Updated August 2008 reprogramming: funding will go through MSH / OHPS program area.

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

The only changes to the program since approval in the 2007 COP are:

• This activity will be linked to the Leadership, Management and Sustainability project implemented by

Management Sciences for Health (MSH).

1. LIST OF RELATED ACTIVITIES

This activity relates to other support for Kenya Medical Training College [#6971] in the Systems

Strengthening / Policy program area.

2. ACTIVITY DESCRIPTION

This is a continuation of activities begun in FY 2006 to enhance the capacity of the health sector and of

HIV/AIDS management in particular, via health systems management strengthening, with an emphasis on

district and provincial hospitals. In Kenya, operational and management inefficiency and poor quality of

service provision for HIV/AIDS management in hospitals has been attributed to, among others, weak health

systems and a lack of effective capacity in planning, budgeting, and management. This results in difficulties

in linking needs with available resources; forecasting revenue and expenditures; planning within a defined

resource allocation; poor investment portfolio in health; lack of confidence in public facilities; and cost-

ineffective interventions. Substantial Ministry of Health (MOH) funds are often reverted to the Treasury at

the end of the fiscal year due to MOH capacity constraints. The shift in the focus of health sector

management, which leads to the move from an input to an output orientation, a stress on quality client-

based service and the increasing role of performance-based management systems, gives rise to a new

concept of "accountable professionalism" within the health sector. With PEPFAR support, training will

continue through three institutions - Kenya Medical Training College (KMTC), Galilee College and Unites

States International University (USIU) - to design, deliver and evaluate a technical course for at least 80

selected MOH staff in health systems management, financial and management planning, budgeting and

priority setting. This activity aims to develop strengthened health management teams across 69 provincial

and district hospitals in Kenya. The training course is intended to reach 3 managers per facility, or 210

managers. With FY 2006 funds, this activity trained three groups of 20 students each resulting in 60 trained

health managers. In FY 2007, this activity will train a minimum additional 80 health managers. The course

curriculum was created in close consultation with experts and authorities of the Ministry of Health and the

civil society, including the private sector. The course is an intensive program that is designed to impart

knowledge and skills in health sector management with an emphasis on HIV/AIDS management in hospital

settings. The course includes examination of best practice cases, presentations by faculty members and

resource persons, and discussions with outstanding health sector managers. Skills will be developed

through action learning, case analysis, guided practice and interactive learning experiences. The program

includes a two-week intensive course on the management of the Health Sector to be held at USIU/KMTC.

The second part of the program includes a two-week seminar about Health Sector Reform and Renewal

held at the Galilee College Study Centre, with study visits to public and private health care organizations

with an emphasis on HIV/AIDS systems management, and meetings with officials and managers. At the end

of the program, participants develop a final project in Health Strategic Planning.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA

This activity is aligned with Kenya's 5 Year Strategy and directly contributes to improved health systems

management training and leadership management within the country.

4. LINKS TO OTHER ACTIVITIES

This activity relates to other support for KMTC under the Systems Strengthening program area (#6971).

5. POPULATIONS BEING TARGETED

These activities target host country government workers and health care providers. The targeted staff of

Ministry of Health will include the following: Hospital Management Team, comprised of the Chair of the

Hospital Management Team, Nursing Officer in Charge, Health Administrative Officer, Pharmacist, Medical

Records Officer, Supplies Officer, Laboratory Technologist, Medical Officer of Health, Medical

Superintendent, Health Information/Record Officer and Health Board Members, District PHN, District Public

Health Officers, Hospital Planners, Communications and Public Relation Specialists.

6. EMPHASIS AREAS

The major emphasis area for this activity is training with a minor emphasis on local organisation capacity

development.