Child survival a major challenge
About a third of all child deaths occur in the first month of life, linked with inadequate care during pregnancy and birth. About 60% of all births in Kenya occur without skilled attendance. Other primary causes of child death are malaria, diarrhea, respiratory infections and HIV and AIDS.
During the 1990s, health services were eroded through insufficient funding, poor management, the introduction of user-fees, and the delivery of child health services through vertical unsustainable systems. This is slowly changing with a shift to strengthening of routine services.
The Health Programme aims to increase national and local capacity to develop and implement evidence based policies to fulfill the rights of children and women to access affordable and quality health care. More specifically, the programme aims to increase access and use of evidence based quality maternal and child health services and to support the Government of Kenya to achieve the health related Millennium Development Goals.
The Programme focuses on two areas: Safe motherhood and neonatal health; and child health. The Programme has shifted the balance of its support more upstream to focus more on policy development, advocacy for increased resources for child health through the Medium Term Expenditure Framework and support to evidence based strategies that will help Kenya achieve the MDGs whilst continuing to strengthen health systems in the northern areas to be able to deliver both emergency and routine services
HIV and AIDS
The medical aspects of HIV are integrated into each programme. Prevention of Mother To Child Transmission is a fundamental aspect of evidence based antenatal care. Prevention of paediatric HIV only takes place when mothers deliver with skilled attendants who can provide the necessary treatment. Hence the focus on improving safe motherhood and access to HIV prevention services simultaneously. Although there has been considerable scale up of adult HIV treatment, paediatric treatment is far behind, particularly the prophylactic use of cotrimoxazole in HIV positive children. UNICEF continues to support the Ministry of Health to increase the coverage and quality of care for children living with HIV/AIDS as part of routine child health services
In addition to development programmes, UNICEF supports emergency interventions in Northern Kenya. Therefore the health and nutrition programmes support the Northern areas to deliver a package of essential health and nutrition services in a more systematic manner that can be scaled up when required. This includes: defining a package of care to be delivered by all partners; planning of services based on populations and increasing the delivery of routine services through static and fixed outreach; and supporting the District Health Management Teams (DHMTS) to prepare coordinated health and nutrition plans. Low staffing in these areas continues to be a major constraint in the delivery of essential health services. UNICEF is also working at policy level to help in the development of an HR policy and plan to alleviate this problem.