REPUBLIC OF KENYA
COUNTY GOVERNMENT OF TURKANA
KIBISH SUB COUNTY
SOCIAL INTELLIGENCE REPORT
SEPTEMBER 2018
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TABLE OF CONTENT EXECUTIVE SUMMARY ...... 4 SOCIAL INTELLIGENCE REPORT ...... 5 Relevance of Social Intelligence Report ...... 5 Methodology ...... 5 Analysis of SIR ...... 5 CHAPTER 1 ...... 7 BACKGROUND INFORMATION ...... 7 1.1 COUNTY LEVEL ...... 7 1.1.1 Location, size, administrative units and political units...... 7 Administrative Units by Sub-County ...... 7 Political Units by Sub-County ...... 7 1.1.2 County subdivision...... 8 1.1.3 County population and area coverage ...... 8 1.1.4 Language and culture ...... 8 1.1.5 Climate...... 8 1.1.6 Economic activities ...... 8 1.2 SUB-COUNTY LEVEL ...... 9 1.2.1 Position and size of the Sub-county ...... 9 1.2.3 Administrative and political Units ...... 9 Table 1: Sub County Administrative Units ...... 9 Table 2: Sub-County Political Units ...... 9 1.2.3 Settlement Structure ...... 9 1.2.4 Economic activities ...... 10 1.2.5 Topographic features ...... 10 1.2.6 Climatic Information ...... 10 1.2.7 Population ...... 10 CHAPTER 2 ...... 11 EDUCATION AND LITERACY SECTOR ...... 11 2.1 COUNTY LEVEL INFORMATION ...... 11 2.2 FACILITY LEVEL INFORMATION ...... 11 2.2.1 Loruth Primary School ...... 11 Brief background of the school ...... 11 The school Infrastructure ...... 12 Table 3: Loruth Primary Enrolment ...... 13 Dropout rate ...... 14 Funding ...... 15 2.2.2 Kokuro Primary School ...... 15 Brief background of the school ...... 15
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The school Infrastructure ...... 15 Table 4: Kokuro Primary Enrolment ...... 16 Dropout rate ...... 17 Funding ...... 18 2.2.3 School Performances ...... 18 2.2.4 Staffing ...... 18 2.2.5 School Facilities...... 18 Toilets ...... 18 Water Points ...... 18 2.2.6 Challenges facing the facilities and Recommendations ...... 19 2.1.7 Secondary Schools ...... 20 CHAPTER 3 ...... 21 HEALTH SECTOR ...... 21 3.1 COUNTY LEVEL INFORMATION ...... 21 3.2 FACILITY LEVEL INFORMATION ...... 21 3.2.1. Loruth Dispensary ...... 21 3.2.2. Kokuro Health Center ...... 23 3.2.3 Challenges facing the facilities and Recommendations ...... 24 WATER AND SANITATION SECTOR ...... 27 4.1 COUNTY LEVEL INFORMATION ...... 27 4.1.1 Water Resources and Quality ...... 27 4.1.2 Water Supply Schemes ...... 27 4.1.3 Water Sources ...... 27 4.1.4 Sanitation ...... 27 4.2 FACILITY LEVEL INFORMATION ...... 28 4.2.1 Loruth Water Supply System ...... 28 4.2.2 Loruth Primary Hand Pump ...... 30 4.2.3 Kokuro Water Supply System ...... 32 4.2.4 Challenges facing the facilities and Recommendations ...... 33 CHAPTER 5 ...... 35 CONCLUSION AND RECOMMENDATION ...... 35
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EXECUTIVE SUMMARY
The Inter- Religious Council of Kenya (IRCK) under a Consortium led by the Amref Health Africa in Kenya is implementing a 5-year project dubbed AFYA TIMIZA. The overall goal of the project is to provide enhanced access to and utilization of quality Family planning, / Reproductive, Maternal Newborn and Child Health (FP/RMNCAH) WASH and Nutrition services in Samburu and Turkana Counties.
IRCK‟s scope of work within the consortium will contribute to increased care seeking and health promoting behavior on FP/RMNCAH, WASH and Nutrition services in both counties. Additionally, a key delivery of the project is to conduct county level advocacy using the Social Budgeting Observatory Framework SBOF/Social Intelligence Reporting SIR.
The Social Budgeting initiative is one key step towards ensuring more equitable social development via engagement of the „claim holders‟ as well as “duty bearers” and increasing levels of citizen participation and shared accountability in the social budgeting process.
A key element of the Social Budgeting Initiative is the conduct of the Social Intelligence Reporting (SIR). The reports are derived from participatory engagements of the communities and interactions with various stakeholders. It is not a survey or data gathering exercise but facilitates community involvement and engagement; it focuses on problem identification and problem- solving.
AFYA TIMIZA supported a cadre of sensitized religious leaders in liaison with the county departments of finance and economic planning, health, water and education to conduct the site visits to SIR mapped facilities: Loruth dispensary, Kokuro health center, Loruth primary school, Kokuro primary school and the water access points to the communities, schools and hospitals.
