facilitate understanding, communication and cooperation among by HC12110513610


									     DRAFT 0     January 21, 2009

 Glossary of Terms and List of Acronyms
commonly used in the Kenya Health Sector

                      Compiled by: Maureen V Nafula

                              October 2008
Table of Contents
Forward....................................................................................................................................... ii

Glossary of Terms...................................................................................................................... 1

List of Acronyms/Abbreviations .................................................................................................43

References ...............................................................................................................................52


The Health Sector in Kenya has many acronyms and technical terms which seem to grow by the
day as new concepts and ideas are adopted. This can be quite confusing to readers of the
many policy papers, strategic plans, reports and evaluation in the Health Sector.

This publication contains a list of acronyms used in major documents in the health sector and
definitions of terms of commonly used technical terms. The aim of this publication is to provide
a common understanding of the acronyms and terms used within the health sector in Kenya.
This list of acronyms and glossary of terms will be particularly useful to new comers to the
Kenya Health Sector, managers, administrators and students taking health care management
public health and professional health care training courses.

The definitions were drawn from a number of published literature and existing international
organizations’ sources including the Department for International Development, Organisation for
Economic Co-operation and Development, World Bank and World Health Organisation. A complete
list of the source documents is provided.

As with any other sector, the list of acronyms and glossary of terms is expected to evolve with
time. It is therefore intended that this publication will be updated on a regular basis. Any
comments and suggestions that will improve future publications are welcome and can be
emailed to ihm@sbs.co.ke

Support for the development of this list of acronyms and glossary of terms has been provided by
German Technical Corporation. The support is greatly appreciated.

Glossary of Terms

Abuja Declaration

The agreement made by leaders at the African Summit on HIV/AIDS, Tuberculosis, and Other
Related Infectious Diseases in April 2001 to work together in addressing public health concerns
and crises. In this declaration Heads of State committed to allocating at least 15 percent of their
annual budgets to improve the health sector in their countries. In 2007/8 FY, the Kenya Ministry
of Health gross expenditure as a percentage of total government spend was 6.4 percent.


The ability of an individual or a defined population to obtain or receive appropriate health care.
This involves the availability of programmes, services, facilities and records. Access can be
influenced by such factors as finances (insufficient monetary resources); geography (distance to
providers); education (lack of knowledge of services available); appropriateness and
acceptability of service to individuals and the population; and sociological factors
(discrimination, language or cultural barriers).

Accounting Officer

In the Kenyan context, Accounting Officers refers to the Permanent Secretary/Head of
Department appointed by the Permanent Secretary, Treasury to take full responsibility on the
finances, assets and liabilities of the respective Ministry/Department.


Artemisinin Combination Therapy

Drug therapy for malaria consisting of a combination of an artemisinin derivative (derived from
the plant Artemisia, also known by the Chinese name Qing Hao), and another drug with anti
malaria parasite activity. ACT is rapidly replacing cheaper conventional medicines, to which
malaria parasite resistance is now widespread


The process by which an organization recognizes a provider, a program of study, or an
institution as meeting predetermined standards

Adult Literacy Rate

The percentage of people ages 15 and over who can, with understanding, read and writes a
short simple statement. The Adult Literacy Rate in Kenya in 2006 was 79 percent.


African Development Bank

The ADB is a multilateral development bank whose shareholders include 53 African countries
and 24 non-African countries from the Americas, Asia, and Europe. It was established in 1964.
The African Development Bank is the premier financial development institution of Africa,
dedicated to combating poverty and improving the lives of people of the continent and engaged
in the task of mobilizing resources towards the economic and social progress of its Regional
Member Countries.


Appropriation in Aid

Appropriation in Aid are particular classes of revenue which the Treasury authorizes an
Accounting Officer to use in addition to the amounts to be issued from the exchequer to meet
approved expenditure. Appropriation-in-Aid are scheduled in annual the Appropriation Act and
any amount in excess of the limit set by the Act is surrendered to Exchequer unless the sum
authorized is increased by supplementary appropriation.

Aid Untying

The ending of the practice of most donors to insist that aid is spent on goods and services from
the donor country in favour of giving unrestricted access to those who can compete best on


Aid also known as "assistance" refers to flows which qualify as Official Development Assistance


Acquired Immune Deficiency Syndrome

An advanced stage of infection with HIV (human immunodeficiency virus) in which the immune
system is weakened. The individual becomes more susceptible to a variety of infections (called
opportunistic infections) and other conditions, such as cancer


French for “aid to memory” is memorandum summarizing the items of an agreement presented
to a foreign official. It is a useful device to ensure that it is the “governments" words, not the
foreign official's notes, are the ones which convey the government’s views to his superiors who
may not be present for the discussion.


Ante Natal Care

Concerned with the care and treatment of a pregnant woman and her unborn child


Annual Operational Plan

An annual operating plan is a schedule of events and responsibilities that details the actions to
be taken by each major organizational unit in a fiscal in order to accomplish the goals and
objectives laid out in the strategic plan.


Antiretroviral treatment

Anti-retroviral therapy is the course of medications or drugs taken to fight HIV and to prevent
HIV from damaging the immune system.


Anti Retro Viral

A substance, drug, or process that destroys a retrovirus (such as HIV), or suppresses its
replication. Often used to describe a drug active against HIV.

Authorised Officer

The Permanent Secretary who exercises supervision over the Ministry concerned or over the
Ministry in which the public officer concerned holds an office. I the case of a department which
is not assigned to any Minister, the Head of that Department is the accounting officer

Base-line study

An analysis describing the situation prior to a development intervention, against which progress
can be assessed or comparisons made.

Basket Funding

This refers to when a government combines the funds from several donors to be used on one
program or sector.


Someone who is eligible for or receiving benefits under an insurance policy or plan.

Benefit Package

Services covered by a health insurance plan and the financial terms of such coverage, including
cost sharing and limitations on amounts of services.

Bilateral Aid

Bilateral means "two sides". Development assistance provided by one party or country directly
to another.


Budget Management Centre

Cost centres with responsibility to manage and spend an allocated budget from the government
specific to their activities


Bed Occupancy Rate

The percentage of available beds which have been occupied over the year. The bed occupancy
rate is a measure if the intensity of the use of hospital resources by inpatients.

Budgetary Support

Budget Support is a form of programmatic aid in which: a. Funds are provided in support of a
government programme that focuses on growth and poverty reduction, and transforming
institutions, especially budgetary; b. The funds are provided to a partner government to spend
using its own financial management and accountability systems. Budget Support is also referred
to as General Budgetary Support.

Capacity Building

Capacity building is the development of knowledge, skills, commitment, structures, systems and
leadership to enable effective health promotion. It involves actions to improve health at three levels:
the advancement of knowledge and skills among practitioners; the expansion of support and
infrastructure for health promotion in organizations, and; the development of cohesiveness and
partnerships for health in communities.


A method of payment for health services in which an individual or institutional provider is paid a
fixed amount for each person served, without regard to the actual number or nature of services
provided to each person in a set period of time

Catastrophic health insurance

Health insurance, which provides protection against the high cost of treating severe or lengthy
illnesses or disability. Generally such policies cover all, or a specified percentage of, medical
expenses above an amount that is the responsibility of another insurance policy up to a
maximum limit of liability.


Community-based distribution

An approach to delivering family planning and sexual and reproductive health services which
does not require a clinic setting.


Community Based Contraceptive Distributors

Individuals who live in and are members of the community are trained to provide health
education, advice and supplies, and to make referrals. CBCD educate people in their own
community, motivates them, distributes contraceptives, refers clients to health facilities, and
possibly provides other sexual and reproductive health services.


Community Based Health Care

The blend of health and social services provided to an individual or family in their place of
residence for the purpose of promoting, maintaining, or restoring health or minimizing the effects
of illness and disability.


Community Based Organisation

Groups of individuals within a village or group of villages or residential area with similar vested
interests that have established an agreement to work together in a structured manner to achieve
common objectives.


Crude birth rate

The number of live births per 1,000 populations in a given year. Kenya’s crude birth rate in 199
was 41.3, a decline from 52 in 1979.


Country Coordinating Mechanism

A country-level partnership that includes representatives from government, multilateral and
bilateral development partners, nongovernmental and faith-based organizations, affected
communities, academic institutions and the private sector. The CCM develops and submits
proposals based on the country’s needs to the Global Fund. It nominates the PR. It is also
responsible for overseeing implementation of all programs in the country financed by Global
Fund grants and for submitting grant renewal.


