Since achieving independence from Great Britain in 1963, Kenya has worked to improve its healthcare system.

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Medical Management Plan Kenya OVERVIEW Company Mission Our mission is to encourage young people to volunteer for worthwhile work in developing countries. We expect that doing this kind of voluntary work will in time become the norm. As more and more people join us, we aim to create a multinational community with a passion to serve, to learn, to understand, to teach, to inspire, and to be inspired. Medical Programme Mission Our Medical programme mission is to enable an exchange of medical knowledge and facilitate a greater understanding of global healthcare practices. By empowering local communities, we aim to improve standards of health through awareness, prevention and treatment. Background Information Since achieving independence from Great Britain in 1963, Kenya has worked to improve its healthcare system. An economic downturn in the 1980s, the intensification of the HIV/AIDS pandemic in the 1990s, and setbacks in government programmes after allegations of political corruption in the 2007 elections i have all exacerbated a number of health challenges for Kenya, where at least 45.9% of the population currently lives in poverty ii. Financially, Kenya has become increasingly dependent on donor country contributions to supplement the national health budget, but the health sector remains under-financed iii. One of the main challenges is that of extending health services to poorer rural communities and geographically dispersed populations. More than half of the population lives in rural areas where health centres and dispensing clinics are far and few between, where there is a lack of facilities and trained staff iv. With many health professionals leaving Kenya to find better working conditions abroad, there is a significant lack of qualified staff v With poor hygiene and sanitation facilities, hygiene-related illnesses remain life, but HIV/AIDS is the leading cause of mortality in Kenya, killing 80,000 people each year vi. All of these factors continue to contribute to the challenges faced by the Kenyan healthcare system. Beyond a persistent high burden of infectious diseases, including malaria, HIV/AIDS, and tuberculosis, Kenya faces an emerging chronic diseases problem characterised

by increasing rates of cardiovascular disease, cancers, and diabetes. Since the 1990s, some of Kenya s early achievements in health have begun to change. According to statistics, over the past two decades: Life expectancy at birth: 61.72, Infant mortality rate (per 1000 live births): 49, under five mortality rate (per 1000 under five children): 73, infants lacking immunization: 11 % of one year olds, infants lacking immunization: 7 % of one year olds, intenatal coverage: 91.5% of live births, HIV prevalence ( ages 15-24): female 3.65%, HIV prevalence (ages 15-24) male : 1.8%,HIV prevalence (ages 15-49) total: 6.1%, adult mortality rate (per 1000) female: 294, adult mortality rate (per 1000), male: 346. Kenya faces a significant shortage of physicians, with only 4,500 in the entire country, according to the World Health Organisation. Whereas the United States counts on 26 physicians per 10,000 people, Kenya has just one doctor per 10,000 residents, a ratio that is below average for the African region. Due to this, much of Projects Abroad s work in Kenya involves improving the quality of healthcare provided to patients. Partners Projects Abroad Kenya registered as a non-profit organisation in February 2012. We focus on building strong partnerships with carefully selected placements that help vulnerable populations in Nanyuki. The government oversees 42% of health centres, NGOs run 15%, and the private sector operates 43%. Some of these placements are Nanyuki Teaching and Referral Hospital and Pope John Paul II Huruma Health center GOALS In order to work towards our Medical programme mission, we have set the following goals to achieve in the placements where we send our volunteers: 1. Encourage an understanding of medical practices and promote an exchange of medical knowledge (*** priority goal ***) In Kenya, people still practice old methods and procedures of doing treatment and diagnosis in the hospital. The cooperation arrangements Projects Abroad has established with our partner hospitals in Kenya allow volunteers to observe nurses and doctors on their daily ward rounds. Shadowing health professionals and the eventual creation of bonds of trust between doctors and volunteers in a busy hospital encourages the knowledge exchange, enriching both the local staff and those proactive foreigners with a desire to learn. Their project allows the volunteers to gain

