BUTERE COUNTY HOSPITAL Achievements
Background Butere County Hospital is a government facility situated off Butere- Mumias road in Butere Sub county, Marama central ward. It serves an estimated catchment population of 30, 671.
Staffing
Deliveries increased from 1,080 to 2,069 (2013 -2015) through participation of Hospital Management in community dialogue days.
There is a functional theatre
Improved doctor: client ration by increasing Doctors 2 to 6 (2013-2015)
Integration of HIV services into the MCH/FP clinic.
HIV testing services offered to mothers at the Maternity.
Long acting contraceptive methods made available at maternity before 48hrs post delivery
Facility staff capacity enhanced through training, mentorship and OJT
Facility has resident Nutritionist
Established a responsive system for skills, knowledge and practice gap analysis.
Established a Data Quality Assessment system.
Challenges
Inadequate equipment
Labour ward has few delivery sets
Acute shortage of Nursing staff
Inadequate working space especially in MCH, maternity and Laboratory
Late ANC attendance leading to low 4th ANC visit
HIV Stigma still prevalent a barrier to testing and treatment uptake
Table showing data on some selected indicators INDICATORS 1st ANC Skilled deliveries
2013 1064 1080
2014 1179 1756
2015 1032 2069
2016* 683 1662
Family planning methods
4880
6383
6011
2645
Children Fully immunized
488
802
879
504
*Jan-Aug
IGUHU COUNTY HOSPITAL Community Units/Community Engagement
Background
The facility is supported by 3 Community Units (CU) 30 CHVs working under 3 CHEWs.
Iguhu County Hospital is a government facility situated along Kisumu-Kakamega Highway in Ikolomani sub county Kakamega County. The facility serves an estimated catchment population of 17,862 of whom 643 are <1 year old and 3,126 < 5 years. The catchment areas serves 4,072 women of reproductive age and recorded 643 deliveries.
The CHVs attached to County Hospital, are tasked with responsibility of: client retention, treatment adherence and psychosocial support, community/ facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities. CHVs Brief on follow up:
Staffing
follow up of children for immunization
Mapping of ANC Mothers.
Follow up of mothers for skilled delivery and referrals for ANC visits
Community based promotion of FP
Community case management with diagnosis and treatment of malaria.
Outreaches-CHVs mobilization
Achievements
Facility staff capacity enhanced through training, mentorship, OJT and CMEs.
Human resource support from APHIAplus
Established supply chain for: delivery kits, ambubags, fetoescopes, roaster boards, cervical dilation boards color coded bins, bin liners for health care waste management, ORT corner commodities
Established standards and guidelines for the service providers
Trained CHVs and HCW in growth monitoring and IMAM.
Effective referral mechanism established with community facility linkage
Establishment of Pediatric and Adolescent clubs to enhance adherence and viral suppression.
Challenges
Infrastructure – inadequate equipment
Late commencement of ANC attendance leading to poor completion rate of 4th ANC visit
Inconsistent funding to fully support outreaches
Shortage of staff to meet the increasing demand for services
IPALI HEALTH CENTER Community Units/Community Engagement
Background
The facility is supported by 6 Community Units (CU), 6 CHEWs and 60 CHVs.
Ipali Health Centre is located along Busia Kisumu highway in Vihiga County Emuhaya Sub County. The facility serves a catchment population of estimated 14,089 of whom 464 are less than 1 year and 2,261 under 5 years. The facilities caters for 3,147 women of reproductive age and in 2016 recorded 61 estimated deliveries.
The CHVs attached to the facility, are tasked with responsibility of: client retention, treatment adherence and psychosocial support, community/facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities. CHVs Brief on follow up:
Staffing
Follow up of children for immunization
Mapping of ANC Mothers.
Follow up of mothers for skilled delivery and referrals for ANC visits
Community based promotion of FP
Community case management with diagnosis and treatment of malaria.
Outreaches-CHVs mobilization
Achievements
Facility staff capacity enhanced through training, mentorship, OJT and CMEs.
Human resource support from APHIAPlus
Established supply chain for : delivery kits, ambubags, fetoescopes, BP machines, roaster boards, cervical dilation boards color coded bins, bin liners for health care waste management, ORT corner commodities
Trained CHVs and HCW in growth monitoring and IMAM.
Establishment of Pediatric and Adolescent clubs to enhance adherence and viral suppression.
Effective referral mechanism established with community facility linkage
*There are no Drivers and Lay Counsellors in Ipali Health Center.