The objective of conducting the exercise was to gather credible evidence on the real issues affecting essential social service provision at the sub County and facility levels. This would create an understanding of these issues and articulate responsibilities and accountabilities around them, at the end of the process, build consensus on time-bound, remedial actions to be undertaken by relevant stakeholders at the identified facilities.
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SOCIAL INTELLIGENCE REPORT
Relevance of Social Intelligence Report The report is an assessment tool on quality of service delivery particularly in the Social Pillar of the Vision 2030 at facility and community levels. In addition, the report provides a broad evaluation of effectiveness of the social sector policies, projects and programmes carried out in selected communities.
The report describes the communities‟ status, milestones, opportunities, constraints, conclusions, action points and recommendations that require attention in addressing the overall progress of communities for quality social services.
Guidance on undertaking SIR was based on the following principles: a) Facilitating the engagement of „duty bearer‟s‟ and „rights‟ holders‟ b) Promoting accountability for quality and equitable delivery of social services c) Ensuring transparency and good governance d) Identifying constraints to optimal utilization of public investments e) Monitoring the situation of vulnerable groups f) Informing meetings of social budgeting observatories at all levels
The entire report covers executive summary, sub county back ground information, SIR methodology, Sectoral analysis (Education. Health, Water) Follow Up Actions, Conclusion and Recommendations.
Methodology Preparation of SIR entails a lengthy process of series of data collection, field visits, meetings, stakeholder‟s engagements by various committees coordinated by Sub County Social Sector heads. The County SIR lead team comprised of the County representatives in the department of Health, Education, Water, finance and Planning.
The scope of the report is limited to major human development activities undertaken in the three facilities where this SIR was conducted. Engagement with stakeholders during collection and compilation of information and generation of SIR was done from relevant County departmental reports. Field visits and observations from Water, Education and Health for committees were the main points of discussion. Analysis of SIR This is the second generated SIR conducted by AFYA TIMIZA and the County Government of Turkana. The main challenges included lengthy time in data collection, analysis and reporting. The vastness in geographical coverage also meant that a lot of time was taken travelling from one place to another during the field visits. Also, not all the respondents were willing to give out information Rationale of Social Budgeting and SIR. The Social Budgeting initiative is one key step towards ensuring more equitable social development via engagement of the „claim holders‟ as well as “duty bearers” and increasing levels of citizen participation and shared accountability in the social budgeting process.
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The Social budgeting initiative aims to speed up the realization of socio-economic rights by creating an accountability mechanism to engage, review and demand rights fulfillment in a transparent and inclusive manner.
A key element of the Social Budgeting Initiative is the conduct of the Social Intelligence Reporting (SIR). The SIRs products (reports) are derived from participatory engagements of the communities and interactions between a mix of independent observers (Sub-county Development Officer, social services providers, social facility and fund managers) at the service delivery levels and the „claim holders‟ largely children, women, young people, elders and members of communities.
Approach Applied The exercise targeted two schools, two health facilities and two water facilities. In the work plan, the SIR was set to run from 5th September to 12th September 2018. Eventually, we managed to carry out the SIR activity in two communities namely; Loruth and Kokuro communities. The SIR team consisted of the following Officers: Dr. Salim Otieno- Kibish Sub County MoH Benedict Ekeru- Kibish Deputy Sub County Water Officer Paul Etabo Lokaran- Turkana County Government Education Officer Lokinei Lomaniko- Kibish Sub County Economic Planning Officer Rev. Samuel Ekales-Member, Turkana Inter-Religious Council Sheikh Noor Abdallah-Treasurer, Turkana Inter-Religious Council Pr. Philip Ereng- Kibish Sub-County Religious Leader TOT on FP/RMNCAH Daudi Etakapan- Kibish Sub-County Religious Leader TOT on FP/RMNCAH Halima Abdi- Kibish Sub-County Religious Leader TOT on FP/RMNCAH Abiba Mohammed – Kibish Sub-County Religious Leader TOT on FP/RMNCAH Linus-IRCK Monitoring and Evaluation Manager, Nairobi Lydia Ndinda- AFYA TIMIZA Project Officer
In our data collection we engaged both the management of the facilities and their clients in discussions which were guided by the templates tools provided to collect the information contained in this document. In addition, more information was collected through observations and photographs.
During the SIR activity the following challenges were realized We had difficulties in accessing Napak Community which was initially selected for the exercise due to bad road network. However, the team opted for Loruth Community which was secure and accessible. Accessing respective in charge of facilities was a challenge and therefore, minimal information was obtained from the facilities‟ committees who were not the most reliable.
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CHAPTER 1 BACKGROUND INFORMATION
1.1 COUNTY LEVEL
1.1.1 Location, size, administrative units and political units Turkana County is situated in North Western part of Kenya. It borders West Pokot and Baringo Counties to the South, Samburu County to the South East, and Marsabit County to the East. It also borders South Sudan to the North, Uganda to the West and Ethiopia to the North East.
It lies between Longitudes 34° 30‟ and 36°40‟ East and between Latitudes 1° 30‟ and 5° 30‟ North It covers an area of 71,597.6 Km2, accounting for 13.5% of the total land area in Kenya.
