Presentation during the session on LMG Training Successes at the First National Conference on Health Leadership, Management and Governance

1. LEADERSHIP, MANAGEMENT AND GOVERNANCE
FOR COMMUNITY ENGAGEMENT
IN HEALTH DEVELOPMENT & SERVICES
By
Prof. MIRIAM K. WERE
Medical Doctor & Public Health Specialist
Laureate, Hideyo Noguchi Africa Prize by JAPAN.
Community Health strategy Goodwill Ambassador, Kenya;
Member of Champions for HIV-Free Generation, Africa;
Queen Elizabeth II Gold Medalist in Public Health.
ON THE OCCASION OF THE
THE FIRST NATIONAL CONFERENCE ON
HEALTH LEADERSHIP, MANAGEMENT & GOVERNANCE
BY THE HEALTH SECTOR MINISTRIES, KENYA
INTERCONTINENTAL HOTEL
NAIROBI, KENYA.
29th January -1st February, 2013. 1

2. 1. LOW LIFE EXPECTANCY IN AFRICA INDICATIVE OF POOR HEALTH STATUS
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3. 2. POSITIVE LEAP FORWARD
A LEAP FORWARD HAPPENS WHEN THE COMMUNITY LEVEL IS RECOGNIZED
AS LEVEL 1 = THE FOUNDATION= OF THE NATIONAL HEALTH SYSTEM
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4. 3. THE COMMUNITY LEVEL AS THE FOUNDATION OF
THE NATIONAL HEALTH SYSTEMS
VISION: PEOPLE LIVING HEALTHY AND GOOD QUALITY LIVES IN
ROBUST AND VIBRANT COMMUNITIES THAT MAKE UP A
HEALTHY AND VIBRANT NATION.
MISSION: MAKING THE COMMUNITY HEALTH APPROACH THE
MODALITY FOR SOCIAL TRANSFORMATION FOR
DEVELOPMENT FROM THE COMMUNITY LEVEL BY
ESTABLISHING EQUITABLE, EFFECTIVE AND EFFICIENT
COMMUNITY HEALTH SERVICES IN COMMUNITY UNITS IN
KENYA.
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5. 4. ACHIEVEMENTS FROM COMMUNITY ENGAGEMENT IN THE
KENYAN CONTEXT
 Immunization has increased
appreciably;
 Diarrhea cases among children
under two years have reduced;
 More women using ANC services
and giving birth with the assistance
of skilled workers;
 Increased latrine construction and
use;
 Increased use of safe drinking
water through boiling or chemical
treatment and spring protection;
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6. Achievements observed in Kenyan CHS continued
 Better case management e.g. of
malaria and pneumonia
 Increased uptake of contraception
for child spacing and family size
planning.
 The strategy amended to
accommodate emerging issues:-
⁺ remuneration of CHWs,
⁺ supply of information tool kits,
⁺ medicine kits,
⁺ maintenance of the competencies of
CHWs and their supervisors, the
CHEWs.
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7. 5. RECOMMENDATION FOR COMMUNITY ENGAGEMENT
IN THE DEVOLVED HEALTH SYSTEMS
5.1.ESTABLISH THE 3-CADRE TEAM IN EVERY
COMMUNITY IN THE NATION:
 COMMUNITY HEALTH WORKERS (CHWs);
For giving services to people in the community.
COMMUNITY HEALTH EXTENSION WORKERs (CHEWs);
For managing and supportive Supervision of CHWs.
COMMUNITY HEALTH COMMITTEES
For providing Leadership and Governance oversight at
the community level.
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8. 5.2 MAKE CLEAR TO EACH COMMUNITY WHICH HEALTH FACILITY IS
THE LINK HEALTH FACILITY TO THE COMMUNITY
THE COMMUNITY LINKAGES TO THE NATIONAL LEVEL
National
County
County
HFC = Health Facility Committee
CHC = Community Health Committee
District
Level 2
HFC HFC HFC HFC HFC
Community Unit with CHC Level 1
Village 1 Village 2 Village 3 Village 4 e.t.c Each served by a
CHW
Households in the CU
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9. 5.3 ESTABLISH IN EVERY DISTRICT
THE DISTRICT FOCAL TEAMS FOR CHS (DFTs FOR CHS)
These DFTs for CHS are to be dedicated to providing
oversight and supportive Supervision to all the CUs in the
district to ensure successful community engagement.
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10. 5.4 ESTABLISH IN EVERY COUNTY
COUNTY FOCAL TEAMS FOR CHS (CFTS FOR CHS).
These County Focal Teams for CHS (CFTs for CHS) are to be
dedicated to providing oversight and supportive supervision
to DFTs for CHS.
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11. 5.5 ESTABLISH AT MINISTRY OF HEALTH HEADQUARTERS
THE DEPARTMENT OF COMMUNITY HEALTH SERVICES
Transform the current Division of Community Health Services into the
Department of Community Health Services in the HQ of the Ministry of
Health in order to have sufficient staff to provide national oversight and
supportive Supervision to the 47 CFTs for CHS and guide acceleration of
the implementation the CHS to every sub-location (Community Unit) in
the country. Specifically, the Department will:-
a) Guide the cadre mix and numbers for the CFT for CHS & DFT for CHS;
b) Supportive Supervision to the 47 CFTs for CHS;
c)Monitor Performance of CFTs for CHS;
d)Guide Operation Research to take place within each County;
e)Facilitate sharing of Lessons Learnt in successful implementation of
the CHS amongst the 47 Counties. 11

12. 5.6 DEVELOPMENT PARTNERS FOR
THE COMMUNITY HEALTH STRATEGY:
Both at the national level and county level there should
be deliberate planning on how to reach out and solicit
the involvement of development partners to support
implementation, monitoring and periodic evaluation of
the Community Health Strategy. The development
partners include the private sector in the Public-Private
Partnership (PPP) context.
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