Constituencies Development Fund

A fund established in January 2003 through the CDF Act in Kenya to control imbalances in
regional development brought about by partisan politics. It targets all constituency-level
development projects, particularly those aiming to combat poverty at the grassroots.


Crude Death rate

The number of deaths per 1,000 populations in a given year. Kenya’s crude birth rate in 1999
was 11.7, compared to 14 in 1979.


The process by which a governmental or nongovernmental agency or association evaluates and
recognizes an individual, institution, or educational program as meeting predetermined
standards. One so recognized is said to be "certified." It is essentially synonymous with
accreditation, except that certification is usually applied to individuals, and accreditation to
institutions. Certification programs are generally nongovernmental and do not exclude the
uncertified from practice as do licensure programs.


Community Health Workers

A trained health worker who works with other health and development workers as a team. The
community health worker provides the first contact between the individual and the health
system. Community health workers come from and are chosen by the community in which they
work. Community health workers may work as volunteers; normally those who work part-time or
full-time are rewarded, in cash or in kind, by the community and the formal health services.

Chronic Illness

Any persistent medical condition that can be managed but not cured with treatment


Group whose members share a significant experience at a certain period of time or have one or
more similar characteristics .

Community health worker

A person who works for the health care system and provides health care and education services
outside the clinic setting by going to people’s homes, places of work, or community gathering


Refers to the knowledge, skills and attitudes which an individual possesses. Competencies are
accumulated and developed through education and training and experience.


Policy measures which the partner government agrees to implement as a condition of receiving
development assistance. New approaches to promoting policy change are being developed
given evidence that policy conditionality is often ineffective, particularly where there is little
domestic support

Corporate Governance

Corporate Governance is the relationship between the shareholders, Board of Directors, and the
management of the company to ensure that management acts in a way to protect the interests
of the investors (including creditors) in the company.


Community Owned Resource Persons

A Community Owned Resource Person is an individual identified by the community to promote
maternal health services at the health facility voluntarily in the community

Cost-Benefit Analysis

Cost benefit analysis also known as value for money is the analytical procedure for determining
the economic efficiency of a program, expressed as the relationship between costs and
outcomes, usually measured in monetary terms.

Cost effective

Economical, based on the tangible benefits produced by the money spent.

Cost effectiveness.

A measure of the value received (effectiveness) for the resources expended (cost). Usually
considered as a ratio, the cost effectiveness of a drug or procedure, for example, relates the
cost of that drug or procedure to the health benefits resulting from it. In health terms, it is often
expressed as the cost per year of life saved or as the cost per quality-adjusted life-year saved


As refers to insurance, the guarantee against specific losses provided under the terms of an
insurance policy.


Continuous Professional Development

Continuous Professional Development is a process that enables individuals to acquire, maintain
and enhance their knowledge, skills and attitude to optimise individual and organisational
performance. CPD can take many forms: involvement in courses, seminars and conferences;
professional work based activities such as secondments, project management and contribution
to strategic planning; self directed and informal learning such as reading professional journals
and books and membership of relevant professional bodies and associations. CPD can be any
activity that keeps an individual 'up-to-date' with current ideas and practice in their field of work.


Contraceptive Prevalence Rate

The percentage of all women of reproductive age or married women of reproductive age,
typically aged 15-49, who are using a method of contraception. The Contraceptive Prevalence
Rate in Kenya in 2003 was 39.3%


Civil Society Organisation

Non-governmental groups that provide public services. CSOs may include community based
organizations (CBO), faith-based organizations (FBO), trade unions, business associations,
foundations, academic institutions and the media.


Couple-years of protection.

A measure representing the total number of years of contraceptive protection provided by a
method, for one couple, for one year.

Development Assistance Committee

The Development Assistance Committee of the Organisation for Economic Co-operation and
Development is a forum for consultation among 22 donor countries and the European
Commission, on how to increase the level and effectiveness of aid flows to all aid recipient
countries. The member countries are Australia, Austria, Belgium, Canada, Denmark, European
Commission, Finland, France, Germany, Greece, Ireland, Italy, Japan, Luxembourg,
Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, UK and United


Disability Adjusted Life Years

The sum of years of potential life lost due to premature mortality and the years of productive life
lost due to disability.


The transfer of authority and responsibility to lower levels from the central government to
peripheral levels or lower levels of government or quasi-independent government organizations
or the private sector.

Demographic and Household Survey (DHS)

Demographic and Household Surveys are nationally representative household surveys with
large sample sizes of about 5,000 households. DHS surveys provide data for a wide range of
monitoring and impact evaluation indicators in the areas of population, health, and nutrition.

Development Cooperation

Commonly called aid, this is the international transfer of public funds in the form of loans or
grants, either directly from one government to another (bilateral aid), or indirectly through
nongovernmental organizations or a multilateral agency (multilateral aid) such as the World
Bank or WHO

Development Revenue

Development revenues refer to the finances needed for implementation of development
programmes and projects and are mainly obtained from internal and external sources through
grants, loans and government stock and bond issues.
Direct Budget Support

Direct Budget Support is a form of programmatic aid in which funds are provided in support of a
government programme that focuses on growth and poverty reduction, and transforming
institutions, especially budgetary. The funds are provided to a partner government to spend
using its own financial management, procurement and accountability systems. It can take the
form of General Budget Support, which is a contribution to the overall budget, or Sector Budget
Support, which is financial aid, earmarked to a discrete sector.

Doha Declaration

A resulting Declaration from the fourth World Trade Organization (WTO) Ministerial meeting
(i.e., meeting of trade ministers) held in Doha, Qatar in November 2001. The declaration
stressed that it is important to implement and interpret the Trade-Related Aspects of Intellectual
Property Rights (TRIPS) agreement in a way that supports public health, by promoting both
access to existing medicines and the creation of new medicines.


A donor is an official agency — including state and local governments — that provides Official
Development Assistance


Direct Observed Treatment, Short-course

The standard approach internationally to treating tuberculosis, in which a healthcare worker or
another trained person observes patients as they take their medication for tuberculosis to
ensure treatment compliance. Interrupted treatment presents certain risks, such as the spread
of drug-resistant tuberculosis.


Development Partner

The term used to describe a developed-country government (or its specialized agency) that
provides official development assistance. This may be done through a ministry of foreign affairs,
a ministry of development cooperation, a sectoral ministry such as health or education or an
independent agency that receives government funding.


Earmarking is a way of tying budget support to the financing of pre-specified items within the
National Budget.


Describing the presence of a disease in a community.


Rapid and/or widespread outbreak of a disease through a community in which the disease is
normally absent or present at a low level.


European Union

The European Union comprises the following 27 countries: Austria, Belgium, Bulgaria, Cyprus,
Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy,
Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovak
Republic, Slovenia, Spain, Sweden, and United Kingdom.


The principle by which all persons or things under consideration are treated in the same way.


The degree to which some distribution or other is judged to be 'fair'. 'Fairness' involves a value
judgment so; e.g., 'greater equality' need not imply 'greater equity'.

Essential drug (or medicine)

One of a group of drugs which together comprise safe, effective treatment for the majority of
communicable and non-communicable diseases currently affecting the world’s population.


Enterprise resource planning

This describes software systems designed to manage most or all aspects of a manufacturing or
distribution enterprise. ERP systems are usually broken down into modules such as Financials,
Sales, Purchasing, Inventory Management, Manufacturing and Distribution Resource Planning.
The modules are designed to work seamlessly with the rest of the system and should provide a
consistent user interface between them. These systems usually have extensive set-up options
that allow users to customize their functionality to their specific business needs.


Evaluation is the systematic and objective assessment of an on-going or completed project,
programme or policy, its design, implementation and results. The aim is to determine the
relevance and fulfillment of objectives, development efficiency, effectiveness, impact and
sustainability. Evaluation also refers to the process of determining the worth or significance of
an activity, policy or program


Faith Based Organisation

Nonprofit organizations affiliated with a particular church or faith, but established as a separate

First-line treatment.

Initial treatment for a specific disease or condition.


Family Planning

The conscious effort of couples or individuals to plan for and attain their desired number of
children and to regulate the spacing and timing of their births.

Fiduciary Risk

The risk that expenditure, for example through budget support, will not be properly accounted
for or will not be used for the intended purposes.

Framework contract

A contract listing a range of suppliers who are able to supply specified goods or services. The
contract enables organisations to call upon one or more of the suppliers to supply the goods or
services as they are required.


