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Kenya

  • Community Partnerships for Child Protection in Africa | Publications

    This flyer describes the Regional Psychosocial Support Initiative (REPSSI), the African Network for Protection and Prevention of Child Abuse and Neglect (ANPPCAN), and the USAID Health Care Improvement Project (HCI) working together to support existing national groups and district and community networks to improve the effectiveness and reach of child protection systems in four countries, Kenya, Swaziland, Tanzania and Uganda, through the development of an action-oriented, bottom-up community of learning on child and family protection systems that cuts across multiple levels of the system in the four countries.

  • Birth Registration Results From Improvement Activities In Care For Vulnerable Children | Publications

    This flyer discusses the legal protection of a child. This includes assurance that they have access to birth registration, an official recording of the child’s birth by government, and, upon death of their parents, access to assets and appointment of a legal guardian. Birth registration provides state recognition of a child’s existence and establishes their identity, nationality, kinship and age, key for one’s legal protection and access to essential services, including health, education, grants, and legal employment when older. Registering for a birth certificate is not so simple in many parts of the world. For children left orphaned or vulnerable because of poverty, displacement, or other risk factors such as HIV and AIDS, the weak registration systems result in children with restricted access to basic services and protection and increases the children’s susceptibility to abuse, violence and exposure to HIV. For example, a child orphaned by AIDS who is not registered and does not have a birth certificate to prove their identity is extremely vulnerable to having property rights violated and left to live a life of poverty and survival by whatever means possible, including child labor, transactional sex, or early marriage.

  • CHW Regional Meeting: Country Follow-up Plans and Actions | Publications

    The USAID-sponsored Community Health Worker (CHW) Regional Meeting held in Addis Ababa, Ethiopia was intended as a forum through which to demonstrate and discuss tools and strategies to strengthen the functionality, scale-up and sustainability of government and NGO-led CHW programs.

    The main purpose of the workshop was to highlight tools and strategies to support CHW program performance by using presentations, case studies, small group activities and participant exchanges to help attendees absorb and then practice what they learned.

    By the end of the meeting, five countries: Ethiopia, Kenya, Rwanda, Uganda, and Zambia, will have developed action plans to guide their post-workshop follow up. This report includes the five countries’ plans and updates.

  • Fact Sheets for Community Health Workers in APHIAplus Nuru Ya Bonde | Community Resource

    The Fact Sheets for Community Health Workers in APHIAplus Nuru Ya Bonde were developed to provide community health workers — who are playing increasingly significant roles as health care providers — with digestible information and standard messaging for common health challenges. The set of 20 fact sheets provides information on a range of issues including prenatal care, hygiene, diarrhea, family planning, HIV and AIDS, and malaria.

  • Qualitative study to identify solutions to local barriers to care-seeking and treatment for diarrhoea malaria and pneumonia in select high burden countries: Report on findings from Kenya | Community Resource

    This report is based on UNICEF's three country qualitative study to identify solutions to local barriers to care-seeking and treatment for diarrhoea, malaria and pneumonia. The study had three main objectives:

  • CHW Regional Meeting | Addis Ababa, Ethiopia, June 19-21, 2012 | Publications

    The USAID-sponsored Community Health Worker (CHW) Regional Meeting held in Addis Ababa, Ethiopia from June 19 to 21, 2012, was attended by over 60 government and nongovernmental (NGO) representatives from six African countries (Ethiopia, Kenya, Mali, Rwanda, Uganda, and Zambia) as well as participants from international NGOs and organizations. The meeting was planned by Initiatives Inc. under the USAID Health Care Improvement Project (HCI) and designed to share new tools and strategies to strengthen the functionality of government and NGO CHW programs; facilitate dialogue about challenges and best practices among participating countries and identify and support evidence-based strategies for scale-up. This report details proceedings from the meeting.  

    A follow-up report describing actions taken by participants following the meeting is now available at:http://www.hciproject.org/publications/chw-regional-meeting-country-follow-plans-and-actions

  • Kenya | ANC and PMTCT Demonstration Collaborative in Kwale District | Collaborative Profile
  • Kenya Children/Youth Workshop Report | Publications

    This report describes the implementation of a children and youth workshop held in Nairobi in April 2010, to gather and understand the perspectives of vulnerable children and youth with regard to services provided for them.  The report was developed by the national Orphans and Vulnerable Children Technical Working Group, with support from HCI.

  • Care that Counts Initiative: A Standards-Based Approach to Improving Quality of Programs for Vulnerable Children and Families | Publications

    This short report describes the activities of HCI under the PEPFAR-funded Care that Counts Initiative to provide technical assistance to ministries and partner organizations to develop and implement minimum care standards for services to vulnerable children and families.

