Homabay County Factors that hinder implementation of child health - - PowerPoint PPT Presentation

Homabay County

Factors that hinder implementation of child health programs

• 1. Funds allocation to child health programs

‐ Inadequate funds allocated ‐ Diversion of funds

• 2. Inadequate human resources to deliver child health programs in level 2

and 3

• 3. Minimal training and cascading of guidelines to the front line health

workers eg RMNCAH framework, EMONC, MPDSR

‐ The trained health personnel do not adhere to training guidelines, ‐ There is minimal supervision and follow up on the same

• 4. Inadequate and disjointed integrated support supervision

‐ Weak/disjointed support supervision from CHMT to SCHMT and HFs; Homabay has held one integrated SS since devolution ‐ Vertical support supervision is mostly spearheaded by partners who mostly are able to support 1‐2 persons in each program ‐ Inadequate logistical support.

• 5. Minimal knowledge among the health workers on key child health

indicators leading to mis‐ interpretation of the same

‐ Poor data management practices in the HF level ‐ Irregular data reviews at health facility and sub‐county levels

• cont. Factors that hinder implementation
• f child health programs

• 6. Limited transparency and accountability mechanisms among the

county leadership

‐ Inadequate no. of civil society groups to undertake advocacy initiatives in the county. ‐ Weak oversight role by MCAs on the county legislature and the executive

• 7. Lack of motivation amongst the health workers

Cont.Factors that hinder implementation

• f child health programs

Factors that support child health service delivery

• 1. Structured management and leadership at the County health offices

‐ Scheduled meetings with CHD/CEC, MCAS, CHMTs, Functional TWGs

• 2. HRH

‐ ‐ availability of H/Ws at all levels of service delivery

• 3. Coverage of CUs to provide quality child health services.
• 4. Competent and skilled core leadership (CDH,COH,CECM) to implement programs
• 5. Implementing partners who support the child health programs

What should be changed? /Recommendations

• 1. Strengthen leadership and governance
• 2. Strengthen accountability frameworks at the county level
• 3. Resource mobilization‐ embrace a holistic approach to child health
• 4. Prioritization of key health issues and implementation of allocated budget
• 5. Advocacy for increased political commitment and negative interference by the political elite

(MCAs)

• 6. County partners to advocate and implement integrated support supervision
• 7. Scale up mentorship, CMEs support supervision to support gaps in knowledge, adherence to

guidelines, data etc.

Interventions for scale up

• 1. Using data to drive programming
• 2. Commodity management: currently the county is able to forecast and quantify

vaccines and non‐ vaccine supply.

• Monitoring: Consistent documentation of vaccines and non‐vaccine supplies by the sub county EPI coordinators

and MCH nurses.

• Reaching the unreached ‐ Map the unimmunized children
• 3. Budget advocacy
• Conduct quarterly forums to meet county committee for health
• 4. Coordination‐
• Conduct data quality reviews at select HF
• Integrated supportive supervision to drive the quality of data for the county health department.
• Stakeholder forum to discuss the integration of programs – April 2019

Immediate workplan

Activities Responsible Dates

• 1. A brief to the CDH on the child health symposia deliberations

with a focus on the interventions for scale up/budget Christine /Mageto 3rd April 2019

• 2. performance review meetings for health

‐ Data review/ resource sharing Christine 1st wk, April, 2019

• 3. Stakeholder forum to discuss the integration of programs

Christine /Charles May, 2019

• 4. Conduct integrated SS

Christine/ HRIO Quarterly

• 4. review AWP to support additional CH needs

Christine 1st wk, April, 2019