Service
Antenatal care, Post Natal care Child Welfare Services Family planning, HIV Care and treatment Cervical cancer screening. Maternity Services Rehabilitative services
Challenges
Shortage of staff.
Inadequate supplies to include: pharmaceuticals, nonpharmaceuticals and laboratory reagents.
KHWISERO HEALTH CENTER Challenges
Background Khwisero Health Centre is situated along Khwisero- Eshibinga Road, Khwisero market centre in Khwisero Sub-county. The facility serves a catchment area of 26,455 of whom 953 are less than 1 year old while 4,630 are under 5 years old. The facility catchment has 6,985 women of reproductive age and records an estimated delivery of 953.
Community Engagement The facility is supported by 4 CUs, 37 CHVs and 3 CHEWs. The CHVs and the CHEWs have undergone several trainings supported by APHIAPlus. They are able to roll out their activities every month.
Training on danger signs in pregnancy and verbal autopsy
Training on community family planning
Training on community malaria case management
Basic training on CBHIS for CHEWs, CHCs and CHVs
Staffing
Inadequate working space especially in MCH, maternity and Lab.
Late commencement of ANC attendance leading to poor completion rate of 4th ANC visit
1st ANC visit delay leading to more deliveries at home
Increased work load for care providers because of client in-flows from neighboring maternity resulting from positive client reviews.
Achievements
Increase in uptake of skilled facility deliveries, immunization and ANC attendance.
Integration of HIV services into the MCH/FP clinic.
HIV testing services offered to mothers at the Maternity.
Facility staff capacity enhanced through training, mentorship, OJT and CMEs.
Human resource management and support through performance contracting.
Supply of furniture (tables and chairs), benches, electric kettle, delivery couches and delivery packs
Provision of lab equipment e.g. HB machine,
Nutritional support
Data cleaning and reconstruction
Selected Indicators Trends Indicator
Qtr 1
Qtr 2
Qtr 3
Qtr 4
EPP
240
240
240
240
New ANC
199
207
188
753
Skilled deliveries
182
141
176
669
Imm. Penta-1
220
215
194
824
*There are no Doctors in Khwisero Health Center.
KISUMU COUNTY HOSPITAL Background
Staffing
Kisumu County Hospital is a government facility situated within Kisumu City CBD, next to Kisumu Bus Park. The facility was established in 1920 during the building of the Kenya –Uganda Railway. The facility serves a population of approximately 59,021 of whom 2,066 are < 1year olds and 9,444 are < 5 years. The catchment area has 15,346 women of reproductive age and in 2016 recorded 2,361 deliveries.
Community Units The facility is supported by 13 CHVs working under 1 CHEW and 6 CHCs, attached to the County Hospital. The CHVs attached to County Hospital, are tasked with responsibility of: client retention, treatment adherence and psychosocial support, community/ facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities.
CHVs Brief on follow up: Follow up of children for immunization
Mapping of ANC Mothers.
Follow up of mothers for skilled delivery and referrals for ANC visits
Community based promotion of FP
Community case management with diagnosis and treatment of malaria.
Outreaches-CHVs mobilization
Challenges
Inadequate working space especially in MCH, maternity and Lab –Renovation on going.
Delayed referrals from the community leading to maternal deaths.
The graph showing trend on skilled deliveries vs target
MAKUNGA RURAL HEALTH DEMONSTRATION CENTER Community Units/Community Engagement
Background
The facility is supported by 30 CHVs working under 4 CHEWs in 3 CHUs. The CUs have been trained on CBHIS, for CHEWs, CHCs and CHV. The community link persons have received training in: growth monitoring, maternal, and new-born and child care, identification of danger signs in pregnancy and conducting verbal autopsies. They have also received training on community malaria case management.
Makunga Rural Health DC is a government facility situated along Kakamega/Mumias in Mumias East Sub County. The facilities has a catchment of approximately 18,639 among whom 706 are less than 1 year old and 932 under 5 years old. The facility is meant to serve 4,250 women of reproductive age and in 2016 estimated delivery stood at 706.
Monthly CU Activities
Staffing
Monthly mapping, referral and linkage of pregnant women for ANC services
Defaulter tracing for Immunizations, HIV/AIDS, TB, ANC
Monthly review meetings
Dialogue and Action Days
Escorted referrals for skilled deliveries
Conducting home visits and conducting health education & promotion and doing mobilization for health services available in the link facility
Supporting the customer care desks and growth monitoring at the link facility
Monthly PSSGs and children club meetings
Monthly Peer educators meetings
Facility-Community linkages meetings
Challenges
Service
Antenatal care,
Post Natal care
Child Welfare Services
Family planning,
HIV Care and treatment
Cervical cancer screening.
