The University of Nairobi's Fellowship in Healthcare Capacity Building for Sustainable Development aims to build the capacity of Kenyan Health Care Workers and Local Organizations in the health sector through an academic model. Under this program, 2-year post-masters Fellowship Programs and 9-month Post-Graduate Diplomas are offered under 5 training specializations namely: 1) Program Management, 2) Monitoring and Evaluation, 3) Health Economics, 4) Health Informatics and 5) Epidemiology and Biostatistics. Certificate programs which are 7-weeks long are also offered to provide an opportunity for Health Care Workers to access professional training to acquire skill sets that are critical for sustainable and innovative implementation of health programs.
Wednesday, July 31, 2019
The Fellowship in Healthcare Capacity Building for Sustainable Development Program held an Online Tutor Training Workshop from 15th – 17th July, 2019 at the KCB Leadership Center.
The 3-day training was aimed at building the human resource capacity of faculty to support learners through the college e- Learning Portal http://echs.uonbi.ac.ke.
This portal hosts a Learning Management System (LMS) where a three-tier training program namely; 2-Year post-masters fellowship, 9-month post-graduate diploma and 7-week certificate courses are being offered online.
Friday, July 26, 2019
Presenter: Maurice Kodhiambo Onditi
Topic: Socio-Economic and Health Systems Determinants of Access to Paediatric Malaria Treatment in Homabay County
Topic: Socio-Economic and Health Systems Determinants of Access to Paediatric Malaria Treatment in Homabay County
Wednesday, July 3, 2019
OPTIMIZED RETENTION IN CARE MODEL FOR NEWLY DIAGNOSED HIV CLIENTS IN KISUMU COUNTY REFERRAL HOSPITAL
Name: Willis Gasami Kiriago
Registration No.: W82/89464/2016
Fellowship: Program Management Track
Kisumu County is one of the 47 counties in Kenya. The county has a diverse background comprising of urban and rural set-ups as well as a rich ethnic, racial and cultural diversity. There are seven sub counties within Kisumu County where the major economic mainstay of the residents include: Fishing, Farming (rice and sugarcane growing) and Trade. With the prevalence rate of 19.3%, the county ranks third among the 9 counties that account for the highest number of new HIV infections in the country. Having one of the highest HIV incidence and prevalence in Kenya, Kisumu County is working to prioritize and optimize HIV service delivery right from the community to all of its level 2 – level 6 health facilities. In this regard Kisumu county referral hospital is one of the high volume health facility that offers HIV services right at the heart of Kisumu city. Due to its strategic position KCRH has 17600 clients ever enrolled in care with 5400 active registered HIV clients. This number could increase three fold were it not for clients who drop out right after HIV diagnosis. The metropolitan environment with mass transit of people makes it hard to track and retain the newly HIV diagnosed clients in care and treatment within KCRH. This coupled with other operationalchallenges are hindering the achievement of 959595 UNAIDS targets for Kisumu County. There is therefore need to bring on board innovative approaches especially targeting high volume facilities to help in facilitating and resolving the said challenges.
Efficient and effective innovations and strategies can therefore play a pivotal role in closing some of these gaps, the project sought to design and implement a retention in care strategy that aimed at retaining newly diagnosed HIV clients in care and treatment hence strengthening the quality of care and achievement of the 959595 targets in KCRH and Kisumu county as a whole.
Upon designing the RIC model, it was piloted in KCRH for 6 months. Over that period cases of HIV positive clients who missed to be enrolled in care and treatment reduced significantly, proving that program data can help to inform designing of innovative interventions that can significantly help to improve RIC among HIV positive clients without much strain on existing health system infrastructure.
