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KENYA COORDINATING MECHANISM
CONSTITUENCY FEEDBACK MEETING REPORT
NGO CONSTITUENCY CONSULTATIVE MEETING
6TH TO 8TH MARCH 2019
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1.1 Executive Summary
This report provides feedback on the NGO constituency meeting and the plans made for 2019.
The meeting was held to provide feedback to the NGO constituency as well as highlights from
KCM members, secretariat, SRs and PRs on the Global Fund implementation, OIG report and
other highlights.
The NGO constituency interacted with the reports and raised concerns which were discussed and
informed the recommendations in the report of importance was the need for KCM to look at
ways of building the capacity of smaller/ grass root organizations, the need for improved CSO
audit of Global Fund implementation in Kenya. The need for scheduled feedback sessions were
key on the meeting agenda with members agreeing on cost effective ways of consultations and
feedback.
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Table of contents
2.1 List of Tables
3.1 Table 1: Constituency work Plan report 2018/2019
4.1 Acronyms
AIDS Acquired Immune Deficiency Syndrome
CCM Country Coordinating Mechanism
CHV Community Health Volunteer
CHEWs Community Health Extension Workers
GFATM Global Fund
HIV Human Immuno -deficiency Virus
KCM Kenya Coordinating Mechanism
ICC(s) Inter – Agency Coordinating Committee (s)
LFA Local Fund Agent
M&E Monitoring and Evaluation
NFM New Funding Model
OC Oversight Committee
PR(s) Principal Recipient(s)
SOP Standard Operating Procedure
SR(s) Sub Recipient(s)
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SSR(S) Sub-sub-Recipient(s)
TB Tuberculosis
ToR Terms of Reference
TS Technical Support
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Day One
5.1 Introduction
The meeting was opened with a word of prayer by Daniel followed by introductions of the
members. This was followed by introduction of the meeting including the purpose and
objectives. The objectives were discussed and adapted for the meeting. This was followed by
discussion on the expectations and feedback on a few with the rest being handled later during
The expectations for the meeting by the stakeholders were as follows:
Understand how PRs select SRs
To know how to fight TB and HIV
To get more know what Global Fund does and the processes
How Kenya can self fund
How smaller / grass root organizations can benefit from Global Fund grants
Know which organizations are getting GF and if they ar considering SSRs
Understand the funds breakdown and allocation of all 3 diseases
Understand the deliverables for the NGO representatives at KCM
How youth can get funds directly
How can we ask GOK to increase funding
Understand the feedback mechanism between NGO representative to the KCM and the
constituency.
The participants also shared what they know about GF. Some of the responses included: GF
funds TB; puts together funds; fund and supports low income countries; Funds 3 diseases; assists
youth, supports health and others did not know about GF.
Ground Rules were also set: phones on silent, active participation; mingling; show of hand
before talking
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6.1 Purpose and Objectives of the Constituency feedback workshop
Purpose
Engage with Constituent members and share Global Fund information with a view to
strengthen and sustain Global Fund Programming in Kenya.
Specific Objectives
1. Update constituency members on GF/KCM operations ,OIG report, SR Selection
Process and GF replenishment.
2. Share overall experiences and achievements in relation to GF grants.
3. Review 2018/2019 Constituency Work plan implementation progress.
4. Develop Constituency Annual Plan for 2019/2020
5. Discuss strategies to strengthen and sustain GF Programming in Kenya.
Ms. Faith Ndungu gave updates on KCM, Global Fund strategic objectives 2017- 2022, Global
Fund key principles, and partnerships. This was followed by an update on KCM functions,
mandates and membership which stands at 23 constituencies. The roles of KCM, PRs and LFAs
was discussed.
Participants were taken through the new Global Fund Grant to Kenya and the allocation per
disease. 15th
December, 2017 Kenya signed new grant amounting to USD 380 Million for the
period Jan 2018 to June 2021.
HIV= 25 billion, TNT, 17.9 billion, KRCS=KShs 7.1 billion
Malaria 6.7 Billion, TNT 5.4 billion, Amref Health Africa, KShs 1.3 billion.
Tuberculosis =KShs 6.3 billion ,TNT KShs 3.0 billion, Amref Health Africa, KShs
3.3 billion
7.1 Status of planned activities- as per 2017.2018 work plan reporting template-annex
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8.1 Highlights of sessions covered during the meeting
Day Two
Ms. Pamela Kibunja started the session by conducting a recap session and well as lead
participants on the expectations and program for Day 2 of the program.
