County Profile Edition

Siaya County Profile

CHS CEO Dr Paul Wekesa and County’s CEC for Health Dr Olangi Onudi uncover a CHS plaque during the official opening of the Siaya offices

Support from PEPFAR through CDC Achievement The United States President’s Emergency Program for AIDS Relief (PEPFAR), Highlights as at through the US Centers for Disease Control and Prevention (CDC) has been working in partnership with the Ministry of Health in to September 2017 strengthen health systems towards the delivery of sustainable health services. 738,800 Using the World Health Organisation (WHO) approach to health systems Total Number of Clients Tested strengthening, CDC has invested heavily in service delivery, health leadership and governance, human resources for health, health infrastructure and 9,798 Total Number of Clients Identified equipment, health information systems, as well as health products and commodity security. 66,882 Clients Currently on ART In support of devolved health functions, CDC through its implementing partner Centre for Health Solutions - (CHS), has a Memorandum of 3,368 Understanding with Siaya County Government that guides this investment. In HIV Positive Pregnant Women on ART the current PEPFAR year 2016/17, the Siaya County Department of Health is 829 operating on a budget of Kshs 409,387,684 from CDC towards stemming the Number of TB/HIV clients started on ARVs HIV epidemic. This funding is channelled to the county through a sub-grant 39,674 managed by CHS. Number of VMMC Circumcisions

2017 Snapshot of Siaya County Population: 842,304 Population Density: 33 people per km2 Area: 2,530 KM2

Location: Located in Nyanza, Siaya borders to the North-West, County to the North-East, and County to the East and to the South.

Doctor to Population Ratio: 1:44,000

Source: Kenya Open Data (www.opendata.go.ke), Commission on Revenue Allocation Kenya (www.crakenya.org)

CHS Supported Facilities With support from PEPFAR through CDC, CHS supports 119 health facilities in Siaya County to implement and expand sustainable high quality HIV services, specifically comprehensive HIV prevention, care and treatment with improved yield and retention of patients on treatment, and three (3) facilities for voluntary medical male circumcision services.

Abidha Health Centre Inuka Hospital and Maternity Home Matangwe Community Health Akala Health Centre Jera Dispensary Centre Sub-District Hospital Kabura Dispensary Matibabu Ukwala Clinic Anyuongi Dispensary Kadenge Ratuoro Health Centre Mawere Dispensary Asayi Dispensary Kagwa Health Centre Midhine Dispensary Ashburn Ohuru Clinic Kaluo Dispensary Misori Dispensary Bama Hospital Kambajo Dispensary Mulaha Dispensary Bar Achuth Dispensary Kambare Dispensary Mur Malanga Dispensary Bar Agulu Dispensary Kapiyo Dispensary Mwer Dispensary Bar Aluru Dispensary Kogelo Dispensary Naya Health Centre Bar Ndege Dispensary Kunya Dispensary Ndeda Dispensary Bar Olengo Dispensary Usigu Dispensary Ndere Health Centre Bar-Sauri Dispensary Wagoro Dispensary Ndori Health Centre Barding Dispensary Lidha Dispensary Nyagoko Dispensary Benga Bi Dispensary Lieta Health Centre Nyaguda Dispensary Hospital Ligala Dispensary Nyangu Dispensary Boro Dispensary Ligega Health Centre Nyathengo Dispensary Chianda Dispensary Lihanda Health Centre Nyawara Health Centre Dienya Health Centre Mabinju Dispensary Nyenye Misori Dispensary Dolphil Nursing and Maternity Madiany Sub District Hospital Odede Community Health Centre Home Mageta Dispensary Oding Dispensary Future Life Dispensary Mahaya Health Centre Ogam Dispensary Gobei Health Centre Malanga Health Centre Ogero Dispensary Gongo Health Centre Maliera Mission Dispensary Ong’ielo Health Centre Got Agulu Sub-District Hospital Manyuanda Health Centre Uyawi Dispensary Got Matar Dispensary Marenyo Health Centre Yala Sub-District Hospital Got Osimbo Dispensary Masala Dispensary Othach Dispensary Got Regea Dispensary Masogo Dispensary Ouya Dispensary Hawinga Health Centre Masumbi Dispensary Oyamo Dispensary 1 Pap Kodero Health Centre Serawongo Dispensary Uhembo Dispensary Rabar Dispensary Siala Kaduol Uhuyi Dispensary Radier Dispensary Siaya District Hospital Ukwala Health Centre Rageng’ni Dispensary Sifuyo Dispensary Ulungo Dispensary Rambugu Dispensary Sigomere Health Centre Uluthe Dispensary Rambula Dispensary Sikalame Dispensary Umala Dispensary Ramula Health Centre Simenya Dispensary Umer Dispensary Randago Dispensary Sirembe Dispensary Urenga Dispensary Rera Dispensary St Joseph’s Obaga Dispensary Uriri Dispensary Rwambwa Health Centre St Mary’s Yala Dispensary Usenge Dispensary Sagam Community Hospital Sumba Community Dispensary Wagai Dispensary Saradidi Dispensary Ting’wangi Health Centre Sega Dispensary Tingare Dispensary Human Resource for Health

