Table 1 Key elements by program approach

Horizontal

○ Non-dedicated MoH MC teams, working an average of 12-38%* of a 220 day work year, provide MC services integrated with routine health services.

○ Teams are based at, and provide services at, district or sub-district hospitals as well as at outreach and mobile locations.

○ Additional strategies used for meeting demand during high volume periods, such as the Rapid Results Initiative**, include task shifting to nurses, scheduling more MC services during evenings and weekends, and ensuring a sufficient number of non-dedicated MoH MC teams are scheduled to provide adequate coverage to meet demand.

○ APHIA-II provided the MoH with the following types of technical assistance:

▪ Minor renovations to surgical theaters

▪ MC supplies/equipment

▪ Training and supportive supervision

▪ Quality assurance

▪ Client flow optimization

▪ Vehicles for transporting outreach and mobile teams

▪ Demand generation through collaborating with public health officers to carry out one-on-one and group mobilization strategies

▪ Community engagement activities

Diagonal (Combination of Horizontal and Vertical)

○ Dedicated MC teams employed by NRHS, working 100% of a 220 day work year, provide MC services at base health facilities, outreach sites, and mobile locations to supplement MC services offered by the MoH.

○ Teams are based at the NRHS office in Kisumu and travel to base facilities as well as outreach and mobile locations.

○ Additional strategies used for meeting demand during high volume periods, such as the Rapid Results Initiative, include task shifting to nurses, hiring short term contract staff, and scheduling more MC services during evenings and weekends.

○ NRHS provided the MoH with the following types of technical assistance:

▪ Minor renovations to surgical theaters

▪ MC supplies/equipment

▪ Operating a MC training center for certifying MC providers

▪ Quality assurance

▪ Supportive supervision

▪ Client flow optimization

▪ Vehicles for transporting outreach and mobile teams

▪ Demand generation through one-on-one and group mobilization strategies

▪ Community engagement activities