FUNCTIONS AND ROLES OF HEALTH ADMINSTRATION UNIT
An efficient and high quality care system that is accessible, equitable and affordable for all Kenyans.
To promote and participate in the provision of integrated and efficacious promotive, preventive, curative and rehabilitative health care services to all Kenyans.
Functions of the Health Administrative Unit
Health administration is the coordination of efficient and effective management of health support services.
Promoting the welfare of patients and staff at ensuring their security.
Liaising with other professional and technical departmental heads in order to improve overall management and delivery of health care services.
Overseeing procurement, provision and maintenance of facilities.
Preparing of budgets; sound management of budgeting allocation and revenue collection.
Develop structures for effective management, utilization, repair and maintenance of health fleet of motor vehicles including ambulances.
Ensure health facilities, especially buildings, comply with safety, health and other laws and regulations and are well maintained.
Be responsible for administration of service provider contracts in maintenance of ICT facilities, buildings, motor vehicles, security etc in the health departments.
Coordinate project proposals and oversee implementation.
Coordinate gazettement of health facilities and management committees.
Oversee implementation of cost-sharing/ Facility Improvement Fund (FIF) programmes.
Coordination of transport services in the department which entails timely maintenance of motor vehicles.
Coordination of Makueni Universal Health Care (UHC) program across the facilities.
Installation and implementation of citizen service charter in all health facilities.
All mothers not on NHIF have been enrolled on Linda mama programme across all county facilities.
All facilities have been gazetted.
All rural facilities and hospital management committees have been gazetted.
Plans for Improvement
Rolling out registration on NHIF and Universal Health Care (UHC) for those services that are not offered under Makueni care eg, Oncology and Renal unit.
Training of health facility management committees.
Quarterly CHMT meetings.
ACTIVITIES OF PUBLIC HEALTH IMPORTANCE IN PUBLIC HEALTH UNIT
This is achieved through community Led Total Sanitation process which encompasses the following;
DISEASE SURVEILLANCE UNIT
Disease surveillance is the ongoing and systematic Collection, Analysis and
interpretation of disease specific data and use of that data in the planning,
implementation and evaluation of public Health practice. This data is then used for
The unit is responsible for:-
1. Monitoring trends, patterns and estimate magnitude of health problems and
responding to them as they occur. This includes monitoring alert and action thresholds.
2. Detecting sudden changes in disease occurrence and distribution
3. Monitoring changes in infectious agents
4. Detecting changes in health practices
5. Evaluating disease control measures
6. Generating hypotheses, stimulate research
7. Facilitating planning and decision making
8. Handling cross boarder diseases
9. Implementing disease control rules and legislations as per the Public Health ACT CAP
Surveillance activities being undertaken by the unit include:-
1. Weekly reporting of community and Health facility occurrences through Kenya Health
Information System (KHIS).This is done through uploading weekly health facility reports
to the system.
2. Conducting regular weekly active case search for priority epidemic prone diseases in
various health facility departments. This ensures that no case of possible outbreak has
occurred unmissed in all levels of the health care system.
3. Facilitating use of Standard case definitions for diseases
4. Collection of food and water samples for bacteriological and chemical analysis
5. Collection of specimens from suspected cases for disease outbreak investigations
then proper shipment to the reference laboratories.
6. Conducting training, sensitization and on job training to health care workers on new
7. Tracing of COVID 19 contacts and ensuring their home based quarantine to such a
time specified in the protocols.
8. conducting home based care for COVID 19 patients who do not require
9. Documenting and reporting details of COVID 19 cases and contacts on a daily basis to
10. Supervising interment of COVID19 dead bodies.
11. Managing COVID 19 Home based care data.
12. Ensuring Acute Flaccid Paralysis (AFP) and measles detection through use of
standard Case definitions provided by the Ministry of Health and World Health
13. Ensuring that all cross boarder diseases such as COVID 19 are handled as per
international health regulations (IHR) 2005.
The Nutrition Unit implements various programmes to prevent and manage diseases thus promoting health and wellbeing of the citizens. These programmes include:
Several achievements have been realized by the Unit which include and not limited to;
The nutrition unit endeavors to improve services by;
Launch of Makueni County Nutrition Action Plan
World breastfeeding week launch
Health products and technologies are recognized by WHO as one of the key building blocks of a health system. The Kenya Health Policy (2014-2030) outlines HPTs as one of the eight policy orientations. Investments under this policy orientation in Makueni County is aimed towards ensuring that effective, safe and affordable HPTs are available and rationally used at all times, while moving towards a strategic County HPTs reserve.
Functions of the HPT Unit include:
Good management of Health Products and Technologies (HPT) is important to ensure that the quality of these valuable commodities is maintained up to the point of use and that items required for delivery of quality health care are continuously available.
