REPUBLIC OF KENYA

Health sector
HOSPITAL ANNUAL work plan Awp

County:
Sub County:
Ward:
MFL Code
Health Facility Name:
Facility ownership:
Facility Type:

Level of Care:

Financial Year:

Contents
1.1 Population Demographics..........................................................................................................................................................3
1.1.1
Catchment population for facility..........................................................................................................................................3
1.1.2
Population description...........................................................................................................................................................4
1.2 Status of Health Investments.....................................................................................................................................................5
1.2.1
Health Workforce.................................................................................................................................................................5
1.2.2
Health Infrastructure..........................................................................................................................................................6
1.2.3
Health Products....................................................................................................................................................................7
1.2.4
Health Expenditures (previous year).................................................................................................................................8
1.2.5
Health Information..............................................................................................................................................................8
1.2.6
Health Leadership................................................................................................................................................................8
1.2.7
Service Delivery....................................................................................................................................................................8
2.1 Major Health Problems observed at the facility and catchment area......................................................................................10
3.1 Annual performance targets (including Community indicators).........................................................................................12
3.2 Annual service delivery work plan...............................................................................................................................................14
4.1 Resource Envelope....................................................................................................................................................................20
4.2 Budget Framework...................................................................................................................................................................21
4.3 Budget Summary, by investment area....................................................................................................................................22
ANNEX 1: INTERVENTION SCOPE, AND CODES.............................................................................................................................23
ANNEX 2: BUDGET CODES..................................................................................................................................................................25

1.1 Demographics profile

1.2 Population Categories
Sno

Description

Population
Proportion

Estimated Number

1 Population total
2 Population Female
3 Population Male
4 Households
5 Population under 1 year
6 Population under 5 years
7 Population under 15 years
8 Population 15-24 years
9 Women of childbearing age (1549yrs)
10 Estimated Number of Pregnant Women
11 Estimated Deliveries
12 Estimated live births
13 Neonates 0- 28 days
14 Population 25-59 years
15 Population over 60 years
16 Estimated Emergency obstetric complications
17 Estimated of post abortion cases
18 Population 6-11 Months (50% of <1yrs)
19 Population 12-59 Months (80% of < 5yrs)
20 Population 6-59 Months (90% of < 5yrs)

Source of data: Health facility catchment projection by County Bureau of Statistics

1.3 Population Description

3

________________________________________________________________________________________________________
________________________________________________________________________________________________________
________

1.4 Status of Health Investments

____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________

1.4.1

Health Workforce

Medical-Technical officers
Cadres

Norm

Medical Consultants
General medical officers
Specialised clinical officers
General clinical officers
Community Oral Health officers
Dentists
Dental Technologists
Nursing officers (Bsn)

Available

Deficit /
surplus

Kenya Registered community Health Nurses

Kenya Enrolled community Health Nurses
Public Health Officers
Public Health Technicians
Radiographers
Pharmacists
Pharmacist Technologists
Orthopaedic Technologists
Plaster Technicians
Nutritionists
Physiotherapists
Laboratory Technologist
Health Record & Information Officers
Health Record & Information Technicians
Occupational Therapists
Medical Engineering Technicians
Medical Engineering Technologists
Trained Community Health Workers
Community Health Extension Workers
All others technical officers

Non-Medical Officers
Cadres

Norm

Administrators
Accountants
Secretaries
Medical Social health workers
Nurse aids/ Patient attendants
Clerks
Mortuary attendants
Cleaners
Cooks
Drivers
Security officers

Available

Deficit /
surplus

All others non-technical HR

1.4.2

Health Infrastructure

Area of facility

Number

Minimum Infrastructure

Norm

Waiting room
Consultation rooms
Special clinics consultation rooms
Registration room
Injection room
OPD Block

Pharmacy/drug dispensing room

Plaster room
Minor theatre
Dental unit room
ENT services room
Laboratory room
Immunization services room

MCH/FP unit

FP room
Antenatal room
Maternity ward
Beds for male inpatients
Beds for female inpatients
Beds for children
Maternity Beds
Nursery room

Inpatient services

Operating theatre beds

Accounts department/Cash office
Stores
Administration offices
Room for health records
Community services room

Available

Functioning

Mortuary
Staff quarters for persons on duty
X-ray room

Radiology unit

USS room

Ablution block
Pit latrine
Source of running water Inside Tap
Water reservoir Outside Access
Water storage for roof catchment
Generator house
Community board
Health Facility Board
Ambulances
Support/Utility vehicles
Transport