Ms. Faith Ndungu, lead members through the OIG report by sharing key highlighted good
practices, areas of risks and concerns.
Background
• The Global Fund OIG Team conducted audit in June, 2018
• 21 health facilities, ten bed net distribution points, five KEMSA warehouses, five key
population groups in ten counties and KCM Secretariat visited during the Audit Period.
Specifically the audit assessed the efficiency and effectiveness of the:
1. Design and implementation of the programs to deliver quality services to intended
beneficiaries.
2. Procurement and supply chain processes and systems in ensuring availability of
quality assured medicines and health products to patients.
3. Grant implementation arrangements in the context of devolution including
governance, oversight and coordination to ensure sustainability.
4. Adequacy and effectiveness of frameworks in place to measure grant
performance.
Key Achievements and Good Practices
• Significant progress made in the fight against the three diseases:
• Increased government financial commitment to the three diseases:
• Functional in-country procurement and supply chain systems and processes, with
KEMSA, able to procure quality assured medicines at cheaper rates than
international reference prices.
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Key issues and risks
Improvement required in quality of services: A number of quality of service issues to be
addressed
case notification targets for TB not met for the last three consecutive years.
TB treatment coverage remains low (45%).
Challenges in programming and implementation of interventions for key populations:
• Outdated bio-behavioural data informing current KP programs.
• New national survey (2017) suspended due to lack of consensus on use of
biometrics.
• The “in and out of school” AGYW behavioral interventions for 10-17 year olds,
piloted in Turkana, have not been effectively implemented.
- Delayed engagement of service providers by PR since January 2018, with no
commencement of AGYW interventions
Members participated acknowledged that the report as a true reflection of what was happening.
Key suggestions were given on ways of mitigating the risks and challenges including:
There is need for review of the TB targets especially on case notifications
There is need for improved TB diagnosis in order to identify more people and link them
to treatment
There is need to embrace new strategy in TB programs by embracing innovative ways
The need to invest more in community support systems especially the family when it
comes to the TB clients
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Continuous medical education (CME), refresher trainings and On job trainings were
identified as ways of mitigating the capacity gaps in healthcare workers performing HIV
testing and Counselling
WOFAK and EMAC gave an update on the Global Fund implementation from SR point of
view. The presenters highlighted the programs they were performing as well as successes
and challenges faced.
Success in the implementation
Established community advisory board that is a crucial link with the community
Engaged National Police Service for security during the activities at no cost
Trained beneficiaries on self-reliance through entrepreneurial skills such as poultry
farming. The banks approached are willing to provide loans to the beneficiaries at low
interest rates.
Mobile wellness van clinic
Challenges
Constrained resources
Vast areas of coverage
Lateness in disbursement of funds
Poorly motivated CHVs sometimes they don’t get the money
Ms. Margaret Ndubi National Treasury (PR1) In her presentation she stated that 80% of the
new grant funds were allocated to procurement of commodities, an update of the activities which
were to be held in the new grant were presented. This lead to plenary session where participants
raised a number of questions including:
Why TB funding targeted commodities while the biggest gap was in finding the missing
TB cases: Response: TB case finding was funded through the catalytic funding
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Why was there a general reduction of funding and no fund allocation towards nutritional
commodities
Lube stock outs
The National Treasury clarifications
The proposal from Kenya is spearheaded by KCM with an input from other stakeholders
and experts such as WHO, in this regard the fund allocation is not done by National
treasury. It is important for members to engage in the proposal writing process for key
areas for focus to be raised there eg TB funds allocation,
The research about the side effects of TLD is ongoing in Botswana results expected soon
In regards to late start of implementation, the TNT has an acceleration plan to ensure that
the program is on track
Mr.Ishmael Maina Kenya Redcross (PR2 implementing the HIV grant). An highlight of the
Sub Receiptient selection was given as well as the achievements in the grant implementation.
The PR also gave feedback on the OIG report and areas for KRCS which included the adolescent
girls and Young women Turkana Pilot project
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Program status updates
Implementation started with 25 counties and has continued to grow. Now stands at 33
counties remainder 4 counties;
o All contracted SRs have started implementation of the grant activities
o Counties were involved in implementation sites mapping, prioritization and
selection
o The county needs are more than the GF grant can support hence need for stronger
partnerships and leverage with the county and other donors.
Generally, there were noted delays in grant implementation and each SR developed an
acceleration plan that was shared with KCM for discussion and approval
PLHIV networks, Youth Organizations and 5 additional SRs are in the process of
contracting to enable them start implementation. This is started in October 2018 to enable
the county engagement and identification of HF and CHVs be done before end of
December 2018.
