Baringo County Child health report
Leadership , Governance and Management • CEC Head of department, represents department at cabinet • Chief officers‐Public Health and Medical services • Directors: County director Public health and medical services, administration and planning • CHMT consists of Lead program officers
• At sub county level, the sub county health service coordinators head the sub counties with various heads of departments • The hospitals are headed by medical superintendents and managed by hospital boards. • Health facilities are managed by health facility committees • Community health committees manage the community units
Coordination • CEC represents the governor and engages with county Assembly Health committee • Stakeholders are engaged at County level(Leadership and CHMT) including National government and other line ministries • For example security issues are chaired by the commissioner at county level and deputy commissioners at sub county level
Strengths • Existing structures eg. EPI (immunization) coordinator, RH coordinator, Nutrition at county and sub county level with clear roles • Strategic and annual work plans are in place including policy guidelines • Adequate supply of Vaccine antigens • Staff Trained on IMCI modules • Partner support for Child health programs: Afya Uzazi, CHAI, GAVI, UNICEF among others
Weaknesses • Poor integration of services eg nutrition considered stand alone • Inadequate financial and human resources. Three(3) million our 2.3 Billion allocation to support Primary Health Care FY 2018‐2019 • Inadequate and inequitable distribution of facilities and HRH across sub counties( Tiaty most affected). More staff in urban areas than rural areas.
• Low coverage of community units with minimal support by county, community activities partner dependent • Majority of CHVs are not trained on technical modules including child health. • Inadequate non pharmaceuticals eg .BCG syringes • Budget for procuring nutrition commodities has not been taken up by the county after WFP pulled out
• Mothers have poor access to emergency maternal care especially in Tiaty, and other hard to reach areas • Inadequate incubators • Lack of alignment between plans and county budgets • Poor dissemination of guidelines to lower levels • Poor documentation and data management • Socio‐Cultural aspects and insecurity
Opportunities • Improved health financing through health insurance by up‐scaling Linda mama and NHIF enrollment • Aligning county and partner priorities towards child health • Increased collaboration with national ministry of interior to curb insecurity, roads to improve access, safe water provision • Presence of partner support e.g. THS‐UHC • Advocacy and awareness for increased health budget allocation targeting county assembly budget and health committee and county treasury. • Align work plans to approved budget • Improve dissemination of guidelines to lower levels • Improve documentation and data management for decision making • Learning from best practices from other areas
Interventions for child health • Increase coverage of immunizing sites by increasing the number of facilities offering immunization including power connection facilities. • Scaling up integrated outreaches especially in Tiaty and Baringo north • Implementation of the guidelines by offering immunization daily • Regular mapping to identify missed children and Scaling up defaulter tracing by giving incentives to CHVs • Advocacy and resource mobilization for immunization services . strengthening linkage with immunization champions like organizing community events like marathons • Strengthen surveillance for vaccine preventable diseases
• Scale up of high impact nutrition interventions in all health facilities like growth monitoring, Vit A supplementation, IMAM, good childhood practices. • Active case search, defaulter tracing using CHVs • County to procure nutrition commodities • Advocacy and health education of minimum dietary diversity, focused antenatal care, multi‐sectoral collaboration, • Maternal shelters before and immediately after delivery to improve maternal and child nutrition. • Scale up baby friendly community initiative resource centres to supplement the already established in Ngoron and Tangulbei. • Each health centre to have a demonstration kitchen garden like the one in Timboywo. • Scale up of KMC in facilities
• Follow up of trained IMCI staff in all health facilities and provision of commodities eg. dispersible Amoxil tabs • Continued establishment of ORT corners • Equipping health facilities to meet child health care services standards eg provision of pulse oxymeters, therapeutic oxygen, thermometers, testing kits, MUAC tapes etc • Provision of IEC materials and job aids • Continuous IMCI training to cover for attrition and recruitments
• Thank You • Kongoi Mising!
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