RURAL AND SUB COUNTY EXPERIENCE AT NDURU LEVEL 4 HOSPITAL- KISII

FROM 02/12/24 – 26/01/25 BY ST. CAMILLUS SCHOOL OF NURSING TABAKA

SEPTEMBER 2022 GROUP A.
RURAL REPORT AS FROM 02/12/2024- 10/01/2025.
Report compiled by September 2022 nursing student group A.
1. Bonface Chiro
2. Iyvon Chepkemoi
3. Beverly Moraa
4. Pamela Nalumio
5. Wambui Nyambura
6. Faith Monari
7. Roselyn Siago
8. Mary Osuta
9. Henly Kipkoech
10.Johnson Ombogo
11.Mary Nyaboke
12.Paschaline Mutheu
13.Sylvia Osoro
14.Jecinta Bosibori
15.Brian Onyonka
16.Clarion Nyambura
17.Lydia Ochara
18.Melab Ogutu
19.Daisy Cherotich
20.Mondestar Moraa

Report approved by ……
TABLE OF CONTENT
Acknowledgement
Introduction
Hospital health management
Objectives
Conclusion
Recommendations

List of abbreviations
HTS- Hiv testing services
ANC- Antenatal clinic
CCC- comprehensive care clinic
MCH- Mother child health
FP-Family planning
SHA-Social health authority
TB-Tuberculosis
EMTCT - Elimination of Mother to Child Transmission
HEI - Hiv exposed infant.
ART - Antiretroviral
ACKNOWLEDGEMENT
We express our profound gratitude to all individual and organization who
responded to the successful preparation of this report.
Special thanks to Nduru sub-county hospital management team for their guidance
and support throughout the data collection analysis and report writing.

The background information of Nduru hospital

Nduru Sub county hospital is situated in South Mugirango sub county, Bogetenga
ward, Nyamarambe division. It borders Gucha Sub County to the North, transmara
Sub County to the East, Kisii South to the West and Rongo Sub County to the
South.
It was started in 1948 as a dispensary under county council in a placed called
Nduru. In 1976, it became a health center and in 1981 it was opened as a health
rural demonstration center by then Minister of finance the late president Mwai
Kibaki. In April 2007, it became a sub district hospital. In 2008 it became a district
hospital. The hospital since been endorsed as a sub county hospital in October
2016 and a referral facility. In the year 2022 they moved to a new building which
was opened by Raila Amollo Odinga.
The hospital catchment area population of 26450. It serves public and primary
schools, secondary schools, village polytechnics and the market centers. The
facility has a bed capacity of 100 and sits on a six-acre farm.
Services offered in the facility include; outpatient, inpatient, MCH\FP, pharmacy,
occupational and physiotherapy, HTS. The same facility is used with students for
rural and sub county experience.
Nduru sub county hospital is headed by the medical superintendent who is also a
sub county medical officer.
INTRODUCTION
We began our rural experience at Nduru sub county hospital on 2 nd December
2024.We were 20 in number, received in the facility by the student mentor who
also has a cadre of Sub County reproductive health nurse. Starting from the
hospital gate, the student mentor took us through the casualty and outpatient
department, the administration office, then the medical supretendant office then
we proceeded to revenues and the SHA office, the public health office then the
sub county health management team where the sub county clinician as well as
the TB services in charge is found. We were taken through pharmacy, laboratory,
patient support center and MCH/ FP Department ending our orientation with the
physiotherapy department. We then proceeded to the students mentor office
who gave us the rules of the hospital and what it entails. We were grouped into 5
groups where each group had 4 students
She also gave us some topics to be discussed by each of us, including;
1) Diabetes Mellitus

2) Hypertension

3) Malaria

4) Pneumonia

5) Upper respiratory tract infection

6) Gastro enteritis

7) Typhoid fever

8) Tuberculosis

9) Brucellosis

10) Meningitis

11) Measles

12) Dysentery
13) Cholera

14) Poliomyelitis

15) Covid 19

16) Mental illness

17) HIV/AIDS

18) Peptic ulcer disease

19) Whooping cough

20) Asthma / status asmaticus

21) Urinary tract infection

22) Psychosis associated with pregnancy

23) Family planning

24) Cold chain maintenance

25) Management of disease outbreak

26) Mental illness

27) Immunization

28) ANC

29) Mumps

30) Suicide

31) Cellulitis

32) Epilepsy

33) Sickle cell

 34) Tonsillitis

35) Arthritis

36) Diphtheria

ORGANIZATIONAL STRUCTURE OF NDURU HOSPITAL AND THEIR ROLES

Medical superintendent
 He supervises work of all departments in a hospital including medical
departments and takes daily hospital rounds supervision.

