Gertrude’s Children Hospital

Gertrude's Children Hospital

Dr. Gordon Odundo, Judy Maye

MDI – Kenya Class of April 2009

History of the Agency
Gertrude’s Children’s Hospital was founded in 1947. Gertrude’s Children’s Hospital, Nairobi ,Kenya is one of the few hospitals in Sub-Saharan Africa that is dedicated solely to the provision of healthcare for children. The hospital is a non-profit organization, chartered with responsibilities benefiting humankind such as providing health services, fostering good health, carrying out research and teaching healthcare professionals. The hospital board and management share the belief that hospitals can apply business acumen and enterprise in performing their responsibilities. Gertrude’s Children’s Hospital aims to be the preferred healthcare provider for East and Central Africa’s children. The hospital is devoted to the care of children as the fundamental concern while providing a favorable environment for both patients and members of staff. The hospital and its satellites attend to close to 300,000 patients as outpatients while we have close to 6,000 children admitted annually as inpatients. The hospital recently established the Gertrude’s Hospital Foundation which now formally serves as the charitable arm of the hospital, raising funds to support care of needy children and implementation of various projects addressing the less fortunate in the community.

Statement of the Problem
In Kenya, where infant and child mortality rates had been decreasing, HIV/AIDS, malaria, and malnutrition are now the leading cause of mortality. WHO estimates that 400 million children worldwide are infected with HIV or ill with AIDS annually, with more than 90% of them coming from Sub-Saharan Africa. Indications are that 45,000 children are infected each year in Kenya by HIV/AIDS with less than 20% of the eligible children accessing the ARVs while other healthcare interventions that can greatly improve the quality of life for these children are largely unavailable. Clinical treatment of children with HIV/AIDS poses particular challenges; children are not just small adults they require special care, treatment, and drug formulations and this requires that healthcare workers receive specific education, training, and on-going support.

Gertrude’s Children’s Hospital

In Kenya, despite 150,000 children infected with HIV, with 19 000 new infections each year, there were only 30,000 on care and treatment.

CHIP Project
To increase access to comprehensive care and treatment of pediatric patients, including nutrition through establishing a family-based clinic

Impact to Date
The key objectives to end pediatric HIV and AIDS include family-centered care and nutrition, early infant diagnosis, treatment and access to appropriate medications. The hospital, supported by APHIA plus and other partners provides comprehensive HIV care to children and their families. The hospital endeavors to make a difference in the survival of HIV positive infants, children, adolescents and adults within the family based program. Key components of care provided include diagnosis, primary healthcare (nutrition ,counseling, immunization, prophylaxis against common infectious diseases) as well as HIV specific care which includes provision of opportunistic infection prophylaxis, antiretroviral therapy, laboratory tests, Tuberculosis clinics and psychosocial care. The main hospital campus runs a daily clinic, as does the outreach clinic at Githogoro while the satellite clinics run weekly or biweekly HIV clinic services. This is one of the few dedicated pediatric sites addressing issues beyond care and treatment in a family set up. The adolescent cohort that has grown in number is transitioning to adulthood and under the program’s care will contribute to a HIV free generation. The psychosocial support has enabled clients to live positively particularly adolescents who have been disclosed to. To ensure sustainability of our efforts; the social work department has provided advice on income generating activities helping clients particularly mothers address food security issues and other socio economic needs. Uptake of services at the satellite clinics has been very encouraging with clients from the areas surrounding the clinics accessing care and treatment. Social welfare assistants supported under the program have played a critical role in referring patients to these facilities to access services and in providing home based care. The laboratory monitoring continues to support patient care and ensures that the clinical outcomes and patient follow up are up to standard. In this regard the patients access baseline tests and other specific tests.

• 100 caregivers deployed.
• Increase in enrollment from 9 children in 2004 to 500 children in 2010 – a pace quickened as a result of the CHIP.
• 600 have benefitted from nutritional support
• The number of pediatric treatment sites run by the Hospital has increased from 1 to 4 in 2011.

Lessons Learned
Gertrude’s Children’s Hospital has demonstrated that through scale up the skills of healthcare workers through a multidisciplinary approach save lives of children who prior to this initiative were not receiving the care they deserved and were condemned to early death. Due to the innovative approach adopted it was evident that limited technical knowledge and managerial expertise in project implementation was a challenge for Gertrude’s Children’s Hospital as optimal staff numbers could not be easily assigned due to budget limitations. The biggest lesson learned was the need for effective monitoring and evaluation supported by effective planning. Through training in Results Based Management useful skills have been acquired to support effective implementation.