1. PRESENTATION FROM ONGATA-RONGAI HHHHHEALTH CENTRE
PRESENTED BYAnouk
Daniel, Dorcus, Anouk, Ahmadshah, Nancy,.

2. Presentation outline
Inputs of thehealth unit
Sources of funding
Fund holder
Health system
Separation of functions
Multisector PBFactivities
Patients opinion regarding health care
3. Profile of the health facility
Location: OngataRongai
Coverage population: Around 100,000
Number of staff: 34 (5 clinical officers, 14 nurses, 7 public officers, one clerk, one nutritionist, 3 support staff, 4 casual workers
HealthCentre Management Committee (9 members)
4. 5. INPUTS: Does the health facility receive inputs? Which ones ? Autonomous management?
Yes, the health facility receives limited inputs like Medicines, Equipment and other supplies from the central Government
Supplied on quarterly basis and not based on need
Some inputs from verticalprogrammes like Marie Stopes, Mosquito nets
The medicine stores was almost empty
Salaries are paidfrom the ministry to staff , fix and low
Limited autonomous management,used the revenue collected from user fees to purchase some medicines and pay for casual staff (Casual staff work harder than the clinical staff)
Received some funding ksh.240.000 abouta week agowhich will supplement to purchasing lab reagents, emergency drugs etc (this was a new scheme)
6. 7. Sources of funding:
The funding comes from the Government
However, they also collect some revenue from user fees. For example:
OPD- Ksh.50
Delivery-Ksh. 300
Referral-Ambulance
Ksh . 1300
8. Under-table payment?
9. Independent fund holder?
There is no independent fund holder
10. Monopoly
The health facility contain monopolistic organization (MoH) for the distribution of essential drugs e.g.Kenya National Medical Stores
However, the user fees collected can also be used to purchase some suppliesin the private pharmacies.
11. Separation of functions: Fund regulator, fund disbursement, service provision and strengthening consumer voice?
This is noseparation of functions:MoH
The in charge however, reportedly said they have suggestion box in place-oftenfound empty
Supervision is not effective (once-twice a year) by the district team
12. Consumer Voice
No mechanism in place, however, community rep. in the committee
Suggestion box in place but not used-Empty
13. Incinerator was in place, but not used
14. Conclusions/observations
Classic input-basedhealthservice provision
Limited autonomy utilisation ofuser fees to pay casual workers,somelimited medicines
Quite a large catchment population to serve (120,000 population)-projection 2009
Staff Salaries low Approximately 20,000 Ksh
No financial expert e.g.
an accountant
The incineratorwas in
place but however not in use
15. Recommendation PBF Experts
More Autonomyshould be granted
Clear indicators and targetsneeds to be understood by all the staff
Quality improvement
Workload- paid according to outputsto motivate the staff
16. Asantesana