Vision:
A County with healthy residents that embrace preventive health care and have access to affordable and equitable health care services.

Mission:
To provide accessible, affordable, quality health care services to all through strengthening health systems, scaling up health interventions, partnership, and innovation and empowering communities to foster sustainable social and economic growth.

Medical Services
The goal of a medical services department is to ensure accessible, affordable, high-quality healthcare services for all citizens, through policy development, training, research, collaboration, compliance, public awareness, and technology.

Priorities:
1. Strengthen Curative and Rehabilitative Healthcare Services.

2. Strengthen performing of specialized professional skills and referral functions.

3. Improving healthcare access and quality through investing in medical facilities and infrastructure, as well as implementing quality improvement
programs to enhance healthcare services.

4. Prioritize Universal Health Coverage (UHC).

5. Strengthening healthcare workforce through training and professional development opportunities for healthcare professionals, as well as
addressing workforce shortages and skill gaps.

6. Promoting the adoption of new technologies and practices in healthcare delivery through research.

7. Improve healthcare information system in liaison with the National Government and upgrade the County’s two main hospitals to teaching and
referral level.

8. Developing and enforcing healthcare regulations and standards to ensure the safety and quality of healthcare services.

9.Upgrade of the existing operational health facilities at level II and III.

Public Health and Sanitation
The goal of the public health and sanitation department in the Ministry of Health is to protect and promote the health of the population by preventing and controlling the spread of diseases, ensuring access to safe and clean water, improving sanitation and hygiene practices, and promoting healthy lifestyles

Priorities
1. Improve Health promotion, disease prevention activities.

2. Utilize Mobile clinics to bring services closer to under-served areas through mobile outreach clinics.

3. Work with other stakeholders to sensitize the community on sanitation and hygiene through building and upgrading of pit-latrines, using clean water.

4. Accelerate vaccination drives for prevention of vaccine preventable diseases.

5. Enhance collaboration between private sector, partners involved in health service provision.

6. Enhance vector control through spraying of breeding sites.

7. Promotion of disease surveillance activities.

8. Improve nutrition services to malnutrition in the County.

9. Promote Reproductive Maternal Child and Adolescent Health activities.

10. Strengthening healthcare workforce through training and professional development opportunities for healthcare professionals, as well as
addressing workforce shortages and skill gaps.

11. Developing and implementing policies and programs to address public health issues such as epidemics, pandemics, and chronic diseases.

12. Developing public health campaigns and initiatives to promote healthy behaviors and lifestyles, as well as to raise awareness about health-related
issues.

Drugs and Medical Supplies Management
The goal of the drugs and medical supplies department in the Ministry of Health is to ensure access to safe, effective, and affordable medicines and medical supplies through quality assurance, availability, affordability, rational use, innovation and research, and collaboration with other agencies and organizations.

Priorities:
1. Enhance capacity for leadership, governance and partnership.

2. Strengthen Human resources and capacity development in management. for Health Products and Technologies supply chain.

3. Improve and sustain a robust Health Products and Technologies selection, quantification, procurement, warehousing, distribution, use
and accountability.

4. Promote rational use of Health Products and Technologies and patient safety.

5. Improve medical equipment supplies and management.

6. Conduct continuous support supervision to promote accountability of commodities.

7. Embrace and adopt Health Information Systems for supply chain aspects of Health Products Technologies through use of an integrated
HMIS to improve inventory control and revenue collection.

8. Embrace robust, continuous and sustainable financing for Health Products and Technologies

The County Ministry of Health and Sanitation is headed by the County Executive Committee Member of Health and Sanitation. The accounting officer is the Chief Officer of Health. The top technical administration is headed by the Deputy Director and assisted by an Assistant Director. Heads of the various technical departments complete the County Health Management team. The ministry is organized into various key service departments which include: – Clinical, Nursing, Diagnostics, Rehabilitative, Pharmacy, Public Health, Nutrition, Ambulance services etc.

The ministry has a vibrant workforce of about 1086 health workers who man 11 hospitals, 24 health centers and 220 dispensaries spread across the 30,000KM2 of the county. The ministry’s core mandate is to provide quality curative, preventive and promotive and rehabilitative health care services to the people of Kitui County.

To achieve this, the ministry’s services are organized into three tiers; there are various services that can be accessed at different tiers of care. Tier 1 encompasses community strategy where health promotion, community hygiene, and sanitation, Ambulance linkage, and referral to health facilities and disease prevention services are provided. Tier 2 comprising of health centre and dispensaries provide health promotion, curative, preventive, Ambulance services, HIV and TB services, maternal and child health services etc. Tier 3 comprising of Sub County and County hospitals provide all the services provided by tier 2 and in addition it provides specialized services such as surgical services, Dental services, Ophthalmology services, Psychiatry care, Physiotherapy, Occupational therapy, Orthopedics therapy, specialized pediatrics services, Specialized Medical services, Radiology services, Obstetrics and Gynecological and Ambulance services.