Some key achievements for the unit include consistent availability of essential medicines and medical supplies for public health facilities in Makueni County and select Faith Based Organizations via proper quantification, timely procurement and efficient logistical support to enable redistribution and avoid wastages and expiries. This is further entrenched by training staff on commodities management and other emerging topics such as antimicrobial stewardship and strengthening institutional capacities through hospital medicines and therapeutic committees, county and sub-county commodities technical working groups and the building of a county store to act as a buffer warehousing facility for the county.
The HPT unit plans to automate the management of commodities by progressively deploying a computerized systems to enable end to end visibility of all product in health facilities.
NURSING AND IMMUNIZATION UNIT
Function of the Unit
The County Government of Makueni is committed to achieving the sustainable development goals that are geared to the reduction of deaths among children under five years old. This is actualized by the Nursing and Immunization Unit. The Unit provides vaccination services for childhood and antenatal women and against other diseases outside the Expanded Programme on Immunization schedule for preventive and emergency disease outbreaks through 276 immunizing facilities. Immunization is one of the most cost effective preventative health care interventions that is available to the community.
Vaccines improve quality of life as they can prevent diseases that can cause physical and mental disability such as poliomyelitis. Immunization is not only valuable to individuals and families but also to communities, societies and governments.
Plans for improving service delivery in the unit
COMMUNITY HEALTH STRATEGY UNIT
Community health department is crucial in delivery of level one health services and strengthening of community facility linkage. Integration of community health services with other thematic areas in important for optimal positive reversal of health indicators. Makueni County has a total of 3512 active Community Health Volunteers, 219 Community Health Units attached 207 health facilities. 98% of the Community Health Volunteers are trained on basic module ,which is basically the foundation for level one service delivery .Community health Workforce has been instrumental in reversing majority of Nutrition, WASH and Maternal New Borne and Child health negative indicators. This has been achieved through training and mentoring and supportive supervision .The County is however, experiencing increasing trend of non-communicable diseases for the last 5 years, the department of health is leveraging in community health volunteers to disseminate information on early screening and prevention measures. Medtronic labs is working with the county government closely to reverse the trend.
The county just like the rest of the globe aspires all its citizens to receive quality and affordable health care .This aspiration spurred calls for Makueni Universal Health Care, which CHVs have been instrumental in sensitizing the communities to enroll together with other available health insurance services like NHIF, Edu Afya and Linda Mama.
The department is in process of finalizing community health policy 2021-2030 and costed strategy 2021-2025 with technical support from Financing Alliance for Health .The policy and strategy are seeking to address contextual challenges which are mostly not addressed by national policy and strategy. Community strategy has outlined activities that shall be carried out in the next five financial years. Both documents are aligned to the CIDP, County Vision 2025 and the department envisions the subsequent Annual work plans shall be informed by the strategic implementation matrix.
Makueni Community Health Policy draft and strategy are envisioning a sustainable community health besides monetary incentives the county has already invested on motorbike IGAs in 43% of Community Health Units. Plans are underway to support Community Health Units to be sustainable as stipulated in the strategy and policy .During the journey to self-reliance community health units, the county shall pay a stipend to the community health volunteers, brand, and procure name tags for easy identification during household visits in the current financial year.
Figure 1Community Health Volunteer visiting visually impaired client during pregnancy at household for health messaging and referral
Figure 2Motor bike IGA flag off by the governor
Figure 3Community Health Volunteer performing Random Blood Sugars to a community member during outreach (supported by County Government and Medtronic Labs
Figure 4CHMT, Ministry of planning and Financing Alliance for Health during community policy writing
Medical laboratory unit play a crucial role in total patient management in health care service delivery, Laboratory investigations help to determine the presence, extent, or absence of disease as well as monitor the effectiveness of treatment, the unit also play an indispensable role in saving lives through provision of blood and blood products to needy patients.
Makueni county laboratory unit has a total of 82 public laboratories which are managed by two hundred and ten personnel across the six sub counties and one blood donor satellite.
The hospital laboratories are equipped to offer more comprehensive tests and serve as referral sites for primary health care facilities which offer basic routine tests.
Currently Makueni laboratory services unit has six sections which offer an array of tests according to the level of the facility laboratory.
Microbiology section, culture clinical specimens to isolate possible suspected pathogens which further subjected to drug sensitivity tests to determine medicine efficacy.
Parasitology section, examine specimens to determine presence, type and the density of parasites in a patient
Hematology section, analyze whole blood specimens, perform full blood counts, and examine Blood film to determine blood disorders. Carry out coagulation studies to determine blood clotting times, coagulation factors, and platelet abnormalities.
Clinical biochemistry, perform different tests on serum or plasma, these tests, mostly automated, includes quantitative testing for a wide array of substances, such as lipids, blood sugar, enzymes, and hormones.
Immunology/Serology use the process of antigen-antibody interaction as a diagnostic tool to determine presence or absence of blood pathogens
Immunohematology, or blood bank determines blood groups, and performs compatibility testing on donor blood and recipients. This section is tasked to provide safe and adequate blood and blood products to patients with emergency and chronic conditions.
Since devolution, Makueni laboratory services unit through department of health has achieved notable developments, which include: equipping County, sub-County and five primary care level laboratories with specialized automated analyzers, renovation and equipping of blood donor satellite, increasing the laboratory coverage and workforce.
