WORLD HEALTH ORGANIZATION KENYA

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					2nd GENERATION COUNTRY COOPERATION
                 STRATEGY, 2008 – 2013




             Draft summary of key orientations
                                   WHO Corporate policy framework
   The World Health Organization, in contrast to many other organizations, is a member state organization,
    deriving its direction and activities from the World Health Assembly (WHA); the global forum for countries
    to collectively address health issues. Its mission remains “the attainment by all peoples, of the highest
    possible level of health” (Article 1 of WHO Constitution).



   The WHO Secretariat is responsible for carrying forward the agreements made by countries in the field of
    health, at the World Health Assembly, or regionally. Its work is guided by 6 core functions, as agreed by the
    WHA. These are:
    o   Providing leadership on matters critical to health and engaging in partnerships where joint action is needed;
    o   Shaping the research agenda, and stimulating the generation, dissemination and application of valuable knowledge;
    o   Setting norms and standards, and promoting and monitoring their implementation;
    o   Articulating ethical and evidence-based policy options;
    o   Providing technical support, catalysing change and building institutional capacity; and
    o   Monitoring the health situation and assessing health trends.


   The focus of health internationally, as agreed by the World Health Assembly, is put together in the 11 th
    Global Program of Work, 2006 – 2015. this outlines 7 priority areas for global health as (1) Investing in
    health to reduce poverty; (2) Building individual and global health security; (3) Promoting universal coverage,
    (4) gender equality, and health related human rights; (5) Tackling the determinants of health; (6)
    Strengthening health systems and equitable access; (7) Harnessing knowledge, science and technology; and
    Strengthening governance, leadership and accountability.



   The expectations of the WHO secretariat in supporting attainment of these health priorities is elaborated in
    its Medium Term Strategic Plan, MTSP, 2008 – 2013. This focuses on 5 main areas for providing
    interventions: (1) public health interventions; (2) global health security; (3) determinants of health; (4) health
    systems development; and (5) Leadership and enabling.



   Within the AFRO region, these focus areas are translated into the “Strategic Orientations for WHO Action
    in the African Region 2005-2009”. These orientations are focused on 5 main areas of providing
    interventions. They are (1) Strengthening the WHO country offices; (2) Improving and expanding
    partnerships for health; (3) Supporting the planning and management of district health systems; (4)
    Promoting the scaling up of essential health interventions related to priority health problems; and (5)
    Enhancing awareness and response to key determinants of health.



   The overall work of the WHO secretariat is therefore translated into 13 Strategic Objectives that guide its
    activities and functioning.


   The previous WHO cooperation in the country was guided by the 1st generation CCS. It was developed in-
    line with the Kenya Health Policy Framework (KHPF) and was to be operationalised in biennial plans and
    budgets. It was based on five program components, based on WHO’s comparative advantage and Areas of
    Work. These were health systems development; disease prevention and control; reproductive and child
    health; health promotion and environmental health.
   Resource flows to support the organisation’s activities in Kenya increased over the period, from under 1
    million US$ for the 2002/03 biennium, to over 20 million US$ for the 2006/07 biennium. Human resources
    have also increased, from 31 staff in 2002 to 52 staff in 2006.

                    Mission, priorities and strategic objectives for CCS 2
   The 2nd generation Country Cooperation Strategy in Kenya is a translation of the WHO secretariat
    strategic agenda at the country level, in the context of the Country priorities and WHO available and
    potential capacities. It will aim to:
    o   Provide the strategic direction for the activities of the WHO secretariat in Kenya for the period 2008 – 2013
    o   Define the Medium Term objectives and approaches for WHO in Kenya, to guide the operational activities in the
        Biannual operational plans and budgets
    o   Provide a program structure to reflect how the WHO office in Kenya will function, and collaborate with the other levels of
        the organization


   The work of the WHO secretariat in the 2nd generation CCS is summarized in the following mission
    statement. “Contributing towards the attainment of the highest possible level of health for all the people in
    Kenya through providing technical leadership in support of the Government and its partners to ensure an
    enabling policy framework, strengthened systems built on evidence based policies, guidelines and standards”

