Work Plan �for �the 2^nd Phase of SAMACH

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Project for Strengthening the Accountability in the Management of County Health Services

July 2023 to March 2027

Framework of SAMACH

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Output 1. Quality of AWPs is improved based on the analysis of the progress of previous year. (1/3)

The Challenge:

• AWP should be a document that should be used for the whole financial year but many HFs do not “Check (monitor progress)” if the planed activities is implemented or not.
• As many HFs do not “Check” the implementation status, the HFs do not exactly understand what challenges the HFs are facing and therefore cannot “Act” to take effective countermeasures.
• As many HFs do not “Check” the implementation status, the AWP’s feasibility is not guaranteed (meaning it can be a wish list or/and an unrealistic plan)

(The above challenges were identified during the Costing Exercise)

Output 1. Quality of AWPs is improved based on the analysis of the progress of previous year. (2/3)

What SAMACH aims:

• To use the AWP as a “management document” that can be used for the whole financial year

How?

• Use the AWP online tool to manage the

PDCA cycle.

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PDCA cycle is a management cycle for

effective implementation to achieve the

defined objectives.

Output 1. Quality of AWPs is improved based on the analysis of the progress of previous year. (3/3)

Processes to improve the quality of AWP:

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Monitor the plan and implementation every quarter (this can be done using several online tools)

If there are activities that are not implemented as planned the FICs have to figure out why.

(MCH services should have a priority since it is agreed with the CDOH as a priority area)

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Depending on the bottlenecks identified, the FICs should take action.

If the bottleneck is related to structural problems, those issues should be shared with

the SCHMTs and/or CHMT.

The SCHMT should check if other HFs are facing similar issues.

If so, it should be reported to CHMT.

CHMT has to take action to tackle the bottlenecks and provide feedback to SCHMT and FICs.

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After taking actions, results should be reflected to the current or/and FY+1 AWP.

The issues raised may require amendments of the AWP or

should be reflected while making the next FY’s AWP.

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CHECK the progress of DO

ACTION

PLAN

Output 2. �AWP implementation capacity of county, sub-county and HFs is enhanced by improving resource mobilization and management. (1/4)

The Challenge:

It is difficult to implement all the planned activities in the AWP due to lack of resources (human, equipment, finance, etc.) and management.

Activities for the 2^nd Phase (July 2023 to March 2027)

• Conduct training to strengthen the capacity of HFs to secure NHIF reimbursement and efficiently utilize funds for MCH service delivery
• Enhance the capacity of CHMTs and SCHMTs to support the HFs so that they can secure NHIF reimbursement and efficiently utilize funds for MCH service delivery.

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Output 2. �AWP implementation capacity of county, sub-county and HFs is enhanced by improving resource mobilization and management. (2/4)

• Use the Tools/SOPs for health resource management
• Online Tools
1. SAMACHーNHIF Online Tool

The status of NHIF reimbursement secured by health facilities will be checked monthly using this tool.

• R&E Online Tool

The status of the reimbursement and withdrawals of NHIF and other financial resources will be captured and monitored.

• Gap Capturing Online Tool (the name of the tool will be confirmed later. Under development)

The gap between current status and the required amount of essential “HR" and "equipment" for level 2 and 3 HFs to provide MCH services will be captured. This will allow the managers to prioritize their investment while planning.

Output 2. �AWP implementation capacity of county, sub-county and HFs is enhanced by improving resource mobilization and management. (3/4)

• Stock Shortage Alerting Online Tool (the name of the tool will be confirmed later. Under development)

Stock shortages of HPT (pharms, non pharms and lab) will be alerted. This tool will encourage SCHMTs and CHMT to take actions to avoid stock shortages.

• Contents of the SOPs
• Work procedures and required documentation for HFs to request and confirm receipt from NHIF reimbursement.
• How to expand clients for MCH services.
• How to forecast reimbursement revenue.
• How to priorities inputs to be invested and how to manage limited resources to improve MCH services.
• The role of the SCHMT and CHMT in supporting HFs’ resource management.

