Building Strong Health Systems in Kenya

“From the very beginning, APHIAplus participated in our planning process,” said Dr. David Wanjala (center) with staff at Tudor District Hospital. “They helped us understand what needs to be done—things we never thought of before.”

Dennis Muhindi, Pharmacy Technician: “APHIAplus has contributed to everything in our pharmacy. This database allows us to keep track of supplies and a patient’s care. It triggers an alert if they do not come to get their medicine, so we can follow up.”

“APHIAplus does not just come and say ‘Doctors, we want to support you,’” said Dr. Wanjala. “They train managers, so we can better identify needs and come up with good work plans.”

“Before, staff would have to come from one department to another to borrow equipment…Now there is much less burden on patients. All departments are equipped with necessary items and skilled staff,” said Dr. Wanjala.

Dorah Kiplagat, Nursing Matron (left): “In past six months there has not been a single child born here to an HIV-positive mother who has been born positive.”

Tudor District Hospital is just one of the more than 600 health facilities where the APHIAplus Nairobi-Coast project strengthens health systems, so clients can access a range of quality integrated care.

Dr. David Wanjala, Medical Officer in Charge at Tudor District Hospital in Mombasa, Kenya, recently sat down with Linda Suttenfield, Pathfinder International’s Director of Communications, to share how the APHIAplus Nairobi-Coast project,* led by Pathfinder and funded by USAID, has made a difference at his health facility.

Can you tell me a little bit about the Tudor Hospital?
This is a district hospital with skilled senior staff. We have staff who work in the hospital, as well as those who are part of the ‘district management health team.’ APHIAplus provides both of them with support—to better supervise staff at our institution and at lower-level health facilities within the Mombasa health jurisdiction.

How has APHIAplus helped improve health services here?
APHIAplus trained most of our staff to provide integrated services related to reproductive health and HIV and AIDS. Before APHIAplus, a person visiting the hospital might have to move from one department to another, because the services were not well integrated. Now they can visit just one department and get what they need. For example, someone visiting a comprehensive care center, can get everything they need right there without going to another department. This is one of the greatest steps we have made with support of APHIAplus.

In what other ways has the project built the capacity of your staff?
APHIAplus trained them on logistics. I remember we used to have issues with data collection. APHIAplus worked with us to identify data clerks and determine how to motivate them financially. Recently, one of our clerks was so hard working that she was promoted to district health records information officer.

Also, APHIAplus trained our heads of departments to better supervise their juniors and coordinate with other institutions. Actually, I am one of the beneficiaries of this training.

Why is supervision—and mentorship—so important?
APHIAplus assists us with mentorship, which we never had before. They train experts—pharmacists; lab technologists; and clinicians in many disciplines, including HIV counseling and testing—to mentor staff at facilities in our district.

There was a site with HIV-positive clients who needed to start their antiretroviral treatment, but the health office did not have the capacity to assist them. The mentors sat down with staff and taught them about clinical diagnoses; how to start the treatment; how to monitor and document their work. They took their mentees through the entire process until they were confident and able to deliver the services. Then the mentors moved to another facility—in the spirit of decentralization.

Also, twice a month at this institution, there is continuing medical education. These experts train health workers for 1-2 hours per session to expand their skills.

How has APHIAplus strengthened the health system here?
If you look at health systems building blocks—there are six—APHIAplus has covered all six in this hospital. In addition to the health worker training and supervision, and the training of department heads in supportive supervision, APHIAplus has provided financial assistance in the form of renovations and equipment—examining beds and lamps, weight scales, tables, screens, blood pressure machines, autoclaves, and a pharmacy dispensing booth. These have been excellent; they have made service provision very easy.

Before, staff would have to come from one department to another to borrow equipment. Or they might send a weak patient to another department to be weighed or have their blood pressure taken. Now there is much less burden on patients. All departments are equipped with necessary items and skilled staff. In terms of technology, APHIAplus has assisted with new software to improve data collection and storage. We have three new computers on the way.

With all of these improvements, what kinds of results do you see?
There has been a great change. Because of the smooth provision of services, the numbers of patients visiting the institution is very high. We are attracting people from other institutions to come to our hospital. The waiting time has been reduced and is now low. Client satisfaction has also increased.

About client satisfaction—APHIAplus taught us how to confidently communicate with patients. For example, we have the new pharmacy dispensing booths, which give patients confidentiality. Now they can get their medicines privately and really take in the instructions, without fear that others are listening.
In an average month at Tudor District Hospital, 5-10 babies are born to women living with HIV. According to Nursing Matron Dorah M Kiplagat, in past six months, not a single one of them has been born with HIV thanks to support from APHIAplus Nairobi-Coast.
Also, in terms of outcomes, just look at the prevention of mother-to-child transmission of HIV services in the last two years. The quality of the services the mothers and infants are getting, as well as the follow-up they are receiving through our linkages with vibrant community structures, has improved. More people are accessing antiretroviral treatment and utilizing support groups that decrease stigma.

