CHAK held its AGM/AHC on April 20-22, at the Jumuia Conference and Country Home, Limuru. The event whose theme was “MOU with Government, enhancing partnership for health” saw CHAK members from around the country converge to get a first hand explanation of the MOU signed between Government and FBHS in July 2009 and share experiences. CHAK departments shared with the network their achievements for 2009 as well as their plans in serving the network in 2010.

The keynote address was delivered by Dr J. Odondi from the Ministry of Public Health and Sanitation on behalf of the Permanent Secretary Mr Mark K. Bor. He emphasized on the importance of partnership in the health sector, especially with FBOS, to reach all citizens including those in remote and poor areas.

Stressing that it was important for the Government to focus beyond its facilities, he added that FBOs would have to be included in the national bread basket if the country’s health needs were to be adequately addressed. He also spoke on the need to include all in decision making in the health sector, saying FBOs were currently represented in various government structures.

Further, Dr Odondi challenged the church to devolve decision making to fully benefit from the Health Sector Service Fund and added the Government had already effected devolution to health facility level to ensure patients fully benefitted from the fund. He cautioned top church organs against interfering with the fund, saying FBO health facilities would be trained on management of the funds.

Church health facilities were also challenged to give their health workers periodic updates to ensure they remained competitive in the health sector.

MOU with Government
The AHC participants were taken through each section of the MOU by CHAK General Secretary Dr Mwenda in order for member units present to have a clear understanding of the contents of the document. Giving a brief history of the process of developing the MOU, Dr Mwenda explained that the journey had begun in 2004, reaching its climax in July 2009. He observed that in most countries, MOUs are signed with just the health ministries. However, it was felt that Treasury needed to sign the document as the highest form of commitment although the signature of the Finance PS was still pending. A booklet of the MOU with all the signatures would be published and widely disseminated to CHAK members and partners. 

CHAK HMIS software
Vincent Kiarie took participants through the process of developing computer software to serve the CHAK membership. During a consultative workshop held at the CHAK Guest House and Conference Centre, members expressed their desire for open source software that could be easily adapted to individual health facility needs. To give CHAK member health facilities a better competitive edge and optimize efficiency in resource mobilization, use and accountability, two types of software are being developed as part of CHAK’s health systems strengthening initiative; an immediate software to be used by smaller health facilities and larger hospitals that do not currently have a HMIS system and a comprehensive software to be used by larger hospitals that are already using a HMIS software but which has failed to meet their needs.

Participants at the AGM were told that the immediate software had already been developed and was being piloted in two CHAK health facilities while development of the comprehensive software was still in the initial stages. Members were enthusiastic about the software, with those in the pilot sites testifying that it had made their operations much easier.

Maseno Hospital, one of the pilot sites, explained to the participants that there had been a definite improvement in revenue collection, report generation and patient management following the introduction of the software. The hospital suggested that the software be used to link up various people with interest in the hospital such as the Board, MOH reporting systems and NHIF. Soweto Kayole PHC Clinic shared with other members how the software had ensured accuracy in accounting, saying it was working quite well. The participants were also cautioned on the need to be creative in order to minimize costs of operating the software, including ensuring support from the health facilities themselves as well as from CHAK.

Church Health Services Coordinating Committee (CHSCC)
Jonathan Kiliko, who is the CHSSC Secretary, took participants through the committee’s mandate and background. He informed the gathering that the committee, a common voice for church health services, had been mandated by Church leaders to be the technical arm to follow up on the MOU between Government and FBHS.

The CHSSC has a membership of 12, with three members each from KEC, CHAK, MEDS and SUPKEM with the heads of these institutions being members. The chair and vice chair rotate between KEC and CHAK while MEDS has been left as the secretariat as it is universal to the other two. The technical team works closely with the MOH-FBHS-TWG to give feedback to the ministries concerned with health. A key result of this collaborative effort is the drugs kits that are currently being given to faith-based dispensaries by the Government. Mr Kiliko called on CHAK health facilities to utilize the forum by making suggestions and recommendations to enable lobbying and representation. The CHSSC, which meets every month, has facilitated a lot of engagement with Government and other partners in health.   