A HIV Testing Services (HTS) provider offers counselling services to a client prior to taking a HIV test

Human Resource Support CDC through CHS strengthens human resource capacity CADRE NUMBER by supporting facilities with different cadres of health care workers to bridge the human resource gap. Accountants 4 Adherence Counsellors 100 Siaya County currently has a CHS managed sub-grant to Clinical Officers 94 the tune of Kshs 409,387,684 used to support 722 health Data Clerks 25 care workers and to complement the management functions of the County Department of Health including Health Records Officers 31 joint support supervision/mentorship, laboratory Human Resource Assistants 3 networking and defaulter tracking. HTS Counsellors 163 HTS Screeners 120 CDC through CHS supports the training of health care HTS Supervisors 13 workers to promote the delivery of quality health Laboratory Technologists 24 services including enhancing health worker capacity Nurse Counsellors 55 on the current Ministry of Health HIV management Nutritionists 4 guidelines, differentiated care model, HTS optimisation Pharmaceutical Technologists 15 to complement other HIV prevention strategies like PITC Counsellors 14 Voluntary Male Medical Circumcision towards HIV Phlebotomists 4 epidemic control. Social Workers 5 VMMC Assistant Surgeons 16 VMMC Counsellors 16 VMMC Infection Prevention Officers 16

Total 722 2 Case Study: Bondo County Hospital Bondo County Hospital is a government health facility which caters to the health needs of a catchment population of 42,506 people (17,780 children and 24,526 adults) and serves 11,223 households. With a hospital staff to population ratio of 1:697, this human resource capacity was not adequate for the delivery of HIV care and treatment services, alongside other services at this facility, which has an average monthly workload of 5,000 clients per month with a bed capacity of 63. Through support from CDC, CHS has helped bridge this gap by supporting an additional 58 healthcare workers of different cadres, effectively reducing the staff to population ratio to 1:357. Guided by the project target of optimising HIV testing services (HTS) at both the outpatient and inpatient departments, 28 HTS providers formed the bulk of the additional human resource capacity. This support has translated into 100% optimisation of HTS services at the facility, whereby all eligible patients visiting the hospital now receive HTS services. Additional capacity has seen these services expanded to the special clinics, mother-and-child health clinic, laboratory and TB clinic, in addition to the outpatient and inpatient departments. Services have also been extended to non-patients visiting the facility, testing of partners and family members of infected clients and the provision of HTS services over the weekend, weekday evenings and night time.

Equipment Support CDC has invested over KES 197 million worth of equipment in Siaya County ranging from BP machines, adult and paediatric weighing scales, examination couches, autoclave machines, screens, IT equipment and project vehicles.

CHS project staff interact with a patient outside a HIV testing booth as she awaits the HTS services

Centre for Health Solutions - Kenya, Head Office: Kasuku Road off Lenana Road, CVS Plaza, 4h floor, North Wing Siaya Office: Next to Care Kenya Offices, off Siaya-Ndere Road P. O. Box 23248 - 00100, , Kenya Tel: +254 (0) 271 0077 www.chskenya.org