Maternity Services
Rehabilitative services
Inadequate working space especially in maternity, ccc and Lab –if any
Late ANC attendance leading to low 4th ANC visit
1st ANC visit delay leading to more deliveries at home
Increased work-load at maternity since many mothers from other catchment areas come for delivery services at the facility since it’s the only facility offering 24hours maternity services.
Stock-out of commodities - pharmaceuticals, nonpharmaceuticals and laboratory reagents.
MBALE PROVINCIAL RURAL HEALTH TRAINING CENTER
Staffing
Background Mbale Provincial Rural Health Training Center (MPRHTC) is a Level 3 government facility situated along Kisumu-Kakamega road in Vihiga county in Mbale town. This facility has a catchment population of 24,122 of whom 868 are under 1 year old and 4,221 are under 5 years. The facility is meant to offer service to 5,500 women of reproductive age and in 2016 is expected to deliver 868 babies.
Community Units The facility is supported by 3 CHUs and 60 CHVs. The CHVs responsibility includes client retention, treatment adherence and psychosocial support, community/ facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities in all the entry points which they are attached to. CHVs Brief on follow up:
follow up of children for immunization Follow up of pregnant mothers for skilled delivery TB screening, follow up and defaulter tracing.
Achievements
Staff capacity enhanced through training, CMEs, mentorship and OJT
Improved provider: client ratio through APHIAplus human resource support
Supply of medical equipments (BP machine fetal scope, waste segregation bins, delivery packs)
Use of Electronic Medical Records (EMR) courtesy of APHIAplus
Support in PSSP ( paediatric,adolescents and PMTCT)
Challenges
Inadequate working space especially in MCH, CCC, OPD and Lab.
High clientele against low number of service providers.
Inadequate supplies to include pharmaceuticals, non pharmaceuticals, Lab reagents and equipments.
Inadequate financial support.
MUMIAS MODEL HEALTH CENTRE Background Mumias Model Health Centre is a government facility situated along Mumias - Musanda road in Mumias west Sub-County. The facility has a catchment population of 22,641 of whom 815 are under 1 year while 3,962 are under 5 years. The facility is expected to offer services to 5,977 women of reproductive age and in 2016 is expected to deliver 815 children.
Staffing
Community Units/Community Engagement The facility is supported by 2 CHUs and 20 CHVs. The CHVs are responsible for client retention, documentation of referrals, adherence and psychosocial support, community/facility linkages, contact tracing, conducting health promotion activities, and Positive Health Dignity and prevention activities in all the entry points that they are attached to. CHVs Brief on follow up:
Follow up of children for immunization
Mapping of ANC Mothers.
Follow up of mothers for skilled delivery and referrals for ANC visits
Community based promotion of FP for facility linkages, contact tracing, conducting health promotion, preventive and curative activities.
Community case management with diagnosis and treatment of malaria.
Outreaches-CHVs mobilization
Challenges
Achievements
Introduction of ‘Oparanya Care’ Project has led to improved number of skilled deliveries
Community to Facility referrals is successful through CHVs
Capacity building to staffs through training, OJT and mentorship
Human resource support through APHIAplus
Support from APHIA plus e.g. IPC materials, furniture, IEC, equipment.
Inadequate working space especially in CCC and OPD Knowledge gap on reporting tools. Inadequate supplies especially non-pharms Lack of funds e.g. free maternity funds. Frequent power blackouts and lack of standby source of power
Graph on Family planning, 4th ANC, skilled deliveries, Fully immunized children Month
FP
4TH ANC
Skilled deliveries
FIC
January Feb March April May June July August Sept
244 217 236 213 263 239 243 226 217
43 46 44 55 50 58 86 57 46
77 45 62 78 90 84 83 64 85
67 91 81 72 67 111 100 72 97
MIGOSI LEVEL 4 HOSPITAL Background
Achievement
Migosi Hospital is a Level 4 government facility situated in Kisumu city, Kondele location, Migosi ward on the KisumuKakamega Highway Kisumu Central Sub County. The facility has a catchment population of 20,103 of whom 764 are under 1 year and 3,217 under 5 years old. The facility is expected to provide service to 5,227 women of reproductive age and in 2016 to deliver 764 babies.
The Hospital has increased its deliveries from 3 in 2012 to 249 in 2015 throught robust home follow ups, household mapping of ANC mothers, referral by CHV for ANC and facility delivery.