Fiscal Year

A 12-month period for which an organization plans the use of its funds, such as the
government's fiscal year (July 1 to June 30). In the private sector, organizations can designate
their own fiscal years.


Global AIDS Vaccine Initiative

A global effort to strengthen childhood immunization programmes and bring a new generation of
recently licensed vaccines into use in developing countries. These include vaccines against
hepatitis B, childhood meningitis, yellow fever and respiratory infections, which are the leading
cause of death in children under age five.


Gender-based violence

The United Nations General Assembly in 1993 adopted the definition of violence against women
as "any act that results in, or is likely to result in, physical, sexual, or psychological harm or
suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty,
whether occurring in public or private life. It encompasses, but is not limited to: physical, sexual
and psychological violence occurring in the family, including battering, sexual abuse of female
children in the household, dowry-related violence, marital rape, female genital cutting and other
traditional practices harmful to women, non-spousal violence and violence related to
exploitation; physical, sexual and psychological violence occurring within the general
community, including rape, sexual abuse, sexual harassment and intimidation at work, in
educational institutions and elsewhere; trafficking in women and forced prostitution; and
physical, sexual and psychological violence perpetrated or condoned by the state, wherever it


Gross Domestic Product

Total market value of all final goods and services produced in an economy during some time
period (usually a year). Kenya’s GDP in 2007 was Ksh. 1,814.2 billion


Gender refers to the economic, social and cultural attributes and opportunities associated with
being male or female in a particular point in time. Gender roles are defined as the social and
cultural traits that different societies assign to males and females. Such gender roles are the
patterns of behaviour, rights and obligations defined by a society as appropriate for each sex. A
gender perspective is a way of looking at situations and issues taking into account the
respective roles and contributions of men and women in society.

Gender equality

Measurable equal representation of women and men. Gender equality does not imply that
women and men are the same, but that they have equal value and should be accorded equal

Gender equity

The application of fairness or justice in all gender issues. This applies both to the composition of
power structures and to social divisions of labour.

Gender mainstreaming

A new term that is similar to gender perspective or gender sensitive focus. It is the
reorganization, improvement, development and evaluation of policy processes, so that a gender
equality perspective is incorporated in all policies at all levels and at all stages, by those
normally involved in policy-making.

General budget support

General budget support is a sub-category of direct budget support. In the case of general
budget support, the dialogue between donors and partner governments focuses on overall
policy and budget priorities


Global Fund to fight AIDS, Tuberculosis and Malaria

Also referred to as the Global Fund, GFTAM is a fund established in January 2002 to
dramatically increase resources to fight three of the world's most devastating diseases, and to
direct those resources to areas of greatest need.

Ghost Worker

Personnel formally on payroll but providing no service

Global Health Initiatives

Global initiatives are programmes targeted at specific diseases and are supposed to bring
additional resources to health efforts. Three major global health initiatives were launched
between 1998 and 2000: Roll Back Malaria, Stop TB and Global Alliance for Vaccines and

The Global Fund to Fight HIV/AIDS, TB and Malaria is another example. However, this is a
funding mechanism rather than an implementing initiative.

Global Health Partnerships

Collaborative relationships among multiple organisations, usually including the private sector,
where risks and benefits are shared in pursuit of a common goal.


Gross National Income

Previously known as Gross National Product, Gross National Income is the market value of all
final goods and services produced in a given time period (usually one year) by the nationals of a
country residing either in the country or abroad. Kenya’s GDP in 2007 was Ksh. 1,801.3 billion


Governance refers to the manner in which public officials and public institutions acquire and
exercise the authority to provide public goods and services, including the delivery of basic
services, infrastructure, and a sound investment climate.


Grants are transfers from donor countries made in cash, goods or services for which no
repayment is required.


The principle of donors using common, simplified, and more transparent arrangements and
procedures and better dividing labor. Using common systems reduces the transaction costs for
recipients of managing aid.


Home Based Care

Care that is provided to someone in their own home. Also referred to as home care.


Health Centre

A centre that may carry out promotive, protective, preventive, diagnostic, curative and
rehabilitative health care activities for ambulant people

Health care

Care, services, and supplies related to the health of an individual. Health care includes
preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, and
counseling, among other services. Health care also includes the sale and dispensing of
prescription drugs or devices.

Health Care Policy

Decisions, usually developed by government policymakers, for determining present and future
objectives pertaining to the health care system.

Health Care Provider

An individual or institution that provides medical services (e.g., a physician, hospital, laboratory).

Health Financing

Health financing is the system of fund generation or credit, fund expenditures and flow of funds
used to support the health services delivery system. Modes of financing include direct
public/government payment for service, social insurance, insurance schemes, user fees and
contracts with managed care.

Health Impact Assessment

Health impact assessment is any combination of procedures or methods by which a proposed
policy or program may be judged as to the effect(s) it may have on the health of a population.

Health Indicators

A health indicator is a characteristic of an individual, population, or environment which is subject
to measurement (directly or indirectly) and can be used to describe one or more aspects of the
health of an individual or population (quality, quantity and time). Examples of health indicators
include childhood immunization rates and life expectancy.

Health Insurance

Coverage that provides for the payments of benefits as a result of sickness or injury. Includes
insurance for losses from accident, medical expense, disability, or accidental death and

Health Outcome

Changes in health status (mortality and morbidity) which result from the provision of health (or
other) services.

Health Promotion

Health promotion is the science and art of helping people change their lifestyle to move toward
a state of optimal health. Optimal health is defined as a balance of physical, emotional, social,
spiritual and intellectual health

Health Sector

The sector consisting of organized public and private health services (including health
promotion, disease prevention, diagnostic, treatment and care services), the policies and
activities of health departments and ministries, health related nongovernmental organizations
(NGOs) and community groups, and professional associations.

Health sector reform

A process that seeks changes in health sector policies, financing, and organization of services,
as well as in the role of government, to reach national health objectives. Sector reform is by
definition sector-wide in that it affects more than one service, supply, or clinical policy, and more
than one provider, institution, or geographic location. Typical goals that countries have for their
health sector reform efforts include improvements in access, equity, quality, efficiency and/or
sustainability of their health care services.

Health Systems

As defined by WHO, all organizations, people and actions whose primary intent is to promote,
restore or maintain health. It comprises the following six core building blocks: service delivery;
information and monitoring systems; medical products and technologies; health workforce;
financing and leadership and governance.

Health Systems Strengthening

As defined by WHO, the action of improving the six health system building blocks and managing
their interactions in ways that achieve more equitable and sustained improvements across
health services and health outcomes. It requires both technical and political knowledge and


Health Facilities

Collectively, all physical plants used in the provision of health services; usually limited to
facilities which were built for the purpose of providing health care, such as hospitals and nursing
homes. They do not include an office building which includes a physician's office. Health facility
classifications in Kenya include: Dispensaries, Health Centres and hospitals, both private and
public (Sub District, District, provincial and National Referral Hospitals)


Human Immune-Deficiency Virus

Human Immunodeficiency Virus (HIV) is the virus that weakens the immune system. The
weakening of the immune system leaves the body open to attack from opportunistic infections,
eventually leading to the development of Acquired Immune Deficiency Syndrome (AIDS).

HIV Prevalence Rate

The estimated number of adults aged 15-49 years living with HIV/ AIDS divided by the adult
population in the same age group. The HIV prevalence rate in Kenya in 2007 was 7.4%.


Health Management Information System

A system to collect routine data from hospitals and community health facilities.


Health Maintenance Organization

An organization that arranges for or contracts with, a variety of health care providers to deliver a
range of services to consumers who make up its membership. HMOs employ managed care
strategies that emphasize prevention, detection and treatment of illness

Human Development Index

This is a measure, developed by the United Nations Development Programme, which ranks
national development based on measures of life expectancy at birth, educational attainment,
and adjusted real per capita income. It is designed to give a more holistic view of a country's
development status, compared to per capita income (the measure used by the World Bank to
rank countries).

Human Rights Approach to Health

A human rights-based approach to health means integrating human rights norms and principles
in the design, implementation, monitoring, and evaluation of health-related policies and
programmes. These include human dignity, attention to the needs and rights of vulnerable
groups, and an emphasis on ensuring that health systems are made accessible to all. The
principle of equality and freedom from discrimination is central, including discrimination on the
basis of sex and gender roles. Integrating human rights into development also means

empowering poor people, ensuring their participation in decision-making processes which
concern them and incorporating accountability mechanisms which they can access.

