Analysis of The Kirinyaga County Health System - Esbon - Gakuu
Analysis of The Kirinyaga County Health System - Esbon - Gakuu
Analysis of The Kirinyaga County Health System - Esbon - Gakuu
KIRINYAGA COUNTY
HEALTH SYSTEM,KENYA
GAKUU Esbon
Kirinyaga County
KENYA
KIRINYAGA County
Proportion of PHC Facilities by Ownership
Total Area - 1,479 KM
Total Population - 632,154 (2018 Projection)
Population Density - 427/Km2 Private Public
Urban: Rural Ratio - 16:84 44% 39%
Faith-
Based
17%
ETHIOPIA Legend
UGANDA
SOMALIA
Public Hospitals
Private For Profit Hospitals
Faith Based Hospitals
INDIAN Primary Healthcare Facilities
TANZANIA OCEAN
2
ORGANIZATION OF COUNTY HEALTH SERVICES
NATIONAL REFERRAL HEALTH SERVICES
Community Referral
• Basic Health promotion activities
Community Health Services
Community Units - 69 • Provide agreed health services e.g. deworming
Decentralized: Periodic; polyvalent
• Facilitate community diagnosis & referral.
Health Actors in Kirinyaga county
•National Ministry Responsible for
Health •Technical Partners and Non-
•County Department of Health State Implementing Partners
•Semi-Autonomous Government
Agencies e.g. National Health Insurance
Fund
Faith-Based
Private Health •Catholic Church
•Private Practitioners Health Service •Anglican Church
•Private Health Insurance Providers
Providers Providers •Methodist Church
•Christian Health Associaltion of
Kenya
4
Overview of the Health Workforce Distribution
within the County
Distribution by Ownership
Cadre Government FBOs Private Total Key Cadres per 10,000 people
Medical Consultants 8 3 3 14
Medical Officers/GPs 33 6 12 51 Cadre Kirinyaga National*
Dentists 4 1 2 7 Doctors 1 2
Pharmacists 11 1 7 19 Nurses 12 15.4
Clinical Officers (General) 94 9 21 124
Clinical Officers 26 3 8 37
(Specialized)
Nurses (specialized) 13 4 1 18
Nurses 546 87 104 737
Laboratory Technologists 112 19 46 177
Other Health Personnel 1015 157 204 1376
* World Bank, 2015
Total 1862 290 408 2560 5
Demand, Need And Supply Analysis
• Basic Emergency Maternal
Obstetric and Neonatal Care
(BEMONC) services
• HIV/AIDS, TB, Malaria diagnosis
care and Treatment services Demand • Irrational use of
• Routine Immunization services antibiotics in the
• Management of common Free Hospital-Level management of colds
ailments Health services and flus.
Affordability Free treatment of certain population High out of pocket payments due to Low Health insurance
segments (under 5s) and certain diseases in general population
(TB, HIV, Malaria) Weak community Indigent ID system Weak waiver
Insurance cover to mother and unborn system
child, All High school students; Insurance Public-Private dual practice
cover to all elderly (>65)
Acceptability Enlightened community Stigma (HIV, mental health)
Availability Presence of health workers with the Frequent stock-out of essential health commodities in
right competencies and skills mix Public hospitals
Inadequacy of highly trained health professionals
Absenteeism in public health facilities
Inadequate diagnostic equipment in PHC facilities
Poor Information sharing on health care
providers/choices 9
ANALYSIS OF QUALITY OF CARE
(Facilitators) (Barriers)
ENVIRONMENTAL HEALTH
→ HEALTH INFRASTRUCTURE → NURSING SERVICES → → HIV → HEALTH RESEARCH
& SANITATION
PARTNERS’
→ ICT → CLINICAL SERVICES → HEALTH PROMOTION → MALARIA →
COORDINATION
DISASTER PREPAREDNESS 12
→ LEGAL MATTERS → → NCD CONTROL
AND REFERRAL SERVICES
13 ROLE OF COUNTY HEALTH MANAGEMENT TEAM
Indicator Analysis
Needs assessment Most of the services at PHC level designed by health professionals with minimal
community involvement
Leadership and Existence of legal provisions emphasizing inclusion and representation of community
Management interest groups
Resource mobilization Limited amounts of resources for health raised by the local communities
Organisation Weak integration of health committees with other public participation structures
Community Participation Analysis
17
Health care financing
Public Hospitals Public PHC Facilities Faith Based Health Private For-Profit
Facilities
Direct Government
Financing
National Health
Insurance Fund
Private Insurance
Schemes
Donors/ Development
Partners
18
Synthesis of the Kirinyaga County Health System
Strengths Challenges
Good geographical access Relatively High Out-of-Pocket Payment for health
services
Presence of Comprehensive package of care at PHC Need to create demand for preventive interventions
facilities offered at PHC facilities
Existence of a clear stewardship framework at the county Administrative constraints
level Weak regulation of private health sector providers
Existence of a formal framework of public participation at Most of the services at PHC level designed by health
all levels professionals with minimal community involvement
Leadership focus on patient centered care High workload and unconducive environment for
Presence of policies supporting integration of care patient centered care.
19
Lessons Learnt
• Need to decode real demand for health
• There is a price to be paid for Integration of services
20