Health Accountability Project-HAP

Aim

The accountability initiatives were aimed at promoting effective and substantive civic engagement and civilian oversight to ensure adequate access to essential drugs and medicines within the public health facilities in Elgeyo Marakwet county.

Landscape

Accessibilty of essential drugs is a challenge for the citizens of Elgeyo Marakwet County. Drug theft in public health facilities is rampant and where the drugs have been supplied, there is no system in place to track their dispensation to the clients, and the general public does not have sufficient knowledge on how they can oversee public health services especially relating to medicine. This is why TI-Kenya sought to increase the accessibility of essential drugs and medicines within the public health facilities in Elgeyo Marakwet County under the Health Accountability Project (HAP) by promoting citizen and public health stakeholders’ engagement and by promoting the adoption of ICT systems.

The combination of citizen led accountability initiatives and use of ICT accountability system such as the Mobile Drug Tracking System solution (previously implemented by TI-Kenya in two public health facilities within Elgeyo Marakwet County) will therefore increase the accessibility of essential drugs and medicines within the public health facilities in Elgeyo Marakwet County.

The accountability initiatives were aimed at promoting effective and substantive civic engagement and civilian oversight to ensure adequate access to essential drugs and medicines within the public health facilities in Elgeyo Marakwet county. It included the following outcomes:

• Empower members of the public in Elgeyo Marakwet County to use the health management system and the county budget process affecting supply and management of essential drugs and medicines. The empowerment is operationalised through the development, production and dissemination of Information Educative and Communication (IEC) materials and capacity-building modules. After completion, the citizens will be able to demand information from the relevant health departments on essential medicines and drugs and provide oversight to ensure proper supply and management of essential drugs and medicines.

• Building the capacity of the members of the health facility management committees, health public officials and community health volunteers on effective management and oversight in the provision of essential drugs and medicines as they play a critical role in supply and management.

• TI-Kenya will also lobby and advocate for upscaling of the Mobile Drug Testing System (MDTS) by the Elgeyo Marakwet County Government to support the supply and management of drugs and medicines within public health facilities because the system is aimed at promoting transparency and accountability in the supply and management of essential drugs and medicines for effective service delivery. The system is currently being used in two health facilities and therefore TI-Kenya proposes that it is expanded to other 20 health facilities within Elgeyo Marakwet County.

Activities

1. Training members of the health facility management committees, health public officials and community health volunteers on effective management and oversight of the provision of essential drugs and medicines as they play a critical role in supply and management.
   Awareness raising
2. Lobbying and advocating for expansion of the Mobile Drug Testing System (MDTS) by the Elgeyo Marakwet County Government to support the supply and management of drugs and medicines within public health facilities. MDTS, which is aimed at promoting transparency and accountability in the supply and management of essential drugs and medicines for effective service delivery, is currently only being used in two health facilities. Therefore TI-Kenya is pushing for its expansion to other 20 health facilities within Elgeyo Marakwet County.
   System development
3. Educating members of the public in Elgeyo Marakwet County on the health management system and the county budget process affecting supply and management of essential drugs and medicines by developing, producing and disseminating Information Educative and Communication materials and giving capacity building modules
   Awareness raisingPolicy briefing

Achievements

1. The County Government of Elgeyo Marakwet have committed to put an ICT system, the Integrated Commodity Management System (ICMS), in place within the County Referral Hospital to manage the dispensation of drugs, the facility staff and the collected revenue within a facility. This is aimed at enhancing transparency and accountability in general facility management.
2. As a result of the empowerment and improved capacity-building among the health care practitioners in the county, the County's Health and Sanitation Department are now directly supplying procured drugs and other medical commodities to the public health facilities, as opposed to storing them in a centralised depot first and distributing them to the health facilities thereafter.
3. Through TI-Kenya's close engagement with the Elgeyo Marakwet County Government since the beginning of the project, the County was willing to set up a complaint redress mechanism in form of a phone number where citizens can share their feedback on service delivery. The complaints are acted upon as soon as possible by a special committee installed by the County Executive.

Lessons Learnt

• The choice of entry point for a project is critical for its success. The commitment of and acceptance by the County Government of Elgeyo Marakwet towards adopting a technological system, MDTS, to manage the distribution of their drugs, was influenced by TI-Kenya's close cooperation with the county government since the beginning of the planning process of the project.