Health Systems Advocacy Quarterly Report Introduction We are in the first quarter of HSA. The first three months were focused on assigning project teams to the program, defining program activities, composing country teams and aligning work plans. In the course of the program a more systematic quarterly report form will be designed. For the time being updates on the progress of your work as a program manager in one of the countries were HSA is active is being asked with this form. Organization Name: Amref Health Africa in Kenya Planning Period: April 2016 October 2016 Reporting Period : January 2016 March 2016 1. Programme process (1: Please use provided table to explain your work in the past three months; 2. Increase the rows and columns of the table below depending on the number of activities you like to mention) Brief description of the activity Key results/ achievements Remarks Comments Held Project inception meetings at County Level- Siaya County, Kenya The project introduced the HSA project in Siaya County, through the inception meetings at County level where various stakeholders, public government institutions as well as private sector members were present. The project will continue sensitizing stakeholders at county and national level Held Inception meeting with regional partners-amref Netherlands, Amref HQ, ACHEST, HENNET, MACs and (through skype) WEMOS and HAI. The governor for Siaya County committed his support to the project initiatives in order to address challenges in Human Resources for Health (HRH) & Sexual Reproductive Health (SRH) commodities During the period, the project team held an inception meeting with various partners whose objective was to familiarize with the project, discuss specific partner plans, baseline survey as well as to come up with action points for the inception period. The partners present were: Amref Health Africa in Netherlands, Amref Health Africa- HQ and KCO The senior Policy Officer from the Embassy noted the meeting was informative. She highlighted that the Embassy needs to be informed on the specific advocacy issues in Kenya and will work with the respective teams; she also highlighted that in as 1 P a g e
project staff, ACHEST (African Centre for Global health and social transformation), HENNET, MACs and (through skype) WEMOS and HAI. A senior policy officer- Naisola Likimani representing the Embassy of the Kingdom of the Netherlands in Kenya was equally present to clarify the roles of the Dutch government during implementation. Various issues were discussed that included: much as they are they are part of the donors, they are also partners and will be involved in high level advocacy should this be required. Governance structure of the HSA programme Various roles and mandates of the different partners- that the partners should work in complementarity whether at the county, national, regional and global level. Launch of project in Kenya- it was recommended that the launch should be conducted after baseline survey All the partners shared their M & E practices in advocacy and discussed on the baseline survey and reporting standards as required by the donor. As part of its coordinating mandate, Amref Netherlands will guide the different countries on the baseline survey to ensure standardization. Project team attended a committee meeting on reproductive health care bill, 2014 The Reproductive Health Care Bill (2014) adopts a comprehensive and rights based approach as indicated in the action plan of the International Conference on Population and Development (ICPD), the Constitution of Kenya 2010, and other international obligations such as: the Abuja Declaration and the Protocol to the African Charter on Human and Peoples Rights on Rights of women in Africa (Maputo Protocol). It is an act of parliament to provide for the recognition of reproductive rights, to set the standards of reproductive health, provide for the right to make decisions regarding reproduction free from discrimination, coercion and violence and for connected purposes. As a result of the meeting, the HSA Kenya alliance is now part of the platform (stakeholders) revising the bill which we anticipate will be passed before the next general elections in 2017. The project will closely work with the legislators (parliamentarians, MCAs, women representatives) to identify HRH & SRH polices, and laws for amendment, analysis and review. The bill seeks to: 2 P a g e During the period, the project team attended a meeting whose aim was to review the Increase the political will and create supportive policies, secure resources and drive a focused,