Health Sector Service Fund
Dr Odondi of MOPHS also took participants through the HSSF and how it would operate. Saying that the fund was set up to address equitability, quality and responsiveness of the health sector as well as foster partnerships, Dr Odondi said user fees would go into a common basket from which they would then be drawn. The fund was established through a legal notice which was later revised following the establishment of the two ministries responsible for health. There are now two funds to cater for primary care services and secondary and tertiary level services. The policy shift, according to Dr Odondi, was hinged on documents guiding the health sector. Being a no-year fund, the money pooled from various resources would not lapse at the end of the year and disbursements would be speeded up.

Already, the National Health Services Committee has been set up and members gazzetted and inducted while manuals for use by health facility management committees were in the process of being edited. The process of developing a resource allocation criteria has been started while a communication strategy was also being developed. The fund would be rolled out in a phased manner beginning july 2011. District accountants have already been trained while provincial teams will need to be updated on the revised tools.  

Development partners
Dr Klaus of GTZ made a presentation on enhancing partnerships through SWAps, the perspective of development partners. He noted that donor collaboration remained a challenge given the many interests although dialogue was continuous. He also noted that countries that had made it did so because of a well-established PPP system, adding that Kenya’s health sector CoC was one of the most progressive in the world. Noting that the MOU was taken from the COC, he further advised FBOs to ensure representation in all relevant forums.  

Dispensary kits support  
Dr Wanjau Mbuthia from KEMSA made a presentation on the essential drugs support from MOH to FBO dispensaries. Although most of the facilities are on the push system, KEMSA was in the process of introducing the pull system but was being hampered by various factors including warehouse decentralization and staff capacity. The intention was to convert to the pull system within the next two years.

Health centres had been excluded from the distribution list in the last quarter following shortage of drugs nationwide as the funds allocated were not adequate to buy kits and KEMSA did not have any buffer stocks. 

Dr Wanjau further informed the audience that complaint forms were available online and responses were guaranteed within 48 hours. Short message service would be used to alert recipients as soon as their orders had left the warehouse while an interface would be set up to improve communication with customers. He also advised CHAK MHUs to avoid receiving drugs that had been tampered with but instead make a comment on the delivery note about the state in which they were delivered. 

Dr Wambani of the National Radiation Board took the audience through the measures the board was taking to reduce unnecessary radiation in hospitals while the Nursing Council appealed to all health facilities to furnish the council with information about the nurses in their employment to enable the council to build an up-to-date database.

Participants were also taken through the AIDSRelief transition progress while Mr Wekesa of St Lukes Hospital, Kaloleni, made a presentation on the hospital’s transformation from a dilapidated facility that was nearly shut down to a currently thriving centre for medical care that has taken the initiative to reach out to its catchment community to ensure sustained utilization of its services. 

RCCs and partnership with the Government
CHAK RCCs have evolved into centres for lobbying and advocacy at the district level and are the devolved system of CHAK. Currently, DMOHs hold monthly meetings with the facilities in their zones and the meeting heard that there was need for the RCCs to attend these meetings in order to represent the facilities effectively. Lack of resources has however hampered improved interaction with the membership for the RCCs.  

AGM
During the AGM held on April 22, 2010, Mrs Nancy Ng’ang’a was elected CHAK vice chair for a second term. Central/Nairobi/Coast Region RCC Chairman Dr James Kariithi of PCEA Tumutumu Hospital retired after serving the maximum six years and was replaced by Justus Marete, CEO of AIC Kijabe Hospital. Mr Jomo was also officially elected as the Western/Nyanza/Rift RCC Chairman to replace Mrs Rose Muhando who has moved to the Ministry of Medical Services.