The department of health has plans to operationalize two laboratories in each sub county, increase laboratory workforce, establish molecular and histopathology laboratory, enroll five hospitals in accreditation process and increase the number of automated analyzers so as to improve on service delivery.
SCHOOL HEALTH UNIT
The objective of the School Health Unit is to provide health services towards meeting the health needs of children in and out of school together with their teachers and parents and eventually the entire community considering that children act as agents of change .
School health functions include the following:
NOTE: The unit achieves the above in collaboration with other units in the department, other county departments/ ministries and other stakeholders.
The school health unit has been able to achieve the following:
PLANS FOR IMPROVING SERVICE DELIVERY
The unit plans to do the following:
A nurse conducting Health education on adolescent sexual and reproductive health and life skills
A public Health Officer demonstrating effective hand washing techniques
UNIT OF CLINICAL SERVICES.
1874 Diabetes patients being screened and linked to care in 2020/21 compared to 251 in 2019/20 at same time. 64,743 Hypertensive patients have been screened and linked to care in 2020/21 compared to 9,222 in 2019/20.
Oral rehydration treatment centre
Kambu CHV screening blood sugar in Kitenge’i community .Courtesy of partnership between Makueni County and Medtronic Labs.
Kilungu CHV conducting blood pressure screening in Kilungu community. Courtesy of Partnership between Makueni County and Medtronic Labs.
Unit Head-Clinical Services
THEME: To provide rehabilitative care to patients with physical impairments so as to return to the highest and/or near normal level of physical function through cost effective quality service.
The rehabilitative unit is comprised of three departments:
Functions of the unit
The Makueni County Health Department in the 2020/2021 financial year committed to construct and equip a modernized rehabilitation unit at the Makueni County Referral Hospital. Currently, construction of a physiotherapy clinic is complete whereas the occupational clinic and orthopedic workshop construction is projected to take place in the next financial year.
The health department is also spearheading the Makueni Community Based Rehabilitation program that brings rehabilitative services closer to persons with disabilities and those not economically empowered at the community level. This is a program that is running in all 6 sub counties.
Projected future plans
The Makueni County CIDP 2018-22 focuses on actualizing socio economic transformation and one of the themes that will ensure this is socio-economic development that has health care as a priority area. The county government has committed to invest in the healthcare building blocks such as adequate health infrastructure and human resource for health.
The health department plans to equip the newly constructed physiotherapy clinic as well as other rehabilitation units in the county and commits to recruit 13 rehabilitation professionals in this financial year.
HEALTH RECORDS AND INFORMATION UNIT
Major functions of the unit
Plans to improving health records and information services
County Health Records and Information Officer busy in office.
Health records and information students being mentored at sub county records office
Heath records and information officers working at the county referral hospital registry office
Health Records officer working at Makueni County Referral hospital
-alleviation of pain during surgery.
-administration of anaesthesia during surgery.
-Maintenance of patients admitted in ICU.
-provision of counseling on patients undergoing surgery.
-maintenance of anaesthetic equipment.
-ensuring patients safety during surgery.
-provision of leadership at the county level.
-provision of relevant data to the CHMT
-smooth running of all county operating theatres.
-attending CHMT meetings on data reviews and planning.
-training of anaesthetists on relevant and current trends.
-Increase in the number of anaesthetists from 3-35
-increase the number of operating theatres from 3 to 9
-approximately 20 anaesthetists have been trained on OSS (Obstetric safe surgery)
-timely resignations and promotion of anaesthetists.
PLANS OF IMPROVING SERVICE
-operationalizing KALAWA SUB COUNTY HOSPITAL THEATRE.
-increase the number of anaesthnetists by 12
-training more anaeshetists on obstetric safe surgery
-up to date data collection and analysis.
-continuous supply of theatre drugs.
-creation of Makueni county anesthesia conference.
-proper and prudent use of resources
REPRODUCTIVE, MATERNAL AND NEWBORN HEALTH UNIT
Description of the Unit
The unit has three components namely;
Functions of the Unit
Launch of the costed family planning strategic plan
Newborn resuscitation skills demonstration
Early initiation of breastfeeding after a successful caesarian section operation
Health talk session
Implant insertion session
HEALTH PROMOTION UNIT
UNIT HEAD -BRETTA VILITA MUTISYA QULIFICATIONS – BSc. HEALTH PROMOTION AND STUDENT MASTER DEGREE IN COMMUNITY HEALTH AND DEVELOPMENT.
Definition of health promotion according to WHO.
ACHIEVEMENTS OF HEALTH PROMOTION SERVICES IN MAKUENI COUNTY
Health promotion skills of using champions, key public finger and an influencer to create health awareness on cancer agenda to create demand for uptake of early screening.
Health literacy is a paramount -Health knowledge is a right, anywhere any time.
County Health Promotion Officer and the team at work.
Health promotion towards achievements of SGDS and fight of NCDs..