   The priorities of the 2nd generation CCS are based on elaboration of how the WHO secretariat would
    contribute towards attainment of the WHO strategic objectives, in the context of the Kenya Health Sector
    priorities as outlined in its Joint Program of Work and Funding (JPWF). There are 4 priorities proposed,
    with strategic objectives to guide attainment of these priorities. These are:


    o   Priority area 1: To build health security at the household, community and national levels;

           Strategic Objective 1: To prevent and reduce the health, social and economic burden of communicable and non
            communicable conditions

           Strategic Objective 2: To reduce morbidity and mortality and improve health during key stages of life, while
            promoting active and healthy ageing for all individuals
           Strategic Objective 3: To reduce the health consequences of emergencies, disasters, crises and conflicts, and
            minimise their social and economic impact


    o   Priority area 2: To advocate for policies and strategies to address determinants of health;
           Strategic Objective 4. To address the underlying social and economic determinants of health
           Strategic Objective 5: To improve nutrition, and food safety throughout the life-course and in support of public
            health and sustainable development



    o   Priority area 3: To support governance and facilitate strengthening of health systems for
        universal and equitable access to quality health services;
           Strategic Objective 6: To improve governance, financing, staffing, organisation and management of quality and
            accessible health services informed by evidence and research
           Strategic Objective 7: Ensure improved access and quality of medical products and technologies, including
            appropriate regulation, safety and standards on traditional medicines
    o   Priority area 4: To provide technical leadership on matters of health; and promote partnership
        and networking.
            Strategic Objective 8: Provide leadership, based on WHO norms and standards, foster partnership and
             collaboration in health to advance health development
            Strategic Objective 9: Strengthen the capacities of the country office to enable it carry out its mandate efficiently
             and effectively



                          Expected results against each Strategic objective

Strategic Objective 1: To prevent and reduce the health, social and economic burden of communicable
and non communicable conditions
The main strategic approach of WHO will be to provide technical guidance, and leadership towards
introduction, scale up, and strengthening of strategies and interventions for prevention, early detection,
diagnosis, management and control of communicable, non communicable, emerging conditions. This includes
strategies that will promote healthy lifestyles and reduce risk factors to disease, in line with the country’s strategic
approach.

Expected results
    Strengthened Immunization Services and support introduction of new technologies through district
         based monitoring and Integrated services
    Strengthened VPD Surveillance and prompt response for outbreaks
    Capacity strengthened in control efforts for defined NTDs
    National capacity for IDSR strengthened and monitored
    International Health Regulations minimum core capaicty built
    National capacity for prevention and response to major epidemics and pandemic prone diseases
         strengthened
    Policy framework to support prevention, treatment and care of malaria, TB and HIV/AIDS
         strengthened
    Strengthened ATM laboratory capacity and networking
    Delivery of integrated prevention, treatment and care interventions for HIV/AIDS, Malaria and TB is
         expanded and strengthened
    Equitable access to essential medicines for the prevention and treatment and care ATM conditions
         strengthened
    Availability of HIV/AIDS, malaria and TB information through national surveillance, monitoring and
         evaluation systems strengthened
    Political commitment and partnership strengthened and sustained for HIV/AIDS, malaria and
         tuberculosis prevention and control through appropriate advocacy
    Advocacy and support provided to increase political, financial and technical commitment in Kenya in
         order to address chronic non-communicable conditions (including mental and behavioural disorders,
         violence and injuries and disabilities)
    Enhanced national capacity to collect, analyze, disseminate and use data on the magnitude, causes and
         consequences of chronic non-communicable conditions (including mental and behavioural disorders,
         violence and injuries and disabilities)
    Guidance and support provided to national authorities for development and implementation of policies,
         guidelines, strategies and regulations for chronic non-communicable conditions, mental and behavioural
         disorders, violence and injuries and disabilities
    Health promotion capacity improved
    Capacity to address/prevent public health problems associated with tobacco enhanced.

Strategic Objective 2: To reduce morbidity and mortality and improve health during key stages of life,
while promoting active and healthy ageing for all individuals.
The strategic approach of WHO will focus on supporting the country in scaling up interventions towards
attaining universal access for effective public health interventions to promote maternal, newborn, child and
adolescent health.