 He is responsible for application and implementation of the hospital policy.

 Support of leadership and provide leadership in improvement of patient

care programs and development of staff programs.

 Promotes the most efficient use of available resources, health service and
facilities.

 To monitor, supervise and attend to patient and staff grievances.

 Proposal for expansion, improvement of existing facilities and

implementation of the same.

 Co-ordination with the administrator and other facility staff.

 Receives reports from the various departments.

 Chairs disciplinary committees.

Administrator
 Management of hospital budgets and maintain documentation

 To scrutinize all proposals of accounts, general section to supervise of

appointments and posting transfers.
  To attend disciplinary action meetings as well as union matters.

 Organize and oversee hospital services as well as development.

 Managing of staff and ensuring compliance.

 Assist in recruitment and training of staff.

 In charge of all casual workers.

Departmental heads
Nursing department- matron
 To distribute nursing staff to various wards in the hospital according to
experience and workload.

 To keep records of duties, attendance, capacities and temperament of all

nursing personnel in the hospital.

 To give assistance during disbursement of salaries of nurses.

 To supervise the general working conditions of nurses as well of labor.

 To demonstrate autonomy and expertise in the delivery of patient care.

 To take lead and co-ordinate action on standards of cleanliness across the

areas of responsibility.

 Providing nursing activities and write a report to the facility.

Clinical department
 Diagnosis of various conditions, ordering laboratory and imaging
investigations.

 Screening and examination of patients

 Supervise patient care in the clinic

  Performing of medical procedures, medical education and minor surgical
procedures.

 Treatment of patients by prescribing medications.

Pharmacy department
 Ordering and receiving drugs in the facility according to workload and
budget.

 Controlling of the medications in the facility by maintaining quantity of

medications.

 To check stock of medicines as soon as the stock reaches reserve level

and see timely indents for medicines.

 To maintain drug store ledger up to date for verification of stock by

auditors and hospital authorities.

Laboratory department
 Receiving, labeling, and analyzing of samples and specimen

 Designing and executing laboratory testing according to standard

procedures

 Conducting experiments under defined conditions to verify \reject various

types of refined scientific methods with adherence to all safety guidelines.

 Prepare and collect specimen and samples from clients

 Clean and maintain laboratory equipment

Health record officer
 Co-ordinates with all departments for proper billing and health records of
patients.

 Prepare final invoices and engage patients and insurance companies on

regular basis to ensure payments made on time. Also, follow-up with
patients and health insurance when payment lapses occur.

 Supervision of admission office, patient’s registry, medical record

department and research workers.

 Wok as liaison officers between the hospital departments.

 Sorting and arranging all the facility records.

Public health officer

 Ensure proper management of waste, adequate hand washing spots,
adequate lighting, ensure infection prevention and proper environmental
sanitation.

 Monitoring, reinforcing and implementing strategic provision and other

relevant registration.

 Guide and mentor students.

 Compiles monthly departmental and facility reports.

Objectives for the placement;

a) Clinical diagnosis of patients above 5 years

b) Physical examination and diagnosis of 0-5 years

c) Immunization services

d) Family planning services

e) Group and individual counseling

 f) Environmental health and assessment of wash services.

g) Slaughter house and meat inspection

h) Market inspection

i) School health program

j) Community outreaches

k) Community strategy

PREVIEW OF ACTIVITIES DONE DURING THE PLACEMENT.

2/12/24: Reported to the facility
17/12/24: slaughter house and meat inspection at Nyamarambe.
20/12/24: Support supervision at Moticho Health Center.
20/12/24: Etago Market inspection
2/1/25: Community Strategy at Bogetenga ward Nyamarambe
3/1/25: Outreach Services offered at Esaka Village.
9/1/25: School Health program at Igare D.E.B

2/12/2024
On arrival the student mentor took us through the assessment tool and what is
expected in line with our objectives from the school. The session was helpful as it
pointed out the areas which the assessor and co- assessor expect at the end of
the placement. Duty roster was made and was distributed to every department
within the facility.
The departments where theses rotations were done included;
 Maternal child health and family planning department

 Comprehensive care Centre (ccc)

  The wards (maternity, pediatrics, male and female wards)

 Outpatient department

 Pharmacy

These departments have activities carried out and they are listed down below.

