ENGAGING PRIVATE HEALTH FACILITIES

IN FINDING MISSING TB CASES:

KIRINYAGA COUNTY
Esbon Gakuo
Health Programs Coordinator, Kirinyaga
&
IMPACT Distinguished Fellow 2022
 KIRINYAGA County
Area -1,479 KM
Population -610,411 (Census, 2019)
Density -413 Persons/Km2 Mt Kenya
Forest

ETHIOPIA Legend
UGANDA

SOMALIA

Public Hospitals
Private For Profit Hospitals
Faith Based Hospitals
INDIAN Primary Healthcare Facilities
TANZANIA OCEAN
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 The Private Health Sector is the 1st Port of
call for many seeking care in Kirinyaga
Distribution of Health Facilities in Kirinyaga by He alth Facility of Initi al Care Se e king2
ownership1
100%

GoK
26% Private Health
Facilities 47%

Proportion of people seeking care

50%

63% 11% GoK Facilities

53%

0%
Private-Not-For Profit Private-For-Profit
GoK Facilities Private Health Facilities

2 3
1
Kirinyaga Health Sector Annual Performance Report FY 20/21 TB Patient Pathway Analysis, 2016
 Many Potential TB cases Missed in Private Health Facil-
POTENTIAL TB
CASES MISSED
ities in Kirinyaga, 2012-2020
National Target: 25%*
2020 11.6
2019 13.6
2018 12.4
2017 16.2
2016 10.8
2015 12.2
2014 13.5
2013 15.3
2012 9.7
0 10 20 30 40 50 60 70 80 90 100

Proportion (%)

Non-State Healthcare Providers Public Health Facilities *2019-2023 National Strategic Plan for TB & Lung Diseases

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 SWOT ANALYSIS OF PRIVATE PROVIDER
ENGAGEMENT FOR TB CARE
INTERNAL
STRENGTHS
• Presence of a robust TB monitoring system
• A wide network of Private healthcare
providers
• Availability of TB Policy documents,
Treatment guidelines, Medicines and
diagnostic commodities
BENEFICIAL
OPPORTUNITIES
• Acceptability of Private health facilities by
community
• Adoption of new and appropriate TB
diagnostic techniques
• Working with NHIF Accreditation system as a
means of scaling TB services in the private
sector
EXTERNAL
WEAKNESSES
• Sub-Optimal engagement of the Private
Health providers
• Unmapped private health providers
• Under-involvement of Community Strategy
• Shortage of experienced implementers
• Insufficient understanding of private health
markets HARMFUL
THREATS
• High staff turnover
• Resistance-to offer TB services in Private
sector
• Fragmented Private Providers
 STAKEHOLDER MAPPING & ANALYSIS

• Private Health • General Public • MoH-TB Program • Media

care Providers • TB Patients • County Health
• Public Health Department
Management
Care Providers
• Politicians
• TB Program
• Partners/NGOs
coordinators

Supply Demand Policy Others

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 POWER/INTEREST GRID FOR
STAKEHOLDER PRIORITIZATION
LATENTS; SATISFY PROMOTERS: MANAGE

County TB Private Health

Coordinator Providers

Politicians MoH-TB Program

County Health
POWER/IFLUENCE

Partners Leadership

APATHETICS; MONITOR DEFENDERS: INFORM

Community TB Patients
Media Members

Public sector Health

workers

INTEREST 10
 “Tuberculosis Programme
STAKEHOLDERS Is Public Sector Driven…”
SENTIMENTS Private Practitioner

“Observation of TB DOTS Is
Difficult and costs me time and
money”
Private Practitioner

Government should treat

us as partners and not
adopt a “stick” approach
Private Practitioner

“I have witnessed several

Private practitioners who are
willing to engage on
providing TB care”
TB Program Coordinator
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 OBJECTIVE TREE ANALYSIS
Increased Productivity Decreased need for hospital care Decreased TB-related
Morbidity & Mortality

Ends Decreased TB cases in the community

Increased Tuberculosis Case Finding in Kirinyaga County

Main Objective: Enhance TB Diagnosis and Treatment in Private Health Facilities in Kirinyaga County
•

Ensure Effective leadership & Strengthen community, facility and

stewardship of Public-Private Optimize delivery of TB services in
Private Health Facilities  TB diagnostic linkages in Kirinyaga
Partnership of TB Prevention & Care county

Enhance capacity of Continuous

HCWs in Private OJT/
Means facilities to provide Technical Establish a network support TB Patient/
Assistance sample networking and referral 15
TB care
LOGICAL FRAMEWORK

Reduce the incidence of Tuberculosis

Goal/Overall Objective (Impact
in Kirinyaga by 40% by end of 2023

Increase Proportion of people

Increase private health facilities (Private
with TB diagnosed in Private
Purpose
& FBOs) (Outcomes)
providing TB treatment
health facilities to 25% by June
services from 28% to 50% by June 2023
2023

All private health Strengthened Well trained

facilities Mapped for linkages to TB Continuous
HCWs in Private
engagement Outputs
in TB (Results)
diagnosis and care health facilities
mentorship to
care in Private facilities Private facilities
on TB care
Train 170 Conduct
Conduct a mapping Network to support HCWs from
TB Patient/Sample Supervision &
Facilities
Activities
exercise for all Private
networking and
private health
facilities on TB
Mentorship on TB
referral care to private
care facilities

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CALL TO ACTION
More collaboration &
Partnerships

Tap into Private Sector innovation

Leverage on expertise

More investment
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THANK YOU

24