HSAP Kenya

www.amref.orgPolicy Recommendations

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Increase government funding for family planning to ensure the availability of adequate financial resources to meet the unmet need for contracep�on in Kenya.

Tailor family planning policies to address the specific needs of different groups of women who experience high unmet need for family planning, par�cularly young women, those who are poor or poorly educated, and women in rural and underserved areas.

Engaging men in family planning programmes will help create an environment in which both male and female can seek services and discuss family planning with their spouses, partners, guardians and share responsibility for their reproduc�ve health rights.

Community Health Workers (CHWs) should be recognized and renumerated in the formal health sector.

Who is a Community Health worker? A Community Health Worker is a community member with an in-depth understanding of community values, culture and language with elementary training who links the community to the health facility.

Background

• CHWs provide health promo�on, disease surveillance and referrals for a wide range of services at community level.

• While there is robust evidence that CHWs can improve health and well-being of households, less a�en�on is given on the need to integrate them in the formal health system.

• Integra�on of CHWs in the Health Workforce by Policy and Law has significant impact on Universal Health Coverage

Community Health Workers (CHWs) Tasks at Household Level

Use of treated mosquito nets – Malaria preven�on

Proper waste disposal

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Promotion of Health Services

Treat common diseases – malaria, diarrhea, deworming

Educate on knowledge of HIV status

Educate on benefits of skilled deliveries

Educate on Family Planning

Do community mobiliza�on for health ac�on

Screen for high blood pressure for NCDs

Trace treatment interrupters of TB,HIV, NCDs

Educate on balanced diet for good nutri�on

Refer cases promptly to health facili�es

2 Promotion of Health ServicesEducate communities and households on the benefits of

Immuniza�on of under 5 years – Prevent polio, TB, Measles, Tetanus

Trea�ng drinking water and safe storage

Hand-washing using running water and soap – Prevent diarrhoea

Use of toilets for faecal disposal

Provide Preventive Health Services

Provide home-based care services for terminally ill

•Cancer •TB•Stroke •Hypertension •Diabetes

Social Accountability

What is Social Accountability

Social accountability is an approach towards building accountability that relies on civic engagement. In social accountability, ordinary ci�zens and/or civil society organisa�ons (CSOs) par�cipate directly or indirectly in exac�ng accountability from public officials.

- Involves ci�zens and CSOs in public decision making.

- Enables ci�zens and CSOs to ar�culate their needs to governments and service providers.

- Brings the perspec�ve of ci�zens and CSOs to government ac�vi�es, such as policy making, the management of public finances and resources, and service delivery.

- Allows civil society to par�cipate in monitoring the public sector and giving feedback on government performance

Social accountability is based on three principles:

- Transparency - Accountability - Par�cipa�on

Social Accountability Tools and Approaches

Transparency Accountability Par�cipa�on

Transparency & Informa�on

- Informa�on Campaigns - Ci�zen Charters - Ci�zen Service Centers

Budget Transparency

- Public Repor�ng of Revenues & Expenditures - Ci�zen’s Budget - Budget Literacy Campaigns - Public Expenditure Tracking - Independent Budget Analysis

Monitoring by Non-State Actors

- Community Scorecard - Social Audit - Ci�zen Report Card - Ci�zen Sa�sfac�on Survey

Grievances Redress

- Formal Grievances - Redress Mechanism - Ci�zens’ Jury

Consulta�ons

- Public Hearings - Focus Group Discussions - Advisory Body/ Commi�ee

Par�cipatory Planning, Management & Decision Making

- Par�cipatory Planning - Community Management - Community Contrac�ng - Ci�zen/User Membership in Decision-Making Bodies - Ci�zens’ Jury

Par�cipatory Procurement & Financial Management

- Procurement Monitoring - Public Expenditure Tracking - Integrity Pacts - Par�cipatory Budge�ng

Human Resources for Health

Health begins with health workers. The empowerment of health workers is key. The voice, rights and responsibilities of health workers must play a central role in developing and implementing solid policies and strategies towards universal health coverage.

Health workforce produc�on must be made a top priority. This necessitates poli�cal commitment, long-term strategic planning & forecas�ng and adequate financing to make a whole-of-government agenda on universal health coverage a reality. Na�onal stakeholders and development partners from educa�on, finance and labour and other sectors have cri�cal roles to play in in order to produce adequate quan��es of the right mix of quality health professionals.

Governments, Workers unions, professional associa�ons and civil society have a joint responsibility in improving and securing the working condi�ons of their health workers while empowering them in the decision making process.

The current discourse on HRH needs to evolve from an exclusive focus on availability of health workers – i.e. numbers – towards according equal importance to accessibility, acceptability, quality and performance. By availability, we mean an adequate supply of health workers, with the required competencies to match the health needs of the popula�on. Accessibility is also cri�cal as it implies equitable distribu�on across urban and rural areas ensuring access to under-served popula�ons. Acceptability refers to the health workforce characteris�cs (e.g. sex, language, culture, age, etc) and their ability to treat all pa�ents with dignity and promote a demand for services. Quality refers to the skills, knowledge and behaviour of health personnel, assessed according to professional norms and as perceived by users of health services.