Administrative Units by Sub-County Number Sub-County Divisions Locations Sub-locations Turkana South 3 9 21 Turkana East 2 12 30 Turkana North 3 6 17 Kibish 2 9 17 Turkana West 4 13 36 Turkana Central 3 8 21 Loima 3 9 20 Total 20 66 162 Source: Ministry of Interior and National Coordination, Turkana County
Political Units by Sub-County Number Constituency Wards Turkana Central 5
Loima 4 Turkana South 5 Turkana North 6 Turkana East 3 Turkana West 7
30 Total Source: Independent Eelectoral and Boundaries Commission, Turkana County
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1.1.2 County subdivision Sub-County Population* Headquarters Turkana North
Turkana South
Turkana East
Turkana West
Loima
Kibish
Total
* 1999 census. Sources:
1.1.3 County population and area coverage In the last census carried out in Kenya in 2009, Turkana County population was reported to be 855,399, the total population is expected to grow to 1,122,207 in 2017 and to 1,366,596 by 2023.
1.1.4 Language and culture The Turkana, who are plain Nilotes, are the dominant community in the county. The El Molo community the Minority community in the County and are found on the southern shores of Lake Turkana
1.1.5 Climate Turkana has a hot, dry climate with temperatures ranging between 20°C and 41° C and with a mean of 30.5°C. Rainfall in the area is bimodal and highly variable. The long rain occur between April and July and short rains between October and November .annual rainfall is low, ranging from 52 mm to 480 mm with a mean of mm
Rain patterns and distributions are erratic and unreliable
1.1.6 Economic activities The main economic activity in the County is pastoralism characterized by livestock rearing. The major livestock reared include cattle, donkeys, camels and goats. Fishing is also practiced at Lake Turkana, mainly by the El Molo people. Basket weaving is also a major income generating activity in the county, especially among women in Lodwar and other urban centers. Other economic activities include farming of cassava, millet, sorghum and drought resistant maize, honey production, charcoal production, weaving and tourism.
The recent discovery of oil has brought in a fresh focus on Turkana County and the entire region as a whole with the economic status of the County expected to change when oil drilling commences.
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1.2 SUB-COUNTY LEVEL
1.2.1 Position and size of the Sub-county Kibish Sub-county is one of the seven sub-counties in Turkana County. It previously formed part of the former Turkana district before its sub-division in 2007 into three districts namely Turkana South, Turkana Central and Turkana North. Turkana North was further sub-divided into Turkana North, Turkana West in 2009. Kibish Sub County was created after March 2013 General elections as a special Sub County. The sub-county headquarters for Kibish is based at Kibish center.
The sub-county borders Turkana North sub-county to the south, Turkana West sub-county to the west, South Sudan to the North West and Ethiopia to the north east. The total area of the sub- county is approximately 5,087 km².The sub-county lies between Longitudes 35013‟ and 35033‟ East and between Latitudes 4020‟ and 4037‟ North.
1.2.3 Administrative and political Units Administratively, Kibish Sub- County consists of two divisions, five locations and seven sub- locations. The sub-county also comprises of one electoral ward.
Table 1: Sub County Administrative Units
Number Sub-County Divisions Locations Sub-locations Kibish 2 9 17
Total 2 9 17 Source: Ministry of Interior and National Coordination, Turkana County Table 2: Sub-County Political Units
Number Sub county Wards Kibish 1
Total 1
Source: Independent Eelectoral and Boundaries Commission, Turkana County
1.2.3 Settlement Structure The population density in the Sub-County varies from 20 persons per Km² in Kaikor Location to 10 persons per Km² in Lobulono Location. This is based on the 2009 Housing and Population Census. The low density in Lobulono Location is attributed the frequent cases of cattle rustling experienced along the border with South Sudan and Ethiopia.
Permanent and semi-permanent settlement areas in the sub-county are found in Kibish, Kokuro and Kaikor centers. Along these areas, there exist peri-urban market centres with the necessary social infrastructure like schools and health facilities that support human settlement.
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1.2.4 Economic activities The main economic activity in the Sub County is pastoralism characterized by livestock rearing. With the major livestock reared being cattle, donkeys, camels and goats. Farming is also done in some parts of the sub county especially Kaikor and Kokuro. Some of the crops farmed include sorghum, maize, Sukuma wiki, spinach, tomatoes and onions. Other economic activities include honey production and charcoal production.
1.2.5 Topographic features The physiographic features in the sub-county include low lying open plains known as Kasarani plains, mountain ranges and river drainage patterns. The sub-county has an altitude of 1,579 metres above sea level. The mountain ranges, because of their high elevation are normally green, covered with dense bushes and high woody cover. The ranges support important economic activities like honey production, grazing during the dry season, water catchments sources, gum Arabica harvesting and wood production.
The plains form part of the arid area in the sub-county and receive the lowest amount of rainfall of around 200 mm per annum. These plains are dominated by dwarf shrub and grassland, which provide forage for livestock during and shortly after rainy season. However, this forage dries rapidly at the onset of the dry season.