OIG Mamangement Action status
KRCS has signed an MOU with National Quality Control Laboratory in 2018 where as
part of the tendering process potential suppliers had to submit their needles & syringe
samples to them for evaluation and testing. Also upon award and delivery of the
commodities analysis & testing was done by NQCL and certificate of analysis showing
compliance issued upon which the commodities were then accepted by KRCS and
distributed to the beneficiaries.
AGY Turkana pilot project
New concept note developed and shared which:
Review of the beneficiaries – done for all
Biometric registration done for 4981 girls
2,411 were successfully reached with cash and dignity kits.
Vulnerability assessment done for an additional 5,447 girls
EBIs like SHUGA My Health My Choice, Healthy choices for a better future, sister to
sister k, were also offered.
The cash transfer conditioning is based on HTS and STI screening and treatment as part
of the health service provision at enrolment and every subsequent year. So far 93 percent
of the adolescent girls and young women had accessed STI screening, while 98 percent
received HIV Testing Services (HTS).
AGYW receive cash together with Dignity Kit (bathing towel (1), washing soaps (3,
hand towel (1), comb(1), toothbrush (1), toothpaste (1),slippers(1), bathing soaps (3),
Vaseline jelly(1), panties (2), sanitary towels (8)).
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Each AGYW receives KES. 2000 per month: payment is done once every 2 months: last
done 1-3 March, 2019
AGYW must be present in person for biometric validation: those below 18 years are
accompanied by their caregivers/parents
Out of 3502 girls approved 2975 (85%) received cash and dignity kits
Concerns
Participants were worried in the lack of TWGs are supported at County level/ at national
level. County TWGs to also be supported.
Response
The PR informed members that they support National TWGs and the County
commodities TWG.
Mr. Edward AMREF Health PR2 who are implementing TB and Malaria grant. The
presentation focused on the new SR selection, new grant plans and focus areas were handled.
Updates
• Orientation of 11 SRs on grant making processes and Global Fund procedures
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• Training of 1,470 CHEWS on CCMM
• Training of 7,350 CHVs on CCMM
• Established and support 735 CUs
• Trained 48 county and 243 sub county ToTs on school health program
• Trained 2,953 teachers under the school health program
• Trained 22,636 school pupils who reached 113,180 households with malaria
prevention and control messages
• CHVs have diagnosed and treated 496,752 uncomplicated malaria cases at
household level
• 3 more Counties; Busia (53 CUs), Kisumu (71 Cus) and Vihiga (69 CUs) have taken over
payment of stipend to CHVs
• All GF supported CUs are now reporting monthly on DHIS2 facilitated by the Ksh1000
worth of data bundles given to SCHRIOs monthly
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Ms. Ann Ithibu AIDSPan Global Fund Accountability. The facilitator introduced AIDSPan
by stating that it is an Independent observer of the Global Fund which was founded in 2002 and
headquartered in Kenya,. The organisation offers information, targeted critical analyses,
sharing best practices/lessons learned and independent commentary.
• The NGO constituency has a role to play in the implementation of Global Fund in
kenya. Co-financing is an important requirement of Global Fund and Kenya has
adhered to this requirement. Below is Kenya’s performace on Co-financing
• Co-financing commitment for the 2018-2020 grant is $ 86 million
– A 10% increase from 2015-2017
– Mostly dedicated to health commodities
• Kenya met the co-financing requirements for 2015-2017 (100%) with a 78%
absorption rate.
– Spent US$ 84 million on the three programs
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• Participants were taken through the importance of tracking funds absorption because
Global Fund is a performance based fund. The Global Fund requires grant recipients to
report results on a regular basis as part of the disbursement schedule through the
dashboard. Global Fund has a five-tier rating system: A1, A2, B1, B2 and C (description
of rating in the next slide).The rating influences disbursement decisions and future
funding decisions by the Global Fund.
•
•
• There after participants were given strategies of monitoring Global Fund grants as listed
below:
- Accurate and timely information. Potential sources (Global Fund website: strategies,
policies, grant performance reports, funding requests, OIG reports etc)
- Understand the GF strategies, policies and processes
- Pre-empt the implication of GF policies
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- Understand and leverage the existing accountability framework (see diagram below)
- Push for increased transparency (Key documents to be published: budgets and
expenditures, proposed reprogramming requests)
- Strong and strategic partnerships
-
•
9.1 Constituency Work plan 2018/2019-as per 2018/2019 work plan template –annex
The workplan was developed by members by first reviewing the 2018 planned activities. The
members guided by previous years work plan made some additions. From the discussion it was
clear that the need for more feedback and engagement was necessary. This was proposed to be
done through constant communication and invitations to different fora.