Maternal child health and family planning

o Performance of maternal child activities to include; vaccination of pregnant
women, vaccination of children from birth up to 5 years of age as well as
diagnosing of clinical pediatric conditions

o Monitoring and maintenance of MCH equipment; refrigerators, weighing

scale, blood pressure machines, thermometer and glucometers.

o Offer EMTCT services including prophylaxis, follow up of pregnant mothers

with HIV as well as HEI with right medications according to the health ART
guidelines.

o Enrolling pregnant women to focused antenatal care visits and offering

health messages, physical examinations, weight, blood sugar and blood
pressure monitoring, ultrasonography, antigen D administration and fetal
wellbeing monitoring.

o Partner notification services to prevent spread of HIV

o Providing outreaches to the community members who are from hard to

reach areas within a geographical location that is immunization, curative by
giving medications and offering referral services.

o Providing family planning services to the clients; barrier methods, implants,

injectable, intrauterine device and explaining on natural methods.
 o Conducting and follow up of clients especially among the trainees

o Advising mothers on the health strategies the government has put in place
to prevent diseases; use of long lasting treated mosquito nets, free
pregnant women services.

Comprehensive care center

o HTS services; pretesting, testing and post testing as well as link to
comprehensive care center.

o Ensuring adherence to medications by these clients

o Nutritional assessment upon each routine clinic visits as well as routine visit

o Clinical diagnosis of opportunistic infections by immunocompromised

clients

o Reproductive health services of these clients to prevent spread from one

mother to their child

o Registration of new clients diagnosed with HIV, TB and ensuring follow up

care from the beginning

o Doing defaulter tracing for clients who have missed their clinic and routine
refill clinic

o Taking samples for viral load checking, collecting samples for sputum for
gene expert for clients on TB treatment.

o Performing an active case finding to avoid spread of diseases

o Health promotion services by giving health education, to achieve a healthy

living among clients.
Outpatient services
o Clinical diagnosis of patients and assessment of conditions for children,
infants, adults and the old

o Performing a physical examination on every system of human body to rule

out any illnesses

o Providence of procedures and outpatient services i.e., wound dressing,

catheter insertion and removal, gastric lavage incases of poisoning,
administration of medications and stitching of cuts.

o Giving health messages to clients as preventive measures against infections

and illnesses

o Ensuring triage of clients so as to attend to emergency cases first before

those in order

o They do HTS and counseling among clients attending outpatient

o Laboratory services also provided outpatient

o Offering routine follow up clinic services

Pharmacy
o Development of new chemical entities, formulate into medicines, testing
and marketing, supply and distribution to patients

o Dispensing and packing medications per prescription or order as per

physician

o Consulting patients on prescribed medication use

o Reviewing of medications for safety and efficacy

o Providing drug information with patient counseling

 o Processing of insurance claims

o Tracking of inventory

Wards
o Admission of clients who need admissions like the children, adults and the
aged who need close monitoring within the facility.

o Close monitoring of clients with acute symptoms of a disease

o Daily review by the doctors, physician, nutritional counselors and the

nurses.

o Offer services that are most expensive as outpatient services

o Offer delivery services for mothers due to give birth

o Offer proper management of newborns and mothers intrapartum and post-

partum before discharge.
A REPORT ON SLAUGHTER HOUSE AND MEAT INSPECTION ON 17/12/ 2024 AT
NYAMARAMBE SLAUGHTER HOUSE.
We left the hospital at 9:00am accompanied by the student mentor and the
public health officer. It’s located in Bogetenga ward South Mogirango Sub County
in Kisii County. We arrived in the slaughter house at 9:30 am and met the
vetenary officer who took us through the meat inspection process.
Objective
I. To ensure that healthy and psychologically normal animals are
slaughtered for consumption.

II. To know how abnormal and infected animals are dealt with.

III. To identify zoonotic diseases.

Findings
 The slaughter house was fenced for security purpose.