1.2.6 Climatic Information Kibish sub-county is Arid and Semi-Arid and is characterized by warm and hot climate. The temperatures range between 25ºC and 41ºC with a mean of 30ºC. The rainfall pattern and distribution is erratic and unreliable both with time and space. There are two rainfall seasons. The long rains usually occur between April and July and the short rains between October and November and range between 120 mm and 500 mm.
The driest periods are January, February and September. Rainfall is distributed on an east-west gradient with more rainfall in the eastern parts and other areas of higher elevation. The rain falls in brief violent storms resulting in flash floods. The surface runoff and potential evaporation rates are extremely high.
1.2.7 Population According to the 2009 Population and Housing Census, the present Kibish sub-county comprised of Kibish division with a population of 21,673. By 2015, the population was projected to be 26,492.
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CHAPTER 2 EDUCATION AND LITERACY SECTOR 2.1 COUNTY LEVEL INFORMATION
Increased investment in Early Childhood Development Centers (ECDCs) has raised the number of children enrolling for basic education in Turkana. The number of primary schools has significantly increased and this can be attributed to the Constituency Development Funds (CDF) used in establishing new schools, Faith Based Organizations and Non-Governmental Organizations.
The number of secondary schools has also increased with two national schools, as shown below:
Staffing and Performance by Education Number of schools/institutions Enrolment Gender and type Sector Unit Public Private Public Private Public Private 2016/ 2017/2 2016/2 2017/ 2016/ 2017/ 2016/ 2017/ 2016/ 2017/2 2016/ 2017/ 2017 018 017 2018 2017 2018 2017 2018 2017 018 2017 2018 ECD 863 35 Primary Education 390 395 36 38 143,884 145,707 9,014 Secondary Education 46 46 6 10 13,631 15,185 967 8,227
2.2 FACILITY LEVEL INFORMATION The following schools were visited; Loruth Primary School and Kokuro Primary School 2.2.1 Loruth Primary School
Brief background of the school The school is located at Loruth Centre, Kaaleng/Kaikor ward in Kibish Sub County. Since inception the school has pupils from class one to class eight. The current total population for the year 2017/2018 is at 291 pupils; 171 boys and 120 girls. For year 2016/2017 the total population was 229 pupils. 141 boys and 88 girls. K.C.P.E mean score is 164.46 for 2016 and for 2017 was not available. The school has 5 teachers, male gender. However, it was observed a difference on the school register records against the actual number of pupils in class.
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Grade 8 Class, actual number of pupils is 6 against the records which shows 15 pupils
The school Infrastructure Boarding: There‟s no boarding facility in the school. Though inadequate, the school has 5 Toilets; 2 for male pupils, 2 for female pupils and 1 for teachers. The toilet funded by Unicef is in bad condition, the roof and the door are incomplete. 2 Water points, a hand pump and a solarized borehole. 7 classrooms; one classroom is shared between class 1 and class 2.
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Shared Classroom Between Grade 1 and Grade 2 Pupils Loruth pupils' gender disaggregated toilet
Hole from the collapsed toilet
Table 3: Loruth Primary Enrolment
Loruth Primary Enrolment figure by level and gender Class 2016/2017 2017/2018 Male Female Male Female ECDE One (1) 47 42 51 47 Two (2) 31 20 38 24 Three (3) 26 18 30 26 Four (4) 6 2 10 6 Five (5) 7 1 8 4 Six (6) 6 2 9 4 Seven (7) 10 0 15 4 Eight (8) 8 3 10 5 Total (exclude ECDE) 141 88 171 120
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Loruth Primary Enrolment in 2017
160 141 140 120 100 88 80
60 47 42 40 31 26 20 18 20 6 7 6 10 8 2 1 2 0 3 0 Boys Girls
Std 1 Std 2 Std 3 Std 4 Std 5 Std 6 Std 7 Std 8 Total
Loruth Primary Enrolment in 2018 180 171
160
140 120 120
100
80
60 51 47 40 30 30 24 26 15 20 10 9 10 8 6 4 4 4 5 0 Boys Girls
Std 1 STd 2 Std 3 Std 4 Std 5 Std 6 Std 7 Std 8 Total
Dropout rate The dropout rate for girls as drastically increased to 87% in 2017/2018 as compared to 80% in 2016/2017. These was because of early marriage and being pregnant at an early age. The dropout for boys has marginally reduced to 65% in 2017/2018 up from 70% in 2016/2017.
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Funding The school is largely funded by the national government to support the free primary education program. In 2017, the school received KES 151,000 for the School Instructional materials, KES 161,000 for General Purpose Account. It also received KES 300,000 from UNICEF for the construction of toilets. The information of amount received in 2018 was not displayed as required. 2.2.2 Kokuro Primary School
Brief background of the school The school is located at Kokuro Centre, Lapur ward in Kibish Sub County. Since inception the school has pupils from ECD, class one to class eight. The current total population for the year 2017/2018 is at 238 pupils; ECD has 26 boys and 17 girls. Primary school has 124 boys and 71 girls. For year 2016/2017 the total population was 235 pupils. ECD had 20 boys and 13 girls. Primary school had 132 boys and 70 girls. K.C.P.E mean score for 2016 181.52 and for 2017 was 191.50. The school has 6 teachers, all are male. However, it was observed a difference on the school register records against the actual number of pupils in class.