invaluable insight into the healthcare system and procedures within a developing country, and learn about the prevalent local diseases. Professional medical volunteers are able to share their knowledge and experiences both with other volunteers as well as the local teams, initiating a discussion and exchange around best practices. We also aim to promote a better knowledge of best medical practices with other partner institutions such as local schools and orphanages, to encourage better hygiene and healthier lifestyle choices. Through these actions, the project is able to become a real learning experience. 2. Improve hygiene standards Observing hygiene is important for everyone in the community as a Standards of cleanliness and sanitation within different institutions (hospitals, schools, orphanages) are often quire poor. Many people also come from low income families where this is not a priority. A lack of proper hygiene leads to infections and diseases hygiene-related illnesses, and this in turn is affecting the country s economic development; however, in Kenya the hygiene standards are still low due to factors such as the limited financial ability, lack of awareness of sanitation and hygiene, and cultural factors.. Through our outreach programmes, volunteers educate, raise awareness and run activities to promote proper hygiene with the aim of improving the overall health of the population. 3. Improve access to basic healthcare for disadvantaged groups Due to financial limits and a lack of healthcare facilities, many Kenyans do not have access to a basic healthcare system. Indeed, 40% of people who do not seek medical assistance are hindered by cost, and another 18% are hindered by the long distance to the nearest healthcare facility vii. Through our outreach programme of visits to local orphanages, schools and nearby villages, we aim to provide basic healthcare to some of these vulnerable groups as well as raise awareness about some of the more pressing health issues facing the country. By holding community outreaches on health education and providing treatment and outreaches in children s homes and safe homes helps improve the basic healthcare for the disadvantaged. 4. Reduce the number of cases of malaria In Kenya, Malaria is also estimated to cause 20% of all deaths in children under five (MOH 2006)*. 25 million out of a population of 43 million Kenyans are at risk of malaria. It and accounts for 30-50% of all outpatient attendance and 20% of all admissions to health facilities. Though easily treatable when detected early, the disease can be life-threatening when left untreated. An estimated 170 million working days are lost to the disease each year (MOH 2001)**. Malaria is also estimated to cause 20% of all deaths in children under five (MOH 2006). The most vulnerable groups to malaria infections are pregnant women and children under 5 years-old of age. From an economic perspective, Aan estimated 170 million working days are lost to the disease each year (MOH 2001).

Difficulties in tackling this disease include poor waste disposal and drainage systems causing stagnant waters, funding gaps, and public misconceptions viii. Projects Abroad undertakes school and community outreaches to educate people on how to prevent malaria and the importance of getting treatment as soon as symptoms appear. Volunteers conduct screenings and offer treatments of affected people to prevent further complications. Volunteers can help reduce the number of malaria cases by holding workshops on malaria in the community. RESOURCES Human Resources Average 40 Medical volunteers per year Projects Abroad global staff teams Placement staff support Physical Resources Projects Abroad offices Placement materials Online Resources Volunteer Resources Database Myprojectsabroad webpages Financial Resources Monthly budgets for overall operations Donations to specific projects or placements Intangible Resources Reputation in destination communities Goodwill; genuine desire to help Expertise Projects Abroad provides a range of resources for each of our programmes. These fall into four interdependent categories: Human: Volunteers themselves are our most crucial asset in achieving our goals. Through their creativity and energy, all of our ambitions can be realised. Another central support team is our extensive network of Projects Abroad staff worldwide, dedicated to supporting volunteers and achieving our company mission. We also depend greatly on the staff in all of our placements; whose support guides volunteers through their daily activities.

Physical: Projects Abroad has offices in all of our destinations, where volunteers can come to speak to staff or attend workshops. There are also office materials and placement supplies available to volunteers. Online: The Volunteers Resources Database and myprojectsabroad webpages all provide vital support before, during and after their placements. Financial: Funds for all of Projects Abroad s work come solely from volunteer placement fees. These are distributed via monthly budgets, to ensure fair allocation of funds for each destination. Occasionally volunteers may also send donations directly for a specific placement or project. Intangible: The good reputation of volunteers in local communities is what makes our work possible. This reputation has been earned over years of dedicated volunteer contribution. This is supported by the combined knowledge of our extensive staff network. With over 700 staff across every continent, we are proud to be a diverse and accomplished team. MONITORING & EVALUATION Placement visits Volunteer workshop sessions Staff meetings Volunteer Resources Database Feedback evaluation Physical monitoring: Through placement visits and volunteer workshops, volunteers are in frequent contact with staff members, who will observe and advise volunteers in action. Staff participate in regular meetings to discuss best practices within and between destinations. Online monitoring: The Volunteer Resource Database is platform for staff and volunteers to share and develop ideas. Feedback evaluation: Feedback from placement staff, Projects Abroad staff and volunteers is continuously gathered and used to inform future plans.

LOCATION OF PLACEMENTS

REFERENCES i Kenya Malaria Fact Sheet https://www.childfund.org/struggles-facing-the-kenyan-health-care-system/ ii http://www.smartglobalhealth.org/pages/kenya-mission/kenya-health iii http://www.smartglobalhealth.org/pages/kenya-mission/kenya-health iv http://www.our-africa.org/kenya/poverty-healthcare v http://www.our-africa.org/kenya/poverty-healthcare vi http://www.our-africa.org/kenya/poverty-healthcare vii http://www.allianzworldwidecare.com/healthcare-in-kenya viii IX X http://www.kemri.org/ XI kenya-malaria-fact-sheet http://tv.accaglobal.com/content/dam/acca/global/pdf-technical/healthsector/tech-tp-khcg.pdf http://www.kemri.org/index.php/help-desk/search/diseases-a-conditions/29-malaria/113-