Humanitarian Assistance

Humanitarian Assistance comprises food aid and other disaster relief. It generally involves the
provision of material aid (including food, medical care and personnel) and finance and advice to
save and preserve lives during emergency situations and in the immediate post-emergency
rehabilitation phase; and to cope with short and longer term population displacements arising
out of emergencies.

IDA International Development Association

Part of the World Bank Group which makes loans to countries at concessional rates (i.e. below
market rates) of interest.


Internally Displaced People

Persons or groups of persons who have been forced or obliged to flee or to leave their homes or
places of habitual residence, in particular as a result of or in order to avoid the effects of armed
conflict, situations of generalized violence, violations of human rights or natural or human-made
disasters, and who have not crossed an internationally recognized State border.


Information, education and communication

 A programme to ensure that clients or potential clients of sexual and reproductive health
services are given the means to make responsible decisions about childbearing and about their
sexual and reproductive health. Information involves generating and disseminating general and
technical information, facts and issues, in order to create awareness and knowledge. Education
whether formal or non-formal, is a process of facilitated learning to enable those learning to
make rational and informed decisions. Communication is a planned process aimed at motivating
people to adopt new attitudes or behaviour.


Integrated Management of Childhood Infections

A health strategy developed by WHO and UNICEF that targets children under 5 and addresses
5 leading causes of death -- malaria, pneumonia, diarrhoea, measles, and malnutrition.


International Monitory Fund

The IMF is an international organization of 183 member countries, established to promote
international monetary cooperation, exchange stability, and orderly exchange arrangements; to
foster economic growth and high levels of employment; and to provide temporary financial
assistance to countries to help ease balance of payments adjustment.


Positive and negative, primary and secondary long-term effects produced by an intervention,
directly or indirectly, intended or unintended.


Infant Mortality Rate

The number of deaths of infants aged less than one year per 1,000 live births in a given period,
usually a year. The infant mortality rate in Kenya in 2006 was 60 deaths per 1,000 live births.


As used in epidemiology, is the number of new cases of a disease occurring within a specified
period. An incidence rate is a measure of the frequency with which new cases occur in a
population over a period of time. The denominator is the population at risk and the numerator is
the number of new cases occurring during a given time period.


Health insurance benefits provided in the form of cash payments rather than services. Insurance
program in which covered person is reimbursed for covered expenses. An indemnity insurance
contract usually defines the maximum amounts that will be paid for covered services.


A measure of a specific component of a health improvement strategy. An indicator can reflect
an activity implemented to address a particular health issue-such as the number of children age
one who have received all appropriate immunizations, or it might reflect outcomes from activities
already implemented-such as a decline in the number of HIV infections in any given year.


A person who does not have insurance and is not covered by the National Health Insurance
Fund, or other public programs.

Inpatient care

Care given to a patient who is admitted to a hospital or other medical institution for at least one
overnight stay; distinct from care given when visiting such institutions as an outpatient.


An action or strategy to address a particular problem or issue and to accomplish a specific


Intellectual Property Rights

Intellectual property rights are exclusive rights, often temporary, granted by the state for the
exploitation of intellectual creations. The principal Intellectual Property Rights are copyrights
(material which can be reproduced only with permission of the owner, who can charge for it),
patents (product designs or processes which can be used only with permission of the owner,
who can charge for it), trademarks (registered marks that exclusively identify a product or
economic entity, which cannot be used by others), and industrial designs. Once IPR have been
established, the property cannot be copied or used without the agreement of the owner.


Indoor residual spraying

Spraying long-lasting insecticide on indoor walls or rafters in order to kill resting insects,
specifically female malaria vectors that rest indoors following blood meals


Certified by the International Organization for Standardization

Integrated programmes

Integrated programmes (also known as horizontal programmes, integrated health services or
horizontal approaches) seek to tackle the overall health problems on a wide front and on a long-
term basis through the creation of a system of permanent institutions commonly known as
‘general health services and include “a variety of managerial or operational changes to health
systems to bring together inputs, delivery, management and organization of particular service


Insecticide-treated bed net

A fine meshed net that has either been treated with a long-lasting insecticide or manufactured
with insecticide directly incorporated into its fibers, hung over a bed to protect sleepers from
insect bites.


Intrauterine Device

A long-term, reversible method of contraception, involving the insertion into the uterus of a small
flexible device of metal/plastic/hormonal materials. IUDs are effective for at least four years, and
many for much longer.


The Kenya Essential Package for Health

The Kenya Essential Package for Health refers to the provision of comprehensive, integrated
curative and preventive health services, available at the first point of contact, accessible to all.
KEPH integrates all health programmes into a single package focused on improving health at
different stages of the human life cycle. KEPH distinguishes six distinct life cycle stages:
Pregnancy, delivery and the newborn child (up to 2 weeks of age); Early childhood (3 weeks to
5 years); Late childhood (6 to 12 years); Adolescence (13 to 24 years); Adulthood (25 to 59
years) and Elderly (60 years and over)


Kits contain an assortment of medicines and medical supplies in predefined quantities. The
medicines and medical are either packed centrally or procured as pre-packed kits and
distributed unopened to the health facilities where they are to be used. Each kit is usually
designed to supply a given number of patient attendances. The kit system is an example of a
“push” system

Life Expectancy

The average number of years an individual of a given age is expected to live if current mortality
rates continue to apply. The World Health Organisation estimate of the Life Expectancy in
Kenya in 2007 was 51 years.

Logical framework (Log frame)

A Logical framework is a management tool used to improve the design of interventions, most
often at the project level. It involves identifying strategic elements (inputs, outputs, outcomes,
impact) and their causal relationships, indicators, and the assumptions or risks that may
influence success and failure. It thus facilitates planning, execution and evaluation of a
development intervention.


The process of planning, implementing and controlling the efficient and cost-effective flow and
storage of raw materials, in-process stocks, finished goods and related information from the
point of origin to the point of consumption for customers. Put more simply, it is the science and
art of ensuring that the right products reach the right place in the right quantity, in the right
quality, at the right time in order to satisfy consumer demand. Logistics encompasses
warehousing, transport, added-value/pre-retailing services and IT solutions and covers inbound,
outbound, internal, international and reverse product flows.


Logistics Service Provider

Also known as a third-party logistics provider (3PL), an LSP is a supplier of outsourced logistics
services that primarily uses its own assets and resources.

Maternal Mortality

The death of a woman from any cause related to pregnancy that occurs during pregnancy or
within 42 days of pregnancy termination (e.g., birth, stillbirth, miscarriage, or abortion). Late
maternal deaths include deaths from obstetric causes that occur after 42 days but within one
year of pregnancy termination.


Maternal and child health programmes

Programmes providing health care aimed at improving the health of mothers and children,
including efforts to ensure safe motherhood, eliminate unsafe abortion and help women plan
and space their births.


Millennium Development Goals

In 2000, eight Millennium Development Goals (MDGs) were agreed upon by 189 nations. The
MDGs provide a framework for improving health, education, gender equity, economic, and
environmental conditions in developing countries. For each goal one or more targets have been
set, most to be achieved by 2015, using 1990 as a benchmark

Medical commodities

This includes pharmaceutical (drugs) and non-pharmaceutical products including ARVs, Dental,
Family Planning, Kits, Laboratory, Public Health, TB, Vaccines, X-Ray, Stationery or any other
related products for health sector programmes


Maternal Mortality Rate

The number of deaths of women due to pregnancy and childbirth complications per 100,000
women aged 15-45 or 15-49 years. This rate measures a woman's lifetime risk of dying
associated with reproduction. The maternal mortality rate in Kenya between 1993 and 2003 was
414 deaths per 100,000.


 Monitoring is the regular tracking of inputs, outputs, outcomes and impacts of development


The incidence and /or prevalence of certain diseases or disabilities. It is usually expressed as a
rate: the number of cases of disease per 1,000 persons at risk.


Death. Used to describe the relation of deaths to the population in which they occur. The
Mortality rate is the annual number of deaths (from a disease or in general) per 1000 people.


Mother-to-child transmission

Transmission of HIV from a woman infected with HIV to her child during pregnancy, childbirth
and breast-feeding. Also referred to as vertical transmission or perinatal transmission.


Medium Term Expenditure Framework

A MTEF is a system for planning actions and programming spending over a 3 to 5 year period.
It is a rolling process repeated each financial year and aims at reducing imbalance between
what is affordable and what line ministries demand. It provides the linking framework that allows
expenditure to be driven by policy priorities and disciplined by budget realities. MTEF bring
together policy-making, Planning and budgeting

Multilateral Aid

Aid involving more than two nations or parties, usually in the form of donations through a
multilateral organization such as the United Nations or the World Bank

Multilateral Institution

International institution with governmental membership, spanning several regions, including
financial institutions such as the World Bank and IMF, UN agencies and regional groupings.