Expected results
    Policy framework and capacity for implementing child survival strategies strengthened
    National capacity to implement initiatives to ensure skilled care for pregnant women and newborns
         enhanced
    Monitoring and evaluation for reproductive health strengthened
    Child Health development interventions strengthened
    Implementation of adolescent friendly health services scaled up
    National capacity in the screening and management of reproductive tract cancers enhanced
    National capacity to carry out RH and child health research, surveys and evaluations enhanced.
    Gender and reproductive rights in service delivery mainstreamed into the National Reproductive Health
         Strategy

Strategic Objective 3: Reduce the health consequences of emergencies, disasters, crises and conflicts,
and minimize their social and economic impact.
The strategic approach of WHO will focus on strengthening the health response in emergencies, by enhancing
coordination of partners in joint planning, response and information management.

Expected results
    National capacity to co-ordinate detection, confirmation, risk assessment and response to epidemics
         and other public health concern enhanced
    Emergency Preparedness and Response at provincial and district levels in the high risk and vulnerable
         districts strengthened

Strategic Objective 4: To address the underlying social and economic determinants of health, including
healthy environments
The strategic approach of WHO will focus on supporting the country to align its health interventions and overall
national developmental agenda to ensure social, and economic determinants are appropriately addressed, and in
the context of a human rights, and gender based approach.

Expected results
    Information on impact of social and economic determinants of health on health outcomes used to guide
         intersectoral interventions in health
    Mainstreaming of gender and human rights in operational approach for the health sector strengthened
    Policy framework on priority environmental health risks strengthened
    Implementation of primary prevention interventions that reduce environmental health risks
         strengthened
    Occupational health policy framework strengthened

Strategic Objective 5: To improve nutrition, and food safety throughout the life-course and in support
of public health and sustainable development.
The strategic approach of WHO will focus on building capacity to establish, promote and implement a food
safety, nutrition, and environmental health agenda that facilitates creation of necessary intervention synergies and
linkages between programmes and partners.

Expected results
    Coordination and networking, on nutrition and food safety strengthened
    Strengthen national capacity on food safety and nutritional requirements for specific populations in need
         (such as pregnant and breastfeeding mothers, Orphans, adolescents and elderly etc) and key food safety
         actions of importance through the adapt
        Establishment of systematic monitoring of nutrition activities and surveillance systems including early
         warning systems for nutrition
        Implementation and monitoring of nutrition interventions strengthened through development and
         updating of policies, strategies, guidelines, tools and development of operational plans
        Strengthening the implementation of micronutrients strategies through the revision/updating and
         dissemination of policies, guidelines, tools and manuals and monitoring of its implementation
        Food borne disease surveillance, prevention and control systems strengthened


Strategic Objective 6: To improve governance, financing, staffing, organization and management of
quality and accessible health services informed by evidence and research
The strategic approach of WHO will focus on providing technical guidance and leadership support to revitalize
and strengthen the different elements of the health system

Expected results
   - Implementation of the Primary care approach in Kenya enhanced
   - Governance, partnership and stewardship in health enhanced
   - Performance monitoring process for the sector enhanced
   - Utilization of research to inform and guide policy strengthened
   - Equitable distribution of health workers enhanced
   - Availability of information on equity of health care financing increased

Strategic Objective 7: Ensure improved access and quality of medical products and technologies,
including appropriate regulation, safety and standards on traditional medicines
The strategic approach of WHO will focus on supporting development of relevant policies and strategies of
ongoing scale-up towards universal access to healthcare.and elaborate policy framework for appropriate use of
traditional medicines and facilitate integration within the EAC, harmonization of medicines regulation and
procurement systems.

Expected results
    Systems for Good Pharmaceutical Procurement and Supply Management strengthened
    National policy framework on medicines, including traditional medicine enhanced
    National medicines regulatory systems strengthened
    Quality and Safety of medical products & technologies improved
    National guidance on appropriate medicines use, including use of traditional medicine enhanced
    National guidance on standard treatments enhanced

Strategic Objective 8: Provide leadership, based on WHO norms and standards, foster partnership and
collaboration in health to advance health development
The strategic approach of WHO will focus on promoting the visibility and presence of WHO in the country,
through strengthened coordination, leadership and partnership building in the health sector.