Institutionalizing monthly family open days
Integrating HIV services in the MCH/FP clinic
Enhanced capacity of facility staff through training, OJT, Mentorship, CMEs and preceptorship
Increased provider: client ration by human resource support including HTS -2, Nurse-1,CO -1, nutritionist -1 & Data clerk-1
Staffing
Acquired furniture (tables and chairs), benches, file cabinets, delivery couches, computer and delivery packs for facility.
Provision of Basic MNCH equipment e.g. Delivery sets, paediatric Ambubags, Kiwi, baby warmer, foetoscopes, BP machine & thermometer
Provision of IPC/WASH equipment e.g. colour coded bins, bin liners, hand washing facilities, hand sanitizers, point of safe drinking water equipment
Provision of lab equipment e.g. HB machine and other consumables
Revival and providing ORT Corner equipment.
Provision of Child Health Appointment Diaries as well as other IMCI guidelines and IEC materials. Nutritional support e.g. Nutrition Supplements, MUAC tapes, Height board, weighing scale, IEC materials
Provision of data collection tools and mentorship on correct use
Community Units/Community Engagement Challenges
Increased work load at maternity since many mothers are referred by CHVs – support additional staff, MNCH equipment and consumables.
Inadequate working space especially in MCH.
4th ANC performance still below as most clients start ANC clinic visit late.
The facility is supported by 8 CHUs and 105 CHVs supervised by 2 CHEWs 1 PHO and one volunteer CHEW. CHVs Brief are as follows:
Demand creation at community level for service uptake at the facility level.
Defaulter tracing and client follow up for CCC, TB, immunization and ANC visits.
Follow up of mothers for skilled delivery, promotion of FP and growth monitoring.
Facility health talks, Community mobilization for outreaches and
NYANG’IELA HEALTH CENTER Background
Community Units/Community Engagement
Nyang’iela is a GOK Level 4 health facility within Rachuonyo south (formerly Kasipul) sub county. The facility is located along the OyugisRodi Kopany road about 4km from Oyugis town. The facility has a catchment population of 5,960 among whom 336 are under 1 year and 1,459 under 5 years. The facility should serve 2,194 women or reproductive age and in 2016 has an expected delivery of 384.
The facility is supported by one CHU - Kotieno Kochich and 15 CHVs and 7 Peer Educators all supervised by one CHEW. They are tasked with the responsibility of client retention, documentation of referrals, adherence and psychosocial support, community/facility linkages, contact tracing, conducting health promotion activities, and Positive Health CHVs Brief on follow up:
Staffing
Follow up of children for immunization
Mapping of ANC Mothers.
Follow up of mothers for skilled delivery and referrals for ANC visits
Community based promotion of FP
Community case management with diagnosis and treatment of malaria.
Outreaches-CHVs mobilization
Challenges
Inadequate working space especially in MCH, maternity and Lab. New building under construction used by sick antenatal, & post-natal mothers.
Delayed commencement of ANC attendance leading to low 4th ANC visit.
1st Delay leading to more deliveries at home- CHV escorting clients to HF
Increased work load at maternity since many mothers from other catchment areas come for delivery services at the facility – support in MNCH equipment and consumables
CHVs to continue with Mapping of Pregnant mothers during home visits and strengthen escorted referral
*There are no doctors, pham technologists, drivers or lay counsellors in Nyang’iela Health Center.
The table below illustrates 2015/2016 achievements in some selected indicators Indicators
Qtr 1
Qtr 2
Qtr 3
Qtr 4
Total
EPP New ANC Skilled deliveries
96 102 46
96 67 66
96 68 45
96 80 57
384 317 194
Imm. Penta-1
76
63
73
73
270
OBER HEALTH CENTER Background
Challenges
Ober Health Centre is a government facility situated along KisumuOyugis road next to Ringa Market. It was recently upgraded to a level 4 facility. The facility has a catchment population of 10,973 among whom 416 are under 1 year old while 1,811 are under 5 years. The facility catchment has an approximate 2,721 women of reproductive age and in 2016 had an estimated delivery of 439.