Grade 5 Class, actual number of pupils is 4 against the records which shows 16 pupils
The school Infrastructure Boarding: There‟s boarding facility in the school built by NG-CDF Turkana North Constituency but it‟s used as teacher‟s quarters. Insecurity in the area makes it difficult for parents to send the pupils to the facility. Though inadequate, the school has 6 toilets; 3 for male pupils, and 3 for female pupils. No toilets for teachers. There are 2 bathrooms and a urinal meant to serve pupils in the boarding facility. The school accesses water from the solarized borehole which is the main supply in the area. The school has 9 classrooms; only 7 are in use. 2 classrooms are unfinished.
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Unfinished classroom ECD class pupils during break time, they use the dining hall as their classroom which is also used as a store
Class 3 pupils in class session, every pupil is happy to have a Boarding facility being used as teacher's quarter and book place to sit and write on the desks provided by Shalom Centre store
Table 4: Kokuro Primary Enrolment Enrolment figure by level and gender 2016/2017 2017/2018 Male Female Male Female Kokuro Primary ECDE 20 13 26 17 One (1) 32 24 36 23 Two (2) 16 9 14 10 Three (3) 17 9 12 8 Four (4) 13 7 11 8 Five (5) 10 10 8 8 Six (6) 10 7 10 8 Seven (7) 17 1 15 3 Eight (8) 17 3 18 3
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Total (exclude ECDE) 132 70 124 71
Kokuro Primary Enrolment in 2017 140 132
120
100
80 70
60
40 32 24 16 17 17 17 20 13 10 10 9 9 7 10 7 1 3 0 Boys Girls
Std 1 Std 2 Std 3 Std 4 Std 5 Std 6 Std 7 Std 8 Total
Kokuro primary Enrolment in 2018 140 124 120
100
80 71
60
36 40 23 18 20 14 12 15 11 8 10 10 8 8 8 8 3 3 0 Boys Girls
Std 1 Std 2 Std 3 Std 4 Std 5 Std 6 Std 7 Std 8 Total
Dropout rate The dropout rate for girls stands at 72% in 2017/2018. The dropout for boys stands at 15% in 2017/2018. The number of pregnancy cases was last reported in 2014, 2 girls in standard 6 and 8.
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These dropout rates is attributed to: age of the pupils when above a certain age they drop out of school, early marriage, delays in the school feeding program, the nomadic way of life that is during wet season the retention rate is high compared to the dry season and exam fees. Funding The school is largely funded by the national government, but the amount received by the school was not displayed. Development partners such as SHALOM center provided desks and construction materials on 28th August 2018. Safaricom also pays the school KES 120,000 per quarter and was used to construct the kitchen in 2017. UNICEF also donated KES 500,000 for connection of water in 2017 and CDF allocated KES 3 million for the construction of school‟s dining hall in 2017 2.2.3 School Performances School KCPE Mean (Marks 0ut of 500) 2016 2017 Loruth primary 181.52 191.50 Kokuro primary 164.46 -
2.2.4 Staffing Teacher: Pupil Primary Schools Male (TSC) Female (TSC) Total pupils ratio Loruth primary 5 0 520 1:104 Kokuro primary 6 0 397 1:66
2.2.5 School Facilities
Toilets Teachers Pupils School Males Females Males Females Loruth primary 0 0 3 3 Kokuro primary 1 0 6 6
Water Points
School Water points Hand washing facilities Loruth primary 2 0 Kokuro primary 1 0
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2.2.6 Challenges facing the facilities and Recommendations
Facility Challenges facing the facility Recommendations Loruth primary Acute shortage of staff Ensure gender mainstreaming by observing the two thirds gender rule by also employing female teachers
Poor school management Capacity build the Board of Management with skills on management and administration including conducting orientation on their roles and responsibilities Sensitize the local level communities on social accountability to improve governance for improved service delivery Poor school furnishing characterized Provision of pupils with desks by: Install a structural upgrade of Pupils sitting on stones the classroom floor plans. Classes rough floors Lack of staff quarters Construction of staff quarters adequate for the staffing level in the school The school has no fence Construction of the school fence No access to lighting system Establishment of the school‟s lighting system since the school already has installed solar panels. Low birth registration levels Sensitize communities on the importance of civil registry in safe guarding the basic rights of children and identity including legal protection Encourage Civil Registry office to hold open days at the community levels to enhance registration. The toilets structural and hygienic Renovation of the existing
condition is deplorable toilets Incomplete ECD classroom Completion of the ECD
classroom and proper
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furnishing with floor and equipment Inadequate classrooms Construction of one more
classroom Uncovered collapsed pit latrine Fill up the pit Kokuro Primary Challenges facing the facility Recommendations Lack of lighting system Establishment of the school‟s lighting system since the school already has installed solar panels. High levels of insecurity Ensure improved security in the area Lack of staff quarters Construction of staff quarters adequate for the staffing level in the school Lack of ECD Class Construction of an ECD classroom Employment of an ECD teacher Low birth registration levels Sensitize communities on the importance of civil registry in safe guarding the basic rights of children and identity including legal protection. Encourage Civil Registry office to hold open days at the community levels to enhance registration. The school‟s feeding program is not Maintain the feeding program reliable provide food subsidy
Incomplete classroom Commence with the classroom roofing materials delivered by Shalom Centre
