Homabay County
Factors that hinder implementation of child health programs 1. Funds allocation to child health programs ‐ Inadequate funds allocated ‐ Diversion of funds 2. Inadequate human resources to deliver child health programs in level 2 and 3 3. Minimal training and cascading of guidelines to the front line health workers eg RMNCAH framework, EMONC, MPDSR ‐ The trained health personnel do not adhere to training guidelines, ‐ There is minimal supervision and follow up on the same
cont. Factors that hinder implementation of child health programs 4. Inadequate and disjointed integrated support supervision ‐ Weak/disjointed support supervision from CHMT to SCHMT and HFs; Homabay has held one integrated SS since devolution ‐ Vertical support supervision is mostly spearheaded by partners who mostly are able to support 1‐2 persons in each program ‐ Inadequate logistical support. 5. Minimal knowledge among the health workers on key child health indicators leading to mis‐ interpretation of the same ‐ Poor data management practices in the HF level ‐ Irregular data reviews at health facility and sub‐county levels
Cont.Factors that hinder implementation of child health programs 6. Limited transparency and accountability mechanisms among the county leadership ‐ Inadequate no. of civil society groups to undertake advocacy initiatives in the county. ‐ Weak oversight role by MCAs on the county legislature and the executive 7. Lack of motivation amongst the health workers
Factors that support child health service delivery 1. Structured management and leadership at the County health offices Scheduled meetings with CHD/CEC, MCAS, CHMTs , Functional TWGs ‐ 2. HRH ‐ ‐ availability of H/Ws at all levels of service delivery 3. Coverage of CUs to provide quality child health services . 4. Competent and skilled core leadership (CDH,COH,CECM) to implement programs 5. Implementing partners who support the child health programs
What should be changed? /Recommendations 1. Strengthen leadership and governance 2. Strengthen accountability frameworks at the county level 3. Resource mobilization‐ embrace a holistic approach to child health 4. Prioritization of key health issues and implementation of allocated budget 5. Advocacy for increased political commitment and negative interference by the political elite (MCAs) 6. County partners to advocate and implement integrated support supervision 7. Scale up mentorship, CMEs support supervision to support gaps in knowledge, adherence to guidelines, data etc.
Interventions for scale up 1. Using data to drive programming 2. Commodity management: currently the county is able to forecast and quantify vaccines and non‐ vaccine supply . ◦ Monitoring: Consistent documentation of vaccines and non‐vaccine supplies by the sub county EPI coordinators and MCH nurses. ◦ Reaching the unreached ‐ Map the unimmunized children 3. Budget advocacy ◦ Conduct quarterly forums to meet county committee for health 4. Coordination‐ ◦ Conduct data quality reviews at select HF ◦ Integrated supportive supervision to drive the quality of data for the county health department. ◦ Stakeholder forum to discuss the integration of programs – April 2019
Immediate workplan Activities Responsible Dates 3 rd April 2019 1. A brief to the CDH on the child health symposia deliberations Christine /Mageto with a focus on the interventions for scale up/budget 1 st wk, April, 2. performance review meetings for health Christine ‐ Data review/ resource sharing 2019 3. Stakeholder forum to discuss the integration of programs Christine /Charles May, 2019 4. Conduct integrated SS Christine/ HRIO Quarterly 1 st 4. review AWP to support additional CH needs Christine wk, April, 2019
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