Detailed Mechanism Funding and Narrative

Years of mechanism: 2011 2012 2013 2014 2015

Details for Mechanism ID: 13164
Country/Region: Kenya
Year: 2011
Main Partner: Management Sciences for Health
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $1,950,000

This cooperative agreement with Management Sciences for Health (MSH) was awarded in FY2009 from FOA PS09-965. (An award to A Global Healthcare Public Foundation was also made from this same FOA PS-09 965). The activity was written into COP 09 as a TBD for Laboratory Training (mechanism ID: 10243.09, mechanism system ID: 10243). The TBD was declared to OGAC in August 2009 reprogramming with a prime partner name "FOA PS09-988 PRIME PARTNER 2" because the official notice of award to MSH had not been issued at that time. This mechanism is now being submitted in COP 10 as a continuing implementing mechanism with no mechanism system ID.

The PEPFAR/Kenya laboratory program aims to strengthen sustainable and integrated laboratory services to meet the goals of prevention, treatment and care for people living with HIV/AIDS. The Kenya National Laboratory Strategic Plan 2005-2010 provides a comprehensive guide to ensure the delivery of efficient, effective, accessible, equitable and affordable quality medical laboratory services. The overall goal of this mechanism is to strengthen public health laboratory systems through policy formulation, implementation, training and development of indigenous local capacity in Kenya to support HIV prevention, treatment, and care as part of the PEPFAR plan. Specific activities will involve supporting the Kenyan ministries of health and the National Public Health Laboratory Services (NPHLS) to coordinate national stakeholder's fora and disseminate information to regions, expand HIV laboratory testing and ART monitoring coverage, support expansion of EQA capacity for HIV testing sites, strengthen the central data unit to generate timely lab reports. MSH will build capacity at ministries of health both nationally and regionally to write successful grants applications. MSH will also coordinate training for safe phlebotomy and infection prevention/ control practices.

The Becton Dickinson Lab Strengthening PPP will train lab personnel on quality managment and will expand the mapping of TB referral sites beyond the capial region. Becton Dickinson will contue to bring technical capabilities in lab strengthening that make this partnership an important component of the national strategy. This activity has cross-cutting attributions related to Human Resources for Health due to support for in-service training of laboratory personnel.

Funding for Biomedical Prevention: Injection Safety (HMIN): $450,000

This activity will focus on coordination of national and regional training of health care workers in safe phlebotomy practices and surveillance for needle stick injuries. In FY 09 the Kenyan ministries of health, through a public-private partnership with Becton-Dickinson, trained a core team of trainers in safe phlebotomy and commenced a pilot project at eight health facilities in Kenya.

In FY 10, the ministries of health will expand this activity using the core trainers. MSH will support this activity by coordinating national and regional trainings and meetings to promote safe injection practices and prevent transmission of HIV through medical injections. This activity focuses on prioritizing sharps procedures at highest risk of HIV transmission such as phlebotomy and cost-effective strategies for HIV post exposure surveillance. Collaboration with the National AIDS & STD Control Program (NASCOP) will ensure that activities are consistent with national plans and policies regarding injection safety. Training and capacity building will ensure that all health workers are trained in safe phlebotomy practices, including safe blood drawing, standard precautions, waste management and post-exposure prophylaxis (PEP) for occupational exposure. This activity will promote provision of PEP starter packs to all health care workers, including those in remote areas, during their clinical duties. In FY 10 MSH will coordinate training of health care workers from selected MOH health facilities across the country on safe phlebotomy, safe injection and infection prevention and control practices.

An objective of this activity is to significantly reduce or eliminate the transmission of HIV/AIDS and other blood-borne diseases resulting from unsafe practices. This activity will complement the pilot of safe phlebotomy training and practices that will be implemented through a public-private partnership between CDC and Becton Dickinson. It will also build on prior training by John Snow, Inc. Additionally, MSH will support the development and implementation of a sharps injury surveillance system in the facilities where training will be conducted.

Funding for Laboratory Infrastructure (HLAB): $1,500,000

Reprogramming $350,000 in HLAB to University of Manitoba/Univ. of Manitoba and $350,000 in HLAB to Pathfinder International/Pathfinder. The PEPFAR/Kenya laboratory program aims to strengthen sustainable and integrated laboratory services to meet the goals of prevention, treatment and care of HIV infected persons. The Kenya National Laboratory Strategic Plan 2005-2010 provides a comprehensive guide to ensure the delivery of efficient, effective, accessible, equitable, and affordable quality medical laboratory services. The main objectives stipulated in the strategic plan are to reorganize and strengthen a) laboratory administrative and technical management structures; b) standardized quality laboratory services c) human capacity development; d) the legal and regulatory framework for medical laboratory services; and e) monitoring, evaluation, and research.

The broad objectives of this activity will be to support the Ministries of Medical Services (MOMS) and Public Health and Sanitation (MOPHS) to improve quality management systems; develop and revise national policies; and to strengthen organizational management, laboratory information management systems (LIMS) and coordination of the laboratory sample referral network services. This activity will support both national and regional levels of laboratory services delivery.

Objective 1. Guide policy formulation and implementation. In FY 10 Management Sciences for Health (MSH) will coordinate laboratory inter-agency coordinating committee meetings as well as regional and national stakeholders meetings. MSH will also disseminate laboratory policy guidelines approved by the ministries of health.

Objective 2. Expand HIV testing and ART program coverage in Kenya

In FY 10 MSH will support sample referral network in Coast, Eastern, Central, Nairobi and North Eastern provinces in collaboration with National Public Health Laboratory Services (NPHLS). This activity will involve using a model of district hospital supporting satellite health centers and dispensaries for sample testing, quality assurance, training and support supervision. Standardized tools will be used across all sites for sample collection, packaging, transport, testing, and return of results to improve turn-around time and ensure quality.

Objective 3. Support expansion of external quality assessment (EQA) capacity for HIV Testing & Counseling (HTC) sites and labs in Kenya. In FY 10 MSH will support the East African Community based regional external quality assessment scheme (REQAS) run by AMREF for district hospitals, Nairobi city council health centers and hard-to-reach areas as well as other EQA schemes for HIV testing, TB smear microscopy, CD4, clinical chemistry, hematology and opportunistic infections testing initiated by NPHLS. This activity will include enrollment of labs and HTC sites in EQA programs, coordination of distribution of proficiency testing panels, support supervisory visits and refresher training based on the needs of the facilities. MSH will also support quarterly feedback meetings of the hospital Lab In-charges for the facilities enrolled in EQA programs.

Objective 4. Strengthen central data unit to streamline timely submission of lab reports to central data unit.

In FY 10 MSH will collaborate with the NPHLS central data unit, and provincial and district hospitals to enhance reporting from facilities and data analysis to guide decision making. The activity also includes strengthening use of paper-based reporting which will finally pave the way to electronic medical records (EMR).

Objective 5. Build capacity at ministries of health both nationally and regionally to write successful grants applications. This activity will continue form FY 09 to FY 10.

Cross Cutting Budget Categories and Known Amounts Total: $500,000
Human Resources for Health $500,000
Key Issues Identified in Mechanism