2.1.7 Secondary Schools There were no Secondary schools around Loruth and Kokuro centers.
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CHAPTER 3 HEALTH SECTOR
3.1 COUNTY LEVEL INFORMATION
Access to health service in the county has improved in the last four years, the average distance a person needs to travel to the nearest health facility dropped from 50Km in 2013 to 35Km in 2017. A majority (81.7%) of the Population seek care from Public clinics. In Turkana North, nearly 10% seek assistance from mobile clinics, the highest proportion in the county. Lodwar County Referral Hospital has a new ICU, among other upgrades. There are 13 hospitals, 19 health centers, 177 dispensaries and 168 community health units. Of these there are 1 hospital, 2 health centers with maternity wards and 5 health clinics serving refugees and host communities in Kakuma camps and Kalobeyei settlement. Number of health personnel Staffing Public Private 2016/17 2017/18 2016/17 2017/18 Doctors/Pharmacists 21 1 Clinical officers 123 2 Nurses 56 99 Other health personnel
3.2 FACILITY LEVEL INFORMATION The following health facilities were visited: Loruth dispensary and Kokuro health center. 3.2.1. Loruth Dispensary
Brief background of the facility The dispensary is located in Loruth Centre, Kaaleng/Kaikor ward. It was started as a public dispensary in 2006 and is operated by the County Government of Turkana. Currently, the facility has 6 staff members. These includes; 2 females and 4 male workers. 3 are subordinate staff; 1 watchman, 1 cleaner and 1 patient attendant. 3 are technical staff; 2 nurses, a nutritionist and a community health extension worker (CHW).
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Focus Group Discussion between the SIR Team with the Loruth Dispensary Management Committee
Infrastructure Water serving the facility is outsourced and stored in water tanks from community water Supply System. Water is purified once in every 2 months though supply of PUR to the community, since the water is not purified from the source. Water is not enough to efficiently sustain the facility because the facility is not the only beneficiary of the supply system. Causes of morbidity in the last three months for outpatients Leading causes of 2016/2017 2017/2018 morbidity Male Female Male Female Adult > 18 Malaria Upper Malaria Upper Respiratory tract Respiratory infection tract infection Diarrhea Diarrhea Diarrhea Diarrhea Upper Malaria Upper Malaria Respiratory Respiratory tract tract infections infections Children < 5 Upper Upper Upper Upper Respiratory Respiratory tract Respiratory Respiratory tract infection tract tract infection infections infections Diarrhea Malaria Diarrhea Malaria Malaria Diarrhea Malaria Diarrhea
Causes of morbidity in the last three months for inpatients Leading causes of 2016/2017 2017/2018 morbidity Male Female Male Female Adult > 18 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
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Children < 5 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Note: The facility has no inpatient services Funding The center is funded by Ministry of health. At the time of visit, records were not accessed because the records office was locked. The facility committee however pointed out that the subordinate staffs are paid using the HSSF funds received from the County Government of Turkana. It was noted that the facility receives little amount of money which is not enough to effectively run the facility activities. 3.2.2. Kokuro Health Center
Brief background of the facility The dispensary is located in Kokuro Centre, Lapur ward. It was started as a public dispensary though the County Government has since upgraded it to a Health center, but it has not yet been approved by the National Government Ministry of health services. Currently, the facility has 6 staff members. All are male.
Focus Group Discussion between the SIR team with the Kokuro Health Centre Management Committee
Infrastructure Water serving the facility is outsourced and stored in water tanks from community water Supply System. Water source is reliable throughout the year though was is not purified but the quality is fresh ad soft. Causes of morbidity in the last three months for outpatients Leading causes of 2016/2017 2017/2018 morbidity Male Female Male Female Adult > 18 Upper Upper Upper Upper Respiratory Respiratory tract Respiratory Respiratory
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tract infection tract tract infection infection infection Malaria Malaria Malaria Malaria Diarrhea Diarrhea Diarrhea Diarrhea Children < 5 Diarrhea Upper Diarrhea Upper Respiratory tract Respiratory infection tract infection Malaria Diarrhea Malaria Diarrhea Upper Malaria Upper Malaria Respiratory Respiratory tract tract infection infection
Causes of morbidity in the last three months for inpatients Leading causes of 2016/2017 2017/2018 morbidity Male Female Male Female Adult > 18 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Children < 5 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Note: The facility has no inpatient services
Funding The center is funded by Ministry of health. At the time of visit, there were no actual records of funds received by the facility. The facility in charge was on a field visit to Merikuka center to support Afya Timiza staff on Kimormor exercise.