Tuesday, July 2, 2019
HEALTH CARE HUMAN RESOURCE CAPACITY BUILDING INITIATIVES INFLUENCING SUSTAINABILITY OF HIV/AIDS SERVICES AT SIAYA COUNTY REFERRAL HOSPITAL, KENYA
Name: Gloria Chelang’at Kitur
Registration No.: W82/89462/2016
Fellowship: Program Management
Institutional Affiliation: Siaya County Referral Hospital
The HIV prevalence in Siaya County is 24.8 percent (4.2 times higher than the national prevalence) according to the Kenya HIV Estimates 2015. It is estimated that by the end of 2015, a total of 126,411 people were living with HIV in the County. There is a need for improvement in the County’s cascade of care to achieve the unmet gaps of the UNAIDS 95:95:95 targets in identification, linkage, and viral suppression. Timely HIV diagnosis, optimal linkage and retention to care for persons diagnosed with HIV, increased coverage of ART and viral suppression can only be achieved with a competent Healthcare workforce. The Kenya Healthcare system however, experiences an acute shortage of qualified and competent Human Resources for Health (HRH) in addition to their uneven distribution both geographically and within facilities. Focusing on Siaya County Referral Hospital (SCRH), this project sought to determine the Healthcare Human Resource Capacity Building Initiatives Influencing Sustainability of HIV/AIDS Services at Siaya County Referral Hospital. Project objectives included: to identify the human resource capacity gaps in terms of knowledge, skills, competencies and numbers; to identify the human resource capacity building initiatives currently being applied at Siaya County Referral Hospital; to determine the influence of terms of engagement, remuneration, performance appraisal, work environment and turnover intent of staff; and to identify the program level challenges faced by development partners all influencing sustainability of HIV/AIDS services at Siaya County Referral Hospital. A sample of forty SCRH staff, four hospital executives and two program officers was drawn. Questionnaires and Interview Schedules were used to collect primary data for the baseline survey. The survey findings revealed the major human resource capacity gap was staff numbers with specific skills and competencies. The widely used human resource capacity building initiative at SCRH was formal training and on-job training/mentorship. The terms of engagement, remuneration, performance appraisal and work environment greatly influenced the staff turnover intent and ultimately employee satisfaction. Lack of sustainability plans for the HIV programs at SCRH was a major challenge. It was therefore recommended that an SCRH Human Resource Capacity Building Committee be established whose mandate, in conjunction with the SCRH Management Team, Siaya County Health Management Team and the HIV Program Development Partner, would be to develop a HR Needs Assessment Report, a HR Capacity Building Plan, a Staff Engagement and Performance Status Report which would guide the development and implementation of a HIV Program Sustainability Plan for SCRH. The project could eventually be rolled out to the sub-county hospitals in Siaya County as well as other facilities offering HIV clinical services in Nyanza region and Kenya at large.
Monday, July 1, 2019
A WEB BASED ROUTINE DATA QUALITY ASSESSMENT (RDQA) TOOL FOR UPSCALLING HIV DATA AUDIT AND MANAGEMENT FOR SIAYA COUNTY HEALTH FACILITIES
Name: George Odhiambo Okoth
Registration No: W82/89456/2016
Fellowship Track: Health Informatics
Participating Local Partner (PLP): Siaya County Health Department
The project provides for an enhanced user oriented Random Data Quality Assurance (RDQA) tool .It forms a valuable monitoring and evaluation tool that should be used to elucidate the national information system strengths, and determine country specific data quality issues that require to be addressed at each level. Its aim is to encourage and support implementation of the County EMR in order to ensure good, robust and reliable quality health data are produced from the health facilities. This RDQA tool provides an enhanced way of working with health data and assuring data quality or planning and decision making. For this reason, the tool will aid Data Quality Assurance processes for facility, sub-county, county, project/ programme, national managers and planners to determine whether the type, quantity, and quality of health data needed to support sector decisions have been achieved. The tool is the culmination of experiences and lessons learnt in the design, implementation and statistical analyses and use of health data over time. The tool is intended to be updated and used periodically by all to verify the quality of data and employ interventions to correct existing procedures and practices that would lead to good data quality. The DQA Tool focuses exclusively on (1) verifying the quality of reported data, and (2) assessing the underlying data management and reporting systems for standard program-level output indicators. The DQA Tool is not intended to assess the entire. M&E system of a country’s response to HIV/AIDS, Tuberculosis or Malaria. In the context of HIV/AIDS, the DQA relates to component 10 (i.e. Supportive supervision and data auditing) of the “Organizing Framework fora Functional National HIV M&E System”.
