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Nominee Information

Institutional Information
Member State Kenya
Institution Name Machakos County Government
Institution Type Public Agency
Administrative Level Local
Name of initiative Emergency and Rescue Service
Projects Operational Years 5
Website of Institution http://www.machakosgovernment.com/accountability/PMSHealthEmergencyServicesReports.aspx

Question 1: About the Initiative
Is this a public sector initiative? Yes

Question 2: Categories
Is the initiative relevant to one of the UNPSA categories? Reaching the poorest and most vulnerable through inclusive services and partnerships
UNPSACriteria
2017.1.1 Introduces an idea, policy, practice or structure that is distinctively new, innovative and unique in the context of a given country or region, for reaching the poorest and most vulnerable and ensuring that they make progress towards the SDGs
2017.1.2 Increases the access of the poorest and most vulnerable people to quality and affordable public services. This can be done notably by addressing the obstacles that hinder their access to public services such as geography, income or other social or economic factors, security issues, care burden, mobility, discrimination related to sex, gender, age, race, ethnicity and other factors depending on the country or regional context. This can also include introducing new approaches to delivering services or claiming rights and obtaining benefits, so that the poorest and most vulnerable can access those more easily.
2017.1.4 Encourage and promote effective partnerships between public, private and civil society organizations to deliver public services or respond to the needs of the poorest and most vulnerable. Those can be based on experience and strategies that can empower the poorest and most vulnerable to reach the SDGs in various areas
2017.1.5 Creates mechanisms to ensure that the poorest and most vulnerable (and those who represent or assist them) can easily obtain information about public services -notably services related to the SDGs- , related decisions and approaches, as well as about their own rights and entitlements.
2017.1.6 Creates mechanisms that can help the poorest and most vulnerable (and those representing or assisting them) to hold the government accountable on the delivery of public services. This may include mechanisms allowing them to provide feedback on the relevance, quality and cost of public services; report any wrongdoing; initiate investigations; file complaints or request compensation where relevant.
2017.1.7 Introduces mechanisms that ensure that public officials are informed about the special needs of the poorest and most vulnerable, trained and equipped to meet them and held accountable when these needs are ignored or when the rights of the poorest and most vulnerable people are not protected.

Question 3: Sustainable Development Goals
Is the initiative relevant to any of the 17 SDG(s)? Yes
If you answered yes above, please specify which SDG is the most relevant to the initiative. (hold Ctrl to select multiple)
Goal 3: Good Health
Which target(s) within the SDGs specified above is the initiative relevant to? (hold Ctrl to select multiple)
3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents

Question 4: Implementation Date
Has the initiative been implemented for two or more years Yes
Please provide date of implemenation (dd/MM/yyyy) 18 Mar 2014

Question 5: Partners
Has the United Nations or any UN agencies been involved in this initiative? No
Which UN agency was involved? (hold Ctrl to select multiple)
The Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization
Please provide details

Question 6: Supporting documentation
Will you be able to provide supporting documentation for your initiative? Yes

Question 7: UNPSA Awards
Has the initiative already won a UNPS Award? No

Question 8: Other Awards
Has the initiative won other Public Service Awards? Yes
If yes, please specify name, organisation and year. Information and Communication Technology Authority

Question 9: How did you learn about UNPSA?
How did you learn about UNPSA? Government to Government communication

Question 10: Validation Consent
I give consent to contact relevant persons and entities to inquire about the initiative for validation purpose. No

Question 1: About the Initiative
Is this a public sector initiative? Yes

Question 2: Categories
Is the initiative relevant to one of the UNPSA categories? Reaching the poorest and most vulnerable through inclusive services and partnerships
UNPSACriteria
2017.1.1 Introduces an idea, policy, practice or structure that is distinctively new, innovative and unique in the context of a given country or region, for reaching the poorest and most vulnerable and ensuring that they make progress towards the SDGs
2017.1.2 Increases the access of the poorest and most vulnerable people to quality and affordable public services. This can be done notably by addressing the obstacles that hinder their access to public services such as geography, income or other social or economic factors, security issues, care burden, mobility, discrimination related to sex, gender, age, race, ethnicity and other factors depending on the country or regional context. This can also include introducing new approaches to delivering services or claiming rights and obtaining benefits, so that the poorest and most vulnerable can access those more easily.
2017.1.4 Encourage and promote effective partnerships between public, private and civil society organizations to deliver public services or respond to the needs of the poorest and most vulnerable. Those can be based on experience and strategies that can empower the poorest and most vulnerable to reach the SDGs in various areas
2017.1.5 Creates mechanisms to ensure that the poorest and most vulnerable (and those who represent or assist them) can easily obtain information about public services -notably services related to the SDGs- , related decisions and approaches, as well as about their own rights and entitlements.
2017.1.6 Creates mechanisms that can help the poorest and most vulnerable (and those representing or assisting them) to hold the government accountable on the delivery of public services. This may include mechanisms allowing them to provide feedback on the relevance, quality and cost of public services; report any wrongdoing; initiate investigations; file complaints or request compensation where relevant.
2017.1.7 Introduces mechanisms that ensure that public officials are informed about the special needs of the poorest and most vulnerable, trained and equipped to meet them and held accountable when these needs are ignored or when the rights of the poorest and most vulnerable people are not protected.