National Health Expenditures

Total spending on health services, prescription and over-the-counter drugs and products,
nursing home care, insurance costs, public health spend, and health research and construction.


Non Governmental Organisation

These are private non-profit making organizations that pursue activities to promote the interests
of the poor, protect the environment, provide basic social services, relieve suffering or
undertake community development. NGOs often differ from other organizations in the sense
that they tend to operate independent from government, are value-based and are generally
guided by principles of community and cooperation.

National Health Accounts

National health accounts (NHA) constitute a systematic, comprehensive, and consistent
monitoring of resource flows in a country’s health system for a given period. They are designed
to capture the full range of information contained in these resource flows and to reflect the main
functions of health care financing: resource mobilization and allocation, pooling and insurance,
purchasing of care, and the distribution of benefits.


An organization whose primary objective is to support an issue or matter of private interest or
public concern for non-commercial purposes, without concern for monetary profit. Status of
nonprofits does not permit them to be a source of income, profit or other financial gain for the
entities that establish, control or finance them.


Output-Based Aid

Output-Based is an innovative approach to increasing access to basic services such as
infrastructure, healthcare, and education—for the poor in developing countries. It uses explicit
performance-based subsidies to support the delivery of basic services where policy concerns
would justify public funding to complement or replace user-fees.

OBA involves delegating service delivery to a third-party, typically private firms, but also public
utilities, NGOs, and community-based organizations, under contracts that tie disbursement of
the public funding to the services or outputs actually delivered. OBA is also known as
“performance based aid” or “results-based financing” (in the health sector). It is part of a broader
donor effort to ensure that aid is well spent and that the benefits go to the poor.


Official Development Assistance

Grants and concessional loans that donor governments provide to developing countries for the
purpose of promoting economic development and welfare.


Opportunistic Infection

A disease caused by a microorganism that does not normally cause illness in a person with a
healthy immune system, but that may cause serious disease when the immune system is


Out of Pocket

Household out-of-pocket expenditure on health comprise cost-sharing, self-medication and
other expenditure paid directly by private households, irrespective of whether the contact with
the health care system was established on referral or on the patient’s own initiative.

Outpatient care

Treatment or diagnosis provided in hospitals or clinics that does not require an overnight stay. A
type of ambulatory care


The sub-contracting to external companies of tasks considered to be outside an organisation's
core competence. Logistics outsourcing is one of the most popular forms.


Over-the-counter Refers to health care products available without a prescription.


A disease occurring over a wide geographical area and affecting an exceptionally high
proportion of the population, e.g. malaria and HIV


The individuals and/or organizations that collaborate to achieve mutually agreed upon
objectives. The concept of partnership connotes shared goals, common responsibility for
outcomes, distinct accountabilities and reciprocal obligations. Partners may include
governments, civil society, non-governmental organizations, universities, professional and
business associations, multilateral organizations, private companies, etc.

Participatory Monitoring and Evaluation

This provides feedback on ongoing program effectiveness, allowing for adaptation during
implementation. The perspectives and insights of all stakeholders (beneficiaries as well as
project implementers) are considered. Stakeholders identify issues, conduct research, analyze
findings, make recommendations and take responsibility for necessary action. The participatory
aspect of the process can be particularly effective because it ensures the ownership and
commitment of the involved stakeholders for any identified corrective actions.


The public or private organization that is responsible for payment of health care expenses.
Payers may be insurance companies, government institutions, self-insured employers, or


The Paris Declaration on Aid Effectiveness

An international agreement to improve aid effectiveness and be held accountable by a series of
indicators and targets as a way of combating poverty in developing countries. Endorsed on 2
March 2005 at the Second High Level Forum on Aid Effectiveness. Over one hundred Ministers,
Heads of Agencies and other Senior Officials adhered and committed their countries
and organisations to continue to increase efforts in harmonisation, alignment and managing aid
for results with a set of monitorable actions and indicators.

Per Capita Health Care Spending

Annual spending on health care per person. In Kenya, the per capita health care spending in
2007 was Ksh. 983 (USD 13.8)

Performance-based Contracting

A contracting approach that emphasizes the achievement of measurable results, for example
raising immunization rates or improving nutritional status. Performance based contracts typically
give contractors a financial reward for meeting or exceeding agreed- upon goals and penalize
them for sub-par performance.

Performance indicator

A variable that allows the verification of changes in the development intervention or shows
results relative to what was planned.

Performance measurement

A system for assessing performance of development interventions against stated goals.


Public Expenditure Tracking Survey

 PETS are tracing surveys, ultimately intended to provide local communities with information
about the level of resources allocated to particular services in their area; perhaps to the local
school or health clinic. They are systematic, tracking the flow of resources through the various
layers of government bureaucracy. This is to determine how much of the originally allocated
resources reach each level and how long they take to get there. The surveys therefore assess
the leakage of public funds and can help to assess the efficiency of public spending and the
quality and quantity of services.


Primary Health Care

Basic or general health care provided outside of a hospital environment, usually by general


A course of action adopted and pursued by a government, Ministry, department or other
individual or organization; any course of action adopted as proper, advantageous, or expedient.
The term is sometimes used less actively to describe any stated position on matters at issue,
i.e., an organization's policy statement on national health insurance. Policies bear the same
relationship to rules (regulations) as rules do to law, except that unlike regulations, they do not
have the force of law.

Money paid out in advance for insurance coverage. A monetary amount paid to an insurer in
exchange for providing coverage under a contract. A periodic payment by the insured to the
Health Insurance Company or prescription benefit manager in exchange for insurance
coverage. This amount varies depending on the health plan in question.

Post Natal Care

Care for a mother and infant in the 6 weeks following birth.


Someone who has less than $1 per day to live on. (World Bank definition)


Public Private Partnership

A Public/Private Partnership brings public and private sectors together in partnership for mutual
benefit. The term Public/Private Partnership covers a wide range of different partnerships,
including the introduction of private sector ownership into businesses that are currently state-
owned, the Private Finance Initiative, and selling Government services into wider markets.

Procurement Plan

A Procurement Plan provides information about the purchase of goods and services, how
suppliers will be chosen, what kind(s) of contract(s) will be used, how suppliers will be
managed, how timeframes for delivery will be scheduled and who will be involved at each stage
of the process. This document should be approved by appropriate individuals before the actual
procurement process begins.


The proportion of a population that is affected with a particular disease at a given time.

Preventive care

Health care that emphasizes disease prevention, early detection, and early treatment, thereby
reducing the costs of health care in the long run. Health care that seeks to prevent disease or
foster early detection of disease and morbidity and that focuses on keeping patients well in
addition to healing them when they do become sick.

Private Sector

A business or company not owned or managed by the government. The private sector for health
care comprises both for-profit and non-profit private individuals and organizations. Private for
Profit health care providers exist to earn a profit for their owners and include private practice
physicians, nurses, and midwives; traditional medical practitioners; hospitals, clinics, and health
centers; and pharmaceutical wholesalers, pharmacies and other retail drug and medical supply
outlets. Not for profit health care providers include nongovernmental organizations (NGOs) and
faith based organizations are also private but define their mission in terms of some social or
public health goal.


Shifting functions, in whole or part, from government to the private sector when there is no
continuing public policy reason to retain responsibility within government, or when that
responsibility can be discharged through regulation

Program Aid

Programme aid is financial assistance specifically to fund a range of general imports, or an
integrated programme of support for a particular sector, or discrete elements of a recipient’s
budgetary expenditure.


This term usually refers to a health care institution (usually a hospital) or doctor who “provides”
care. A health plan, managed care company, or insurance carrier is not a health care provider.
Those entities are called payers.


Poverty reduction strategy

Nationally-formulated strategies to reduce poverty. These aim to ensure broad stakeholder
participation in formulating strategies, improve coordination among development partners and
focus on combined resources of the international community to achieve poverty reduction goals.