Bicycles
Motor cycles
Motor Boat

Supply services unit

Kitchen
Laundry

Fence and gate

Acreage
Composite pit
Public Sewerage
Sanitation and waste disposal

Placenta pit
Medical waste disposal means(incinerator,
compost pit)
Septic Tank
Soak Pit
Electricity

Clean energy source

Generator
Generator house
Solar

Communication equipment

Telephone available (landline)

Telephone available ( Mobile)

VHF Radio
Computer
Internet connection/LAN/WAN
Internet connection/modem
Photocopier
Copy Printer
Fax machine

1.4.3

Health Products
Unit of assessment

Pharmaceuticals

Requirements from annual quantification (kshs)

Amounts
KEMSA
received in past
MEDS
12 months (kshs) Other (Donations etc)
Amounts procured using user fees in past 12 months
TOTAL
Gap / surplus (kshs)

1.4.4

A
B
C
D
E
F=
(B+C+D+E)
G = (A-F)

Health Expenditures (previous year)

Item

Amount Budgeted
Amount Received
Expenditure
Expenditure accounted for (SOEs
submitted)
Funds utilization rate
Accounting rate

Non
pharmaceuticals

Calculati
on

HSF

Other GoK

(A)
(B)
(C)
(D)
(C/B X
100)
(D/C X
100)

Source of funds
User fees
CDF

LATF

Partners
(specify)

Item

1.4.5
1
2

Other GoK

Source of funds
User fees
CDF

LATF

Partners
(specify)

Health Information
Norm
4

Actual

100%

Health Leadership

Intervention
Facility committee meetings
Facility Management Team meetings held in past 12 months
Quarterly stakeholder meetings held in past 12 months
Annual Operational Plan available for past year
Annual stakeholders meeting held for past year
Board meetings held in past 12 months

1.4.7
1
2
2
3
4
5
6

HSF

Intervention
Quarterly performance reports prepared, and discussed by Health management
Committee
Monthly MOH 105 Service Delivery reports submitted in previous year (completeness- %)

1.4.6
1
2
3
4
5
6

Calculati
on

Norm
4
12
4
Yes
Yes
2

Actual

Norm
12
Yes
Yes
Yes
Yes
Yes
Yes

Actual

Service Delivery

Intervention
Integrated Outreaches carried out, to community units
First Aid skills amongst community units available (All CHEWs)
First Aid skills amongst community units available (All CHW)
Comprehensive Clinical management guidelines in place, and being utilized
Patient safety protocols / guidelines displayed in facility, and are being followed
Facility service charter is available, and is displayed in Outpatients
Emergency contingency plans (including referral plans) available

2.1 Major Health Problems observed at the facility and

catchment area
Area of
Health

Priority areas
for consideration

Eliminate
Communicabl
e conditions

HIV/AIDS

Halt, and
reverse
increasing
burden of Non
communicabl
e conditions

Heart diseases
Cancers
Mental disorders
Hypertension
Diabetes
Others (specify)

Reduce the
burden of
Violence &
Injuries

Road accidents
Domestic violence
Suicide
Drowning
Wars / conflicts
Others (specify)

Malaria
Tuberculosis
Pneumonia
Measles
Worm infestations
Diarrheal diseases
Others (specify)

Major
Problem*
Yes
No

Area of
Health

Priority areas for

consideration

Provide
essential
health care

Pregnancy / childbirth health

problems
Newborn health problems
Under 1s health problems
Adolescent health problems
Adult women health problems
Adult men health problems
Others (specify)

Minimize
exposure to
health Risk
factors

Obesity
Smoking
Underweight children
Underweight mothers
Poor breastfeeding practices
Poor hygiene practices
Poor child spacing (< 3 years)
Alcohol and drug use
Unsafe sex
Others (Specify)

Strengthen
collaboratio
n with
Health
Related
Sectors

Unsafe water
Inadequate sanitation
Unemployment
Insecurity
Low female Education
Food insecurity
Inadequate nutrition
Poor road networks
Poor housing ventilation
Mobility of population
Others (specify)

10

Major
problem*
Yes
No

* These are problems affecting a significant number of people in the community unit, or are a major threat to the health of persons in
the area of responsibility of the facility. For adequate planning, these should not be more than 40% of all listed priority areas

11

2.2 Problem analysis

Area of Health

Key challenges*
(Relate to access to care, and/or
quality of service delivery)

Priority Interventions to address identified

challenges
(Maximum of 3 per challenge from list in
Annex 1)

