PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2011 2012 2013 2014
1. Mechanism's comprehensive goals and objectives
The health sector in Kenya has well qualified personnel particularly in specific technical skills related to health. However there are clear gaps amongst the health workforce in regards to leadership and management skills and oftentimes these workers find themselves in leadership and management positions without the requisite skills or exposure as they have not been trained and the mentorship process is weak. In addition for a majority of those who would wish to improve their leadership and management skills, there is no easy access to appropriate training.
The Government of Kenya (GoK) recognizes the leadership and management skills gaps that exist in its health workforce. Both the ministry of medical services and ministry of public health and sanitation have identified the development of leadership and management skills as a key strategy that would help improve performance within the health care system. USG has taken a deliberate step to support the GoK's health sector in strengthening the leadership and management skills at all levels through the Management Sciences for Health's Leadership, Management and Sustainability project (MSH-LMS). The MSH- LMS Kenya project was awarded as a follow on to the LMS global award, for the next five years.
The main objective of the project is to strengthen Kenya's health sector leadership, and management skills for effective outcomes of target diseases and interventions. The intermediate results are;
1. improved management and leadership of health sector and priority health programs on HIV/AIDS, TB, FP/RH, Maternal and child health and malaria
2. improved management and systems in health care organizations and priority health programs
3. increased sustainability and ability to manage change
2. Key Activities
Training health workers on leadership and management skills
In order to address the leadership and management gaps that exist among the current health sector managers, the LMS project will continue training health workers at the various levels of health care delivery. The project has a course tailored to address Ministry of Health's senior leadership at the Strathmore School of management. This course is offered in class and follow-up done for individuals at their work stations. The senior leadership is exposed to field visits locally and abroad to learn from success stories. The target is policymaker-level personnel in both ministries.
The mid-level managers are trained on the leadership development program (LDP) which helps them to identify their management challenges and address them as a project over six months duration. This course, based on the observed success among teams that have benefited from it, has gained popularity among the health workers and demand for it has increased.
At the community level the community health committees are charged with the leadership and management roles. These committees are not well prepared to address their roles effectively due to a weak curriculum and inadequate training. The project supports review of the curriculum and roll out in selected communities.
In all the three levels of trainings the LMS Kenya project is designed to impact the training skills to local trainers who will eventually take over the trainings for long term effect.
Pre-service and in-service curriculum development and roll out
The project is in the process of finalizing the pre-service and in-service training curriculum on leadership and management. The curriculum has been developed in collaboration with the government of Kenya, training institutions and key regulatory bodies.
The project will support the roll out of the curriculum in selected training institutions including universities and medical training colleges. This is a long term intervention that will ensure all the health workers who qualify from training institutions are well grounded in management and leadership skills, knowledge and attitudes. The project will support initial stages of roll out to training institutions ensuring that the trainings become one of their examinable courses.
Mentorship program for new health sector managers
The project will support the mentorship program for the health workers who are appointed to management positions. Currently the health workers who are newly promoted to management and leadership positions find it difficult to adjust. The mentorship program will help them learn how the systems operate for effective resources utilization. The project will strengthen the mentorship program and institutionalize it so that it becomes the culture within the health sector.
Priority Hospital reforms
The current public hospitals structures and systems have not adequately responded to the needs and demands for health services. As a result the Ministry of Medical Services has embarked on reforms that will enable hospitals be more responsive to high disease burden in an environment of limited resources. The LMS project has been charged with the responsibility of steering these reforms in selected hospitals in a phased approach. The project will continue with this activity.
Support to various health sector departments
The project shall continue supporting selected department in reorganization of their management and leadership structures. The Division of Reproductive Health (DRH) plays a critical role particularly in relation to decreasing maternal and child health morbidities and mortalities in Kenya. The DRH structure has been weak and needs to be strengthened an activity that this project will support.
Policy revision and development
The project will continue supporting initiatives to review or develop policies in support of leadership and management in the health sector. One of the policies of priority is the development of a career ladder for management and leadership in the sector. This will delink clinical services career development from the leadership and management positions. The policy will help redefine the management structures with emphasis on trained managers running the health sector as opposed to the current system where clinicians hold key non-clinical management positions.
Local training institutions support
The project will continue supporting capacity building for local training institutions to take up the challenge of training health workers on leadership and management. This includes faculty training and mentorship as well as infrastructure development. The desire is to have local institution offering high quality courses using various models such as classroom training, distance education and e-learning for purposes of wide access.
There are intensions to have a centre of excellence institution dedicated to health workforce leadership and management training. The Kenya Medical Training College (KMTC) is intending to offer one of its colleges at Karen for this purpose. The LMS project shall continue pursuing the discussions and support the institution if such a decision is agreed upon.
Networks for exchange of ideas
The LMS project will support forum and networks for exchange of ideas and good practices. This will be done through support for individuals to attend workshops and seminars, sponsoring such activities directly or in partnership, support to community of practice on leadership and management as well as supporting a website where those interested can exchanges views.
3. Linkages to partnership framework and GHI principles
This project's strategies and implementation takes into account the following strategies;
Working with local partners and strengthening their capacity: The project is designed to allow transfer of skills and expertise to local individuals and institutions. The arrangement is such that gradually the local health training institutions will take over the responsibilities of both pre-service and in-service trainings.
Create partnerships that emphasize collaboration and mutual accountability: The project will plan, implement and monitor in collaboration with ministries of health's departments. It will also reach out to other stakeholders working in related projects to minimize duplications and maximize on synergies. Working in collaboration with local training institutions has enabled the project to be more relevant in addressing local needs effectively. The project will therefore continue making use of its existing coordination mechanisms and structures such as interagency coordination committees, annual operational plans and regional forums.
Sensitivity to gender issues and disparities. The project is sensitive to gender imbalances and disparities within the health sector management. Some of its activities are geared towards addressing these inequalities.
4. Geographical Area and Target population
This is a national project in Kenya targeting health workers within the health sector as well as those in the training schools. It also targets the leadership and management personnel in both public and faith-based institutions. The project targets the top level management at the ministries headquarters and heads of departments. These calibers of workers are taken through a specialized leadership and management course. The mid level managers are also targeted such as provincial health teams and leadership. This caliber of staff is taken through a high level of leadership and management training. The last caliber is the facility levels leadership who, via a team approach, are taken through a leadership development program (LDP).
5. Contributions to health systems strengthening
By supporting and strengthening the leadership and management skills in the health sector, the project addresses the leadership and management pillar of Health systems strengthening as defined by Word Health Organization (WHO). Supporting the health sector's leadership and management skills goes a long way in ensuring a better management of resources and impact is felt along the entire system.
6. Cross cutting benefits
The quality of leadership and management determines effectiveness of resources utilization for maximum gains. Impacting these skills to health workers in the long run will ensure optimum value for money for both USG and GOK across the entire health sector.
7. Cost efficient strategies
Through capacity building of local individuals, institutions and organization the project will utilize them in future trainings hence saving on costs on non local consultants and facilitators.
8. Monitoring and evaluation plan
The project develops annual work plans against which its performance is monitored. Regular meetings with the team and quarterly reports allow for monitoring and evaluation process to take place. Field visit are done regularly to establish physically the level to which the interventions are realized on the ground. The project has developed a project monitoring plan (PMP) which is used to gauge against the set indicators. Financial monitoring is done regularly through accrual reports and pipeline analysis.
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