  • Taking Every Opportunity to Save Lives: The Role of Modern Quality Improvement in Enhancing Maternal, Newborn, and Child Health Programs. A Synthesis of USAID Health Care Improvement Project Field Experience. | Publications

    Several quality gaps have been documented across the continuum of maternal, newborn, and child health (MNCH) services.   For antenatal care (ANC), despite the progress in increasing its coverage, quality gaps persist. Several studies show that ANC services often miss the opportunity to provide essential services such as counseling clients on danger signs of pregnancy, delivery plans, nutrition, and postpartum family planning. Similarly, services around childbirth are often provided with compromised quality. Common quality gaps include the inadequate or incorrect use of the partograph to prevent the complications of prolonged labor for the mother and the newborn, neglecting to apply active management of third stage of labor to prevent postpartum hemorrhage, poor quality of emergency obstetric care, and failure to promptly detect newborn asphyxia and apply immediate resuscitation.

    Quality improvement (QI) offers a powerful a means to increase the effectiveness of MNCH programs in resource-limited countries. QI is based on the understanding that a system is designed to produce the results it produces; in order to obtain better results, the system must change. Hence, in applying QI, teams in health facilities or communities analyze the systems and processes of delivering services, test changes to obtain better results, and measure the effect of the tested changes on pre-determined indicators. Teamwork and shared learning between QI teams allow for rapid spread of best practices.

    This paper discusses the role modern QI approaches can play in improving MNCH outcomes and describes specific applications of across the continuum of MNCH care, including ANC, essential obstetric and newborn care, infant and child care, and post-partum family planning.  Drawing on examples from the work of the USAID Health Care Improvement Project (HCI) in Africa, Asia, and Latin America, the paper shows how quality gaps in the services addressing the antenatal, intra partum, postnatal, neonatal, and child periods can be closed through modern QI approaches.

    QI can be applied at all levels of the health system, using existing resources, to put in place long-lasting changes in how care is provided. The first step in any QI project is to engage with national policymakers to understand their priorities and strategies. At the individual sites, process deficiencies and their associated outputs are quantified and the inner mechanisms responsible for those deficiencies, exposed. Specific barriers to implementation of effective processes are addressed with the in-depth knowledge and innovative capacity of individuals who work in those processes on a daily basis. Solutions are created by the owners of the problems who are best positioned to design and implement interventions to close the gaps in health service quality. Quality improvement uses continuous monitoring of processes to understand the effect changes have on health outcomes. When the data show that a change in the process produced an improvement, this learning is then shared with colleagues to spread the idea across facilities, districts, and regions.
  • Implementation of Standards of Service Delivery for Orphans and Vulnerable Children in Kenya: A Prospective Evaluation of Performance, Costs, and Equity | Publications

    Due to an increase in the number of children affected by HIV and AIDS in Kenya, efforts to provide services for orphans and vulnerable children (OVC) have expanded quickly in recent years, with a focus on high coverage and outputs but insufficient attention paid to outcomes. Lately, stakeholders have realized more attention should be given to outcomes and service quality. To address this, standards for services for vulnerable children in Kenya were first drafted at a five-day workshop held in November 2009, and further sessions in 2010 led to the development of the first complete draft of national OVC service standards. USAID and the Government of Kenya then implemented the standards on a pilot basis in four districts.

    To explore the effectiveness, efficiency and equity of implementation of the draft standards, the USAID Health Care Improvement Project (HCI) designed a research study to document the results of the piloting. This report describes the results of the study and provides recommendations based on the qualitative evaluation of the program.

    The full study report can be found here.

     

  • Reliability of Community Health Worker Collected Data for Planning and Policy in a Peri-Urban Area of Kisumu, Kenya | Community Resource

    This article investigates the validity and reliability of Community Based Information collected by CHWs in Kenya. The study concludes that CHWs collect sufficient household data that can be used to inform decisions on health intervnetions  and to scale-up and develop new programs.  

  • Preparing Nurses for Facility Management | Community Resource

    This tool provides a training structure to improve the quality of health care at the dispensary level through training nurses. This document also aims to build capacity of the community committees emphasizing proper management of dispensaries and to incorporate management into the role of the dispensary nurses.

  • Improving Care for Vulnerable Children in Kenya: Results from Piloting Service Standards | Publications

    This case study describes the experience of piloting quality service standards to improve the quality of care for orphans and vulnerable children in Kenya, where there are roughly 2.5 million vulnerable children. When the President’s Emergency Plan for AIDS Relief (PEPFAR) was launched in 2003, interventions to meet the needs of orphans and vulnerable children were designed with a sense of urgency to help address the devastating effect of the epidemic on children. While much progress has been made since then, the “emergency response approach” is no longer adequate.