amendments to the reproductive health care bill, 2014. Various clauses were deleted and respective amendments provided to the bill in respective areas mainly: Access to contraceptives and family planning services, Safe motherhood Termination of pregnancy Child health care as well as reproductive health of adolescents. coordinated response to preventing maternal mortality. Advance the cause of maternal and new born health Address persistent sexual and reproductive health and reproductive rights inequalities and discrimination on any grounds in order to enhance development. Held Monthly HSA Country management Group meetings, for the Kenya Alliance. In the period under review, the project has been having monthly meetings with the HSA alliance members for the Kenyan chapter to discuss and plan for advocacy activities. As a result of the country management group meetings, the management structure was established and respective terms of reference (TORs) developed: Country management Group- Has all alliance partners and meets on a monthly basis for planning of project activities National Advisory Committee- Has various stakeholders- Ministry of Health, Private sector actors and Public sector actors- Meets on a quarterly basis for review and advisory role to project alliance members Three HRH unions-kenya Medical Practitioners and Dentists Union (KMPDU), Kenya Clinical Officers Union (KCOU) and the Nurses Union have shared their challenges with the project team,some of which include: The HSA project team will be working with the unions in order to: Follow up on implementation and evaluation of HRH polices Advocate for equitable distribution of health care workers; Doctors, clinical officer & nurses in the health facilities The project will also align with the various ministries and closely work with government officials for ownership and sustainability purposes. Further at the national level, the unions will participate in the HRH interagency coordinating committee (HRH-ICC) forum, as well as conduct diplomatic lobbying with members of parliament and the senate. Devolution of Healthcare in Kenya has brought disparities in HRH management. There is inadequate public awareness, poor perception and involvement on the right to quality health care debate Bread and Butter employment preoccupation Salary delays, allowances slashed, promotions stalled, poor pay & harassments for the union members Lack of resources for robust health reform campaigns, institutional database, secretariat development, leadership development. 3 P a g e
Held a pre-inaugural meeting in Kampala, Uganda on 13 th to 16 th March with Amref Health Africa implementation offices (Netherlands, HQ Uganda and Kenya) Attended the HSA inaugural meeting with all partners- (representative of the donor, Ministry of foreign Affairs- Netherlands, international partners, regional- Africa partners as well as country level partners on 17th to 19th in Kampala, Uganda. 4 P a g e The project is in the process of establishing a Medicines Transparency Alliance (META) at national level with various stakeholders in the field of SRH commodities. Various partners in SRH commodities have been mapped. The project will also establish a multi-stakeholder platform for HRH issues. The project-amref staff, held a pre-inaugural meeting with all Amref Health Africa Implementing offices whose objectives were to: Have a better understanding of the HSA program in the different countries and overall HSA project governance structure Strategize on linkages between projects in the different countries including the regional, global and Netherlands projects As a result, the governance structure in general was presented and the members present shared the challenges being faced so far in the inception phase (for example timely communication flow from program management group- PMG). It was agreed that the PMG will communicate in harmonization to all partners in a timely manner. The countries present also shared their best practices and networks that the alliance will build on, the partner/alliance structure, their plans for year 1, the opportunities for their respective countries and the foreseen challenges. For the Kenyan chapter, some of the best practices that the alliance will work with are: Networking and collaboration with already existing platforms on HRH and SRH as well as Building synergies with existing Amref projects in different counties in Kenya. Some of the existing opportunities are: signed treaties that Kenya is signatory as well as implementation, review and analysis of the existing policies, bills & laws. The Health System Advocacy program aims to strengthen health systems to deliver equitable, accessible and high-quality SRHR services. Partners at the international level, national and country level include: Amref Flying Doctors/Amref Health Africa, African Center for Global Health and Social Transformation (ACHEST), Health Action International (HAI), Wemos and the Dutch ministry of Foreign Trade and Development Cooperation. Since inception, the HSA alliance The team further discussed the local and international advocacy and how it will shape Amref programs, capacity building agenda based on advocacy strategies; the need to have flexible programming and finance given the nature of the project, and similarly how the HSA programme links with the global advocacy strategy. During the meeting, there was an inaugural ceremony of the HSA project in Uganda, where the minster for Health-Uganda attended the forum. She pledged government s support and willingness to dialogue with CSOs on HRH & SHR issues affecting communities. The donor representative further alluded that it s paramount for the
