Since 2011, CHS has supported the (former) Provincial Medical Office – PMO, through sub-grants to implement programs for the provision of HIV prevention, care and treatment services in Kiambu, Nyeri, Nyandarua, Laikipia and Nyahururu. With funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control (CDC), CHS continued with activities previously supported by ICAP in the Central region through the Tegemeza project.
CHS signed the first sub-agreement with the PMO in 2011 at a funding level of US$775,768. Through diligent use and accountability for these resources, the funding grew to US$ 2,189,157 by September 2013; a partnership that has seen the number of supported sites in the region grow to 194 providing adult and paediatric palliative care and support, adult and paediatric treatment (ART), prevention of mother to child transmission of HIV (PMTCT), HIV testing and counselling (HTC), prevention with positives (PwP) and support for TB/HIV. CHS also provides support for pharmaceutical and laboratory commodity systems, health management information systems (HMIS), and facility-community linkages.
While the focus of support by the CHS Tegemeza project is at health facility level, significant engagement and technical assistance to management structures has been crucial, with this support provided to (former) district and provincial health management teams (DHMTs and PHMTs) through sub-grants to design, implement and monitor these activities. CHS has supported areas include: human resources, health workforce capacity building, facility infrastructure support, laboratory support and facility supervision.
Through this partnership, CHS has supported the recruitment and retention of 278 health workers of various cadres across five counties: 90 in Nyeri, 81 in Kiambu, 67 in Muranga, 23 in Nyandarua and 13 in Laikipia who have in turn supported the decentralization of ART sites due to increased health workers, improved documentation of data and reporting as a result of the employment of data clerks among other achievements.
With the onset of the devolved system of governance that transfers administrative powers from the national to 47 county governments, CHS and the former Central Province team held a ceremony to mark the close out of the sub-agreement at the Great Rift Valley Lodge in Naivasha on Wednesday, February 26, 2014. This function now moves to county and sub-county health management teams.
In his opening remarks, CHS CEO Dr Paul Wekesa applauded the former provincial team for managing the resources that were availed to them in an accountable manner and urged all to reflect on this success moving forward. Dr Wekesa also shared results of a survey conducted by CHS in November 2013 to evaluate the understanding of devolution of health services among health workers from the Central region.
Key highlights of the devolution and health survey results included:
- 83% of respondents felt that lack of adequate information on devolution of health services was a challenge to implementation of the devolution of services
- 88% of the respondents believed that with devolution comes better resource management
- 78% of respondents anticipate an expansion of health services with devolution
Present at the meeting were members of the provincial health management team led by the former Provincial Directors of Medical Services and Public Health and Sanitation, who gave an overview of the CHS support accorded to the Province and spoke highly of the reliable nature of support and the amicable working relationship with CHS.
Anticipated challenges to implementation at County level were also discussed and possible solutions presented. These solutions and lessons learned will be critical in guiding the devolved partnerships across the five counties towards increased and improved service delivery.