Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 1474
Country/Region: Kenya
Year: 2008
Main Partner: Abt Associates
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: USAID
Total Funding: $500,000

Funding for Strategic Information (HVSI): $500,000

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

REFERENCES TO TARGETS AND BUDGETS.

1. LIST OF RELATED ACTIVITIES.

This activity is related to Macro International's Strategic Information activity (#6988), which will conduct two

other surveys (AIS and DHS). It also links to the Strategic Information activity carried out by NASCOP

(#7002).

2. ACTIVITY DESCRIPTION

(1) This activity will assist in funding the Department of Policy and Planning in the Ministry of Health to

conduct the 2007 National Health Accounts (NHA) Survey and in particular the HIV/AIDS sub-analysis. Part

of the FY 2007 funds will be used to complete analyzing and reporting of the work started using COP 2006

funds. Funding will also be used to undertake the third round of NHA as indicated by the Hon Minister for

Health during the launch of the 2nd round of the NHA in March 2005. The primary focus of the third round

will be the assessment of the impact of large inflow of funds (from GFATM, PEPFAR and GOK) on the

households seeking HIV care. It will also include three distinct sub-analyses focusing on HIV/AIDS,

Reproductive Health and Child Health. This will assist in estimating resources towards the support of key

programs necessary to attain the Millennium Development Goals (MDGs). Currently, there exists capacity in

MoH to undertake the NHA. However for quality control, it is important to seek Technical Assistance from

PHR+. The bulk of this cost will thus go towards local survey costs incurred by MoH with PHR+ providing

minimal but critical TA especially in the areas of survey design and analysis. In the process of carrying out

the activity, 40 (MoH and CBS) staff will be trained in sampling techniques, data collection and analysis,

with 2 local organizations being provided with technical assistance in strategic information. ($200,000). (2)

Electronic Medical Records (EMR): HIV/AIDS is a life-long chronic illness requiring numerous visits to

health facilities for continued monitoring and these visits generate lots of data at the health facility for each

patient and can easily overwhelm the current paper system. PHR+ have already started implementing an

ART Health Management Information System (HMIS) in Eastern and Nairobi provinces as an early effort

towards establishing a functional EMR in MoH ART facilities. FY 2007 funds will be used for further

development of the system, training of health care workers and installation of the system at facilities in two

more provinces. The model will have been implemented in four provinces and NASCOP will then be in a

position to complete the national scale up with support from other partners. This system, which is based on

NASCOP's patient cards and registers, will, in addition to providing health care workers with critical

information they need for patient care, provide data for the ART component of the integrated M&E tool

(MoH form 726). The EMR will not only make it easier to evaluate the program e.g. evaluating treatment

regimens for the program and providing data on their effectiveness and thus allowing NASCOP to

determine when certain treatment regimens are not working and need to be changed; but, will also improve

the flow, quality and timeliness of information collected at the service delivery points and send upwards to

NASCOP/PEPFAR databases.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA

The activity will contribute to improved national monitoring and evaluation systems by providing critical data

for health care financing indicators needed for HIV/AIDS program planning and funding. It will also

contribute to the strengthening of Health Management Information Systems at the Ministry of Health.

4. LINKS TO OTHER ACTIVITIES

This activity is related to the Strategic Information activity to be carried out by MACRO (#6988) where two

other surveys (AIS and DHS) will be carried out. It also links to NASCOP's Strategic InformationI activity

(#7002).

5. POPULATIONS BEING TARGETED

The activity targets the general population for sampling, and SI and program managers for training in survey

design/implementation, data analyses and presentation. It also targets healthcare workers in public (MoH)

facilities.

6. EMPHASIS AREAS

The major emphasis area is population survey and minor emphasis includes monitoring and evaluation

systems. NASCOP is currently evaluating all the EMRs in Kenya through a consultancy funded by WHO.

This will provide information to complement work already started using PEPFAR funds to develop training

materials for healthworkers on ART Health Management Information System (ART HMIS). These additional

funds ($200,000) will be used to engage stakeholders to agree on the standard tools as well as initiate the

development and rollout of an agreed upon electronic system through NASCOP. The system will also be

rolled out in sub-district hospitals with high volume of HIV/AIDS patients. An appropriate international or

local partner will be identified to support NASCOP carry out this activity.

The private sector already plays a significant role in delivering and financing health care in Africa. On

average, it delivers 50 percent of the industry's goods and services, with 60 percent of financing for those

goods and services coming from private sources. The private sector can be the only option for delivering

health care services in remote rural regions and poor urban slums. Often perceived as serving only the rich

and elite in Africa, private sector providers (including for-profit and not-for-profit) in fact serve all income

levels and have broad geographic reach.

The activity will support to an in-depth country assessments for the business environment for private health

care, and identify areas for USAID program development . The assessment will identify areas of

government reform in private health care regulation and strategies to expand formal public-private

partnerships. The assesment will obtain information from local businesspeople, financial intermediaries,

policymakers, donors, other countries through south-to-south visits and other stakeholders in the

international community.