Late commencement of ANC attendance leading to poor completion rate of 4th ANC visit
1st ANC visit delay leading to more deliveries at homethe CHVs escort clients to HF for delivery. TBAs incorporated in CHV activities to discourage home deliveries
Increased work load at maternity since many mothers from other catchment areas come for delivery services at the facility – support in MNCH equipment and consumables
Community Units/Community Engagement
Staffing
Ober facility is supported by 30 CHVs working under 2 CHEWS within the Kakelo Dudi A and Kawere CUs. There are 30 CHVs and 4 PEs attached to the facility. At least 2 CHVs are on duty every day. They are attached to MCH and OPD, they are tasked with responsibilities of client retention, documentation of referrals, Adherence and psychosocial support, community/ facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities in all the entry points which they are attached to. CHVs Brief on follow up:
*There are no Doctors, Pharm Technologists, Drivers or Lay Counsellors in Ober Health Center.
Follow up of children for immunization
Mapping of ANC Mothers
Follow up of mothers for skilled delivery and referrals for ANC visits
Community based promotion of FP
Community case management with diagnosis and treatment of malaria
Outreaches-CHVs mobilization
Table showing data on some selected indicators Indicator
Qtr 1
Qtr 2
Qtr 3
Qtr 4
Total
EPP
423
423
439
439
1724
New ANC
112
132
132
128
504
Skilled deliveries Imm. Penta-1
67 92
85 85
111 104
111 102
358 383
OBER KAMOTH SUB-COUNTY HOSPITAL Background Ober Kamoth Sub-County Hospital is a government facility situated along Kisumu Bondo road, Kisumu County, Kisumu West Sub- County. It was started in 1984 as a dispensary and currently a Sub-County hospital. The facility has a catchment population of 13,285 of whom 478 are under 1 year and 2.126 are under 5 years old. The facility is expected to provide service to 531 women of reproductive age and in 2016 is expected to deliver 531 children.
Staffing
Community Units/Community Engagement The facility is supported by 3 CHUs: Kanyawegi A, Kanyawegi B and Osiri with 47 CHVs working under the supervision of 2 CHEWs. The CHUs were established in 2011 under support of CINCO and APHIAPlus. There are 4 PEs attached to the facility and least 2 CHVs are on duty every day to support MCH and OPD. Their roles include: client retention, documentation of referrals, adherence and psychosocial support, community/ facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities in all the entry points which they are attached to. There are also 2 community PEs who work closely with 2 facility PEs and the CCC staff to ensure identification and enrollment of clients into the Community PSSG. The 13 PWP messages promoting adherence to 3 community PSSGs are given and support care and treatment defaulter tracing as well as linkage to care.
Achievements
Integration of HIV services in MCH/FP clinic
Enhanced capacity of staff through trainings, OJT, CMEs, Exchange programmes and Mentorship
Improvement of provider: client ratio through APHIAPlus support for Human resource and development
Acquisition of furniture, delivery couches, delivery packs, resuscitaire, phototherapy machine and other accessories
Provision of lab equipment e.g. HB machine, and other consumables
Nutritional support
Support of HIV counseling and testing and linkage to CCC
Support from the Community units
Mapping for all pregnant mothers and children under 5 years
Enhance defaulter tracing and mapping of herd to reach areas
Table showing data on some selected indicators
Indicator
Challenges
Increased work load with few staffs
EPP New ANC Skilled deliveries
Qtr 1
Qtr 2
Qtr 3
Qtr 4
Total
112
83
99
106
400
60
39
54
93
246
OTHORO LEVEL 4 HOSPITAL Background Othoro Level 4 Hospital is a government facility situated along Kisumu Oyugis road in Rachuonyo East Sub County (formerly Kabondo Kasipul sub-county). The facility has a catchment population of 14,928 out of whom 567 are under 1 year and 2,463 are under 5 years. The facility is expected to cater for 3,702 women of reproductive age and in 2016 expected to deliver 597 children.
Staffing
Community Units The facility is supported by 2 CHUs: Kakangutu East, and Miriu and each has 15 CHVs and 6 community Peer Educators supervised by two CHEWs. The CHVs responsibilities include ensuring client retention, documentation of referrals, adherence and psychosocial support, community/facility linkages, contact tracing, conducting health promotion activities, and Positive Health. There are also the community PEs who work closely with the facility PEs and CCC staff to ensure identification and enrolment of clients into the community PSSGs.The community Pes support care & treatment defaulter tracing as well as clients to be linked to care.
Achievements
Enabled the Hospital to increase its deliveries to 82 % through robust home follow ups, household mapping of ANC mothers in the household, referral by CHV for ANC and facility delivery
Integrated HIV services in the MCH/FP clinic
Enhanced capacity of facility staff through training, OJT, CMEs, mentoring and preceptorship
Improved provider: client ratio through human resource support including HTS -2, Nurse-1, Lab. Tech-1 & Data clerk-1
Acquired furniture (tables and chairs), benches, file cabinets, delivery couches and delivery packs for the facility.