Poverty Reduction Strategy Paper

PRSPs describe a country's macroeconomic, structural and social policies and strategies and
programs to promote growth and reduce poverty, as well as associated external financing
needs. PRSPs are prepared by governments through a participatory process involving civil
society and development partners. Kenya’s equivalent of the PRSP is known as the Economic
Recovery Strategy for Wealth and Employment Creation (ERSWEC)

Public Health

The approach to health that is concerned with the health of the community as a whole. The
three core public health functions are: the assessment and monitoring of the health of
communities and populations at risk to identify health problems and priorities; the formulation of
public policies designed to solve identified local and national health problems and priorities; and
ensuring that all populations have access to appropriate and cost-effective care, including
health promotion and disease prevention services, and evaluation of the effectiveness of that

Public sector

In the context of health care, the delivery of health-related goods and services by and for the
government, whether national, provincial, district or local/municipal.

Pull System

A distribution system in which each public health facility determines the quantities of medicines
and medical supplies to be requisitioned from distributors/suppliers.

Push System

A distribution system in which the ministry, procurement unit or warehouse determines
quantities of medicines and medical supplies to be issued to public health facilities


Quality Assurance

A formal, systematic process to improve quality of care that includes monitoring quality,
identifying inadequacies in delivery of care, and correcting those inadequacies.


Quality is the degree to which health services for individuals and populations increase the
likelihood of desired health outcomes and are consistent with current professional knowledge.
Quality can be also be defined as a measure of the degree to which delivered health services
meet established professional standards and consume value judgments. Quality is frequently
described as having three dimensions: quality of input resources (certification and/or training of
providers); quality of the process of services delivery (the use of appropriate procedures for a
given condition); and quality of outcome of service use (actual improvement in condition or
reduction of harmful effects)


Estimation of quantities of specific EMMS needed, including the financial requirements for
purchasing the estimated quantities.


Results-based management

A management strategy focusing on performance and achievement of outputs, outcomes and


Roll Back Malaria

A global initiative -- made up of more than 90 partners -- whose goal is to halve the burden of
malaria by 2010. The partnership was launched in 1998 by the World Health Organization,
UNICEF, UNDP, and the World Bank to provide a coordinated international approach to fighting

Recurrent Revenue

These refer to finances needed to pay for the operating costs of running the services of the
Government. The major sources of these revenues are: Income Tax, Customs and Excise
Duties (Import duty, Excise duty), Value Added Tax Investment Revenue, traffic, land, aviation,
fines and forfeitures and Treasury bills and Bonds issues


The direction of people to an appropriate facility, institution or specialist in a health system, such
as a health centre or a hospital, when health workers at a given level cannot diagnose or treat
certain individuals by themselves, or face health or social problems they cannot solve by


The practice by an HMO or insurance company of purchasing insurance from another company
in order to protect itself against part or all of the losses that may be incurred in the process of
honoring the claims of policyholders.


An assessment of the performance of an intervention, periodically or on an ad hoc basis. As a
note, “evaluation” is frequently used for a more comprehensive and/or more in-depth
assessment than “review.” Reviews tend to emphasize operational aspects. Sometimes the
terms “review” and “evaluation” are used as synonyms.


Reproductive Health

Reproductive health is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity, in all matters relating to the reproductive system and to its
functions and processes.

Risk pooling

The practice of bringing several risks together for insurance purposes in order to balance the
consequences of the realization of each individual risk.

Road Map

A roadmap is a formal written plan that is a proposed or intended method of achievement of one
or more objectives or goals. It includes a communication plan, business scope, work plan, and
financial plan.


Rapid Results Initiative

The rapid results initiative (RRI) is a management tool through which small components of
larger projects can be geared to achieve set results in 100 days. Each RRI aims to achieve a
meaningful and challenging result. Each wave of RRIs is designed to generate new insights
about longer-term goals, strategies, plans, and policies


Structural Adjustment Programmes

Structural Adjustment Programmes (SAPs) are economic policies for developing countries that
have been promoted by the World Bank and International Monetary Fund (IMF) since the early
1980s by the provision of loans conditional on the adoption of such policies. Structural
adjustment loans are loans made by the World Bank. They are designed to encourage the
structural adjustment of an economy by, for example, removing “excess” government controls
and promoting market competition as part of the neo-liberal agenda followed by the Bank.

Secondary Care

Services provided by medical specialists in a hospital environment on an ambulatory or inpatient
basis, usually following a referral from primary care.

Sector Budget Support

Sector budget support is a sub-category of direct budget support. Sector budget support means
that dialogue between donors and partner governments focuses on sector-specific concerns
rather than on overall policy and budget priorities

Sentinel Surveillance

Monitoring of rate of occurrence of specific conditions to assess the stability or change in health
levels of a population. It is also the study of disease rates in a specific cohort, geographic area,
population subgroup, etc. to estimate trends in larger population.

Social Marketing

Social marketing is the planning and implementation of programs designed to bring about social
change and to motivate healthy behaviors using concepts from commercial marketing.Most
social marketing programs sell subsidized contraceptives and other health products through
pharmacies and other retail outlets, or via the service delivery infrastructure of nongovernmental


A doctor who specializes in a particular area of medicine (as opposed to a physician providing
only primary care).


Sexual and reproductive health services.

This is the constellation of methods, techniques and services that contribute to reproductive
health and well-being through preventing and solving reproductive health problems. It also
includes sexual health.


A function of government or other body responsible for the welfare of the population and
concerned with the trust and legitimacy with which its activities are viewed by the population


Stakeholders include all individuals and groups who are affected by, or can affect, a given
operation. Stakeholders can be individuals, interest groups or corporate organizations.

Stakeholder analysis

Stakeholder analysis is identification of people, groups and organizations that should be taken
into account when conducting impact analysis for a particular policy, by examining their interests
and influence on policy. The basic output is the identification and analysis of groups that a policy
is designed to help, as well as those whose assent or involvement is required to make the policy


 According to the Institute of Medicine, standards are authoritative statements of: (1) minimum
levels of acceptable performance or results; (2) excellent levels of performance or results; or (3)
the range of acceptable performance or results.


Sexually Transmitted Infections

Sexually transmitted infection. Disease resulting from bacteria or viruses and often acquired
through sexual contact including having sex (vaginal, oral, or anal intercourse) with someone
who is infected. There are many kinds of STIs including herpes, HIV and syphilis. Some STIs
can also be acquired in other ways (i.e. blood transfusions, intravenous drug use, mother-to-
child transmission). Most STIs, like HIV, are not acquired from partners who are obviously ill, but
rather through exposure to infections that are asymptomatic or unnoticeable at the time of

The term 'STI' is slowly replacing 'STD' (sexually transmitted disease) in order to include HIV

Stop TB

A global strategy to stop the spread of TB around the world. One of its objectives is to promote
implementation of the directly observed therapy short-course strategy (DOTS).

Structural Adjustment Loans

Large loans made by the World Bank or IMF to developing countries which may carry strict
financial and budgetary obligations or required reforms intended to open recipient countries to
private investment and increase the recipient's competitiveness in the global economy. Reforms
are usually orientated towards liberalisation, privatisation and reduction in government

Supply chain

A linked set of resources and processes that begins with the sourcing of raw materials and ends
with the delivery of commodities/supplies to the final customer. It covers suppliers,
manufacturing facilities, logistics service providers, internal distribution centres, distributors,
wholesalers and other intermediaries.

Supply chain management

The coordinated control of the supply chain, from the acquisition of raw materials from suppliers
through their transformation into finished goods to the delivery of commodities/supplies to the
final customer. It involves end-to-end information sharing, planning, resource synchronisation
and performance measurement


Sector Wide Approach

A Sector Wide Approach is a process that entails all significant donor funding for a sector
supporting a single, comprehensive sector policy and expenditure programme, consistent with a
sound macroeconomic framework, under government leadership. Donor support for a sector
wide approach can take any form – project aid, technical assistance or budgetary support –
although there should be a commitment to progressive reliance on government procedures to
disburse and account for all funds as these procedures are strengthened.

SWOT Analysis

A method of analysing Strengths, Weaknesses, Opportunities and Threats at individual or
organisational level.


Traditional Birth Attendant

This comprises women who provide delivery services in the community. This includes traditional
birth attendants who initially acquired their skills by delivering babies themselves or through

Teaching hospital

A hospital that provides education for students in the health professions.

Technical Assistance

Technical Assistance (also referred to as Technical co-operation) is the provision of know-how
in the form of personnel, training, and research and associated costs. It comprises donor-
financed activities that augment the level of knowledge, skills, technical know-how or productive
aptitudes of people in developing countries; and Services such as consultancies, technical
support or the provision of know-how that contribute to the execution of a capital project.

Tertiary Care

The provision of highly specialized services in ambulatory and hospital settings.