Overall, APHIAplus has made the health system in this institution much better than it was three years ago, and we expect this assistance will continue.

You can see more photos from Linda's trip to Tudor District Hospital on Storify.

*The APHIAplus Nairobi-Coast Service Delivery project is funded by USAID and implemented through a partnership between Pathfinder International, ChildFund International, Cooperative League of the USA, Population Services International, and the Network of AIDS Researchers of Eastern and Southern Africa. The project provides large-scale support to six county health systems. In very close collaboration with the Ministries of Health and through a coordinated approach with several partners, it carries out activities at every level—from province to county and district level and reaching down to the district health facilities and their communities.

Linda Suttenfield

Linda Suttenfield

Linda Suttenfield is Pathfinder International's Director of Communications.

Maren Vespia

Maren Vespia

Maren Vespia is Pathfinder's Communications Specialist.

Leave a Comment

* Change

Comments

Oahu PhotographersYears of civil war, multiple military coups and almost thirty years of military governance 70-485 have severely hindered infrastructure maintenance plans.
jack April 16, 2014
Nicely presented information in this post, I prefer to read this kind of stuff. The quality of content is fine and the conclusion is advantage. http://staceykreviews.com/
Name April 16, 2014
Thanks may have not intended to do so, but I think you have managed to express the state of mind that a lot of people are inHair Growth Treatment
Hair Growth Treatment April 16, 2014
I did enjoy reading articles posted on this site. They are impressive and has a lot of useful information. https://www.rebelmouse.com/2x4maximumstrengthreviews/
Ahsan April 16, 2014
I certainly enjoy reading all that is posted on your blog. Keeps the information coming. I loved it! exposed skin care reviews
exposed skin care reviews April 16, 2014
his is my first time i visit here. I found so many entertaining stuff in your blog, especially its discussion. From the tons of comments on your articles, I guess I am not the only one having all the leisure here! Keep up the excellent work. Top Rated Mattresses 2014
calvinbrock735 April 16, 2014
vitamin c serum Nice information, valuable and excellent design, as share good stuff with good ideas and concepts, lots of great information and inspiration, both of which I need, thanks to offer such a helpful information here. new york criminal defense lawyer
Ahsan April 15, 2014
nice to read your blog at pathfinder very interesting article sexcontact
Name April 15, 2014
I really enjoy simply reading all of your weblogs. Simply wanted to inform you that you have people like me who appreciate your work. Definitely a great post. Hats off to you! The information that you have provided is very helpful. LED Street Light
Ahsan April 15, 2014
Thanks very much for this great article;this is the stuff that keeps me going through out these day. Dermatologia
calvinbrock735 April 15, 2014
They trail specialists—pharmacists; lab technologists; furthermore clinicians in numerous whips, including HIV counseling moreover testing—to adviser personnel at facilities in our neighborhood. APHIAplus prompts us beside mentorship, which we never had already. european health card
sds April 15, 2014
its really fantastic blog . its realy informational and a such a good job. i love this dianabol
calvinbrock735 April 15, 2014
I simply want to tell you that I am new to weblog and definitely liked this blog site. Very likely I’m going to bookmark your blog . You absolutely have wonderful stories. Cheers for sharing with us your blog. free microsoft points
free microsoft points April 15, 2014
Thank you a lot for providing individuals with a very spectacular possibility to read critical reviews from this site.itunes gift card codes
admire April 14, 2014
Such a very useful article. Very interesting to read this article.I would like to thank you for the efforts you had made for writing this awesome article. best deer antler velvet
Ahsan April 14, 2014
Once I thought about things like: why such information is for free here? Because when you write a book then at least on selling a book you get a percentage. Thank you and good luck on informing people more about it! Top Rated Mattresses 2014
stuart April 14, 2014
proofreading is a complete incarcerate of your procession for plagiarism, errs incite inconsistencies. The dramatist is no going cheap flowers by post
jackman30 April 14, 2014
I've just decided to create a blog, which I have been wanting to do for a while. Thanks for this post, it's really useful! potty training in 3 days
calvinbrock735 April 14, 2014
I simply want to tell you that I am new to weblog and definitely liked this blog site. Very likely I’m going to bookmark your blog . You absolutely have wonderful stories. Cheers for sharing with us your blog. https://thetopmattressbrands.wordpress.com/
stuart April 14, 2014
Essentially, proofreading is a complete incarcerate of your procession for plagiarism, errs incite inconsistencies. The dramatist is no going to pend anything to your pace immovable, so love don’t sample to learn our hack to re-incline a plagiarized separate for you. Sameday courier
abhi April 14, 2014
Scroll to top