 The slaughter house is made of permanent house with strong and

thick beams; ventilation was good and lighting also.

 It had a drainage system.

 There was condemnation pit for disposing condemned animal

products or parts.

Recommendation
 To slash overgrown vegetation around the slaughter house.

 Workers to put on protective gear when handling animal

products.

 To improve the drainage system.

 To ensure latrines are clean and in a god condition.

Conclusion
During the activity we learnt and gained more experience in meat inspection. We
were taken through some types of zoonotic diseases i.e., Rabies, Anthrax and
Brucellosis. The vet also took us through the animal parasites that can affect
humans and on how they control them.

A REPORT ON MARKET INSPECTION ON 20/12/24 AT ETAGO MARKET CENTER.

We left for the market at 9:00am accompanied by the Sub County Public Health
nurse, the student mentor and our tutor. The market is located in Kisii County,
Nduru Sub County. We arrived at the market at 12:00pm and met the public
health officer who took us through the process of market inspection and showed
us various areas of the market.
OBJECTIVES
1. To know the types of foods sold in the market
2. To meet the market committee and know their roles
3. To know the source of water and sanitation of the market
4. To inspect shops and bars
5. To know how they collect revenue and its importance
6. To know waste disposal of the market
FINDINGS
1. There different types of food being sold at the market e.g., groceries, beef, fish,
beverages, wheat products such as mandazi, cereals such as maize, dairy
products
2. The market committee comprised of the Chairman, the assistant chairman, the
Treasurer, the secretary. Their roles include;
 They solve disputes among market members

 They allocate spaces to traders to use for sales

  They lease with the county government for revenue collection and
development

 They are the entry point leaders for traders and people looking to conduct
activities within the market

3. The source of water for the market is a spring and they have no tapped water,
there are allocated market cleaners who clean after every market day.
4. The shops are required to have licenses to operate and the food handlers have
a medical certificate clearing them of communicable diseases.
5. Revenue collection at the market was done through electronic means from
each trader direct to the county government, which is then allocated to develop
the market and to pay the market cleaners.
6. A pit was present that solid waste from the market was disposed into.
RECOMMENDATIONS
1. to complete construction of the closed market to reduce inconvenience to the
traders during harsh weather conditions.
2. Allocation of a liquid waste disposal point to increase market sanitation.
3. The food handlers to wear protective wear such as hair nets and aprons to
reduce contamination of foods
4. The market committee to lease with the county got to provide tapped water to
the market to reduce risks of infection.
CONCLUSION
During the visit we learnt about the operation of the market, the types of foods
sold in the market, revenue collection and usage, members of the market
committee and their roles. Generally, it was an educative experience.
A REPORT ON SCHOOL HEALTH PROGRAMME AT IGARE D.E.B AND JUNIOR
SECONDARY ON 9/1/2025 BY SEPTEMBER 2022 GROUP A.
OBJECTIVES
 To share health messages.
 To promote physical health.
 To assess the problems of school children.
 Establish practical goals for the school children.
 Carry out needed activities.
 Evaluate the process and results of the programs.

We left the hospital at 10:00am accompanied by the student mentor, the disease
surveillance personnel and Mch nurse. Arrived at 11:00am where we were
welcomed by the teachers the male were 203 and the ladies were 199. We held a
parade and we were introduced. The students were divided into two groups the
lower primary and upper primary. Three students and Mch nurse accompanied
the lower primary and the other went with the upper primary.
The lower primary discussed on hand hygiene, while the upper primary discussed
on; sexually transmitted infections, gender based violence, adolescence crisis,
menstrual hygiene, wet dreams, and teenage pregnancies.
The lower primary
They were taught on hand hygiene and a demonstration was done.
Findings
The pupils knew when to wash their hands.
How to wash their hands.
They hand short nails.
The upper primary.
They were taught on;
 Sexual transmitted infections
 Gender based violence
 Teenage pregnancies
 Adolescent crisis
 Menstrual hygiene

Findings
 They were health literate since they were well acquitted with proper
health behaviors e.g. menstrual hygiene and Sexually transmitted
diseases.
 The children were cooperative since they were informed of the
school health program.
 They had a good nutritional status since they were no malnutrition.
 The children were well disciplined

SCHOOL INSPECTION
Location
 The school surrounding was clean.
 Free from noise.
 The gate was made of wood which wasn’t that functional.

