2nd Co-Financed Partnership In Kisumu Underway

Our new co-financed partnership in Kisumu County, Kenya is a key part of this journey. Delayed since Q1 because of COVID-19, a program agreement was finally inked in November to provide targeted support to 3,000 government CHWs, supporting all 1.2 million residents in Kisumu county. After Isiolo, Kisumu marks both our second co-financed project in one of Kenya’s Universal Health Coverage (UHC) pilot counties.

Kisumu has high need, as a malaria-endemic region with high rates of pneumonia and water-borne disease. But, compared to Isiolo, Kisumu has better connectivity, infrastructure, human resource capacity, as well as a more functional health system structure. The four-year partnership was jointly designed with government to address longstanding challenges in Kisumu County related to financing, data and reporting, commodity supply chains and human resource management.

By the end of Q4, we partnered with the county government to train and onboard 400 CHWs. They have already digitally registered the households they serve and are providing them with improved data-driven community health services. An initial county-based team of 12 Living Goods staff will begin working with the county on the technical and operational aspects of the partnership in early February, and we will continue onboarding additional CHWs throughout of 2021.

Advancing Kenya’s First Fully Digitized Community Health Information System

As part of this journey toward national advisory services, throughout 2020, Living Goods supported the Kenyan MOH and County governments in strengthening data management, a key health systems pillar  whose value and demand grew exponentially with COVID-19. While we partnered with MOH to enhance its monitoring and evaluation (M&E) system and incorporate digitization in the national community health strategy, the bulk of our efforts supported MOH’s aspirations for digitizing Kenya’s entire community health system.  

For the last decade, MOH planned to institutionalize a unified digital health platform that encompasses all levels of the health system. Access to reliable, community-level data will help transform healthcare for Kenyans by enabling government to monitor the quality of community health service delivery by its workforce, effectively budget for and operationalize equitable community health programs, as well as strengthen preparedness and response to future health crises.

As government began planning how to digitize everything at the facility-level in the second half of 2020, MOH’s Division of Community Health seized the opportunity and successfully advocated—with the support of Living Goods and other partners—to fast-track the inclusion of the community-level component. This led to the creation of a multisector, MOH-led technical working group drawn from National MOH departments, the Council of Governors, donors and community health implementing partners like Living Goods to support analysis and strategy development to create a robust electronic community health information system (eCHIS).

A comprehensive analysis of the digitization landscape at the community level is complete—and with the National Community Health Digitization Strategy and costing implementation plan almost finalized—the multi-disciplinary team is now designing an eCHIS prototype to meet government’s functionality requirements for testing.

Living Goods is lending its expertise in performance management, service delivery, capacity building, M&E and wraparound services. We are also providing technical implementation support and have received catalytic funding from Johnson & Johnson, the Foreign Commonwealth & Development Office and others for this work. At national scale, the eCHIS platform will leverage more than 95,000 digitally-enabled CHWs for household-level data collection, service delivery and health reporting in all 47 counties. 

STRATEGIC SHIFT TO ADVISORY SERVICES IN KENYA

Since the World Bank designated Kenya a lower-middle-income country in 2014, donors looked to increase their return on investment in countries with greater economic need. While great wealth inequality remains, this development means that the Kenyan government must now find innovative ways to sustainably finance its health sector long-term, with less reliance on dwindling donor resources.

Because of this, Living Goods feels this is the right time to shift toward national advisory services in Kenya. Long-term, we intend to focus on a few demonstration counties that have co-financing in place to drive sustainable, government-led ownership—rather than scaling the networks of government CHWs we directly manage. This will enable government to lead the financing, digitization, commodity supply, supervision and compensation of its CHWs networks independently long-term.