Improved stocking of Basic MNCH equipment e.g. Delivery sets, paediatric Ambubags, Kiwi, baby warmer, foetoscopes, BP machine & thermometer
Improved stocking of IPC/WASH equipment e.g. colour coded bins, bin liners, hand washing facilities, hand sanitizers, point of safe drinking water equipment
Provision of lab equipment e.g. HB machine and other consumables
Revival and providing ORT Corner equipment.
Provision of Child Health Appointment Diaries as well as other IMCI guidelines and IEC materials.
Nutritional support e.g. Nutrition Supplements, MUAC tapes, Height board, weighing scale, IEC materials
Provision of data collection tools and mentorship on use
Challenges
Late ANC attendance leading to low 4th ANC visit.
Delay in making 1st ANC visit leading to more deliveries at homethe CHVs escort clients to HF for delivery.
Increased work load at maternity since many mothers from other catchment areas come for delivery services at the facility.
Achievement in some selected Indicators 2015/2016 Indicators
Qtr1
Qtr 2
Qtr 3 Qtr 4
Total
EPP
145
145
145
145
580
New ANC
76
106
112
87
381
Skilled deliveries
105
86
97
99
387
Imm. Penta-1
108
89
93
105
395
RACHUONYO SUB-COUNTY HOSPITAL Background Rachuonyo Sub County Hospital is a government facility situated in Oyugis town along Oyugis Kendubay road in (Rachuonyo South sub county (formerly Kasipul Sub-County) It serves as a referral facility for CEmONC services for both Rachuonyo East and Rachuonyo South sub counties. This facility has a catchment population of 39,939 of whom 1,517 are under 1 year while 6,590 are under 5 years. The facility should offer services to 9,905 women of reproductive age and in 2016
Challenges
Inadequate working space especially in MCH, maternity and Lab. Late commencement of ANC visits leading to low 4th ANC visit.
Delay in commencing ANC visit leading to more deliveries at home and lower level health facilities.
Staffing
Community Units/Community Engagement The facility is supported by 4 CHUs (Kanyango, Kokal, Kokal and Kamuma) and 60 CHVs all working under the supervision of 4 CHEW. There are 60 CHVs and 8 PEs attached to Rachuonyo SCH.At least 3 CHVs are on duty every day. They are attached to MCH and OPD they are tasked with responsibility of client retention, documentation of referrals, Adherence and psychosocial support, community/ facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities in all the entry points which they are attached to. CHVs Brief on follow up: Training on
danger signs in pregnancy and verbal autopsy
Training on
community family planning
Training on
community malaria case management
Basic
training on CBHIS for CHEWs, CHCs and CHVs
Data on some selected indicators 2015/2016 Indicators
Qtre 1
Qtre 2
Qtre 3
Qtre 4
Total
EPP
409
409
409
409
1636
New ANC
293
335
358
299
1285
Skilled deliveries
652
606
617
664
2539
Imm. Penta-1
361
256
305
358
1280
Achievements
New outpatient block under construction will help ease the congestion when completed. APHIAPlus has provided Tents for HTS, & PMTCT services
CHVs have intensified Mapping of Pregnant mothers during home visits, community sensitization with escorted referrals.
APHIAPlus has supported supply of basic MNCH equipment and consumables.
SABATIA SUB-COUNTY HOSPITAL Background
Community Units/Community Engagement
Sabatia Sub-County hospital is a government facility situated along Chavakali–Kapsabet in Sabatia Sub County. The facility has a catchment population of 32,046 among whom 1,140 are under 1year and 4,486 under 5 years. The facility is meant to cater for up to 7.306 women of reproductive age and in 2016 expected 1,140 deliveries.
The facility is supported by 3 CHUs and 30 CHVs. They are tasked with responsibility of client retention, adherence and psychosocial support, Community/ facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities in all the entry points which they are attached to. CHVs Brief on follow up:
Staffing
Follow up of children for immunization
Follow up of mothers for skilled delivery
Follow up on postnatal
Challenges
Inadequate working space especially in maternity, ccc and Lab
Late commencement of ANC visits leading to low 4th ANC visit
1st ANC visit delayed leading to more deliveries at home
Staff fatigue because of high work load at maternity since many mothers from neighboring other catchment areas come for delivery services at the facility since it’s the only facility offering 24hours maternity services.
Inadequate supplies to include: pharmaceuticals, nonpharmaceuticals and laboratory reagents.
