Background
The African Leaders Malaria Alliance (ALMA), which comprises the African Heads of State and Government, has been working with CIFF since 2011. ALMA has supported countries to roll out Reproductive, Maternal, New-born, Child and Adolescent Health (RMNCAH) scorecards, nutrition and Community scorecards tools.
CIFF funding has supported the institutionalisation of scorecard management tools to drive policy change, inform planning and budgeting, enhance data-driven decision-making to drive action in RMNCAH nutrition and community health, enhance transparency and accountability and harness political power and resources at national and subnational levels to transform health services provided to communities. Additionally, CIFF support the ALMA Scorecard Hub to enhance sharing, understanding and use of scorecards and accountability mechanisms.
Kenya is one of the high performing countries in the use of scorecard accountability and action tools. Below is an overview of the country’s progress to date.
Kenya nutrition scorecard
- Year of launch: 2020
- Decentralisation: All 47 counties
In 2019, ALMA was invited by the Ministry of Health (MoH), Kenya to provide technical guidance on the development of the nutrition scorecard. ALMA in partnership with UNICEF supported the Ministry of Health to develop the Kenya nutrition scorecard. Other partners supporting the process included Save the Children, Kenya Red Cross Society, Action Against Hunger and Terre des Hommes.
The scorecard comprises of 13 national indicators and 17 indicators at the subnational level across 6 categories namely: maternal, infant, young/older children, and adolescent nutrition; IMAM and emergencies; micronutrient supplementation; nutrition sensitive; financial and socio- economic impacts and governance, policy, coordination and Nutrition Information System (NIS).
Scorecard development was guided by the national nutrition priorities as enshrined in the national strategic documents; continental nutrition priorities as provided in the continental Nutrition accountability scorecard as well as global nutrition commitments.
The scorecard was launched in 2020 by the Cabinet Secretary of Health. It has been decentralised to all the 47 counties with the training of all the county nutrition focal persons. A total of 22 counties have mobilised local resources and decentralised the scorecard to the sub-county and facility levels.
The nutrition scorecard has been configured in KHIS2 as well as the Scorecard Web Platform since 2019 and is regularly published on the ALMA Scorecard Hub.
Kenya RMNCAH scorecard
Ministry of Health (MoH), with the support of ALMA and partners including UNICEF, WHO, Measure Evaluation and USAID. The scorecard is published quarterly on the Scorecard Web Platform and included in the MOH’s Quarterly Health Information System (HIS) e-bulletin. The MoH, in collaboration with partners, have rolled out the scorecard to all 47 counties and built county capacity to use the scorecard. Counties are actively using the scorecard in support of evidence-based decision-making and timely response to the gaps and bottlenecks identified.
The scorecard has benefited from support from partners including UNICEF, USAID, Options E4A Mamaye, UN Agencies (UNH6), ICF/Measure Evaluation, JHPIEGO, PATH, Save the Children, World Bank, AMREF, World Vision among others. Extensive use of the RMNCAH scorecard has led to the development of the National Vaccines and Immunization Programme (NVIP), Nutrition, malaria, NTD and Community.
The RMNCAH scorecard is linked to the Kenya Health Information System 2 (KHIS2) and produced every quarter at all levels including at the health facility level. The RMNCAH scorecard is fully interoperable with KHIS2 and is published on the ALMA Scorecard Hub.
Kenya community scorecard
Kenya developed a Community Scorecard that encompasses use of data at the community level to improve decision making, strengthen ownership and participation of communities to improve delivery of quality health services. As part of the country’s sustainability plan, the community scorecard has been integrated into the social accountability pillar of the revised Kenya Community Health Strategy 2020 – 2024. The scorecard was developed in 2020 by the Ministry of Health (MoH), Kenya with support from ALMA and partners including UNICEF, AMREF, JHPIEGO and Living Goods.
The scorecard comprises of nine qualitative indicators:
- Respectful and compassionate care
- Waiting time for provision of health care services
- Availability of medicines and diagnostic services
- Responsiveness to community health needs
- Cleanliness of the facility
- Safety and security of the facility
- Home visits by Health Workers/Community Health Volunteers
- Assessment of NHIF services
- Emergency and referral services
Each indicator is described in detail with all its respective attributes to aid the scoring process. The scorecard leverages on the existing community health structures such as community health committees, community health units, community dialogue days, community action days and health facility management committees.
The Community Health Division, HIS team and ALMA have configured the scorecard in KHIS2 and assigned respective rights to enter data to all the counties that have rolled out the scorecard. Fourteen counties (Kwale, Vihiga, Homa Bay, Migori, Kakamega, Nakuru, Machakos, Siaya, Kitui, Kilifi, Meru, Mombasa, Nairobi, Nyeri and Nyamira) are implementing the scorecard and reporting data on KHIS2. The scorecard data collection tools form A and B have been incorporated into Ministry of Health, Kenya and are now official Ministry of Health data collection tools (MoH 523 A&B).