3.2.3 Challenges facing the facilities and Recommendations
Facility Challenges facing the facility Recommendations Loruth Acute staff shortage e.g. pharmacist Employ more staff Dispensary Gender mainstreaming by employing a female nurse
Poor management of the facility Capacity build the Management characterized by: Committee with skills on management and administration i. High levels of staff including conducting orientation abseentism
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ii. The management on their roles and responsibilities committee lacks capacity Sensitize the local level on management and communities on social administration skills accountability to improve iii. Lack of team work governance for improved service between the clinical delivery officers with the Encourage team work among the management committee clinical officers with the management committee including the community health volunteers Piped water not reaching the facility The facility to apply for new piping connection. There is no security officer The facility in-charge to ensure there is a security officer There is need for a fence and solar Construction of the fence and lighting installation of solar lighting systems Lack of privacy at the maternity Provision of Curtain at the room/ examination room delivery room/ examination room Construction of maternity waiting shelter which can also be used for delivery Lack of laboratory services Recruitment of laboratory personnel Equip the lab The facility lacks a toilet/ pit latrine, Construction of a pit latrine, placenta pit, incinerator and a placenta pit and a bathroom
bathroom (They have been using the latrine at the ECD centre) Bedding facility are not enough Addition of more bedding
Kokuro Health Challenges facing the facility Recommendations Centre Lack of laboratory services Equip the laboratory since the facility already has a lab technician High levels of insecurity Ensure improved security in the area Poor management of the facility Capacity build the Management characterized by: Committee with skills on management and administration i. High levels of staff including conducting orientation abseentism on their roles and responsibilities ii. The management Sensitize the local level committee lacks capacity communities on social on management and
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administration skills accountability to improve iii. Lack of team work governance for improved service between the clinical delivery officers with the Encourage team work among the management committee clinical officers with the management committee including the community health volunteers No access to lighting system Establishment of the school‟s lighting system since the school already has installed solar panels. Acute shortage of staff Gender mainstreaming by employing a female nurse Employ more staff The maternity room has been Follow up with the PHO for declared unfit for use by the PHO recommendations without any recommendations since Renovation or construction of a the room has cracks and is at the new maternity room verge of falling
The facility lacks a fence Commence with the establishment of the fence since
the materials have already been supplied
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CHAPTER 4 WATER AND SANITATION SECTOR 4.1 COUNTY LEVEL INFORMATION
4.1.1 Water Resources and Quality Turkana is generally a water scarce County. The main sources of water for domestic and livestock include; Boreholes, Pans, Dams and Shallow wells, springs and roof catchments. Water quality in the county is generally good.
Most water sources in the county are not protected hence contaminated. Human habitation along Catchment areas, lack of proper sanitation and sewerage services in the major urban centers are the main causes of water contamination.
4.1.2 Water Supply Schemes
Water in major urban centres in the County is supplied and managed by the Lodwar Water and Sanitation Company (LOWASCO) in collaboration with the County Water Directorate. The major urban centers include; Lodwar, Kakuma, Lokichar, Lokichoggio, Kalemng‟orok and Kainuk. Major rehabilitation and augmentation was carried out in all the water supplies under LOWASCO and are currently operational with minimum setbacks.
Rural water supplies across the Counties are managed by respective water management committees.
4.1.3 Water Sources
The county has been classified as water scarce. The average distance to Water points is approximately 20 kilometers in rural areas but it reduces in urban and market centers. The following is a breakdown of the current water sources for domestic and livestock use in the county; Operational Boreholes Water Pans Springs Others are various shallow wells owned by some community members and individuals
4.1.4 Sanitation
Sanitation in the county is poor due to low latrine coverage as most people do not use pit latrines Because of cultural beliefs. The public health department in collaboration with stakeholders undertakes Chlorination of water sources through provision of chlorination tablets across the county. The water Department also undertakes health education on sanitation, water treatment and safe storage before consumption.
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4.1.5 Funding
The county funding information is summarized in the table below:
County Level 2016/2017 2017/ 2018 Notes /Remarks information Kenya Kenya
shillings shilling DW1: Amount of
Fund received (Ksh) DW1a: MoWI 814,000,000 646,319,693 Supplementary budget DW1b: Water Trust 0 0 Anticipating 72 Million Fund DW1c: CDTF 0 0 DW1d: Others Equalization fund through Rift Valley 0 605,000,000 Water Service Board
4.2 FACILITY LEVEL INFORMATION
4.2.1 Loruth Water Supply System Considered as rural facility, the water facility is located at the Loruth Center in Kaaleng Kaikor ward, Kibish Sub County. The water is quality is saline. The water source is reliable. 2016/2017 2017/2018 Average supply per day in 100 liters/HH 100 liters/HH dry season Average supply in wet 60 liters/HH 60 liters/HH season Number of households using 350 HHs 350 HHs the water Number of livestock using 5000 shoats 3000 shoats water % of adult males drawing 20% 20% water %of females drawing water 30% 30% %of female children <18 30% 30% drawing water % of male children <18 20% 20% drawing water
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loruth Average water supply in wet and dry season 120 100 100 100
80 60 60 60
40
20
0 2016/2017 2017/2018
average water supply per day in dry season average water supply per day in wet season
loruth Household Information on Water 400 350 350 350 300 250 200 150 100 50 20 30 30 20 20 30 30 20 0 2016/2017 2017/2018
Number of HHs using water % of adult males drawing water %of females drawing water %of female children <18 drawing water % of male children <18 drawing water
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4.2.2 Loruth Primary Hand Pump
Loruth Primary school hand pump Considered as rural facility, the water facility is located at the Loruth Center in Kaaleng/Kaikor ward, Kibish Sub County. The water is quality is saline.
