Sammy Ole Oinyiaku - Home | Health[e]Foundation Ole Oinyiaku • BA in Psychology, United States...
Transcript of Sammy Ole Oinyiaku - Home | Health[e]Foundation Ole Oinyiaku • BA in Psychology, United States...
Experiences from Kenya
Sammy Ole Oinyiaku
Regional Representative
The Presentation
• Personal Introduction
• Kenya Health Care System
• Health[e]Foundation in Kenya
• Experiences
• Way Forward
Sammy Ole Oinyiaku
• BA in Psychology, United States International University (USIU); Nairobi
• MPH in Epidemiology and Health Communication, Columbia University (Mailman School of Public Health); NYC
Employment
• World Bank
• USAID
• AMREF
• Health[e]Foundation
The Kenyan Health Care
System
Health Care Delivery in Kenya
• The Second National Health Strategic Plan (NHSSP II)
• Community Unit Strategy
– Populations divided into six cohorts
– Health facilities divided into six levels
LIFE CYCLE SERVICES NEEDED
COHORT PREVENTIVE CURATIVE
Pregnancy and the New-Born (up to 2
weeks of age)ANC and nutritional care; PNC; Use of skilled births attendants, clean
delivery; Breast feeding; supplementary feeding;
FP Services; TT2
ITN promotion and use; IPT and Indoor spraying;
Micronutrients / supplements (Iron)
Hygiene, water and sanitation.
Adequate and timely referral system, Partograph, transport (ambulance)
system. Basic and Emergency
Obstetric Care.New born resuscitation,
PMTCT / Nevirapine;Rapid case detection of childhood
diseases
Early Childhood (2 weeks – 5 yrs) Community IMCI + ITNAppropriate nutrition, EBF; EPI and
Vitamin A / Zn.Psychological stimulation; physical /
cognitive development;
Clinical IMCI; ORS for treatment
Diarrhoea, antibiotics and anti-
malarial drugs. ARV
Late Childhood (6-12 years) Health programme;
Adequate nutritional care; ITN promotion and use.
Overall treatment and care;Appropriate feeding, timely treatment
of infectious and parasitic diseases.
Youth and Adolescence (13-24 years) RH (FP & Post Abortion Care)
HIV/AIDS/STI counselling,Adequate nutritional care;
Accident prevention
Overall treatment and care,DOTS, STI and opportunistic
infections
Adult (25-59 yrs) Annual screening and medical
examinations; RH services, accident
prevention. Exercices.
Overall treatment and care,
ART and palliative care,
DOTS
The elderly person (60 yrs ++) Annual screening and medical
examinations. Exercise.
Access to drugs for degenerative
illnesses;
Service Delivery Levels
• Level 1: Community /Household Level
• Level 2: Dispensary
• Level 3: Health Center
• Level 4: District Hospital
• Level 5: Provincial Hospital
• Level 6: National Referral Hospital
Health Care Situation
• Kenya health care system faced by a myriad of Human Resources challenges
– Overall lack of personnel in key areas
– Immigration of trained personal
– Inequitable distribution between rural and
urban health facilities
– Traditional health care approaches e.g.
TBAs and medicine men/women
HIV/AIDS Situation in Kenya
• Comparison was done between the KDHS 2003
and KAIS 2007
• Comparisons restricted to men and women 15-
49
• National prevalence of 7.4%
HIV Prevalence in Kenya
AGE TOTAL FEMALES MALE
15-64 7.4 8.7 4.6
15-49 7.8 9.2 5.8
Health Care Workers: The Numbers
No. of Grauating Nurses, COs and Physicians 2002 - 2006
Staff Cadres 2002 2003 2004 2005 2006Registered Nurses 1,094 1,256 1,253 1,412 1,304
Enrolled Nurses 428 524 536 576 497Registered Clinical Officers 256 293 237 449 489
Laboratory Technicians 164 245 208 228 160
Physicians 210 290 406 363 464
Pharmaceutical Technologists 70 57 66 121 92
Physiotherapists 34 29 32 47 34
Consequences
• High turnover of staff in government health
facilities to NGO, Mission and other facilities
• Emigration to other countries for better
opportunities
• Higher education studies in and out of the
country
• Change of profession including going into
private practice
Emigration Rate (%) 2005
Physicians Nurses
Kenya 51 8.3
South Africa 21.1 5.1
Africa 19 8.4
Educational Options
• Kenya Medical Training College (KMTC)
• Universities offering medical/health-related
courses – Moi, Kenyatta, KEMU
• Upcoming middle-level colleges affiliated to
KMTC or public universities
• Distance learning
Health Workers Challenges
• Minimal information on emerging issues and
trends
• Lack of computer skills
• Lack of CME – “outdated” skills and
knowledge
• Lack of access to trainings and training
information
• Few health workers with little or no time to be
away from their patients
Health[e]Foundation in Kenya
Activities since 2008
• Raising awareness among organizations, professionals and government ministries on HeF –meetings, exhibitions, presentations
• More than 50 organizations reached so far
• High interest on the training programs
• Innovative approach to training “out of the ordinary”
Trainings
• International Child Support (ICS) in Busia – 39
participants from the Ministry of Health – February
2009
– Most of them are from rural health facilities
• Kenya AIDS NGOs Consortium (KANCO) – 27
participants from facilities around Nairobi
- most of them are from resource poor settings
including slums
• Upcoming workshop in July
Participant Support
• Participants supported, monitored through
– Phone
– Emails
– On-site – personal visit for support
– HeF Website – “Lost
My Stick” feature
Training, Trainee Evaluation
• Trainings and trainees are evaluated through:
– TNA questionnaires
– Pre-tests and post-tests in the training modules
– End-day evaluations during KO/Workshops
– Facilitators’ evaluations
– One-on-one discussions
– Email feedbacks/comments
Experiences
• There is great demand for the training programs by health workers
• There is great interest in the “innovative”training approach
• There is great interest for collaboration by organizations including the Ministry of Health, academic institutions and individual professionals
•
Experiences
• There is great demand for the training programs by health workers
• There is great interest in the “innovative”training approach
• There is great interest for collaboration by organizations including the Ministry of Health, academic institutions and individual professionals
•
Way Forward
• Kenya is a “ripe market” with high potential!
• Continuous follow up on contacted organizations, past and present trainees
HEALTH[e]FOUNDATION
WWW.HEALTHEFOUNDATION.EU