Sanitation
 They have tanks which they harvest rain water and also students fetch
water from home to school.
 Latrines were clean
 There was availability of hand washing points all over the area
 They have a waste disposal site.

Classroom
  Classes had a well arranged structure with good ventilation.
 They had desks which they shared among three pupils, the feet touched the
floor.
 The gate was made of wood which wasn’t that functional.

Promotion of nutrition.
 There was a kitchen with good ventilation, firewood were arranged
 The food handlers wasn’t properly covered.
 The area which they cleaned the utensils was dump.

Recommendations
 The food handlers should cover themselves.
 The washing area should be on a raised surface and good drainage.
 They should add number of latrines due to number of male pupils.

A REPORT ON OUTREACH AT ESAKA ON 3/1/2025 BY SEPTEMBER2022 CLASS

GROUP A.
We left Nduru sub county hospital at 10:00 am accompanied by the sub county
GBV person and student mentor.
Findings
We took with us the following services.
Antenatal services. -0
Family planning services
Jadelle insertion -3
Depo Provera- 1
Condoms given
Immunization
Vitamin A -11 children
Other members were not aware of the services.
Recommendation
 The CHP’S should lias with the community in order to mobilize the
community individuals to create awareness of community services.

 The community should be well educating through health talks on

importance of services.

Conclusion
In conclusion to improve outreach service outcomes the key is understanding
community’s needs, engaging them effectively and offering services in a way that
is relevant, transparent and accessible.
REPORT ON SUB COUNTY EXPERIENCE AT NDURU REFERRAL
HOSPITAL- KISII FOR 2 WEEKS FROM 13/1/2025 – 26/1/2025 BY
SEPTEMBER 2022 GROUP A NURSING STUDENTS FROM TABAKA
MISSION HOSPITAL

Table of content
Acknowledgement
Introduction
Sub county health management team members
Objectives
Conclusion
Recommendations

List of abbreviations
KEPI- Kenya expanded program of immunization
SPHNO – sub county public health nurse
SPHO- sub county public health officer
SMOH- sub county medical officer of health
SDSO- sub county disease surveillance officer
MCH- maternal child health
SHMT- sub county management team
SCCO- sub county clinical officer
STI- sexually transmitted infections

Acknowledgement
We would like to thank God for granting good health and enabling us to gain more
from our experience.
We thank the school and the deputy principal who’s in charge of the community
health department for organizing the sub county experience at Nduru hospital.
We then thank the Nduru health management team to include the SMOH, SRHN,
SPHNO, KEPI nurse and the whole team for their undying love and support
throughout the whole experience.
This was conducted within Nduru level 4 hospital.
The sub county referral hospital serves the following hospital in the sub county

Sub Health Dispensaries Faith based Private

county centers
hospital
1. Ndur 1. Nyatike 1. Omogwa 1. tabaka l4 1.ropment
u 2. Moticho 2. Giantunda 2.monianku 2.romeiva
SCH 3. Boige 3. Bokimai HC 3.milleneium
2. Etago 4. Suguta 4. Eburi 3. 4. dencare
SCH 5. Nyamogonchoro 5. Openda nyagichenche 5.nyamainya
6. Nyabiosi 6. Kiagware 4. metaburo 6.romao
7. Gotichaki 7. Nyakey0 HC
8. Bombure
9. Ekerongo
10.nyakeiboreire

Sub county health management team

 1. SCO- sub-county clinical officer
2. SCL–sub-county laboratory
3. SCMOH- sub-county medical officer
4. SCPHN-sub-county public health nurse-in charge of all the nurses
5. SCA- sub-county administration dealing with staffing
6. SCPHO- sub-county public health officer
7. SCP-sub-county pharmacist.
8. SC-RHIO-sub-county recording health records and Information officer
9. SCNO- sub-county nutrition officer
10.SEPI-sub county EPI coordinator
11.KEPI -Kenya expanded program of immunization
12.SASCO- sub county AIDS/STI s coordinator