Tertiary health Facility

The highest-level facility in the health care system. In Kenya, these are Provincial General
Hospitals and the two National Referral Hospitals, Kenyatta and Moi. They provide the most
specialized and comprehensive care available, typically with the full range of medicine, surgery,
and laboratory services available as well as an on-site pharmacy. Tertiary hospitals serve as the
referral center for the hospitals at the secondary level and may also be teaching hospitals.

“Three Ones” principles

Principles by which governments, working in cooperation with their partners in civil society and
the international community, may greatly reduce the spread of AIDS. Donors, developing
countries and UN agencies agreed to harmonize their efforts around three core principles –
known as the "Three Ones". They agreed to have: one HIV/AIDS action framework that
provides the basis for coordinating the work of all partners; one national AIDS coordinating
authority; and one agreed country-level monitoring and evaluation system.

Tied Aid

Tied Aid is official or officially supported Loans, credits or Associated Financing packages where
procurement of the goods or services involved is limited to the donor country or to a group of
countries which does not include substantially all developing countries


Training Needs Analysis

Training needs exist where there is a gap between the knowledge, skills and attributes required
and those already possessed by employees. The gap is identified through the process of
training needs analysis


Total fertility rates

The average number of children that would be born alive to a woman during her lifetime if the
age-specific fertility rates of a given year are applied throughout her childbearing years. The
total fertility rate in Kenya declined from 8.1 children per woman in the mid-1970’s to 5 children
per woman in 2006.

Total Population

The number of people in the country. Kenya’s total population in 2008 is projected to be 38.3
million and will rise to 39.4 in 2009 and 40.4 in 2010.


Trade-Related Aspects of Intellectual Property Rights

The Agreement on Trade-Related Aspects of Intellectual Property establishes minimum
standards of protection for each category of property rights. The agreement aims to bring
Intellectual Property Rights (IPR) systems around the world together under a common
international set of rules, thus addressing problems of international piracy and IPR
infringements. Trained Traditional Birth Attendant


Under Five Mortality Rate

The probability that a newborn baby will die before reaching age five, if subject to current age-
specific mortality rates. The probability is expressed as a rate per 1,000. The Under Five
Mortality Rate in Kenya in 2006 was 92 deaths per 1,000 live births.

Unmet need for family planning

Estimates of women who would like to prevent or delay pregnancy but are not using
contraception, either because they lack knowledge about family planning or access to services,
or because they face cultural, religious and family obstacles. This includes unmarried sexually
active women who do not wish to become pregnant, women with post-partum amenorrhoea,
women with a current unintended pregnancy, and women who are using less-effective or
unsuitable methods, or using methods incorrectly. It also includes those women who are not
able to ensure childbearing when it is wanted because of reproductive health problems such as
infertility, especially when this is the result of untreated sexually transmitted infection

Untied Aid

Untied Aid is official Development Assistance for which the associated goods and services may
be fully and freely procured in substantially all countries.

User Fees

Charges for primary education and health care at the point of use, user fees were introduced in
poor countries by the World Bank and other donors in the 1980


The use of services and supplies. Utilization is commonly discussed in terms of patterns or rates
of use of a single service or type of service, such as hospital admissions, physician visits, and
prescription drugs.

Tied Aid

In this type of aid the giving (or donor) country also benefits economically from the aid. This
happens as the receiving country has to buy goods and services from the donor country to get
the aid in the first place.

Value for Money

With reference to procurement, the provision of the right goods and services from the right
source, of the right quality, at the right time, delivered to the right place and at the right price
(judged on whole life costs and not simply initial costs)


Voluntary Counseling and Testing

Voluntary counseling and testing is the process by which an individual undergoes counseling
enabling him or her to make an informed choice about being tested for HIV.

Vertical Health Programmes

Vertical programmes (also known as stand-alone, categorical or free-standing programmes or
the vertical approach) refer to instances where “the solution of a given health problem [is
addressed] through the application of specific measures through delivery systems that typically
have separate administration and budgets, with varied structural, funding and operational
integration with the wider health system. Examples of vertical programmes in Kenya include:
Kenya Expanded Programme on Immunization, Integrated Management of Childhood Infections
Malaria, National AIDS/STDs Control Programme, National Leprosy & TB Programme and
Reproductive Health.


World Bank

The World Bank is an international financial institution owned by its 184 member countries. It
was set up at the Bretton Woods Conference of 1944 and is referred to, along with the
International Monetary Fund (IMF) and others, as one of the Bretton Woods Institutions. Its main
objective is to provide development funds to the world's poorest nations in the form of loans and
technical assistance.


World Health Organisation

WHO is a United Nations specialized agency concentrating exclusively on health by providing
technical cooperation, carrying out programmes to control and eradicate disease and striving to
improve the quality of human life. WHO has 191 Member States that meet annually at the World
Health Assembly in Geneva.


World Trade Organisation

Multilateral trading organisation comprising of 142 countries (as of July 2001) who accede to
four major treaties governing almost every area of trade. Ascension into the WTO binds all
members to all treaties and all provisions within the treaties (subject to a few minor exceptions)
although grace periods are granted to individual members states as to when implementation of
treaty provisions take place. The four main WTO agreements are: the General Agreement on
Tariffs and Trade (GATT); the General Agreement on Trade in Services (GATS); Trade-Related
Intellectual Property Rights (TRIPS); and Trade-Related Investment Measures (TRIMS).

Youth Friendly

Characteristics of, for example, policies, programmes, resources, services or activities that
attract young people, meet their sexual and reproductive health needs and are acceptable and
accessible to a diversity of young people.

List of Acronyms/Abbreviations
ACT        Artemisinin Combination Therapy

ADB        African Development Bank

AIA        Appropriation in Aid

AIDS       Acquired Immune Deficiency Syndrome

AIE        Authority to Incur Expenditure

APHIA      Aids Population and Health Integrated Assistance

AU         African Unon

BCC        Behaviour Change Communication

CA         Crown Agents

CBD        Community Based Distribution

CBDA       Community Based Distribution Agent

CBO        Community Based Organization

CBS        Central Bureau of Statistics

CCM        Country Coordinating Mechanism

CCS        Contraceptive Commodities Security

CCSS       Contraceptive Commodities Security Startegy

CDF        Comprehensive Development Framework

CDF        Constituency Development Fund

CEO        Chief Executive Officer

CFO        Chief Finance Officer

CIF        Cost, Insurance, Freight

CHAK       Christian Health Association of Kenya

CHW        Community Health Workers

CMU        Contraceptive Management Unit

CNO        Chief Nursing Officer

COC        Code of Conduct

COC      Combined oral contraceptive

CORPS    Community Owned Resource Persons

CPR      Contraceptive Prevalence Rate

DANIDA   Danish International Development Agency

DARE     Decentralized HIV/AIDS and Reproductive health

DFID     Department for International Development (UK)