Eliminate
Communicable
conditions

Halt, and reverse

increasing burden of
Non communicable
conditions
Reduce the burden of
Violence & Injuries

Provide Essential
Health Care

Minimize exposure to
health Risk factors

Strengthen
collaboration with
Health Related
Sectors

* Challenges are those problems within control of the Referral Facility, or County to manage. They form the basis for the planned
activities, and should therefore have achievable solutions
12

3.1Annual performance targets

Indicator
domain

Area of service

Health
Outcomes

Eliminate
Conditions

Indicator of performance measurement

Communicable

Health, and reverse increase in

Non Communicable Conditions

Reduce the burden of violence

and injuries

Provide essential health care

HIV+ pregnant mothers receiving preventive

ARVs to reduce risk of mother to child
transmission (PMTCT)
Number of Pregnant Women receiving TT2
immunization
Number of pregnant women receiving IPT2
Children under 1 year of age fully immunized
Children under 1 distributed with Long Lasting
Insecticide Treated Nets (LLITNs)
Number of Children de-wormed
Number of adults OPD clients with BMI more
than 26
Women of Reproductive Age screened for
cervical cancer
Number of Outpatients with mental health
conditions
Number of Outpatients found with high blood
pressure
New patients with general injury related
conditions
New patients with violence injury related
conditions
Number of Patients with violence/ injury
related conditions dying in the facility
Number of Pregnant women attending at least
4 ANC visits
Number of Deliveries conducted by skilled
attendants in health facilities
Number of children Under 1 dying in health
facility
Number of Fresh Still Births in the facility
Number of Facility Maternal deaths
Number of Persons with ill health referred to
community Units

13

Achieveme
nt: July Dec in
current
year
(A)

Baseline

Target

(B = A X 2)

(C)

Indicator
domain

Area of service

Indicator of performance measurement

Minimize exposure to health

risk factors

Number of Women of reproductive age (WRA)

receiving family planning (FP) commodities
Number of Newborns with low birth weight
(LBW less than 2,500 grams)
Number of Children under 5 years attending
Child Welfare Clinics for growth monitoring
(new cases)
Number of Households provided with health
promotion messages
Number of Clients tested for HIV
Number of Children under 5 years attending
Child Welfare Clinics who are under weight
Number of Children under 5 years attending
Child Welfare Clinics who are stunted
Number of Households with functional toilets
Number of Households with hand washing
facilities

Strengthen collaboration with

health related sectors

Health
Outputs

Access

Quality and safety of care

Health
Inputs &
processes

Efficient service delivery

system that maximizes health
outcomes.
(Including Community Unit
indicators)

Comprehensive leadership that

delivers on the health agenda.

Number of new Outpatients (male)

Number of new Outpatients (female)
Number of inpatients (admissions) Under 5
Number of inpatient (admissions) Over 5
Number of Emergency surgical cases operated
on within one hour
Total inpatient days
Number of Persons referred to facility, from
Community Units
Quarterly Community dialogue days held
% of Maternal deaths audited
Number of Therapeutic committee meetings
held
Number of clinical audit meetings held
Number of Outreaches held from facility to the
community
Number of quarterly Facility Health Committee
meetings held
Number of monthly Facility Health Committee
meetings held

14

Achieveme
nt: July Dec in
current
year
(A)

Baseline

Target

(B = A X 2)

(C)

4
100%
4
12
12
4
12

Indicator
domain

Area of service

Indicator of performance measurement

Adequate finances mobilized,

allocated and utilized, with
social and financial risk
protection assured.

Adequate Health information,

for evidence based decision
making.
Universal access to essential
health products and
technologies.
Adequate and appropriate
Health Infrastructure

Achieveme
nt: July Dec in
current
year
(A)

Annual performance review meeting held

Health facility service charter displayed
Total available financing (kshs)
Cost sharing collections (previous year)
Number of clients waived
Amount for clients waived (Kshs)
Number of clients exempted
Amount for clients exempted (Kshs)
Number of planning meetings held
Number of performance review meetings held

Baseline

Target

(B = A X 2)
1
Yes

(C)

