County Measurements, Learning and Accountability Program: Tupime Kaunti FY 2021Q1 Progress Report for RMNCAH

Notable shifts in implementation approach were made due to the COVID-19 pandemic experienced in Kenya and globally. The project used a hybrid of methodologies, including virtual platforms and small group meetings, with some minimal face-to-face meetings. Tracking of supervisory skills among 75 RMNCAH program officers who were trained in FY20 Q4 was a notable achievement. The assessment focused on five areas: leadership and management, communication, resource management, information analysis and use. Four out of five counties had initial overall scores of above 70%. Migori County reported scheduling of support supervision in the CHMT calendar every first week of the month, while Kisumu, Turkana and Nakuru counties reported having conducted RMNCAH support supervision at sub-county levels and provided feedback to their health management committees. Strengthening data quality initiatives for the RMNCAH program was another key achievement. Counties are making strides in the implementation of the Maternal Perinatal Death Surveillance Response (MPDSR) guidelines. However, challenges in the use of data collection tools like the perinatal deaths' notification and review tool exist, compromising the availability of quality perinatal deaths data. The project provided technical assistance to Kakamega, Turkana, Samburu, and Kisumu counties to improve their perinatal deaths data through mentorship on the use of perinatal death notification and review forms. In Kakamega, Samburu, and Turkana counties, mentorship was provided to staff from the maternity and newborn unit in their respective county referral hospitals. The targeted staff were nurses, clinical officers, doctors, and Health Records and Information Officers (HRIOs) involved in direct patient care and review of perinatal deaths. These facilities reported the highest number of perinatal deaths but often, perinatal deaths data were incomplete with numerous gaps. The project sensitized the team on the Kenya MPDSR 2016 guidelines and disseminated the perinatal deaths notification and review tools. The project also guided the county teams to review some perinatal deaths cases, fill the perinatal review forms, and generate actions. The team presented the findings from the files they reviewed and gave recommendations on what could have been done better to save the lives of the mother or child. This was done to familiarize themselves with the forms and learn from each other through peer-to-peer learning as they practice using the forms. The project will continue to mentor the program officers on the identified gaps while tracking utilization of supervisory skills. Additionally, the project will facilitate further analysis to determine the accuracy of causes of perinatal deaths to maternal antenatal and intrapartum history. The project will also continue providing technical assistance to the county in conducting activities geared towards availing timely, complete, and accurate data for use in decision making. In terms of geographic focus, the project is implemented in Tupime Kaunti, with a focus on the counties of Migori, Kisumu, Turkana, Nakuru, Kakamega, Samburu, and Baringo. The project's timeframes are aligned with the FY21 Q1 period, which spans from October 1 to December 31, 2020. The project's recommendations are aimed at improving the quality of data and services in the RMNCAH program, particularly in the areas of supervisory skills, data quality, and perinatal deaths surveillance and response.