Question 3: Sustainable Development Goals
Is the initiative relevant to any of the 17 SDG(s)? Yes
If you answered yes above, please specify which SDG is the most relevant to the initiative. (hold Ctrl to select multiple)
Goal 3: Good Health
Which target(s) within the SDGs specified above is the initiative relevant to? (hold Ctrl to select multiple)
3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents

Question 4: Implementation Date
Has the initiative been implemented for two or more years Yes
Please provide date of implemenation (dd/MM/yyyy) 18 Mar 2014

Question 5: Partners
Has the United Nations or any UN agencies been involved in this initiative? No
Which UN agency was involved? (hold Ctrl to select multiple)
The Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization
Please provide details

Question 6: Supporting documentation
Will you be able to provide supporting documentation for your initiative? Yes

Question 7: UNPSA Awards
Has the initiative already won a UNPS Award? No

Question 8: Other Awards
Has the initiative won other Public Service Awards? Yes
If yes, please specify name, organisation and year. Information and Communication Technology Authority

Question 9: How did you learn about UNPSA?
How did you learn about UNPSA? Government to Government communication

Question 10: Validation Consent
I give consent to contact relevant persons and entities to inquire about the initiative for validation purpose. No

Question 1: About the Initiative

Is this a public sector initiative? Yes

Question 2: Categories
Is the initiative relevant to one of the UNPSA categories? Reaching the poorest and most vulnerable through inclusive services and partnerships
UNPSACriteria
2017.1.1 Introduces an idea, policy, practice or structure that is distinctively new, innovative and unique in the context of a given country or region, for reaching the poorest and most vulnerable and ensuring that they make progress towards the SDGs
2017.1.2 Increases the access of the poorest and most vulnerable people to quality and affordable public services. This can be done notably by addressing the obstacles that hinder their access to public services such as geography, income or other social or economic factors, security issues, care burden, mobility, discrimination related to sex, gender, age, race, ethnicity and other factors depending on the country or regional context. This can also include introducing new approaches to delivering services or claiming rights and obtaining benefits, so that the poorest and most vulnerable can access those more easily.
2017.1.4 Encourage and promote effective partnerships between public, private and civil society organizations to deliver public services or respond to the needs of the poorest and most vulnerable. Those can be based on experience and strategies that can empower the poorest and most vulnerable to reach the SDGs in various areas
2017.1.5 Creates mechanisms to ensure that the poorest and most vulnerable (and those who represent or assist them) can easily obtain information about public services -notably services related to the SDGs- , related decisions and approaches, as well as about their own rights and entitlements.
2017.1.6 Creates mechanisms that can help the poorest and most vulnerable (and those representing or assisting them) to hold the government accountable on the delivery of public services. This may include mechanisms allowing them to provide feedback on the relevance, quality and cost of public services; report any wrongdoing; initiate investigations; file complaints or request compensation where relevant.
2017.1.7 Introduces mechanisms that ensure that public officials are informed about the special needs of the poorest and most vulnerable, trained and equipped to meet them and held accountable when these needs are ignored or when the rights of the poorest and most vulnerable people are not protected.

Question 3: Implementation Date

Has the initiative been implemented for two or more years Yes
Please provide date of implemenation (dd/MM/yyyy) 18 Mar 2014

Question 4: Partners/Stakeholders

Has the United Nations or any UN agencies been involved in this initiative? No
Which UN agency was involved? (hold Ctrl to select multiple)
The Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization
Please provide details

Question 5: Required Supplemental Documents

Will you be able to provide supporting documentation for your initiative? Yes

Question 6: UNPSA Awards

Has the initiative already won a UNPS Award? No

Question 7: Other Awards

Has the initiative won other Public Service Awards? Yes
Comments: Information and Communication Technology Authority

Question 8: Sustainable Development Goals
Is the initiative relevant to any of the 17 SDG(s)? Yes
If you answered yes above, please specify which SDG is the most relevant to the initiative. (hold Ctrl to select multiple)
Goal 3: Good Health
Which target(s) within the SDGs specified above is the initiative relevant to? (hold Ctrl to select multiple)
3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents

Question 9: Validation Consent

Do you have any objections to us inquiring about the initiative for validation purposes? No

How did you know about UNPSA?