Wednesday, June 12, 2019
Francis Kimani Mwihia
Registration Number W80/85341/2012
Registration Number W80/85341/2012
Background: Management is as old as human civilization and sprung out of necessity to satisfy both individual and communities with basic requirements such as food, cloth, shelter, and security. It is a critical administrative role in ensuring progress in any organization. It is a decision making role aimed at providing strategic leadership for an organization (Black, et. al., 2009) towards the achievement of a set of goals. Like any other organization, hospitals also require proper management coupled with good management practices to ensure high performance with regards to quality and volume (quantity) of healthcare delivery. However, in Kenya after many successive government policies implemented such as free healthcare access, devolution of hospital management etc, all targeting at improving public healthcare delivery over the years, health sector performance especially within the public sector still remains below expectation (MoH, 2014). There still exists high level of inequality in healthcare access both geographically and economically, public health sector workers working part-time in private hospitals (Moonlighting), inadequate human resources, lack of qualified health workers, low morale, poor staff attitude, weak supervision, inefficient use of resources etc. The core of this situation always appears to be management yet many of the policies implemented to improve the health system were directed towards management, thus making it proficient to reassess the role of management in healthcare delivery in Kenya. Against this backdrop, coupled with inadequate literature specific to Kenya, the study purposed to address the question of whether management matters in healthcare delivery, specifically with respect to hospitals. It purposed to address this question through the following specific objectives; to identify key hospital management practices in government owned hospitals in Kenya; to investigate the nexus between hospital management practices and the quantity and quality of healthcare delivery and to analyze the effect of hospital management on the efficiency and health outputs of hospitals in Kenya.
Methods: The study employed cross sectional research design where both qualitative and quantitative data were collected from all the 25 hospitals in central Kenya. The study collected data from samples of hospital managers and patients. The patients sample sizes were computed using Fisher’s method and random sampling method was used in selection of patients where the data was entered into the computer using research electronic data capture (Red Cap) device. In addition, qualitative data about performance of hospitals were collected using key informant and focus group. The data was collected through the administration of questionnaires, interviews, DEA efficiency estimating method coupled with OLS and Tobit estimation techniques were used to analyze the data which was also presented in form of tables and charts.
Results: The study found out that the most popular management practice in the study area was regular supervision, practiced by 99% of the managers, followed by effective communication, practiced by 88%; good relation with others, practiced by 81%; and consultation and consensus building, practiced by 70%. The findings also revealed that 17 (68%) of the hospitals had good management, whereas 13 (52%) were technically efficient and hospitals with good management practice is 2.4 times extra likely to be technically efficient compared to hospitals with poor management practice. Most of the management practices had a statistically significant direct effect on the quantity or volume of hospital service. Moreover, strong associations between quality indicators and management practices were evident from the data. In particular, work plan, work plan implementation, effective communication and overall management index were positively associated with the reduction in emergency waiting time for the Caesarian section.
Conclusions: The study concludes that good management when applied to hospitals results in improved hospital outputs and outcomes. The study concludes that management practices in Kenyan public hospitals are strongly and positively associated with hospital performance (quality and quantity of the services offered), and with the health outcomes of communities. It has also been shown that hospital efficiency levels are generally high, with 19(76%) out of 25 hospitals ranging from 73.2% to 100%.
Recommendations: The study recommends that government (MoH) should make policies that ensure that the three top hospital managers; the medical superintendent, nursing officer and the administrator ) resides within the hospital compound, increase competition among hospitals of a similar category, hospital managers and prospective managers be sensitized and trained in various management practices, continuous monitoring and evaluation on management standards and hospital performance and entrenchment of management practices such as daily supervision, staff empowerment, the delegation of duties and motivation. Finally, it recommends that further study ought to be carried out to investigate how managers’ residence affects hospital performance.