The workplan 2018, will be reviewed in 2019 by the set means of verifications as follows:
Minutes
Meeting reports
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Presence of list serve
List of participants
Meeting photos
10.1 Conclusion and recommendations
The meeting ended with remarks from the two KCM members, Faith Mwende and Pamela
Kibunja. They each thanked everyone for coming for the workshop.
It was recommended on KCM member and alternative working with the NGOs in getting more
forums for engagement as well as looking at ways of constant communication before the annual
consultative and feedback forum.
It was recommended that KCM needed to engage NGOs from across the country for increased
feedback, in the same regard it was proposed for more frequent feedback and consultative
meetings .
A small team of members was selected to work with the NGO constituency representative and
alternate in finalizing on the workplan and sharing the same to members for endorsement within
a week after the meeting:
The team members are:
Daniel Ndungire
Peter Kamau
Francis Apina
Diana Ondato
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11.1 Annexes ( Program, work plan reports, Participants list and Photos)
KENYA COORDINATING MECHANISM
Constituency Workplan Report 2019/2020
S.No Planned Activity Achievements/Deliverable
s
Means of
Verification
Challenges
Noted
Suggestions for
Improvement/Remark
s
1
UPDATING NGO
DATA BASE&
NETWORKS
WORKING IN
KENYA WITH
INTEREST OR
WORKING IN HIV,
This activity was not
concluded .
Email list / Email
content
informing
members on
upcoming
moments &
Global Fund
Time and
resources to
finalise the
database
KCM members will
work in collaboration
with KANCO to
develop the data base
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TB ANDN
MALARIA
Opportunities
ADVOCACY AT
KCM MEETINGS
ON THE
INVOLVEMENT
OF COMMUNITY
BASED
ORGANIZATIONS
IN ACCESSING
GLOBAL FUND
Review was done on the
networks application by
advocating for a criteria
which was CBOs friendy
Meeting minutes
DEVELOPMENT
OF
COMMUNICATIO
N PLAN (Including
a mailing list serve)
This activity was not
done
A email list serve
with constant
communication
by KCM NGO
Member and
alternative
A email list serve will
be created after the data
base is finalised
QUARTERLY
FEEDBACK
FORUMS
Done through the
HENNET forums
(national and Nairobi
Chapter) and also at the
Meeting reports,
List of
participants,
Minutes
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annual CSO forum held
in Dec 2018
Updates/Progress on Previous Recommendations
Workplan templates (landscape orientation) to be annexed in the Narrative Report
Proposed Organisation Position Name Contacts PA
X
Email Address
1. PAPWC Chair Pamela
Kibunja
0722802668 1 [email protected]
2. AHF KENYA Advocacy
Manager
Faith
Ndungu
0728246766 1 [email protected]
3. WOFAK Programs Samantha
Ariri
0722725967 1 [email protected]
4. KENEPOTE Member Angela 0720793761 1 [email protected]
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Maitima
5. KANCO Deputy
Director
Peter
Kamau
1 [email protected] [email protected]
6. STOP TB
PARTNERSHIP
Daniel
Ndugire
0727008232 1 [email protected]
7. BARAKA UNITED Chair Joseph 0721703311 1 [email protected]
8. YOUTH VENTURES
INITIATIVES (YOVI)
CEO Jane
Munene
0722
847835
9. AVAC Fellow Consolata
Opiyo
0718651230 1 [email protected]
1
0.
EMAC Programs Nelson Sila
1
1.
SRHR Alliance Program
Manager
Mwikali
Kivuvani
0710630635 1 [email protected]
1
2.
ITPC EA Board
Chair
Francis
Apina
0703411077 1 [email protected]
1
3.
LEAN ON ME Cordinator Diana
Ondato
1
4.
Love and Hope Programs Minne
Muthoni
1 COPH ED CEO Gabriel 0729174477 1 [email protected]
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5.
1
6.
KIJIJI CHA UPENDO Programs Moses
Omondi
0726296130 1 [email protected]
1
7.
GAPLINK Programs Dickson
Njogu
1
8.
YAPBECK Programs Keji
Stephen
0728013808 1 Keji.malika @gmail.com;
1
9.
AIDSPAN Programs Ann Ithibu 0726995872 1 [email protected]
2
0
KOSO Director Ruth
Nasiyo
0722890769 1 [email protected]
