Policy Briefs from the EIPM Training Programme

  • Deficient water safety surveillance in Kenya August, 2016

    Water surveillance is an investigative activity undertaken to identify and evaluate factors associated with drinking water that could pose a health risk. Surveillance contributes to the protection of public health by promoting improvement of the quality, safety, quantity, coverage, cost, and continuity of water supplies. It is also both preventive in the sense that it detects risks so that action may be taken before public health problems occur. Surveillance contributes to the identification of the sources of outbreaks of waterborne disease so that corrective action may be taken promptly.

    Water safety monitoring and surveillance in Kenya remains way below the recommended standards by the WHO. If monitoring were being done continually in Kenya, the cholera outbreaks that affected more than half of the counties from December 2014 to date would not have occurred. This brief assesses the burden and costs of a failure to institute timely water safety surveillance and monitoring and makes recommendations on how to resolve the issue.

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  • Expanding access to healthcare for the poorest and marginalised in Kenya August, 2016

    Equitable access to quality healthcare remains a challenge in Kenya. Although key health indicators have been improving in recent years, access by various socio-economic groups remains highly disproportionate. For instance, major improvements have been made in the area of child and maternal health related indicators. Infant mortality rate improved from 74 to 39 deaths per 1000 live births between 1998 and 2014 (KDHS 2014). Similarly, under-five mortality rate improved from 111 to 52 deaths per 1000 live births over the same period. On the other hand, deliveries assisted by a skilled provider increased from 42 percent to 62 percent between 2003 and 2014, while deliveries in a health facility increased from 40 to 61 percent over the same period (KDHS 2014).

    With the global push towards universal healthcare and the provisions in the Constitution of Kenya 2010 for the “right to health” for everyone, the need to ensure equitable access, especially by the poor and marginalised cannot be over-emphasised. The Government of Kenya has made several efforts to improve access to healthcare by the poor and the marginalised, including changes in policy, legal, health financing and programming, but serious challenges remain.

    This Policy Brief therefore reviews the policies and strategies to expand access to healthcare by the poor and marginalised as well as approaches used by Kenya and other countries and recommends options that are likely to work to achieve universal health coverage.

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  • Embracing Information Technology to Improve Quality of Health Care in Kenya August, 2016

    Computerised Physician Order Entry (CPOE) is an application that enables health care workers to enter medical orders into a computer system that is located within an inpatient or ambulatory setting. CPOE replaces traditional methods of placing medication orders, including written (paper prescriptions), verbal (in person or via telephone) and fax. Most CPOE systems allow health care workers to electronically specify medication orders as well as laboratory, admission, radiology, referral, and procedure orders. CPOE allows the computerised entry of healthcare provider instructions and helps eliminate errors at every step in the medication process, thereby improving patient outcomes, saving on time, and limiting unnecessary spending of resources.

    This policy brief discusses the need for adoption of IT, including CPOE,  in health facilities in Kenya and the need for implementation research on adoption of CPOE systems in public health facilities to provide evidence on the impact of such systems as well as lessons on how best such systems can be adopted in public facilities.

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  • Tackling the Rise in Non- Communicable Diseases and Conditions in Kenya August, 2016

    Non-communicable diseases and conditions (NCDs) include cardiovascular diseases, cancers, diabetes and chronic respiratory diseases. The World Health Organization estimates that NCDs kill 38 million people each year with three quarters of these deaths (28 million) occurring in low- and middle-income countries. Globally, 16 million NCD deaths occur before the age of 70, with 82 percent of these “premature” deaths occurring in low- and middle-income countries. The WHO further estimates that NCDs were responsible for 64 percent of the total deaths in 23 low- and middle- income countries, 47 percent of these occurring in people who were younger than 70 years.

    Among NCDs, cardiovascular diseases account for most deaths (17.5 million annually), followed by cancers (8.2 million), respiratory diseases (4 million) and diabetes (1.5 million). The major risk factors for these conditions include tobacco use, physical inactivity, alcohol consumption, and unhealthy diets. This policy brief discusses the key risk factors for NCDs, the economic and social costs involved in treating and managing these diseases and the need for Kenya to develop and implement a health promotion programme to educate the public on prevention, the augmentation and implementation of of fiscal and legislative measures and the integration of NCDs into primary healthcare services.

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  • Strengthening Community Health Workforce to Enhance Efforts to Reduce Maternal and Child Death in Kenya August, 2016

    The Constitution of Kenya 2010 recognises that every Kenyan has a right to the highest attainable standard of health. Even then, many Kenyans still lack access to quality health care, and key health indicators remain poor. For instance, according to the 2014 Kenya Demographic and Health Survey (KDHS 2014), maternal mortality ratio stands at 366 per 100,000, infant mortality rate at 39 per 1,000 live births, under-five mortality rate at 52 per 1,000, only 68 percent of children are fully immunised, only 61 percent of deliveries take place in a health facility, and the stunting rate in children remains high at 26 percent.

    Community participation is critical in Kenya’s efforts to accelerate progress in tackling these health challenges. The Kenya Health Policy (2014-2030) and the Kenya Health Sector Strategic and Investment Plan (2014-2018) have both identified community-level high impact intervention as one of the eight health sector flagship projects that will significantly contribute to the achievement of Vision 2030.

    This policy brief  discusses the role of community health in enabling access to universal health care and accelerating progress to reduce child and maternal deaths.

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  • Strengthening the Leadership and Management of the Health Information System for Improved Quality of Health Information in Kenya August, 2016

    Quality health information providing correct measurements and accountability in the health sector is very crucial for evidence-based decision-making and tracking progress of policy and programme actions. The health sector needs quality information primarily for performance, financial and political accountabilities required to implement the Vision 2030 goals as well as the mandates provided for in the Constitution. The sector requires critical information for efficient resource investments in these important areas to optimise provision of quality healthcare to the citizens. These areas include: organisation of service delivery; infrastructure development; financing; health workforce, health information systems; health products and technologies; coordination, leadership and governance; and research and development.

    Strengthening the health information system pillar of the health system is quite central in the strengthening of the other pillars (including leadership and governance, healthcare financing, human resources for health, service delivery, health infrastructure, commodities, vaccines, medical products and technologies), which all require information support to function effectively and efficiently.

    This policy brief therefore discusses the state of Kenya's own Health Information System (HIS), its challenges and recommendations that could be implemented as a remedy.

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