Monday, February, 19, 2018

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Background
The County Department of Health Services is one of the 12 departments in Nyamira County with overall responsibility of health service provision. The mandate of the department as per Fourth schedule part 2(2) of The Constitution of Kenya 2010 and The County Government Act 2012 is to provide framework for provision and management of county health services. There are 130 health care facilities; 81 public, 16 Faith based and 33 private.
The department currently has a workforce of about 803 spread across the five sub counties. Among the key health statistics are crude death rate of 13 per 1,000 people, infant mortality rate of 46 per 1,000 live births and child mortality rate of 58 per 1,000 live births.  The maternal mortality rate is 385 per 100,000 births. HIV prevalence is currently projected to be 6.9%, a significant increase from 3.8% in 2009. Among children under five years of age, 3.4% are underweight.  The county health strategic plan 2013/14-2017/18 has been developed to provide on guidelines on interventions aimed at tackling health problems in the county. The focus is on providing suitable and modern health infrastructure to improve access and service delivery. The annexed report is a summary of the renovation and construction works being undertaken by the department.


Our Vision
A healthy and productive county with equitable access to quality health care.

Our Mission
To provide quality health services for socio-economic development of the people of Nyamira County

Slogan
Afya yetu Uchumi wetu.

Our Mandate
Our mandate is the management of health services in Nyamira County under the devolved governance structure.

Core Functions
According to the fourth schedule of the Kenyan constitution and various ministerial circulars the core functions of the Department of Health Services are:
•    Provision and management of county health services
•    Provision of emergency medical services  and disaster management
•    Promotion of primary health care
•     Licensing and control of undertakings that sell food to the public
•    Cemeteries, funeral parlours and crematoria
•    Waste management.
•    Development of County specific health legislation and policies
•    Development of health infrastructure
•    Resource mobilization
•    Planning, implementation, monitoring and evaluation of service delivery
•    Financial management
•    Procurement of Medical supplies and equipment
•    Human resource recruitment, development and management
•    Manage clinics, dispensaries, health centres and hospitals


Department’s Policy Objectives
 The Nyamira county Health Sector Vision and Goal aims to realize the following six policy objectives:
1.    Eliminate communicable conditions. This is to be achieved through reducing the burden of communicable diseases until they are no longer of major public health concern.
2.    Halt and reverse the rising burden of non-communicable conditions. This is to be achieved by ensuring clear strategies for implementation of interventions to address all the identified non communicable conditions in the country.
3.    Reduce the burden of violence and injuries. This is to be achieved by putting in place specific strategies, in collaboration with stakeholders in other sectors, which address the underlying causes of injuries and violence.
4.    Provide essential health care. These will include preventive, promotive and curative services that are affordable, equitable, accessible, and responsive to client needs.
5.    Minimize exposure to health risk factors. This aims at strengthening health promoting interventions which address risk factors to health, and facilitating use of products and services that lead to healthy behaviour in the population.
6.    Strengthen collaboration with other sectors. This aims to adopt a ‘Health in all Policies’ approach, which ensures the Health Sector interacts with and influences design, implementation and monitoring processes in all health-related sector actions.


Key Health Indicators

Impact level Indicators

County estimates

National

Source of information, year

Life Expectancy at birth (years)

63

60

KNBS, 2008

Crude mortality   (per 1,000 population)

13

106

CRD, 2012/13

Neonatal Mortality Rate (per 1,000 births)

30

31

KNBS 2012,

Infant Mortality Rate (per 1,000 births)

46

56

KNBS 2012

Under 5 Mortality Rate (per 1,000 births)

58

74

KNBS 2012

Maternal Mortality Rate (per 100,000 births)

385

400

Ministry of Devolution & Planning ,2013

Adult Mortality Rate (per 100,000 births)

6.57

30

CRD, 2012/13

HiV Prevarence

6.4

 

NASCOP


Functional Health Facilities by Type and Ownership
The County Health services are organized across three tiers of service delivery: Community services that focus on organizing appropriate demand for services, Primary care and hospital services that focus on responding to this demand. There are a total 69 Community units; 130 health facilities that include Hospitals, health centres and dispensaries of which 62.3% are owned by public, 12.3% owned by Faith Based Organizations (FBO) while 25.4% are privately owned.

Ownership

Primary Care

Hospitals

Total

Community Units

Government

73

8

81

69

FBOs

16

0

16

0

Private for profit

33

0

33

0

Total

122

8

130

69


Status of Health Workforce
The county has a total of 803 health workers of various cadres of which 734 are technical and 69 non-technical. However, there is a shortage both in numbers (none of the cadres meets the established staffing norms) and skills mix to effectively respond to the health needs in Nyamira County. 


Leading causes of morbidity and mortality
The leading causes of morbidity and mortality in Nyamira County are respiratory tract infection, HIV&AIDs, perinatal conditions, Tuberculosis, malaria, skin conditions, accidents and diarrheal diseases. There is increasing burden of Non-Communicable Diseases (NCDs) such as cardiovascular diseases, diabetes and cancers which currently account for 11-13% of disease burden.


Projects  (Sector Priorities):  

Project

Status

Procurement and distribution health products to all public health facilities

 

Installation of Hospital Management Information System at the Nyamira County Hospital

Phase one implemented

Renovation/rehabilitation of 48 health facilities distributed across all wards in the County of Nyamira

On going

Procurement of assorted medical equipment ENT services, theatre, maternal and child health, laboratory for hospitals and primary facilities

On going

Installation of Mains Electricity in at least 10 primary facilities

Completed

Procurement and installation of CT-Scan

Done

Setting up a referral system by initial procurement and distribution of 5 modern fully-equipped 4x4 Land cruiser ambulances

Done

Procurement of a 3 X-Ray machines, one each for Keroka, Kijauri and Ekerenyo sub-county hospitals

Done

Construction of The Doctors’ Plaza and 50-Bed amenity wing at the County referral Hospital

Plans underway

Setting up maternity theatre

Plans underway

Painting of county referral hospital

On going

Rehabilitation of the Accident and Emergency Centre and tiling of the entire County referral hospital

Plans underway

Completion of Wards and Theatre in Keroka

Plans underway

Procurement and installation of a reverse osmosis water purification machine at Nyamira referral hospital

Completed

Procurement of Theatre equipment at the County Referral Hospital

Plans underway

Procurement of Assorted medical, renal and laboratory equipment

Done

Procurement of hospital linen and furniture for the county referral hospital

Plans underway