OUR FOCUS AREAS
The organization will spend considerable resources on developing and delivering projects, services, and activities with a core focus on equipping the health workforce needed to strengthen the health systems of Kenya. The programs IHO aims to focus on include coordination and dialogue platforms, data analytics to guide decision-making, capacity building through training, quality of care standards and accreditation, as well as providing technical assistance in strategic planning, policy development, and assessments.
The IHO, in partnership with donors, the national Ministry of Health (MOH), Council of Governors, County Governments, and stakeholders, shall serve as a platform to accommodate thought leadership conversations that can contribute to policy transformation and increased support for the healthcare workforce and health system strengthening in Kenya. IHO is strong at engaging with governments, implementation partners, donors, and respective health workers, from the national to the grassroots level. By working with these stakeholders, IHO shall not only act as a mediator and advocate for change but shall also participate in the execution of this change.
Health systems are complex. Consequently, they are subject to uncertainty that cannot be left only to chance. Informed decision-making is the key to making rational decisions that lead to measurable impact. To achieve this, decisions must be made based on evidence and facts, not speculation. Through detailed data collection and analysis, IHO serves as a knowledge partner to the public, private and faith-based sectors for matters concerning healthcare, health systems, and their effectiveness in Kenya. This data shall be found in reports and briefs published by IHO periodically and as contracted by external organizations with interest in the Kenyan healthcare sector. IHO is strong in data-driven health services and workforce planning and management. In that regard, IHO will become a go-to platform or repository for accurate health data.
With the increasing demand for health workers as projected by the World Health Organization (WHO), there is a need to equip the current health workforce with future skills to be effective, prepared for pandemics and disease outbreaks, productive in their duty to society, and ensure delivery of health outcomes. IHO, in partnership with donors and implementation partners, shall develop training programs geared towards equipping health workers in different cadres and specialties with the necessary skills in such areas as HIV, reproductive, maternal and child health, TB, malaria, pandemic preparedness, and response, data use and analytics, human resources for health, leadership, management, and governance, amongst others. The aim is to improve productivity through up-skilling and retooling the existing health workforce.
The COVID-19 pandemic stretched the boundaries of healthcare systems in Kenya and beyond. It gave us an opportunity to discover gaps in standardization and processes for guaranteeing healthcare quality outcomes. This includes, but is not limited to, the misrepresentation and miscommunication of hospital facility grading where we found hospitals that claimed to be Level 4 and yet after an audit by Ministry of Health personnel, such hospitals were found to be below Level 4. A similar contradiction is seen with the regulatory authorities being involved in not only regulation but active medical practice, thereby leaving room for no impartiality and fair reward and regulation of the health facilities. IHO shall come in to serve as the impartial and independent regulator to audit and advise health facilities on global, regional and local best practices, based on existing standards. In addition, IHO will strive to be at the conversation table in the formulation of local standards towards the improvement of health service delivery.
The WHO 2020 stock estimated 51 million health workers globally (a 29% increase since 2013); however, against WHO’s 2030 target, there is still a shortage of 16 million. Kenya ranks among the 57 HRH-crisis countries in the world with 1.5 health workforce per 1,000 population, against the WHO threshold of 2.3/1,000. These shortages are exacerbated by inappropriate skills mix; insufficiently rationalized, right-sized workforce; chronic absenteeism; frequent workforce strikes; limited increase/change in domestic funding for health workforce; low morale; and inefficiencies in hiring, deployment, performance, and retention, thus compromising Kenya’s ability to ensure quality health service delivery. The health workforce is vital to the core functionality of a health system. Yet, it tends to be overlooked as a key element of upgrading health systems. IHO can see the role of the health workforce through the eyes of health workers and thus understands their needs, including gender equality, women’s empowerment, and decent work. With IHO’s solid knowledge and expertise in HRH, IHO shall provide TA to the government, so the government can better attract, recruit and manage health workers at the national and local government levels.
6. Organizational development support for good governance practices, institutional strengthening and preparation for donor assessments
Drawing on its history and the pool of organizational development consultants at its disposal, IHO shall work with local organizations in the areas of organizational capacity assessments, capacity building, pre-award assessments, and the building of action plans based on capacity assessment findings to address any critical areas for improvement; building governance structures, including support with the establishment of effective boards, developing of board policy manuals and appraisal documents. Further, IHO shall work with other organizations to develop their operational policies and procedures covering key functional areas, including management, finance, operations, and human resources.
While devolution has been embraced, county management accountability for the health workforce without adequate resources has led to a multitude of problems, including late payment of salaries, unclear roles and job descriptions, inadequate supervisor support, and work overload, contributing to low morale and high attrition.
IHO shall provide technical assistance and support to the national government to formulate relevant policies and guidelines, carry out health systems assessments, and develop strategic plans. Further, IHO shall work with the county governments to strengthen county management systems by supporting the translation of national strategies to the county level for better management and supporting county government counterparts to develop their technical, leadership, and governance skills to reinforce local ownership and responsibility.