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Output 2. �AWP implementation capacity of county, sub-county and HFs is enhanced by improving resource mobilization and management. (4/4)

Activities for the 2^nd Phase (July 2023 to March 2027)

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By using the online tools and SOPs,

• The four sub-counties in Kericho (Ainamoi, Kipkelion West, Belgut, Soin-Sigowet)
• Assigns sub-county NHIF coordinators
• Receive training on securing and utilizing NHIF reimbursement funds, input and output analysis of MCH services, and NHIF planning.

(the training will be led by the SCHMT especially the heads, NHIF coordinators and the SCHRIOs）

• All six sub-counties in Kericho

Conduct NHIF monthly monitoring at their regular Monthly Meeting.

• SCHMTs

Conduct quarterly meetings with the SCHMTs to monitor the availability and utilization of funds at the HFs on a quarterly basis to provide support to address any issues. In addition, the SCHMT will support the CHMT to establish a CHMT-led system to deal with some issues.

• SCHMTs and CHMT

Conduct semiannual workshops to share information and discuss common issues on how to support the mobilization and effective utilization of health facility resources, and to strengthen the management capacity of the CHMT, SCHMT and HFs.

��Output 3. Evidence-informed decision making is enhanced through variety of products developed by the Project. (1/2) ��

The Challenge:

Various health data exists, but the data is not regularly analyzed to be used for decision making.

Activities for the 2nd Phase (July 2023 to March 2027)

• Train the CHMTs, SCHMTs and HFs to analyze if the investments are geared to the necessary HR, HPT and equipment to improve MCH.
• Identify lessons learned / good practices from Outputs 1 and 2.

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Main Outcome Indicators to be used in SAMACH:

(1)the number of pregnant women who receive their first ANC visit,

(2) the number of pregnant women who have completed up to 4 ANC visits,

(3) the number of women who have delivered at HFs, and

(4) the number of pregnant women who have received PNC

��Output 3. Evidence-informed decision making is enhanced through variety of products developed by the Project. (2/2)��

• Conduct input-output-outcome analysis of the lessons learned / good practices with the FICs, SCHMTs and CHMT.
• Analyze whether the prioritized investments are contributing to the expected outputs and outcomes. If not, explore the factors that may be contributing to this.
• For cases that can be shown to be numerically effective, communication materials would be developed and shared with the stakeholders.

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��Output 4. The project approaches and products are scaled up to other counties.��

Activities for the 2^nd Phase (July 2023 to March 2027)

• Discuss and develop strategies with the new C/P,on how to scale up the approaches and tools developed to other counties. Consultations with partner county directors and CECs may work better in identifying scale-up counties.
• Together with the CPs, consider the selection criteria, timing of implementation of each activity related to scale-up, collaboration with development partners, and division of roles among the parties involved.
• Train promoters to enable scale-up.
• In the second year of the second phase, Project products will be sequentially scaled up to other counties.
• Enhance the website to facilitate the scale-up process. https://sites.google.com/view/jica-samach/home

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Framework of SAMACH

1

2

3

4

Target Indicators (Level 2 and 3 HFs) (1)

Output 1

• % of Level 2/3 HFs that developed AWPs based on the analysis of input gaps
• % of Level 2/3 HFs that include prioritized activities in their AWPs with fund source from forecasted NHIF reimbursement
• % of CHMTs, SCHMTs, and HFs quarterly reviewing AWP implementation using the products developed by SAMACH

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Output 2

• % of Level 2/3 HFs claiming on NHIF reimbursement
• % of Level 2/3 utilizing the products developed in Output 2

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Output 3

• # of lessons learned/good practices identified and shared during meetings and workshops

Target Indicators (Level 2 and 3 HFs) (2)

Project Purpose

1. Amount of reimbursement from NHIF is increased by % from the baseline
2. % of Level 2 /3 HFs that have prioritized their investment in improving Maternal and Child Health (MCH) related resources (HPT, equipment, HR)
3. # of HFs that have replicated lessons learnt/good practices identified through the project activities

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