    Lessons learned from OVC programs have revealed the need to improve quality in OVC services and to strengthen harmonization across partners. It was with this goal in mind that the USAID Health Care Improvement Project (HCI) began working with the Government of Kenya through the Ministry of Gender, Children and Social Development and the Department of Children Services, and other implementing partners, to develop and pilot draft service standards.
     
    The standards were drafted with input from the Government of Kenya, HCI, and other implementing partners following a situational assessment which highlighted a number of areas for improvement in services for vulnerable children. In order to determine the utility and effectiveness of these draft standards, eight implementing partners were selected to pilot the standards for a year. The implementing partners were supported by HCI staff through regular mentoring and joint learning sessions in which they were brought together to discuss gaps they were working to address, changes they had made, and results they had achieved.
     
    The implementing partners formed quality improvement (QI) teams and conducted baseline assessments of children’s well-being using the Child Status Index, developed by MEASURE Evaluation. QI teams used the results of these assessments to prioritize their interventions among the service areas. The teams were able to address needs in new, creative ways, and found that using the standards was not only feasible, but led to improved well-being for children they were serving. For example, implementing partner Maua Methodist Hospital adapted their existing interventions to promote better short-term food supply and enhance the households’ capacity to produce and or access food with minimal external support. Over the course of piloting, Maua Methodist Hospital saw increases in Food Security, with 42% of children scoring “fair” or “good” in the CSI at baseline and 100% of children scoring “fair” or “good” at the end of the year. Additionally, at baseline 57% of the children assessed by Maua scored “fair” or “good” at baseline and 100% scored “fair” or “good” at the end of piloting.
     
    The year of piloting the standards culminated in a national learning session in July 2011, during which the Government of Kenya reasserted their commitment to improving the quality of services for vulnerable children and planned to finalize the standards as National Minimum Service Standards for QI in OVC Care in Kenya and scale them up nationally.
  • Implementation of Standards of Service Delivery for Orphans and Vulnerable Children in Kenya: A Prospective Evaluation of Performance, Costs and Equity | Publications

    Due to an increase in the number of children affected by HIV and AIDS in Kenya, efforts to provide services for orphans and vulnerable children (OVC) have expanded quickly in recent years, with a focus on high coverage and outputs but insufficient attention paid to outcomes. Lately, stakeholders have realized more attention should be given to outcomes and service quality. To address this, standards for services for vulnerable children in Kenya were first drafted at a five-day workshop held in November 2009, and further sessions in 2010 led to the development of the first complete draft of national OVC service standards. USAID and the Government of Kenya then implemented the standards on a pilot basis in four districts.

    To explore the effectiveness, efficiency and equity of implementation of the draft standards, the USAID Health Care Improvement Project (HCI) designed a research study to document the results of the piloting. This report describes the results of the study and provides recommendations based on the qualitative evaluation of the program.
  • Existing Education System as a channel for the Improvement of Vitamin A Supplementation Uptake in Njiru Dispensary, Nairobi Province Kenya | Improvement Report
  • Single Use Obstetrical Emergency Medical Kits to Reduce Maternal Mortality, at the Riley Mother and Baby Hospital, Eldoret Kenya. | Improvement Report
  • USING INNOVATION TO IMPROVE ACCESS TO AAFB MICROSCOPY IN UGENYA DISTRICT, KENYA | Improvement Report
  • Improving Iron and Folate Availability for Antenatal Care in Kenya | Publications

    This short report describes how the USAID Health Care Improvement Project (HCI) is working with the Ministry of Health (MOH) in Kenya to improve the quality of antenatal care (ANC) services in Kenya, and subsequently prevention of mother-to-child transmission (PMTCT) of HIV, skilled delivery and family planning services. In February 2011, the HCI and MOH staff piloted an activity in Kenya's rural Kwale district, which was performing below the national average in terms of utilization of ANC/PMTCT services. This report describes the improvement approaches implemented, lessons learned and next steps.  

  • Care That Counts: Applying Quality Standards to OVC Services in Kenya | Publications

    This short film demonstrates how quality improvement (QI) methodology can be used to improve services for orphans and vulnerable children (OVC).  It tells the story of how implementing standards of care and improvement efforts made a difference in service delivery to orphans and vulnerable children by two organizations in Kenya: FHI-360’s Speak for the Child Project, through Okoka community-based organization (CBO) in Nyanza Province, and Maua Methodist Hospital ZOW Project in Eastern Province. These two organizations, along with five others, were selected to pilot OVC quality service standards in Kenya in order to improve services offered to orphans and vulnerable children. This QI initiative was implemented by the USAID Health Care Improvement Project (HCI) in partnership with the Department of Children’s Services of the Ministry of Gender, Children and Social Development with funding support from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).