Republic of Kenya Ministry of Health A report on the Performance Status 2003 and 2004 Health Management Information System A report on the Performance Status Health Management Information System 2003 – 2004 annual report This document may be freely copied on the understanding that full acknowledgement is made to the Ministry of Health; Health Management Information Systems. Contents ABBREVIATIONS..............................................................................................................................................................VIII FORWARD..............................................................................................................................................................................IX ACKNOWLEDGEMENTS:................................................................................................................................................. XI EXECUTIVE SUMMARY....................................................................................................................................................... I 1. CHAPTER 1 – COUNTRY PROFILE.........................................................................................................................1 1.1 Introduction................................................................................................................................................................. 1 1.1.1 Location and Administrative units .......................................................................................................................... 1 1.1.2 Political Organisation............................................................................................................................................... 1 1.1.3 Topology and geology.............................................................................................................................................. 1 1.1.4 Climate ...................................................................................................................................................................... 2 1.2 Trends in Socio-economic development .................................................................................................................. 2 1.2.1 Economic Trends...................................................................................................................................................... 2 1.2.2 Demographic features .............................................................................................................................................. 2 1.3 Trends in Health Status Indicators.......................................................................................................................... 5 1.3.1 Childhood Mortality................................................................................................................................................. 6 1.3.2 Maternal Mortality ................................................................................................................................................... 7 1.3.3 Fertility levels ........................................................................................................................................................... 7 1.3.4 Current contraceptive use ........................................................................................................................................ 8 1.3.5 Delivery in health facilities...................................................................................................................................... 9 1.3.6 Social determinants of health................................................................................................................................... 9 1.3.6.1 Education and literacy rates............................................................................................................................ 9 1.3.6.2 Unemployment .............................................................................................................................................. 10 1.3.6.3 Poverty........................................................................................................................................................... 11 1.3.7 Development indices.............................................................................................................................................. 11 2. `PUBLIC SECTOR HEALTH CARE FINANCING AND EXPENDITURE..................................................... 12 2.1 Financing.................................................................................................................................................................... 12 2.1.1 Expenditure............................................................................................................................................................. 12 2.1.2 Ministry of Health Expenditure by sub Vote........................................................................................................ 13 2.1.3 Ministry of Health Recurrent Expenditure by Economic Category.................................................................... 15 2.1.4 Health services........................................................................................................................................................ 16 2.2 Financial Performance of Cost Sharing Programme.......................................................................................... 19 2.2.1 Reporting Rates ...................................................................................................................................................... 19 2.2.2 Trends in cost sharing revenues ............................................................................................................................ 19 2.3 National Health Insurance Fund Income & Expenditure Analysis ................................................................. 20 2.3.1 Benefits ................................................................................................................................................................... 21 2.3.2 Personnel................................................................................................................................................................. 21 2.3.3 Operations and Maintenance ................................................................................................................................. 21 2.3.4 Surplus..................................................................................................................................................................... 21 3. DIVISION OF HEALTH CARE FINANCE ............................................................................................................ 24 3.1 Financial Performance of the Cost Sharing Programme ................................................................................... 24 3.1.1 Reporting rates........................................................................................................................................................ 24 3.1.2 Revenue................................................................................................................................................................... 24 3.1.2.1 Revenue Banking .......................................................................................................................................... 25 3.1.3 Expenditure............................................................................................................................................................. 26 3.1.4 Waivers and exemptions ........................................................................................................................................ 27 3.2 National Hospital Insurance Fund Claims ........................................................................................................... 27 3.2.1 Manuals Developed................................................................................................................................................ 28 3.2.2 Resources ................................................................................................................................................................ 28 3.2.3 Way forward for division of health care financing .............................................................................................. 28 4. PREVENTIVE AND PROMOTIVE SERVICES.................................................................................................... 29 i Annual Report 2003 - 2004 4.1 Nutrition and Growth Monitoring Services ......................................................................................................... 29 4.1.1 Growth Monitoring and Promotion....................................................................................................................... 29 4.2 Child Health Services ............................................................................................................................................... 37 4.2.1 Aims of the Division of Child Health ................................................................................................................... 38 4.3 Malaria Control Programme .................................................................................................................................... 41 4.3.1 Introduction............................................................................................................................................................