2016/2017 2017/2018 Average supply per day in dry season 400 liters 400 liters Average supply in wet season 400 liters 400 liters Number of households using the water - - Number of livestock using water - - % of adult males drawing water - 7 = 88% %of females drawing water - 1 = 12% %of female children <18 drawing water - 260 = 55% % of male children <18 drawing water - 207 = 45%
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loruth Average water supply in wet and dry season
450 400 400 400 400 400 350 300 250 200 150 100 50 0 Average water supply per day in dry season Average water supply in wet season 2016/2017 2017/2018
loruth Household Information on Water
100 88 90 80 70 60 55 50 45 40 30 20 12 10 0 0 0 0 0 0 0 2016/2017 2017/2018
Number of households using the water % of adult males drawing water %of females drawing water %of female children <18 drawing water % of male children <18 drawing water
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4.2.3 Kokuro Water Supply System
Kokuro water supply system Considered as rural facility, the water facility is located at the Kokuro Center in Lapur ward, Kibish Sub County. The water is quality is fresh. There‟s operational water tariffs. 2016/2017 2017/2018 Average supply per day in dry season 40 liters/HH/Day 40 liters/HH/Day Average supply in wet season 200 liters/HH/Day 200/HH/Day Number of households using the water 2024 People 2500 People 337 HHs 416 HHs Number of livestock using water - - % of adult males drawing water 1194 males 1500 females 58% 60% %of females drawing water 42% 40% %of female children <18 drawing water 35% 40%
% of male children <18 drawing water 65% 60%
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Kokuro Average water supply in dry and wet seasons 250
200 200 200
150
100
50 40 40
1 0 2016/2017 2017/2018
Average supply per day in dry season/HH/Day Average supply in wet season/HH/Day
Kokuro Household Information on Water
450 416 400 337 350 300 250 200 150
100 58 65 60 60 42 35 40 40 50 0 2016/2017 2017/2018
Number of households using the water % of adult males drawing water %of females drawing water %of female children <18 drawing water % of male children <18 drawing water
4.2.4 Challenges facing the facilities and Recommendations
Facility Challenges facing the facility Recommendations Loruth Water Water pump is insufficient. When its It will require a hybrid system Supply System cloudy there is marked reduction of (solar and generator) to solve the the amount of water yielded situation.
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Poor school management Capacity build the Water Users‟ Association with skills on management and administration including conducting orientation on their roles and responsibilities Sensitize the local level communities on social accountability to improve governance for improved service delivery Poor drainage system at Loruth Renovation of the borehole Loruth Primary Primary School Borehole drainage system school borehole
Kokuro Water Challenges facing the facility Recommendations Supply Existence of notable defaulters such The Water Users‟ Committee as the Administration Police and commence disconnection OF the Health Center, from the monthly defaulters. tariffs. The last time the health facility paid its tariff was in October 2017. Poor school management Capacity build the Water Users‟ Association with skills on management and administration including conducting orientation on their roles and responsibilities Sensitize the local level communities on social accountability to improve governance for improved service delivery
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CHAPTER 5 CONCLUSION AND RECOMMENDATION
Optimal staffing at education and health facilities should be addressed towards improving the quality of available services. Strategies for timely interventions should be strengthened at facility levels towards addressing immediate, medium term and long-term needs through strategic plans and school infrastructure development plans.
Timely completion of ongoing structural works at facility levels is called for. Among these are classrooms, administration blocks, staff houses, laboratory blocks, sanitation blocks and perimeter fences. In follow up of agreed recommendations and conduct of subsequent SIR, support is called for ensure that the issues raised are closed out to the desired conclusion by all relevant and responsible authorities.
Adequate provision of essential supplies and nutritional supplements to health facilities on regular basis should be informed by the by facility specific demands. Referral mechanisms and handling of emergency cases require fast tracking through proper equipment such as ambulances services.
Parents need to meet their obligations on timely acquisition of birth certificates as this has been emphasized as a major area of compliance particularly by the Kenya National Examination Council. This should form part of the agenda in school management committee sittings. Religious leaders have a role to sensitize communities and congregations on the importance of civil registry in safe guarding the basic rights of children and identity including legal protection
There is need to empower the local level communities on civic education in the following areas; public finance management act and social accountability in order to encourage improve governance for enhanced public service delivery.
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