Expected results
    Alignment and reprofiling of WHO Kenya enhanced
    Financing of WHO Kenya increased
    Monitoring of implementation of WHO Kenya Strategic approach strengthened

Strategic Objective 9: Strengthen the capacities of the country office to enable it carry out its mandate
efficiently and effectively.
The strategic approach of WHO will focus on strengthening the management and development of resources in
WHO Kenya, to be able to efficiently respond to the expectations of Ministry of Health and its cooperating
partners.

Expected results
         Alignment of country office activities and plans with country priorities strengthened
         Financial management activities in the Country office strengthened
         Harmonization of planning and management systems improved
         Mainstreaming of Human Resources in WHO Kenya strengthened
         Information management in WHO Kenya strengthened
         Managerial and administrative support in WHO Kenya strengthened
         Working environment in WHO Kenya improved


                         Implementation, monitoring, review and follow up
    For each of these strategic Objectives, a strategic approach, indicators, and expected results are defined. The
     strategic approach, and indicators are elaborated in the proceeding table.

    Expected results form the basis of activities and products to be developed and implemented in the
     operational 2 year Biannual Plans of Work. The key Expected results shall be elaborated in the CCS 2, and
     form the linkage between the CCS and the WHO operational plan, the BPOA.

    Monitoring process shall be aligned to the National Sector monitoring and review process. Indicators used
     are results based, and as much as is feasible, should correspond to sector’s indicators
          o    Annual progress shall be elaborated against the planned activities in support of Health Sector AOP
          o    Mid Term Review of the CCS 2 shall be carried out based on the orientations agreed in 2010 at the
               NHSSP II evaluation and new NHSSP III
          o    End term evaluation of the CCS shall be aligned to the Mid Term Review of the NHSSP III

         Budgets for financing activities shall also be elaborated in BPOA’s. the budget for the 1st BPOA (2008 –
          2009), elaborated by WHO MTSP strategic objective, is highlighted below.


                                    Budget distribution for BPOA 2008 – 2009, US$
                              WHO MTSP Objective                                      Regular    Voluntary        Total
                                                                                      Budget    Contributions
1. To reduce the health, social and economic burden of communicable diseases          310,000     4,174,000     4,484,000
2. To combat HIV/AIDS, tuberculosis and malaria                                       123,000     4,970,000     5,093,000
3. To prevent and reduce disease, disability and premature death from chronic         130,000      219,000       349,000
noncommunicable conditions, mental disorders, violence and injuries
4. To reduce morbidity and mortality and improve health during key stages of life,    265,000     1,344,000     1,609,000
including pregnancy, childbirth, the neonatal period, childhood and adolescence
and improve sexual and reproductive health and promote active and healthy aging
for all individuals
5. To reduce health consequences of emergencies, disasters, crises and conflicts,     49,000      1,623,000     1,672,000
and minimise their social and economic impact
6. To promote health and development, and prevent or reduce risk factors for          135,000     244,000       379,000
health conditions associated with use to tobacco, alcohol, drugs and other
psychoactive substances, unhealthy diets, physical activity and unsafe sex
7. To address the underlying social and economic determinants of health through       78,000       53,000       131,000
policies and programmes that enhance health equity and integrate pro-poor,
gender-responsive, and human rights-based approaches
8. To promote a healthier environment, intensify primary prevention and influence     86,000      195,000       281,000
public policies in all sectors so as to address the root causes of environmental
threats to health
9. To improve nutrition, food safety and food security, throughout the life-course,   67,000      537,000       604,000
and in support of public health and sustainable development
10. To improve health services through better governance, financing, staffing and     287,000     2,548,000     2,835,000
management informed by reliable and accessible evidence and research
11. To ensure improved access, quality and use of medical products and                74,000      353,000       427,000
                              WHO MTSP Objective                                      Regular      Voluntary        Total
                                                                                      Budget      Contributions
technologies
12. To provide leadership, strengthen governance and foster partnership and           685,000       230,000        915,000
collaboration with countries, the United Nations system and other stakeholders in
order to fulfil the mandate of WHO in advancing the global health agenda as set
out in the Eleventh General Programme of Work
13. To develop and sustain WHO as a flexible, learning organisation, enabling it to   733,000       352,000       1,085,000
carry out its mandate more efficiently and effectively
                                        Total                                         3,022,000    16,843,000     19,865,000

				
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