At the maternal child health clinic

Vaccination of children under 5 years, girls aged 10-14 and pregnant women
Monitoring and maintenance of MCH equipment; refrigerators, weighing
scale, blood pressure machines, thermometer and glucometers.
Offer EMTCT services like prophylaxis, follow up of pregnant mothers with
HIV as well as HEI with right medications according to the health ART
guidelines.
Enrolling pregnant women to focused antenatal care visits and offering
health messages, physical examinations, weight, blood sugar and blood
pressure monitoring, ultrasonography, antigen D administration and fetal
wellbeing monitoring.
Partner notification services to prevent spread of HIV and STIS.
 Providing outreaches to the community members who are from hard to reach
areas within a geographical location that is immunization and offering
referral services.
Providing family planning services to the clients; barrier methods, implants,
injectable, intrauterine device and explaining on natural methods.
Conducting and follow up of clients especially among the trainees
Advising mothers on the health strategies the government has put in place to
prevent diseases; use of long lasting treated mosquito nets, linda mama, free
pregnant women services.

Sub county public health nurse

Supervising on the inspection of hospital facilities structures including water
supply system and waste disposal systems.

Approval of annual leave of the nurses in the sub county. By allowing equal leave
allocation of the nurses in order to achieve work force.

Handling of indiscipline cases among nurses in the sub county. By being a member
of the disciplinary committee and assisting in making of decisions on the different
disciplinary cases among nurses in the facilities.

Monitoring of other facilities activities including the sub county facility. By

checking on the procedures and documentation done by the nurses. Including
documentation in the registers and correct use of ledger books.

Doing supervision of activities in all facilities in the sub county. In order to ensure
correct application of nursing procedure. Including standard precautions, sterility,
correct use of the facility equipment and correct use of vaccination schedule.

Member of disease surveillance team. In times of disease outbreak in the sub

county, the SCPHN plays a role of mobilizing the community nurses by ensuring
immediate reporting of the prevalence cases. Supervising contact tracing in the
endemic area. Also, answerable to the county public health nurse on matters
disease surveillance.

Allocation of nurses in the sub county. Here; qualification, experience and work
force is considered when allocating nurses in different facilities according to their
catchment population.
Appointment and approval of the facilities in charges within the sub county.
Planning of monthly activity plans in the sub county facility. By coming up with
the health plans including community outreach in the facilities.

Participate in monthly report writing and combination of the facilities reports.

Afterwards reporting to the county public health nurses for combination of in the
county.

The Kepi nurse

Distributing vaccines to other facilities, updating ledger books and KEPI system.
We also performed a physical counting of vaccines and plotting the immunization
monitoring chat for the whole sub county.

Receiving sub county report of immunization from different health facilities in the
region. Combining of the reports of vaccination and immunization and handing
over to the regional KEPI office.

Updating ledgers in the sub county store and redistribution of vaccines among the
facilities in the sub county. By also coming up with a comparison between the
vaccines in the store and the total of vaccines in the Chanjo system in the website
of KEPI. We were taught on how to calculate a demographic estimate of the sub
county that will be important when calculating the estimate number of target of
vaccination depending on the age group.
Also learnt about different ordering registers and forms in the KEPI store.
Understood how vaccines are ordered using the various forms available in the store
and using the system.

We learnt how monitor the condition of the refrigerators by monitoring on the

power supply and monitoring based on the alarm system alert that is installed in
each of the refrigerators.

Roles and responsibilities of the SCHMT members

The SCHMT member roles include:
SCMOH
 Ensures providence of leadership to the sub county teams
 Ensure effective delivery of quality health care to sub county residents by
providing leadership to sub county teams
 Ensure provision of quality primary health care to the members of the sub
county
 Ensure promotive, preventive and curative health services
 Are skilled in data analysis, team building, public speaking, research,
leadership and management.
 Attend county medical meetings
 Receives report, monitors and evaluate sub county medical activities
 Chairs disciplinary committees
SCPHN
 In charge of all nursing activities in the sub county
 Prepare for internal transfers within the sub county
 Managing budgets of public health programs within the sub county
 Focus on prevention of illnesses
 Approves annual leave by allowing equal leave allocation in order to achieve
workforce
 Participate in disciplinary committee
 Doing supervision of facility activities in the sub county; standard
precautions, sterility and correct use of equipment.
  Member of disease surveillance team in the sub county in cases of outbreaks
and notifications as well as mobilization of community nurses by reporting
incidences
 Planning of outreaches especially MCH\FP
 Planning of monthly activities in the sub county
 Participate and supervises monthly reports and sends them to the county.