members have been having start up and kick-off meetings. On 17th to 19th March the alliance held an inaugural meeting which was strategically placed a the mid inception phase so as to: Ensure participants acquaint themselves among all team members of the HSA alliance Share on status of plans, inception phase activities Align plans across levels of programme activities including country programmes, thematic and strategy areas Agree on actions, outputs and outcomes required for successful implementation phase regions and countries to learn from each and further work closely work with the Dutch ministry-embassy at county level. Participants were reminded of the theory of change, program vision and goals. The co-partner organizations (Amref Health Africa, ACHEST, HAI & Wemos) introduced themselves and shared their organizations and their role in promoting health for all. The country teams (Kenya, Uganda and Zambia) and international teams (Netherlands- Europe) thereafter presented on their status of inception phase and year 1 action. The members further discussed: Key thematic areas (HRH & Medical products and commodities). It was noted in as much as the focus is on the two areas; the other four thematic areas (leadership and governance, health care financing, HMIS & service delivery) will indirectly be addressed to ensure strengthened health systems. Project strategies in length: these include capacity building of health stewards & CSOs on advocacy, lobby and advocacy as well as gender & inclusivity Baseline study plans- outcomes, outputs, methodologies and additional questions 2. What success stories/best practice/innovations you would like documented? None at the moment 5 P a g e
3. Highlights of Key events (High level meetings, Visitors, Advocacy issues) Meeting with the Governor Siaya County at Amref Health Africa Kenya Country Offices On 11 th February, the project manager attended a meeting at Amref Health Africa Country offices where the governor for Siaya County and the county s first lady Rosella Rasanga met with the senior management team at the Kenya Country Offices. The governor was briefed about Amref Health Africa and its role in promoting lasting and sustainable health changes in Africa. He pledged his support to work with Amref Health Africa to ensure that the people of Siaya County improve their health status. As a key action point, the project will continue building rapport with the different leaders in Siaya County including Members of County Assemblies (MCAs) to ensure that HRH and SRHR issues are given priority in the county s budget and implementation of the same. Training on leadership, protocol and diplomacy The project manager attended the 2016 Master class on protocol and diplomacy for the UN agencies, international organizations and major corporations by the cornerstone global leadership foundation, on 7th to 11th March 2016 in Johannesburg South Africa. The key learning objectives were: Real definitions of protocol, etiquette, diplomacy, national symbols, flag protocol, official table precedence, official seating arrangements, forms of address, official international visits, international cultural diversity, interacting with VIPs, event management, diplomatic communication skills with stakeholders, international cross cultural diplomacy, dress code, global dining etiquette as well as public speaking. As a result of the training, the key deliverables include: Dissemination of the training package to staff- plans are underway Coming up with/review organization protocol and table of precedence for the organization Train staff on protocol and diplomacy, this will be crucial during our engagement with legislators, governors and Government officials 4. Challenges experienced and actions taken Delay in startup of the project baseline survey, necessary communication made to PME group for further guidance regarding the baseline survey. 5. Lessons learned Involvement of different stakeholders from inception is key to ensuring success and buy-in at the various levels: County and National level. The project team has continued to sensitize all partners at different levels in Kenya during the inception phase. Inauguration built on a network platform that will enhance our advocacy strategy at the National and County level. Sharing of tools for stakeholders mapping, Policy review analysis from alliance members like AMREF Flying Doctors in Netherlands, Wemos, ACHEST and HAI will enhance our success in implementation of the intervention. 6 P a g e
6. Key activities set for the planning period Attend a Strategic Partners Meeting - Dialogue and Dissent, invited by the Embassy of the Kingdom of the Netherlands Introductory meetings at County and National level Baseline survey- Identification of succinct advocacy issues in HRH & SRH commodities at national and county level Dissemination of project baseline survey findings Project Launch Country management group meetings- Monthly National Advisory group meetings Establishment of the Medicines Transparency Alliance( META) platform for SRH commodities Establishment of the HRH platforms Development of project strategy documents- Advocacy plan Participation in stakeholder forums- CSO platforms, Technical working groups, HRH interagency coordinating committee (ICC) Capacity development of implementing team and subcontracting partners 7 P a g e