiated a process of MoU review to
re-align it with the new Devolved Governance system
• This partnership framework ensures alignment with national health
sector plans, policies and information system and facilitates
structured support.
• Kenya has broader partnership that includes FBOs & Private Sector
through the Public-Private-Partnership - Health Kenya (PPP-HK)

18. Medical Education – contributing to HRH
development
(Nurses, Doctors, Paramedics)

19. Site based mentorship for Health Workers

20. Community Systems
Strengthening as an extension
of the health system

21. Church-Community volunteers engagement for NCD –
Hypertension awareness & screening with target of 2.0m people in 18 months
through 134 FBO facilities, 350 HCW, 425 CHVs and 200 Religious Leaders
Presbyterian Church Women’s Group
member trained as CHV checks BP of
Group members & documents data
Hypertension awareness mobilization
partnering with AstraZeneca

22. Community based initiatives: Global Fund supported community
based TB screening and PEPFAR funded community HIV
treatment adherence support and RH/FP mobilization

23. Infrastructure development

24. Architectural & Building Project Management
technical support services for member Hospitals

25. Health Care Technical Services (HCTS) – Medical Equipment
Program for technical support in medical equipment & technology
• Medical Equipment
needs identification,
procurement &
installation
• Medical Equipment
repair & maintenance
• Involved in
standardization of
Medical Equipment
through KEBS

26. HMIS
• CHAK Hospital Management
Software (CHMS) – an
integrated solution for
computerization of medical
records, clinical services,
diagnostics, medicines stock
inventory, revenue
receipting and financial
accounting and HRM

27. Governance and Leadership
•Policy guidelines and tools for Hospital Boards
•Board development through capacity building,
orientation and performance review
•Financial Management policy guidelines
•HRM Policy and technical support
•Strategic planning technical support
•Grant management systems

28. FBOs contribution to HIV treatment achievement in
Kenya– over 200,000 of the total 850,000 (24%) ART
coverage – with some of the best Centers of Excellence
We welcome Universal Health Access and Universal
Health Coverage and expect that UHC financing
mechanisms will allow equitable opportunity for
financing FBO Health Facilities & Services
We can do more and better with increased resources,
further strengthening of systems and technical support

29. Challenges
• Inadequate financing – dependence on user fees due to loss of donor
subsidies and government funding. Only HIV treatment services are well
funded by Donors
• Human Resources for Health – attracting, developing, retaining, financing
• Dynamic Regulatory environment with multiple actors and frequently
changing conditions
• Burden of engaging with 47 County Governments in the devolved system of
governance and health service delivery to build partnership framework and
mobilize support
• Insecurity in some remote rural areas and terrorism targeting Christians and
Christian Institutions
• Lack of segregated data since FBOs report through the MOH - HMIS

30. THANK
YOU