KILIFI County KILIFI County Plan Plan “Every Child Counts” “Every Child Counts” SarovaWoodlands, SarovaWoodlands, Nakuru Nakuru March 25th -28th March 25th -28th 2018 2018 4/5/2019 FOOTER GOES HERE 1
BACKGROUND Morbidity The five most common diseases in the County among children under five years in order of ranking are: 1)Upper Respiratory Tract Infections, 2)Diarrhea, 3)Diseases of the skin, 4)Malaria and 5)Pneumonia. Child Diarrhea prevalence: 12.3% The prevalence of stunting among children under five years stands at 39% in the county. Additionally , 4.7% and 18.2% of children under five years are wasted and underweight across the county. The immunization coverage stands at 72%, implying that 28% of legible children miss out of immunization across county, Ganze, Rabai and Malindi sub-counties having less than 70% Coverage 4/5/2019 FOOTER GOES HERE 2
Governance, Leadership and Management structures Leadership Leadership Governance & Mgt Governance & Mgt County Level CHMT CEC- Policy level CO-Accounting Officer Director Sub County Sub County Level SCHMT Departmental leads Officials of the Hospital Hospital Management Facility Level management teams T eam/ Dispensary HC Officials of the Community Community Health Community Health Level Committee Committee 4/5/2019 FOOTER GOES HERE 3
Identified gaps in Child health service delivery Human Resources for Health - The County is largely understaffed. It has 5,129 medical and 828 non-medical staff, which translates into a total staffing gap of 5,957. -The Doctor patient ratio is 1: 10,000 people while the Nurse patient ratio is 4 per 10,000 people . Community Health Strategy There are 83 functional community health units against a need of 276 . This constitutes 30% coverage and a gap of 193 community health units 4/5/2019 FOOTER GOES HERE 4
Identified gaps in Child health service delivery cont…. DEMAND SIDE CHALLENGES : SUPPLY SIDE CHALLENGES: • Suboptimal functioning of the health systems: • long distances to health facilities religious – Poor workforce distribution and productivity • sociocultural beliefs and practices – funding gaps • Ignorance – weak supply chain management • Poor provider attitudes discouraging clients, poor quality and limited integration of services that also hamper and discourage utilization of services. 4/5/2019 FOOTER GOES HERE 5
Interventions to strengthen Governance/leadership • Strengthen the referral system HCWs to be allowed a minimum of one year for continuity of services • Staffs with passion to be allowed to continue working in maternity • Strengthen post training follow up to assess skills utilization • Budget coordination:AOP tracking by CHMT quarterly • Advocate to have recruitment of midwives/Nurses to work at MNCH/FP department to be to have clear JDs stating department to work
Interventions to strengthen Governance/leadership cont.. • Revive Malindi, Kilifi and Mariakani waiting homes to address access -Advocacy through the CEC health • Multisectoral approach to increase water access in facilities • Strengthen County supervision to the private and FBOs facilities • Contingency planning • Strengthen supply chain to ensure commodity security
Supply side interventions • Scale up perinatal death audits to all high-volume facilities • Scale up use of 7.1% chlorhexidine digluconate for cord care • Promote cost-effective interventions such as kangaroo mother care while incrementally addressing the supply side barriers such as creation of neonate nurseries in Level 4 hospitals • Scale up structured clinical mentorship and QI of key MNCH interventions • Scale the full package of integrated postnatal care
Supply side interventions • Roll out the new neonatal register • Enhance exclusive breast feeding by adopting a structured approach -initiation and support of breast-feeding mothers breastfeeding • Support piloting of Individualized breastfeeding support for acute ill malnourished infants under 6 months old: - Mwang’ombe study • Revitalize the ORT corners with a checklist • Strengthen facility WASH
Health system strengthening interventions • Advocate for better health financing mechanisms • Conduct training needs assessment of health care workers to guide priorities for RMNCAH • Finalize and operationalize county training guide for HCW 4/5/2019 10
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