SCP
 Dispensing and suppling drugs to facilities within the sub county
 Writing reports and giving reports to the county
 Counselling patients on drugs and giving feedback to the suppliers
 Keeping records for the sub county drug supply
 Documentation of data for future use

SCPHO
 Disease prevention and control
 Participate on food quality control
 Involved in disaster management
 Participate in water sanitation, market inspection, and meat inspection
within the sub county
 Involved in health promotive services within the sub county
 Participate in urban, rural and hospital sanitation
SCL
 Coordinate laboratory services in the sub county
 Procurement of laboratory commodities
 Coordinate monthly reports and send them to the county
 Allocation of training sessions in the sub county
 Give attachment services to the laboratory technologists who are studying
SCHRIO
 Collection of all health records in the sub county
 Complication and submission of health record in the sub county
  Management and monitoring of activities within the sub county
 Informational data collection and record keeping
SCNO
 Oversees the nutrition activities in the sub county
 Writes and documents monthly reports
 Serves both inpatient and outpatient
 Provides counselling about nutrition among members of a sub county
 Monitoring and evaluating of growth and weight among children under 5,
people with immunocompromised and those with chronic illnesses
 Give training and mentor students who study as nutritionists

SEPI
 Ordering and forecasting of vaccines from the county stores
 Suppling vaccines to facilities within the sub county
 Responsible for vaccine monitoring chart updates on facilities within sub
county
 Ensuring maintenance of cold chain of vaccines on sub county store that is
care of vaccines, and refrigerators, monitoring vaccine potency, ensuring
presence of an excursion contingency plan, physical counts, updating ledger
books and system update
 Mentoring and training students on activities done at KEPI and about cold
chain and supply of vaccines to the peripheries
 Receiving reports of immunization from the peripheries and updating them
on records every month
 Calculation of demographic data within the sub county and those of
periphery facilities
 Supervision of facilities within the sub county and correcting the gaps noted.

SSCO
 Diagnosis of various conditions, ordering laboratory and imaging
investigations.
 Screening and examination of patients
  Supervise patient care in the clinic
 Performing of medical procedures, medical education and minor surgical
procedures.
 Treatment of patients by prescribing medications

SUPPORT SUPERVISION AT MOTICHO HEALTH CENTER ON 20 TH DECEMBER 2024

BY NURSING STUDENTS CLASS OF SEPTEMBER 2022 OF TABAKA.
Support supervision is method of supervision that helps employees improve their
work performance through non authoritarian mean.
We left for Moticho Health Center at 9:00 am accompanied by our school tutor,
Student mentor and SPHN. We arrived at 10:00 am and was received the nurse on
duty of the facility.
OBJECTIVES.
 To ensure quality of services.

 To promote accountability.

 To encourage team work and collaboration.

 To identify and address challenges.

 To ensure resource optimization.

FINDINGS
GENERAL FINDINGS
 Environment not well-kept overgrown vegetation, flowers not trimmed,
and buildings not attractive.

 Poor drainage.

 Poor security.

 Proper water storage in tanks.

MATERNITY.
 Proper record keeping.

 Equipment’s present.

 No water supplies.

 No decontamination area.

 Expired non pharmaceuticals.

 Clean floor.
  Poor drainage on the entrance.

 Understaffed

 No charting of pathographs.

MCH
 Target not met due to neglect ion of MCH in May and April.

 Defaulter tracing is an issue due to absence of MOH 510 and MOH 525.

 Fridge tag expired in 2022.

 Poor vaccine arrangement in the fridge.

 Ledger books not well balanced.

 Understaffed.

COMPRESIVE CARE CENTER

 Presence of medication.

 Charts present.

 Waste segregation area present and well arranged.

 Patient privacy is met.

 Stock control card not present.

 Understaffed.

RECOMMENDATION
 Nurses to lias with the EPI logistician to get a new fridge tag.
  Expired non pharmaceuticals and pharmaceuticals to be returned back sub
county medical supply store to get new supplies.

 Enhance proper record keeping in MCH and CCC

 Ensure well maintenance of flower beds, fence and grass.

 Enhance proper waste segregation.

 Buy more bins and placenta bins.

 Nurse in charge to lias with the count to get more staff.