Achievements
Staff capacity enhancement through training, mentorship, OJT and supportive supervision.
Increase in health care provider: client ration through human resource support from APHIAplus
Supply of medical equipment (BP machine fetal scope, waste segregation bins, delivery packs and delivery coach)
Nutritional support
Support in pssg( paediatric,adolescents and PMTC)
*There are no Lay Counsellors in Sabatia Sub -County Hospital
SIAYA COUNTY TEACHING AND REFERRAL HOSPITAL Background
Staffing
Siaya County Teaching & Referral Hospital is a government facility situated along Siaya-Ugunja road in Siaya Town Centre Alego-Usonga Sub-County. The facility serves a catchment area of 41,907 of whom 1,329 are under 1 year and 7,082 under 5 years. The facility should cater for 9,513 women of reproductive age and in 2016 expected 1,610 deliveries.
Community Units The facility is supported by 1 CU (Karapul), 40CHVs and 2CHEWs.
Training on danger signs in pregnancy and verbal autopsy
Training on community family planning
Training on community malaria case management
Achievement
Basic training on CBHIS for CHEWs, CHCs and CHVs
Successful integration of HIV services in the MCH/FP clinic
Staff capacity enhanced through training, OJT, mentoring, supportive supervision and preceptorship
CHVs Brief on follow up:
follow up of children for immunization
Follow up of mothers for skilled delivery
Service delivery improvement through human resource support by APHIAPlus support.
Community based promotion of FP
Dissemination of IEC material, posters, Job-aids and guidelines packs
Nutritional support
Systems established for Data Quality Assessment at the facility level to improve data cleaning and reconstruction
Challenges
Late ANC attendance leading to low 4th ANC visit
1st Delay leading to more deliveries at home
Increased work load at maternity since many mothers from other catchment areas come for delivery services at the facility
The table to show trend on skilled deliveries vs Immunization Indicators EPP (Target)
Qtr 1 403
Qtr 2 403
Qtr 3 403
New ANC Skilled deliveries Imm. Penta-1
446 765 329
337 721 410
311 849 303
SIGOMRE SUB-COUNTY HOSPITAL Background
Community Units/Community Engagement
Sigomere Sub-County Hospital is a government facility situated along Ugunja-Musanda road in Ugenya Sub –County. The facility has a catchment population of 13,264 among whom 464 are under 1 year and 2,228 are under 5 years. The facility is expected to offer services to 3,011 women of reproductive age and in 2016 is expected to deliver 531 children.
The CHVs are responsible for client retention, treatment adherence and psychosocial support, community/facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities. CHVs Brief on follow up:
Staffing
Follow up of children for immunization
Follow up of mothers for skilled delivery
Community based promotion of FP
Success of referrals of ANC, deliveries, women for FP.
Community case management with diagnosis and treatment of malaria.
Passing health Information to community members which has a positive impact.
Mapping of ANC Mothers, defaulter tracing and community outreaches.
Facility contacts Immunization defaulted children.
Achievements
Challenges
Inadequate working space especially in MCH, maternity and Lab Late commencement of ANC visits leading to non-completion of 4th ANC visits. Delay in commencement of ANC visits leading to more deliveries at home. Increased work load at maternity since many mothers from other catchment areas come for delivery services at the facility.
Renovation of rooms for offering MNCH services
Formation of ANC clubs to support early commencement of ANC visits. Clubs supported by CHVs.
PD HEARTH for Nutritional support set up.
MPDR Committee put in place.
ANC Mapping done.
Conducted Community Case diagnosis and management.
Commodities acquired: Delivery kits, ambubags, fetoscopes, roaster boards, Cervical
Graph showing trend on skilled deliveries Indicator
Qtr 1
Qtr 2
Qtr 3
EPP
45
45
45
New ANC
106
69
76
4 Visit
66
58
38
Skilled deliveries
127
185
89
Imm. Penta-1
125
100
119
th
UKWALA SUB-COUNTY HOSPITAL Background Ukwala Sub-County Hospital is a government facility situated along Ugunja- Ukwala road in Ugenya Sub –County. The facility has a cathment population of 21,477 of whom 751 are under 1 year old and 1,073 are under 5 years. The facility is expected to provide services to 5,148 women of reproductive age and in 2016 was expected to deliver 751 children.
Staffing
Challenges
Inadequate working space especially in MCH, maternity and Lab.
Late commencement of ANC visits leading to low 4th ANC visit completion.
Delay in initiating ANC visit leading to more deliveries at home. .
