In Kenya and around the world, great significance is attached to health service delivery models that achieve the triple aims of access, quality and cost. Despite resource constraints, CHS is working towards highlighting best practices that optimize the use of available, limited resources, to sustainably improve the health of target populations. This was the focus at the 3rd Annual CHS Stakeholders’ Meeting held November 11-12, 2013 in Nyeri under the theme “Ownership towards Sustainable, Efficient and Universal Health Solutions.” CHS used this meeting as a platform to advocate for sustainability and efficiency among stakeholders through engaging presentations and discussions. Key issues tackled included effective health system strategies, sustainable service delivery, demand creation for health, operational research and devolution.
Efficiency and Sustainability
Intense competition for a shrinking donor pool and increasing demand for quality health services calls for innovative strategies to generate resources and ensure optimal use of what is available. Speaking at the meeting, Nyeri County Director of Health Dr. Gichuiya M’Riara emphasized the need to work towards self- financing of health interventions as donor funding is not a sustainable solution. Dr. Patrick Nyaga, Medical Superintendent at the Thika Level 5 Hospital called for sustainable service delivery through reduced operational costs, innovative strategies including communication strategies to create visibility, engage employees and stakeholders, and strengthen market share. Setting institutional targets in terms of service delivery will ensure that efficiency is achieved. This way, the future will be secure in terms of efficiency and sustainability. Health facilities need to learn from each other through benchmarking and consequent adoption of best practices. An example cited at the meeting was the use of the facility-based learning model applied at Murang’a District Hospital which was demonstrated as cost effective and sustainable compared to hotel-based training.
Demand Creation
Reaching out to the intended recipients of health services completes the demand-supply circuit and ensures that the quality services we strive to deliver are consumed. According to James Kamande of Population Services International (PSI), this is achieved through research to identify the needs of the target population, the problems affecting them and later using various tools such as print and video messages to facilitate decision making among communities to demand for health services. Kenya’s Ministry of Health approach to demand creation is through the use of behaviour change communication strategies, community development, social mobilization, advocacy using existing community structures and health promotion groups.
Devolution and Health
Efficiency begins with an understanding of the system and expected results; hence the need to understand what the constitution demands of the health care workforce in delivering optimal health solutions to the public. In the wake of devolution, expectations, changes, and more so requirements for transition of health services to the County system still remain unclear to many.
Mr. Kariithi Murimi, a policy expert demystified devolution and outlined how it will affect the health sector, making it clear that the constitution calls for health care workers to provide the best quality care for Kenyans. At the facility level, health care workers are already feeling the effects of devolution and challenges including availability of funds, unclear revenue management guidelines, commodity distribution, budget approval processes, information gaps and resistance to change are apparent. Mr Murimi called on participants to embrace change and promote acceptance of the constitution in the health care sector if sustainability and efficiency is to be achieved.
Operational Research in Health
Operational research encourages innovation in health systems to promote cost effectiveness, build knowledge and consequently leads to better quality service provision. Dr. Robert Karanja of KEMRI took participants through the process and specifics of scientific research for health. Through research, best practices in health service delivery can be identified and consequently replicated leading to efficiency and sustainability The meeting brought together 140 participants comprising of county health executive committees and other stakeholders in the health sector from Nyeri, Murang’a, Nyandarua, Kiambu and Laikipia counties; CHS partners and peer organisations including CDC, ICAP, AphiaPlus Kamili, Kenya Pharma, KEMSA, MSH, PSI (Kenya), NASCOP, Gatanga Kiiga Community Based Organisation (CBO) and Vision Gardens CBO.
To view and download the report, please click here
To view and download the presentations from the ASM, follow the links below:
- Kenya Health Policy
- An Introduction to CHS
- Introduction to Operational Research
- CHS Program Achievements and Updates
- Sustainability in Health Services
- ICAP Kenya Program Update
- Kenya AIDS Indicator Survey 2012: Overview and Preliminary Results
- Facility Based Learning – Muranga District Hospital
- Phones for Health – NaroMoru Health Centre
- The Plight of Health Care Workers Living with HIV
- Demand Creation for Health Services
- APHIA II HCM Program Implementation Plans
- County HIV Service Delivery Profiles
- Kenya Health Policy 2012 – 2030
- Preliminary Report for Kenya AIDS Indicator Survey