How did you know about UNPSA? Government to Government communication

Nomination form

Questions/Answers

Question 1

Please provide a brief summary of the initiative including the problems/challenges it addressed and the solutions that the initiative introduced (300 words maximum)
In Machakos County, free emergency services was launched in 2014 with an aim of assisting the residents in accessing primary health care and consequently getting them to the main hospital on case/need basis. Prior to the initiative pregnant mothers were getting challenges in accessing main hospital, this led to increased maternal and infant mortality rate from the associated complications. Similarly accident cases, snake bites and many other emergency cases could not be solved in a timely manner, resulting into unnecessary deaths.
a. What are the overall objectives of the initiative?
Please describe the overall objectives of the initiative (200 words maximum)
To provide primary health care and promote recovery of the patient or casualty, treat the presenting conditions or transport to the next point of definitive care (Hospital). Reducing congestion in main hospitals by providing care at the community level Reducing suffering through provision of prompt help in time of emergency need. Enhancing social economic aspect of the community through employment of the Ambulance personnel and based at the community level.
b. How does the initiative fit within the selected category?
Please describe how the initiative is linked to the criteria of the category (200 words maximum)
Provides and coordinates free emergency and Pre - hospital Care, Disaster Mitigation, Preparedness and Response to the residents in medical emergency related cases.

Question 2

The initiative should improve people’s lives, notably by enhancing the contribution of public services to the implementation of the 2030 Agenda for Sustainable Development and the realization of the SDGs
a. Please explain how the initiative improves the delivery of public services (200 words maximum)
In the past, providing timely Emergency and Health Services in Machakos County was difficult, and residents sometimes had to wait long hours for an ambulance for referral thus access to health services has now improved tremendously since we have Ambulances at the community level in Public Health Care facilities. SDG number 3 denotes good health and well being:- free emergency cover through Ambulances will ensure that the sick/injured get access to health facilities in time, therefore saving lives and improving the quality of life. The service helps towards a healthy population who can contribute effectively to our Country and County socio-economic and political development.

Question 3

The initiative must impact positively a group or groups of the population (i.e. children, women, elderly, people with disability, etc) and address a significant issue of public service delivery within the context of a given country or region.
a. Please explain how the initiative has addressed a significant issue related to the delivery of public services (200 words maximum)
The Emergency & Rescue Service is a free service rendered mostly to the vulnerable residents in the community. Provision of Ambulance service has greatly saved expectant mothers by ensuring that they get primary health care in time and consequently offering quick and effective referral systems in times of difficult deliveries that may need better infrastructure and specialized consultations. Community based Ambulances ensures newborn babies that are either prematurely born or develop complications after delivery are attended to promptly through provision of necessary care. For the social well being of the community, the Ambulances are manned by qualified medical personnel (Nurses/Clinical officers) who offer pre-hospital and on transit care.
b. Please explain how the initiative has impacted positively a group or groups of the population within the context of your country or region (200 words maximum)
Road Traffic Accident response has greatly impacted positively on professional evacuation that has led to reduction of associated disabilities. Improved mother child health care through provision of qualified health personnel and timely transport where necessary. Improve the health care to residents with life threatening conditions through home based care. Through recognizing and contributing to the well-being of the community and therefore committed to provide unique emergency services to the residents.

Question 4

The initiative must present an innovative idea, a distinctively new approach, or a unique policy or approach implemented in order to realize the SDGs in the context of a given country or region.
a. Please explain in which way the initiative is innovative in the context of your country or region (200 words maximum)
The ambulance service is run in 24 hours for effective response and we have geared community sensitization and recovery programs. Ambulances are run by qualified medical personnel (Clinical Officers/Nurses) who offer primary health care at the community level based on the referral strategy. The Ambulance Operators (Drivers) operate at their local communities and as such they are well conversant with the terrain, community dynamics and cultural and religious aspects of the community. The Ambulance Operators (Drivers) have undergone an Emergency Transport Attendant Kenya Course to support the qualified medical personnel (Clinical Officers/Nurses) in provision of Emergency Medical Service.

Question 4b

b. Please describe if the innovation is original or if it is an adaptation from other contexts (If it is known)? (200 words maximum)
The innovation involves the proximity of the service to the population. The response time is between 5-8 minutes after a call is raised. The average response time is 3 minutes. he innovation came into being from the manifesto (attached under documents) of Machakos Governor, Dr. Alfred N. Mutua and his County Government. As stipulated in the manifesto, we should have one or two ambulances at Ward level so that the needy residents can access ambulance emergency services efficiently and effectively.

