the department has successfully achieved the following :

1. Operationalized comprehensive maternal and child health care units and services

 Operationalization of three comprehensive maternal and neonatal units (MCRH, Elwak and Takaba) has been successfully concluded.

2. Gazettement of new and ungazetted health facilities to serve underserved areas

We Gazetted 49 primary health care facilities and operationalized 30 dispensaries to increase access to healthcare services in the county

3. Disease outbreak response and control

Sharing the porous border with Somalia and Ethiopia, Mandera has been facing challenges of importation of communicable diseases every year. Outbreaks like measles (3 episodes), cholera (4 episodes), Chikungunya (1 episode) and dengue fever among others easily spread across the national borders. The department has successfully managed and controlled all major outbreaks and thus reduced fatalities for the county population.

4. Improved health care waste management facilities

Mandera County has been grappling with the challenges of managing its hazardous medical wastes as there was no waste management facility in the entire County. In this regards, three new modern biomedical waste management facilities have been procured, installed and commissioned at Mandera County referral Hospital, Elwak Sub County Hospital and Takaba Sub County Hospital for purposes of biomedical waste management. In addition three old and non-functional ones have been repaired and are currently in use. This will further be cascaded to other level four Hospitals in subsequent years.

5. Improved transport and logistics

The Ministry has secured 10 motorbikes through THS, 2 vehicles (1 from GAVI HSS and 1 from THS) which has facilitated mobility of staffs and logistics across the County.

6. Recognition trophy by National TB programme

Mandera County Health Department was awarded excellence award as best performing County in Kenya in February 2020.

7. Establishment of mini food laboratory in the County

Through concerted efforts by the department, the Ministry has managed to establish two mini food labs in Takaba and Mandera through partnership with WFP. The department can now be able to undertake both food quality surveillance and food quality control in the County.

8. Development and launch of County Nutrition Action Plan (CNAP) 2019 – 2020

The Ministry has developed and successfully launched Mandera CNAP 2019-2020 which will guide the nutrition intervention in the County.

9. Vaccination of Hepatitis B for health care workers

The department has successfully undertaken vaccination of County health care workers totaling to 480. The staffs have been already been given two rounds of the expected three doses of the vaccine. The exercise targets frontline health care workers who are mainly   at risk of contracting Hepatitis B due to the exposure limits.

10. Roll-out of vaccination against COVID-19

The Ministry has received 6,000 doses of Astrazeneca vaccine from MoH targeting three priority groups (HCWs, Teachers and Security personnel’s). The roll out has already been undertaken and sensitization is still ongoing though the uptake is still very low. So far 125 persons have been so far vaccinated.

11. Supplies of essential medicines by KEMSA

 Like all other 46 County Governments, Mandera  County  Government  had  had   a fair share of challenges with sole supplier of essential medical Supplies (KEMSA). KEMSA has never met the supplies needs as far as the departmental requisition orders are concerned. Every time, orders are placed, the highest they ever supply is less than 60% of the orders which has always left the department with a gap of 40% in every order. This has put a lot of pressure on health care facilities in terms of stock status levels. In the current quarter, the Ministry placed an order worth 135M, KEMSA sent a proforma  worth  83M  based  on  what is available at their depot and an LPO of the same amount was issued to them. On delivery, they managed to supply 63M only which less than 50% of the required orders. Most facilities are now lacking basic essential medicines to provide services.

12. Improved service delivery indicators

Mandera County had one of the worst health indicators in the Country before the advent of devolution. With adequate investment towards reversing these trends, the County has been on a trajectory improvement over the years. For example immunization coverage rose  from 28% in 2013 to 74% in 2020. First ANC attendance increased from 20.3% to  84.4% in 2020 while delivery conducted by skilled attendant increased from 11% in 2013 to 72% in 2020. This tremendous improvement of service utilization was as a result of improved access to health services by the communities as functional health care facilities were increased from 33 to 85 health facilities. Family planning uptake has  increased  from  2.8% in 2013 to 10.5% in 2020.

13. Human Resource for Health

To improve access and utilization of quality health care services for patients, the County Government has recruited more than 963 health care workers of mixed cadres up from 154 pre-devolution. Currently, the department has 4 resident medical specialist (2 Surgeons and 2 Obs Gyn) and 1 health economist whom the County sent for specialized training and have since resumed to bridge the gap in specialization after efforts to attract medical consultants became futile.

14. Roll-out of UHC

The Ministry has successfully concluded the registration of indigents. Out of the allocated 21,573, we submitted 24,052 beneficiaries to NHIF. After cleaning and removing with who are covered under other existing programme, a total 21,180 has been received for Mandera which is 98% submission. We are now left with another 393 to be registered. In addition, the department has undertaken facility readiness assessment and the report has been submitted to the respective enabler departments and executive offices for further action

15. Ambulance and emergency referral services

Mandera County has increased the number of ambulance vehicles from 2 in pre-devolution

to 9 currently. All the ambulances were strategically placed  in  centralized  locations  at each Sub  County  Headquarter  for  ease  of access by each  part  of  the  respective  sub county. So far, the total referrals made from 2014 to 2020 stands at 10,109 cases comprising both medical and obstetric cases.

16. Control of vector of public health importance in the County

The department has successfully conducted mass indoor spraying in Mandera East in order to curb mosquito population and distributed 10,000 mosquito nets across all the 7 Sub Counties targeting vulnerable groups like children under five years, the aged and pregnant mothers.

17. Response to Rift valley fever (RVF) outbreak in Mandera North

The department has successfully  responded to RVF outbreak in Mandera North through a robust community sensitization and destruction of dead animals. Collection of surveillance samples are ongoing and so far there was no reported human positive case other than the first confirmed index case.

18. Response to Kalazaar outbreak in Kutulo

The Department has adequately  responded  to Kalazaar in Kutulo. There was only one

Kalazaar treatment centre in Wajir in the entire region and all our patients were accessing treatment at Wajir. Currently, training on case management is currently been done in Wajir   in order to equip health personnel’s with the prerequisite  case   management   protocols  as this is among the neglected tropical  disease which are not very common.  The case management supplies and diagnostic  test kits have been procured for preposition   at the epicenter of the outbreak. Community sensitization and destruction  of  breeding  sites within human habitations have been undertaken. Any future Kalazaar cases will be treated within the County health facilities.

19. Response to COVID-19 Pandemic and establishment of molecular lab

The current pandemic of COVID -19 despite its severity has been put under control with established preventive measures and case management facilities. Since its establishment, 1,441 tests were carried out at Mandera Molecular Lab of which 94 have tested positive. The total number of Covid-19 confirmed deaths in the County stands at seven (7). The third wave is really affecting the communities with its high morbidity and mortality and the department is gearing towards roll out of a robust public health measures across the County in the next few days.

20. Improved Health information and data generation

Health management information system which forms the basis of monitoring and evaluation  in  health care has been improved through procurement of standard reporting tools for each of the operational health facilities in the County. This has enabled the health sector to track the performance targets set to address its objectives. Automation of health information at Mandera County Referral Hospital is near complete and will soon be paper less records. The same has been planned to be rolled out in all hospitals in the Sub Counties.

The department has successfully conducted mass indoor spraying in Mandera East in order to curb mosquito population and distributed 10,000 mosquito nets across all the 7 Sub Counties targeting vulnerable groups like children under five years, the aged and pregnant mothers.

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