Increased work load at maternity since many mothers from other catchment areas come for delivery services at the facility.
Community Units/Community Engagement The facility is supported by 7 CHUs: Doho East, Simur East, Siranga, Doho West, Simur Kondiek, Yenga and Simur. It has 47 CHVs. The CHVs are responsible for ensuring: client retention, adherence and psychosocial support, community/ facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities in all the entry points which they are attached to. CHVs Brief on follow up:
Follow up of children for immunization
Follow up of mothers for skilled delivery
Community based promotion of FP
Success of referrals’ of ANC, Deliveries, women for FP.
Community case management with diagnosis and treatment of malaria.
Passing health Information to community members which has a positive impact.
Defaulter tracing.
Mapping of ANC Mothers’.
Trends Trends in ANC, in ANC, skilled skilled delivery delivery andand immunization immunization (Penta (Penta 1) 1)
Indicators EPP
Qtr 1 189
Qtr 2 189
Qtr 3 189
New ANC
109
259
125
Skilled deliveries Imm. Penta-1
194 109
182 220
213 187
VIHIGA HEALTH CENTER Background Vihiga Health Centre is a government facility situated along Majengo-Luanda road in Vihiga Sub County. The facility serves a population of 18,208 among whom 770 are under 1 year old and 2,136 under 5 years. The facility is meant to serve 4,369 women of reproductive age with an estimated delivery of 770.
Staffing
Community Units/ Community Engagement The facility catchment has 4 Community Units supported by 50 CHVs. APHIAPlus has enhanced the capacity of the CHEWs and CHVs to offer community level services through various trainings and provision of tools. The CHEWs and CHVs have been trained on: basic training on CBHIS, growth monitoring, maternal, and newborn and child health, Kangaroo Mother Care, identifying danger signs in pregnancy and verbal autopsy, community family planning and community malaria case management Monthly CU Activities
Monthly mapping, referral and linkage of pregnant women for ANC services
Defaulter tracing-Immunizations, HIV/AIDS, TB, ANC
Monthly review meetings
Dialogue and Action Days
Escorted referrals for skilled deliveries
Identifying children due for immunization and referring them
Conducting home visits and conducting health education & promotion and doing mobilization for health services available in the link facility
Supporting the customer care desks and growth monitoring at the link facility
Monthly PSSGs and children club meetings
Monthly Peer educators meetings
Facility-Community linkages meetings
Challenges
Infrastructure – lack of space for some of the RH services such as youth friendly centre, PNC and the maternity has only three bed capacity.
Late commencement of ANC attendance leading to poor completion rate of 4th ANC visit
1st Delay leading to more deliveries at home
Stock-out of supplies of: pharmaceuticals, nonpharmaceuticals and laboratory reagents.
Shortage of staff to meet the increasing demand for services especially the clinical staff
Financial support for outreach clinic services
YALA SUB-COUNTY HOSPITAL Background
Community Units/Community Engagement
Yala Sub County Hospital is a government facility situated in Yala Township in Gem Sub-County. The facility has a catchment population of 21,625 of whom 822 are under 1 year old and 1,082 are under 5 years. The facility is meant to provide service to 5,407 women of reproductive age and in 2016 is expected to deliver 840 children.
The facility is supported by 1 CHU: Nyamninia CU and 17 CHVs, 11 CHCs and 1 Facility CHA. These CHVs cover 13 villages. The CHVs responsibilities include client retention, treatment adherence and psychosocial support, community/facility linkages, contact tracing, conducting health promotion activities and Positive Health Dignity and Prevention activities in all the entry points which they are attached to.
Follow up of children for immunization
Staffing
Follow up of mothers for skilled delivery
Community based promotion of FP
Successful referrals’ of ANC, Deliveries, women for FP.
Community case management with diagnosis and treatment of malaria.
Passing health Information to community members which has a positive impact.
Mapping of ANC Mothers’.
Outreaches-CHVs mobilization
CHVs responsibility entails:
Achievements
The table to show trend on skilled deliveries vs immunization
Staff capacity enhancement through training, CMEs, mentorship, OJT and preceptorship
Improved provider, client ration through APHIAplus human resource support
Increased awareness raising material by increased supply of posters, Job aids and guidelines
Nutritional support
Increased in-facility capacity in Data Quality Assessment to conduct data cleaning and reconstruction
Improved customer care at MCH and Maternity, more mothers prefer accessing services in the facility
Challenges
Late ANC attendance leading to low 4th ANC visit
Increased work load at maternity since many mothers from other catchment areas come for delivery services at the facility