12

Episodes with over 7 days stock-outs for any

of the 15 tracer medicines

Number of beds
Number of functional vehicles
Number of functional computers

3.2 Annual service delivery work plan

3.2.1. Result Area 1: Eliminate Communicable conditions
Priority
Areas for
action

Activities targeted

* What the facility intends to do, to implement the

selected interventions from section 2.2

Respo
nsible
persons

Priority
Area 1

15

Timeframe
Q
1

Q2

Q
3

Q4

Budget

Sourc
e

Priority
Area 2

Priority
Area 3

3.2.2. Result Area 2: Halt, and reverse increasing burden of Non communicable conditions
Priority
Areas for
action

Activities targeted

* What the facility intends to do, to implement the

selected interventions from section 2.2

Respo
nsible
persons

Priority
Area 1

16

Timeframe
Q
1

Q2

Q
3

Q4

Budget

Sourc
e

Priority
Area 2

Priority
Area 3

3.2.3. Result Area 3. : Reduce the burden of Violence & Injuries

Priority
Areas for
action

Activities targeted

* What the facility intends to do, to implement the

selected interventions from section 2.2

Respo
nsible
persons

Priority
Area 1

17

Timeframe
Q
1

Q2

Q
3

Q4

Budget

Sourc
e

Priority
Area 2

Priority
Area 3

3.2.4. Result Area 4: Provide essential health care

Priority
Areas for
action

Activities targeted

* What the facility intends to do, to implement the

selected interventions from section 2.2

Respo
nsible
persons

Priority
Area 1

18

Timeframe
Q
1

Q2

Q
3

Q4

Budget

Sourc
e

Priority
Area 2

Priority
Area 3

3.2.5. Result Area 5: Minimize exposure to health Risk factors

Priority
Areas for
action

Activities targeted

* What the facility intends to do, to implement the

selected interventions from section 2.2

Respo
nsible
persons

Priority
Area 1

19

Timeframe
Q
1

Q2

Q
3

Q4

Budget

Sourc
e

Priority
Area 2

Priority
Area 3

3.2.6. Result Area 6: Strengthen collaboration with Health Related Sectors

Priority
Areas for
action

Activities targeted

* What the facility intends to do, to implement the

selected interventions from section 2.2

Respo
nsible
persons

Priority
Area 1

20

Timeframe
Q
1

Q2

Q
3

Q4

Budget

Sourc
e

Priority
Area 2

Priority
Area 3

4.1Resource Envelope
Category

Source of funds
Servic
e
delive
ry

Public
Sources

Human
Resourc
es

Amount Allocated in Kshs (000)

Health
Health
Health
Infrastructu Informati Leadersh
re
on
ip

County Government
Central Government
HSF
LATF

21

Health
Financi
ng

Unspecif
ed

Total
amount
kshs

Category

Source of funds
Servic
e
delive
ry

Human
Resourc
es

Amount Allocated in Kshs (000)

Health
Health
Health
Infrastructu Informati Leadersh
re
on
ip

User fees
Constituency Development Fund
Other (specify)
Developme
nt Partners

Africa Development Bank

Clinton Foundation
Danish Government (DANIDA)
UK Government (DfID)
European Commission
German Government (GIZ)
Italian Government
Japanese Government (JICA)
Netherlands Government
UN agency (UNAIDS)
UN agency (UNFPA)
UN agency (UNICEF)
UN agency (World Bank WB)
UN agency (WHO)
US Government (USAID / APHIA 2)
Other (specify)

Community
/ NGO

NGO / CSO (specify)

Kenya Episcopal Conference (KEC)
Christian Health Association of Kenya
(CHAK)
Supreme Council of Kenya Muslims
(SUPKEM)
Other (specify)

TOTAL

See Annex 1 for details of variables to consider within each area of investment

22

Health
Financi
ng

Unspecif
ed

Total
amount
kshs

4.2Budget Framework
Area of Health

Priority Interventions
(From section 3.1 above)

Activities targeted
(from section 3.1 above)

Eliminate
Communicable
conditions

Sub total
Halt, and reverse
increasing
burden of Non
communicable
conditions
Sub total
Reduce the
burden of
Violence &
Injuries

Sub total
Provide essential
Medical services

Sub total
Minimize
exposure to
health Risk
factors
23

Budget
source(s)

Amount
from
source

Budget
code
(Annex 2)

Area of Health

Priority Interventions
(From section 3.1 above)

Activities targeted
(from section 3.1 above)

Budget
source(s)

Amount
from
source

Budget
code
(Annex 2)

Sub total
Strengthen
collaboration
with Health
Related Sectors
Sub total
Community Units
operations

Sub total
OVERALL
TOTAL

4.3Budget Summary, by investment area

1
2
3
4
5
6
7

Investment area
Service Delivery systems
Health Workforce
Health Infrastructure (physical, equipment, transport, and ICT)
Health Products and Technologies (including Vaccines)
Health Information
Health Financing
Health Leadership & Governance
TOTAL