Under the sub-programme of HIV/AIDS prevention and control, the target for the number of eligible HIV clients using ARVs was exceeded, with 24,493 clients using ARVs compared to the target of 18,750. The percentage of pregnant women counselled and tested for HIV/syphilis during ANC was only 70.2% compared to the target of 98%, due to an erratic supply of supplies. However, the percentage of HIV+ pregnant mothers receiving preventive ARVs and syphilis treatment was exceeded, with 99.5% of mothers receiving treatment compared to the target of 98%. The percentage of HIV-exposed infants (HEI) turning HIV positive was higher than the target, with 10.8% turning positive compared to the target of 5.2%.

Under malaria control, the number of health facilities receiving malaria drugs was exceeded, with 307 facilities receiving drugs compared to the target of 260.

Under immunization and vaccines, the percentage coverage of fully immunized children <1 year was 78.5% compared to the target of 85%, with coverage being affected by the COVID19 pandemic. The number of immunizing health facilities was exceeded, with 300 facilities providing immunization services compared to the target of 260.

Under reproductive health, maternal, neonatal, child, adolescent health (RM), the percentage of women with unmet needs for family planning was 56%, which is slightly better than the baseline of 55.1%. The percentage of deliveries conducted by skilled attendants exceeded the target, with 65.2% of deliveries being conducted by skilled attendants compared to the target of 50%. The number of maternity units/ wards operational was exceeded, with 70 units being
operational compared to the target of 14.

Under nutrition, the number of children classified as overweight showed a significant increase, surpassing the target of 900 and reaching 4,275. This rise was attributed to a lack of knowledge regarding proper nutritional practices. Addressing this knowledge gap could be a key strategy in tackling childhood overweight and promoting healthier lifestyles. Encouragingly, the percentage of infants under 6 months who were exclusively breastfed increased from 70% to 80%, surpassing the set target and reaching 81.5%. This achievement highlights the success of efforts to promote and support exclusive breastfeeding practices among mothers.

Regarding maternal health, the percentage of pregnant women receiving Iron Folate for at least 90 days showed remarkable progress. The target of 68% was surpassed, and the achieved figure reached 81.5%. This improvement signifies the effectiveness of interventions aimed at addressing iron deficiency and promoting healthy pregnancies.

The percentage of children aged 6 to 59 months receiving Vitamin A supplements twice a year witnessed substantial progress, exceeding the target of 70% and reaching 90%. This achievement indicates the successful implementation of vitamin A supplementation programs,
which are vital for children’s growth and development.

The County has made strides in improving health promotion and behavioural changes related to health issues. A total of 36 radio talk shows were held on the control of non-communicable diseases, resulting in improved health seeking behaviour. Additionally, 2,470 Community Health Volunteers (CHVs) were trained on non-communicable diseases control and prevention, although the target was deemed too high given that the County had never had such a number of CHVs before.

Health promotion messages reached a total of 259,236 households through media platforms and household visits by CHVs. In terms of community health services, the County established 247 functional community units, but only 41 were fully functional and equipped with support from CMMB. As a result, 279,969 persons were referred to health facilities by CHVs, but the baselines and targets were considered too high due to the CHS structure not being well-established.

On the issue of clean water and sanitation, the County saw improvements in household access to safe water, with 65% of households having access compared to the previous 30%. This was attributed to the supplies of water treatment chemicals provided by CHVs. Moreover, 100% of households had access to a sanitary facility, thanks to market-based sanitation marketing supported by CHVs and PHOs. The number of units fully using sanitary facilities also increased
from 3,555 to 4,930.

Routine inspections conducted by PHOs resulted in an increase in the number of trade premises meeting minimum requirements on hygiene and sanitation, with the number rising from 6,461 to 10,403. Finally, 90% of public health facilities were disposing of healthcare waste appropriately, and health care workers were trained on waste management and provided with waste collection supplies.

The county established a palliative care centre with both in-patient and outpatient departments fully equipped, and the target for the number of palliative care units established was achieved.

In improving health care county-wide, the goal was to operationalize 24 new health facilities, but the county was able to operationalize 45 new health facilities. However, the goal of adopting the county health bill was not achieved. The target for the number of health facilities using IHMIS was not met due to budget constraints.

In monitoring and evaluation of services, programs/projects, the goal was to improve M&E in the ministry. The County Health Sector M&ETWG was operationalized, and the Ministry’s M&E framework was partially operationalized.