Question 4c

c. What resources (i.e. financial, human , material or other resources, etc) were used to implement the initiative? (200 words maximum)
For smooth running of the emergency services, the following resources were brought on board. Human resource – 230 Emergency Personnel Material resource – 70 Ambulances and 10 Motor Cycles County Government financing for fueling and fleet maintenance, staff remuneration, medial supplies National Government has supplied specialized equipment equipment at Machakos Level 5 Hospital

Question 5

The initiative should be adaptable to other contexts (e.g. other cities, countries or regions). There may already be evidence that it has inspired similar innovations in other public-sector institutions within a given country, region or at the global level.
a. Has the initiative been transferred to other contexts?
Yes
The Machakos neighborhoods i.e Nairobi County to the North, Makueni County to the South, Kitui County to the East and Kajiando County to the South West. Three out of these four Counties….Nairobi, Makueni and Kitui have adopted the initiative of public medical emergency services. These three Counties have purchased Ambulances that help to respond to public emergencies mostly from road traffic incidences, disaster instances and hospital referral system has been strengthened. We have received many delegations from the 47 Kenya Counties for purpose of bench marking and roll out by their respective Governments.

Question 6

The initiative should be able to be sustained over a significant period of time.
a. Please describe whether and how the initiative is sustainable (covering the social, economic and environmental aspects) (300 words maximum)
In the social aspect the recipient of the free emergency service have embraced the whole issue as their own due to initial public participation whereby they unanimously embraced the idea. Economic and environmental aspects to sustain the initiative. The County Government has allocated adequate budget to take care of fueling, repair and maintenance of the fleet and remuneration of the personnel. Other sectors of Government, example agriculture and water have contributed through their efforts to have enough food, and clean drinking water thus lowering pressure to our resources.
b. Please describe whether and how the initiative is sustainable in terms of durability in time (300 words maximum)
The initiative is sustainable with proper governance, leadership and management of all the resources (Human resource, materials and finances). The overall strategy of the county Government is preventive healthcare through adequate food production, and provision clean and safe drinking water. The country is streamlining revenue collection and management so that the programme can be fully funded from the local resources and stop reliance from the National Government.

Question 7

The initiative should have gone through a formal evaluation, showing some evidence of impact on improving people’s lives.
a. Has the initiative been formally evaluated?
Yes
If yes, please describe how the initiative was evaluated? (200 words maximum)
The local residents who are the recipients of the service were interviewed internally and the survey results showed they support the initiative. This is proven through the continuous demand for the service on daily basis.
b. Please describe the outcome of the evaluation of the impact of the initiative (200 words maximum)
The result of the evaluation showed a positive impact as evidenced by the continuously increased demand for the service.
c. Please describe the indicators that were used (200 words maximum)
Data collected showing the number of cases served Our Response time of 5-8 minutes with an average of 3 minutes. The resources invested in the services 70 ambulances and 10 Motor Cycles, 230 medical personnel employed, capacity building training, etc

Question 8

The initiative must demonstrate that it has engaged various actors such as from other institutions, civil society, or the private sector, when possible.
a. The 2030 Development Agenda puts emphasis on collaboration, engagement, coordination, partnerships, and inclusion. Please describe what stakeholders were engaged in designing, implementing and evaluating the initiative. Please also highlight their roles and contributions (300 words maximum)
Below are some of the actors involved: Institutions Both public and private institutions have been incorporated in the development of the initiative. Public institutions, among them the national government for funding and supply of specialized equipment, hospitals and dispensaries have served critical cases that cannot be dispensed with from the grassroots. The local community is empowered to participate in decisions concerning the distribution of health facilities, drugs and ambulances. Other County Departments, The ICT Department has provided Call Center infrastructure to manage emergency calls from the population. The SMS service provided helps to receive citizens feedback for continuous improvement. The Department of water has provided clean drinking water has helped to reduce hygienic related cases (example reduction of cholera cases) etc The National police service is involved to handle any cases that require their actions, for example traffic accidents cases, assault cases The Medical Personnel, Citizens and The Civil Society Civil society organizations have an input for this project in that they carry out social audit of projects and strengthen community and other networks for project evaluation. They also form part of the stakeholders that the government targets for inclusion in the County Integrated Development Plan (CIDP). Private Sector The department contracts private sector players to enhance capacity for our personnel, example the St. Johns Ambulance and Kenya Red Cross. The church and Mosques have been instrumental sensitization of the service to the members of public.

Question 9

a. Please describe the key lessons learned, and any view you have on how to further improve the initiative (200 words maximum)
That is possible to solve many medical cases at the ground/scenes and save lives through the pre-hospital care. That through engagement with the stake holders, the service is a success, for example sensitization of the public through churches and mosques about the services, and our staff capacity building through The Kenya Red Cross and other agencies. That with little resources a Government can provide effective and efficient services to her population.

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