Amount budgeted (kshs in 000)

Information from Priority interventions classification across investment areas (Annex 1)

24

ANNEX 1: INTERVENTION SCOPE, AND

CODES
Code Orientation
area
1
Service delivery

Cod
e
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9

Intervention area
Support provision of referral services from lower levels
Support Provision of referral services across similar facilities
Supportive supervision to lower units
Facilitate outreach services
Emergency preparedness planning
Support follow up of clients during rehabilitation (drug uptake, home recovery, etc)
Hold quarterly therapeutic committee meetings, to monitor staff management practice
Establish Community Units where needed
Facilitate clinical audits (including maternal death audits)

Health
Infrastructure

2.1
2.2
2.3
2.4
2.5

Infrastructure inventory development and management

Comprehensive planning for required health infrastructure
Procurement / purchase of required infrastructure in line with norms
Routine maintenance of existing functional infrastructure
Repair of existing infrastructure, to ensure full functionality

Health
Workforce

3.1
3.2
3.3
3.4
3.5
3.6
3.7

Make available updated HR mapping

Allocation of facility functions, amongst existing staff
Provide allowances where required
Facilitate and follow up recruitment of critical missing human resources
Carry out staff appraisals
Institute mechanisms for staff motivation
Training of Health Workers

Health
information

4.1
4.2
4.3
4.4
4.5

Collate information on health actions at this level of care

Monthly compilation, and submission of Health Information using provided formats
Collate information from health related sectors on key indicators
Maintain update information on vital events (births, deaths and cause of deaths)
Quarterly analysis, and communication of relevant health information to stakeholders
25

Code Orientation
area

Cod Intervention area

e
4.6 Facilitate comprehensive disease surveillance activities
4.7 Quality review of Verbal Autopsies

Health Products

5.1
5.2
5.3
5.4

Health Products inventory development and management

Warehousing / storage of health products
Develop annual, and medium term procurement plan for health products
Procurement / purchase of required health products

Health
Financing

6.1
6.2
6.3
6.4

Produce quarterly reports on status of financing for activities in AOP

Engage with health actors to facilitate implementation of selected activities
Provide summary information to guide health financing
Compile quarterly expenditure returns

Leadership and
Governance

7.1 Carry out quarterly stakeholder meetings with all health and health related actors
7.2 Engage with health related sectors to ensure appropriate prioritization of activities
affecting health
7.3 Carry out monthly management meetings
7.4 Compile quarterly, and annual plans, and performance reports

26

ANNEX 2: BUDGET CODES

Item Code
2110200
2110201
2110202
2210100
2210101
2210102
2210200
2210201
2210203
2210300
2210301
2210302
2210303
2210306
2210500
2210502
2210504
2211000
2211004
2211015
2211100
2211101
2211103
2211200
2211201
2211202
2211204
2211300
2211301
2211305
2220100
2220101
2220103
2220200
2220201
2220202
2220203
2220204

Item Description
Basic Wages-Temporary employees
Contractual employees
Casual Labour
Utilities supplies and Services
Electricity
Water and Sewerage Charges
Communication supplies and services
Telephone, Telex, facsimile, mobile phone services
Courier and postal services
Domestic travel& subsistence and other Transportation
Travel cost (bus, railway, mileage allowance)
Accommodation-domestic travel
Daily subsistence allowance
Repatriation costs (transfer of patients)
Printing, Advertising and information Supplies and services
Publishing and printing services
Advertising a, awareness and publicity campaigns
Specialised materials and Supplies
Fungicides, insecticides and Sprays
Food and rations
Office and General supplies &services
General office supplies (stationery)
Sanitary and cleaning materials, supplies and services
Fuel and Lubricants
Refined fuel &Lubricants for transport (petrol)
Refined fuel &Lubricants for production(Diesel)
Other fuel (wood and charcoal)
Other Operating Expenses
Bank service Commission and Charges
Contracted Guards and Cleaning services
Routine Maintenance-Vehicles and Transport Expenses
Maintenance Expenses-motor vehicles
Maintenance Expenses-boats and ferries
Routine Maintenance- Other Assets
Maintenance of plant, machinery and equipment
Maintenance of office furniture and equipment
Maintenance of medical and dental equipment
Building and stations-non residential

27

District

Constituency

Referral facility Management Team members

1
7
2
8
3
9
4
10
5
11
6
12

Ward

Ownership

Referral facility board members

1
7
2
8
3
9
4
10
5
11
6
12

28