County Profile Edition MACHAKOS COUNTY PROFILE Machakos Level 5 Hospital, a CHS supported facility SUPPORT FROM PEPFAR THROUGH CDC For more than a decade, the United States President’s Emergency Program for AIDS Relief (PEPFAR), through the US Centers for Disease Control and Prevention (CDC) has been working in partnership with the Ministry of Health in Machakos County to strengthen health systems towards the delivery of sustainable health services. Using the World Health Organization (WHO) approach to health systems strengthening, CDC has invested heavily in service delivery, health leadership and governance, human resources for health, health infrastructure and equipment, health information systems as well as health products and commodity security. In support of devolved health functions, CDC through its implementing partner Centre for Health Solutions- Kenya (CHS), has a Memorandum of Understanding with the Machakos County Government that guides this investment. In the current PEPFAR year 2016/17, the Machakos County Department of Health is operating on a budget of US$ 1,460,228 from CDC towards stemming the HIV epidemic. This funding is channelled to the county through a sub grant managed by the CHMT. With support from PEPFAR through CDC, CHS supports 71 health facilities in Machakos 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. MACHAKOS COUNTY PROFILE Population: 1,098, 584 Population density: 177 per KM2 Area (KM2): 6,208 Location: Located in the former Eastern Province, it borders Embu, Murang’a and Kiambu counties to the north, Nairobi and Kajiado counties to the west, Makueni County to the south and Kitui County to the east. Doctor to Population Ratio: 1: 27,000 Source: Kenya open data (opendata.go.ke) Commission on Revenue Allocation Kenya (crakenya.org) 2017 Machakos County Highlights (as at June) • Estimated HIV prevalence: 4.5% • Estimated number of people living with HIV: 32,611 adults and 2,082 children below 15 years of age • 21,883 patients on antiretroviral treatment (ART) including 1,936 children below 15 years of age2017 • Adult ART coverage: 68% • Children ART coverage: 93% • 92% of the people living with HIV had their current viral load as at end of June 2017 with an average viral suppression rate of 85% (87 % and 70% for adults and children respectively SUPPORTED HEALTH FACILITIES Ithaeni Dispensary Kaviani Health Centre Mukusu Dispensary Athi River Health Centre Mitaboni Health Centre Musingini Dispensary Katani Dispensary Miumbuni Dispensary Ikombe Dispensary Kinanie Dispensary Thinu Health Centre Katangi Health Centre Makadara Health Care Katulani Health Centre Kikesa Dispensary Mlolongo Health Centre Masii Health Centre Kisiiki Dispensary St Assisi Sisters of Mary Immaculate Nursing Home Mbiuni Health Centre Kithimani Dispensary St Immaculate Clinic Miu Health Centre Kyasioni Dispensary Apdk Dispensary (Machakos) Muthetheni Health Centre Matuu Sub County Hospital Approved School Dispensary (Machakos) Muusini Dispensary Matuu Mission Hospital Bishop Kioko Catholic Hospital Mwala Sub County Hospital Kakuyuni Health Centre Kalama Dispensary Vyulya Dispensary Kangundo Sub County Hos- Kamuthanga Dispensary Wamunyu Health Centre pital Kiitini Dispensary D Comboni Mission Kivaani Health Centre Kimutwa Dispensary Ekalakala Health Centre Mukunike Dispensary Kititu Dispensary Iuuma Dispensary Ndunduni Dispensary Kola Health Centre Kangonde Health Centre Donyo Sabuk Dispensary Kyawalia Dispensary Kaonyweni Dispensary Kalandini Health Centre Machakos Level 5 Hospital Kathukini Dispensary Kwa Nguu Dispensary Mua Hills Dispensary Kikule Dispensary Matungulu Health Centre Mutituni Dispensary Kithyoko Health Centre Nguluni Health Centre Muumandu Dispensary Kivaa Health Centre Sengani Dispensary Shalom Community Hospital (Machakos) Mananja Health Centre St Mark Maternity Kathiani Sub County Hospital Masinga Sub County Hospital Tumaini Reproductive Health Clinic An Operation Triple Zero (OTZ) club meeting at Kangundo Sub County Hospital HUMAN RESOURCES FOR HEALTH CADRE NUMBER CDC through CHS strengthens human resource capacity by supporting facilities with different Clinical Officers 51 cadres of health care workers to bridge the human Health Records and Information Officers 28 resource gap. Data clerks 12 HIV Testing Officers 79 Through the CHS managed sub-grant, Machakos HTS Supervisors 8 County is currently receiving support for 226 health Nurses 11 care workers and 157 volunteers to the tune of Nutritionists 5 US$ 1,238,064 (85% of the sub grant), while 15% Laboratory Technicians 14 is used to complement the management functions Pharmaceutical Technologists 7 of the County Department of Health including Social Workers 4 joint support supervision/mentorship, laboratory Adherence Counsellors 4 networking and defaulter tracking. Accountants 3 Total 226 CDC through CHS supports the training of health care workers to promote the delivery of quality health services including enhancing health worker capacity on the current Ministry of Health HIV management guidelines and the roll out of the test and treat strategies towards the HIV epidemic control. Launch of the Machakos County HIV and AIDS Strategic Plan by Machakos County First Lady Lilian Ng’ang’a LEADERSHIP AND GOVERNANCE Machakos County has demonstrated ability to sustain the gains accruing from the partnership with CDC through allocation of additional resources to the Department of Health that has enabled recruitment of 800 health workers by the County government since devolution. In addition, the County as committed to absorb at least 15% of the CHS-supported staff every year. To respond to the HIV epidemic, the county has also developed a county specific HIV AIDs strategic plan to guide its response. EQUIPMENT SUPPORT CDC has made investments in equipment for various health facilities in Machakos County ranging from two Biosafety cabinets, four CD4 Count Analysers and 4 Haematology Analysers among others. Centre for Health Solutions - Kenya, Kiamba Mall, 3rd floor Machakos Tel: +254 (0) 271 0077 www.chskenya.org.