CONCLUSION
 We participated in KEPI inspection and managed to sign the EPI supervision
book.

 We learnt lot pertaining support supervision.

 We participated in actives such as helping in client flow and triaging.

 It was an educative experience.

REPORT ON COMMUNITY STRATEGY AT BOGETENGA WARD A ON 2/1/25 by

SEPTEMBER 2022 GROUP A TABAKA.
We met the community health officer at 8:30 am and took us through community
strategy process for 45 mins and we were handed to the community health
promoters and the student mentor.
We left the hospital at 9:00 am and proceeded to the first homestead.
Definition:
It is a set of guiding principles that helps to decide how to build a group of people
who share mutual concern of one another.
OBJECTIVES OF COMMUNITY STRATEGY
 Improve access to health care. Enhance community access to
health care.

 To recognize priority problem relating to health.

 Decide on what needs to be done to overcome the problem.

 Decide on what the community itself can do to solve the problem.

 Empowering the house hold, individuals and community to be

aware of their own health.

 Disease prevention and control. - To reduce maternal mortality

and morbidity.

PRINCIPLES OF COMMUNITY STRATEGY.

 Engagement and collaboration.

 Adaptability

 Equality and dignity of human life.

 Intersectoral multidisciplinary.
  Use of innovative and appropriate technology.

HOW TO BUILD A COMMUNITY STRATEGY

Work plan-timeline; A community health promoter should have a schedule on
what to be done on what time and when following priority.
Budget; to know the resources required to achieve the required expectations.
Research; to identify the target population, gaps priority health problems.
Set of purpose-Identify measurable objective such as measure of success.
Success; measure achievement of the community purpose such as mobilization
Sharing of strategies with stake holders.
AIMS
 Strengthen connection of the members of community and health care
workers

 Improve health care at individual level

 Enable problem finding and support.

 To share health messages

FINDINGS
House hold one;
House
There were two houses made of mud and they had windows and iron sheet roof
that were well ventilated. They sleep under treated mosquito nets. There was a
kitchen that was neat and well arranged. They use firewood.
Source of water
They had a well that had clean water used for domestic use. They get drinking
water from the spring which is treated and is easily accessible.
Source of food
They have a main garden and kitchen garden.
They plant use. They and fruits.
Environment
The grass was well trimmed, there was a hip of waste and they burn. The toilet
was clean and covered. Six meters from the house.
The homestead was well fenced with natural plants.
General assessment of the clients
They were healthy and stable.
Vitals were taken the Blood pressure was of normal ranges, Blood glucose was of
normal ranges and the MUAC of children was normal.
House hold two
House
There were four houses made of mud and they had windows and iron sheet roof
that were well ventilated. With one unfinished permanent house.
There was a kitchen that was neat and well arranged. They use firewood. They
treated mosquito nets
Source of water
They get their water from the spring.
They had a pit with water which was not well covered.
Source of food
They have a main garden and kitchen garden.
Where they plant fruits and vegetables.
Environment
The grass was well trimmed, there was a hip of waste and they burn. The toilet
was clean and covered six meters from the house.
The house was well fenced with one main gate and well-trimmed fence and dogs
for security.
They had a cow shed with poor drainage.
General assessment of the clients
They were healthy and stable.
Vitals were taken the Blood pressure was of normal ranges, Blood glucose was of
normal ranges and the MUAC of children was normal.
RECOMMENDATION
House hold one;
We advise the client on waste segregation area.
We advise the client to empty all bins or burn to avoid harboring of mosquitos.
To have a good drainage on the washing area.
House hold two;
To properly cover the pit.
To make a well drainage on the cow shed.
CONCLUSION
We concluded that the community strategy is a vital for fostering resilience,
promoting equity and addressing complex issues of health through community
participation.
CONCLUSION THE SUB-COUNTY EXPERIENCE
We learnt a lot and more experience gained. We were able to rotate on the KEPI
store, SPHN office, MCH/FP.
We managed to participate in support at one of the Dispensaries within the sub
county region.
CHALLENGES FACED
1. There was scarcity of vaccines to be supplied to the various health facilities.
2. The immunization target wasn't met.
RECOMMENDATIONS
1. There should be enough vaccines to prevent stock outs.
2. Prevent drop out among children under five by ensuring the defaulter
tracing system is functional