Tropical Institute of Community Health and Development, Great Lakes University of Kisumu (GLUK), Kisumu, Kenya.
Glob Public Health. 2010;5(6):595-610. doi: 10.1080/17441690903418969.
Despite focused health policies and a reform agenda Kenya has not made a breakthrough in improving the situations of households entrapped in the vicious cycle of poverty and ill health. Consequently, Great Lakes University of Kisumu developed and tested a model for facilitating improvement in the performance of the District Health System (DHS) and, hence, the health status of poor households served. The model consisted of evidence-based dialogue between the communities and service providers, working with service consumers as partners in improving service delivery and outcomes. The study was undertaken in partnership with the Ministry of Health (MOH) and the Communities. The model was tested by introducing it in selected sites and carrying out health facility and household sample surveys at the beginning of the intervention and two years later in both intervention and control sites. Among the key improvements noted were: governance and management of the health system; service delivery and health outcomes in terms of immunisation coverage; usage of insecticide treated nets; and utilisation of skilled attendance at childbirth. Based on the results, the Kenyan MOH adopted the model as a strategy for the implementation of the Kenya Essential Package for Health countrywide. The University developed the implementation guidelines and training materials for rolling out the strategy countrywide.
尽管肯尼亚实施了重点卫生政策和改革议程，但在改善陷入贫困和健康不良恶性循环的家庭状况方面并没有取得突破。因此，肯尼亚基苏木大湖大学开发并测试了一种模式，以促进改善地区卫生系统 (DHS) 的绩效，从而改善所服务的贫困家庭的健康状况。该模式包括社区和服务提供者之间基于证据的对话，与服务消费者合作，作为改善服务提供和结果的伙伴。该研究是与卫生部 (MOH) 和社区合作进行的。该模式是通过在选定地点引入并在干预开始时以及两年后在干预和对照地点进行卫生机构和家庭抽样调查来进行测试的。注意到的主要改进包括：卫生系统的治理和管理；免疫接种覆盖率方面的服务提供和健康结果；使用经杀虫剂处理的蚊帐；以及熟练护理分娩的利用。根据研究结果，肯尼亚卫生部将该模式作为在全国范围内实施肯尼亚基本卫生包的一项战略。该大学制定了在全国范围内推出该战略的实施指南和培训材料。
