Foreword
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Grass root Civil Society Organizations (CSOs) and the communities they work in are key players in the delivery of health services, as they have unique advantages in advocacy, demand creation and linkage of communities to services.
However, their inadequate involvement in the formal health system continues to weigh down effective responses to priority health challenges including HIV and AIDS, tuberculosis, malaria, and maternal and child health, as revealed by assessments conducted by the African Medical & Research Foundation (AMREF) in Kenya in 2005 and 2008 in Nyanza, Rift Valley, Western and Eastern provinces.
Since 2009, AMREF Maanisha programme has been implementing a linkages framework for strengthening health systems and coordination environments in the HIV response in selected districts in 4 regions in Kenya and aimed at strengthening linkages between communities and health facilities through more than 700 CSOs. The framework, which places the community at the centre of the health system, has successfully been used to gauge working relationships amongst health stakeholders,
providing a basis for concrete actions towards strengthening linkages and collaborations while monitoring for results.
Through the implementation of the framework, AMREF and her partners, the CSOs, Government of Kenya (GOK), have learnt that increased synergy between the formal health system and the community leads to sustainable improvement of service delivery and health outcomes. This has been evidenced through increased client referrals and quality of care offered to People Living with HIV as well as
Orphans and Vulnerable Children. In addition, AMREF has witnessed increased recognition of CSOs by GOK structures through involvement in government led planning, implementation and review processes including Health stakeholders’ Fora (HSF), annual operational planning and implementation of the community strategy.
In a bid to consolidate the gains made in this endeavour, AMREF has developed this guide that offers practical steps to forging synergistic linkages among players in the health system using a linkages framework. The guide has been developed in line with the Kenya Health Policy framework (2012-2030), that recognizes the different roles of various stakeholders, including CSOs, in its implementation at the national and county levels. This augments AMREF’s Business Plan’s (2011-2014) approach to
transforming communities by building the skills, knowledge and resources required for sustainable health change and by enhancing their integration with the formal health system.
The guide is ideal for application during community, county and national fora aimed at enhancing coordination of the health system within a single disease or multiple disease programming. This is key to improvement of service delivery as well as ensuring that resources are not wasted and actions are not duplicated.
As you adapt and apply this guide, we invite you to share your lessons and suggestions for improvements with us, as well as with your colleagues and most importantly the clients you serve.
Dr Lennie Bazira S Kyomuhangi
Country Director, AMREF Kenya
AMREF is a transparent organisation distributing funds of up to $85 million per year.