DH       District Hospital

DHMB     District Health Management Board

DHMT     District Health Management Team

DMOH     District Medical Officer of Health

DMPA     Depot Medroxyprogesterone Acetate

DMS      Director of Medical Services

DOMC     Division of Malaria Control

DP       Development Partner

DPHNs    District Public Health Nurses

DPM      Directorate of Personnel Management

DR       Drawing Rights

DRH      Division of Reproductive Health

DRHC     District Reproductive Health Coordinator

DVI      Division of Vaccines & Immunization

EAC      East African Community

EC       Emergency Contraceptive

EDL      Essential Drug List

EHS      Essential Health Services

EMMS     Essential medicines and medical supplies

ERP      Enterprise Resource Planning

ERS      Economic Recovery Strategy

ERSWEC   Economic Recovery Strategy for Wealth and Employment Creation

EU       European Union

FBO      Faith-Based Organization

FHI      Family Health International

FP       Family Planning

FPLMP    Family Planning Logistics Management Project

FY       Financial Year

GAVI     Global Alliance for Vaccines and Immunization

GDC      German Development Cooperation

GDF      Global Drug Facility

GDP      Gross Domestic Product

GDP      Good distribution practices

GF       Global Fund

GFATM    Global Fund to combat AIDS, TB and Malaria

GMP      Good manufacturing practices

GOK      Government of Kenya

GTZ      German Technical Cooperation

HC       Health centre

HENNET   Health NGOs Network

HERA     Health Research for Action

HF       Health Facility/Health Facilities

HIV      Human Immunodeficiency Virus

HMIS     Health Management Information System

HQ       Headquarters

HR       Human Resources

HRM      Human Resource Management

HSPS     Health Sector Programme Support

HSRS    Health Sector Reform Secretariat

HSSF    Health Sector Services Fund

ICB     International Competitive Bidding

ICC     Interagency Coordinating Committee

ICPD    International Conference for Population and Development

ICT     Information and Communication Technology

IDA     International Drug Agency

IEC     Information, Education and Communication

IFMIS   Integrated Financial Management Information System

IMCI    Integrated Management of Childhood Infections

IMF     International Monetary Fund

INN     International Nonproprietary Name

IP      Intellectual Property

IRS     Indoor residual spraying

IUD     Intra Uterine Device

IUCD    Intra Uterine Contraceptive Device

JDM     Joint Design Mission

JFA     Joint Financing Arrangement

JICA    Japanese International Cooperation Agency

JPWF    Joint Programme of Work & Funding

JRM     Joint Review Mission

JSI     John Snow Incorporated

KACC    Kenyan Anti-corruption Commission

KAPI    Kenya Association of Pharmaceutical Industries

KBS     Kenya Bureau of Standards

KDHS    Kenya Demographic and Health Survey

KEC     Kenya Episcopal Conference

KEMSA    Kenya Medical Supplies Agency

KEPI     Kenya Expanded Programme of Immunization

KEPSA    Kenyan Association of Private Hospitals and the Health

KFPM     Kenya Federation of Pharmaceutical Manufacturers

KfW      Kreditanstalt für Wiederaufbau (German Financial Cooperation)

KHDS     Kenya Demographic Health Survey

KHPF     Kenya Health Policy Framework

KIM      Kenya Institute of Management

KMA      Kenya Medical Association

KMTC     Kenyan Management Training Centre

KNASP    Kenya National AIDS Strategic Plan

KNDP     Kenya National Drug Policy

KNH      Kenyatta National Hospital

KPI      Key performance Indicators

Ksh      Kenyan Shilling

LAN      Local Area Network

LFA      Local Fund Agent

LM       Logistics Management

LMIS     Logistics Management Information System

LMU      Logistics Management Unit

LPO      Local Purchase Order

LSO      Local Service Order

LSP      Logistics Service Provider

M&E      Monitoring and Evaluation

MCA-TP   Millennium Challenge Account, Threshold Program

MC       Management Consultant

MCA      Millennium Challenge Account

MCC      Millennium Challenge Corporation

MCH      Maternal child health

MDG      Millennium Development Goal

MEDS     Mission for Essential Drugs & Supplies

MIS      Management Information Systems

MOF      Ministry of Finance

MOH      Ministry of Health

MOMS     Ministry of Medical Services

MOPHS    Ministry of Public Health and Sanitation

MOU      Memorandum of Understanding

MSCU     Medical Supplies Coordinating Unit

MSH      Management Sciences for Health

MTC      Medicines and Therapeutic Committee

MTEF     Medium-Term Expenditure Framework

MTR      Mid-Term Review

MTRH     Moi Teaching and Referral Hospital

MTTP     Medium Term Procurement Plan

MVI      Malaria Vaccine Initiative

NACC     National AIDS Control Council

NASCOP   National AIDS/STDs Control Programme

NCAPD    National Coordinating Agency for Population and Development

NCB      National Competitive Bidding

NDP      National Drug Policy

NGO      Non-Governmental Organization

NHA      National Health Account

NHIF     National Hospital Insurance Fund

NHMB     Nairobi Health Management Board

NHSSP    National Health Sector Strategic Plan

NLTP     National Leprosy & TB Programme

NPHL     National Public Health Laboratory

NQCL     National Quality Control Laboratory

NSHIF    National Social Health Insurance Fund

OBA      Output-Based Aid

O&M      Operations & Maintenance

OIT      Open International Tender

ONT      Open National Tender

OP       Office of the President

OTC      Over the Counter

PAC      Public Accounts Controller

PBM      Performance-based Management

PEPFAR   President’s Emergency Plan for AIDS Relief

PER      Public Expenditure Review

PFM      Public Finance Management

PHC      Primary Health Care

PHF      Public Health Facility

PHG      Provincial General Hospital

PHMT     Provincial Health Management Team

PHT      Public Health Technicians

PMO      Provincial Medical Office

PMTCT    Prevention of Mother To Child Transmission

POC      Procurement Oversight Committee

POD      Proof of Delivery

PPB      Pharmacy and Poisons Board

PPDA     Public Procurement and Disposal Act

PPDR    Public Procurement and Disposal Regulations

PPOA    Public Procurement Oversight Authority

PPP     Private Public Partnership

PR      Principal Recipient

PRHC    Provincial Reproductive Health Coordinator

PRSP    Poverty Reduction Strategy Paper

PS      Permanent Secretary

PSCMC   Procurement and Supply Chain Management Consortium

PSK     Pharmaceutical Society of Kenya

PU      Procurement Unit

QA      Quality Assurance

RAC     Resource Allocation Criteria

RFP     Request for Proposal

RFQ     Request for Quotations

RH      Reproductive Health

RHCS    Reproductive Health Commodity Security

RHICC   Reproductive Health Inter-Agency Coordinating Committee

RHDTC   Rural Health Demonstration and Teaching Centre

RHF     Rural Health Facilities

RRI     Rapid Results Initiative

RRI     Rapid Results Initiative

RT      Restricted Tender

SCM     Supply Chain Management

SDP     Service Delivery Point

SDH     Sub District Hospital

SNO     Senior Nursing Officer

SOF     Standard Order Form

SOPs       Standard Operating Procedures

SP         Sulfadoxine/pyrimethamine

SPARHCS    Strategic Pathway to Reproductive Health Commodity Security

SPPO       Senior Principal Procurement Officer

SUPKEM     Supreme Council of Kenya Muslims

SWAp       Sector Wide Approach

SWOT       Strengths, Weaknesses, Opportunity & Threats

TA         Technical Assistance

TB         Tuberculosis

TEC        Technical Evaluation Committee

TFR        Total Fertility Rate

TOR        Terms of Reference

TOT        Training of Trainers

TWG        Technical Working Group

UNAIDS     Joint United Nations Programme on HIV/AIDS

UNDP       United Nations Development Programme

UNFPA      United Nations Fund for Population Activities

UNICEF     United Nations Children’s Fund

USAID      United States Agency for International Development

USD        US Dollar

USG        United States Government

WAN        Wide Area Network

WB         World Bank

WHO        World Health Organization

WHO/AFRO   World Health Organization Africa Regional Office

YFS        Youth Friendly Services

Contracting for Reproductive Health Care: A Guide James E. Rosen December 2000

Department for International Development Glossary and Acronyms. Available from:

European Observatory on Health Systems and Policies Glossary. Available from:

Glossary of Bid and Tender Terms and Acronyms. Available from: http://www.scribd.com

Glossary of Health Care and Health Care Management Terms. Available from

Glossary of Selected Terms and Acronyms. Available from: http://www.health.state.mn.us/e-

Glossary of Terms as Commonly Used in Health Care. Alpha Center: Health Policy and
Planning . http://www.uic.edu/sph/cade/abcmco/basics/gloss.html

Glossary terms. Available from: http://www.nature.com

Glossary of Terms. Available from: http://www.globalhealth.org/child_health/glossary/

Health Economics. Glossary of Terms. Available from: http://www.healtheconomics.nl

Health Sector Medium Term Expenditure Framework (2008/09-2010/2011)

Joint Programme of Work and Funding for the Kenya Health Sector 2006/07-2009/10

Kenya Economic Recovery Strategy for Wealth and Employment Creation 2003-1007

Kenya National Pharmaceutical Policy 2008 – Ministry of Medical Services

Kenya National prevention of Mother to Child HIV Transmission Training Curriculum 2005.

Kenya’s Health Policy Framework

Ministry of Health Sessional Paper No. 2 of 2004 on National Social Health Insurance in Kenya

Ministry of Medical Services: Facts and Figures on Health Related Indicators, 2008

National Contraceptive Commodites Security Strategy, 2007-2010. Ministry of Health, Division
of Reproductive health

OECD Glossary of Statistical Terms. http://stats.oecd.org/glossary/detail.asp?ID=376

Report on the Joint Support Programme to the Kenyan Health Sector, April 2007
Republic of Kenya Code of Regulations

Republic of Kenya Government Financial Regulations and Procedures

The Business of Health in Africa. Available from:

The Second National Health Sector Strategic Plan of Kenya –NHSSP II – 2005–2010

World Bank: http://worldbank.org

World Health Organisaton: http://www.who.int


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