SUPPLEMENT_NUMBER:=2 SUPPLEMENT_ARTICLE_NUMBER:=10 SUPPLEMENT_PUB_VOLUME:=25 SUPPLEMENT_TITLE:=Supplement - AMREF 2016 SUPPLEMENT_ID:=12 SUPPLEMENT_LONG_TITLE:=Strengthening health systems in communities: the experiences of AMREF Health Africa SUPPLEMENT_SPONSOR:=African Medical Research Foundation SUPPLEMENT_PERM_LINK:=http://www.panafrican-med-journal.com/content/series/25/2/ ARTVOL:=ARTVOL ARTTYPE:=Supplement ARTISSUE:=ARTISSUE ARTTITLE:=A scorecard for assessing functionality of community health unit in Kenya ARTAUTHOR:=Duncan Ager, George Oele, Samuel Muhula, Susan Achieng, Moses Emalu, Mildred Nanjala, Sarah Kosgei, Susan Wanjiru, Peter Ofware, David Ojakaa, Meshack Ndirangu, Lennie Kyomuhangi ART_AUT_AFF:=Duncan Ager, Amref Health Africa in Kenya, Wilson Airport, off Langata Road, Nairobi, Kenya ARTLINK:=http://www.panafrican-med-journal.com/content/series/25/2/10/full ART_AUT_EMAIL:=agerkakirowo@gmail.com ARTMOOD:=5 ARTDATEPUB:=26/11/2016 ARTDATEREC:=14/08/2016 ARTDATEACC:=25/11/2016 ARTKEYWORDS:=Scorecard, community health strategy, community health unit, functionality PATH_PDF:=http://www.panafrican-med-journal.com/content/series/25/2/10/pdf/10.pdf ARTLANG:=English ARTABSTRACT:=BACKGROUND: in 2005, Kenya’s Ministry of Health (MOH) in its quest to improve health outcomes developed the Community Health Strategy (CHS) as a key approach. The MOH and partners grappled with the challenge of managing the functionality of the Community Health Units (CHUs). Amref Health Africa in Kenya developed a replicable CHUs Functionality Scorecard for measuring and managing the functionality of CHUs. METHODS: we designed and piloted the CHU Functionality Scorecard at 114 CHUs in Rift valley province in Kenya. The scorecard categorized CHUs as Functional, Semi-functional, or Non-Functional. We used before and after design to assess the functionality of the CUs. RESULTS: over seven quarters (January 2012 to September 2013). The proportion of functional CHU increased from 3.5% to 82.9%, Semi-Functional reduced from 39% to 13% while Non-Functional reduced from 58% to 4%. The greatest improvements were noted in Community Health Volunteers (CHVs) receiving stipends, CHVs with referral booklets, monthly dialogue days, actions planning, chalk boards, and CHVs reporting rates. CONCLUSION: the CHU Functionality Scorecard is a valuable tool for the management of performance, resource allocation, and decision making. We recommend the adoption of the Functionality Scorecard by the Kenya Government for country-wide application. We recommend: further work in defining Advanced Functionality and incorporating the same into the scorecard; and implementation research on long term sustainability of CHUs. ARTNUMFIG:=7 ARTDOMAIN:=Public Health ARTCATEGORY:=Research ARTSECTION:=Abstract, Introduction, Methods, Results, Discussion, Conclusion, Competing interests, Authors’ contributions, Acknowledgments, Tables and figures, References ARTARCHIVE:=10524 TABFIG:=Table 1: functionality parameters of a community health unit classified into inputs, outputs, and cardinal elements, and operational standards*tab1 | Table 2: the 17 functionality elements of a community health unit organized sequentially to represent the journey that it follows from inception to maturity*tab2 | Table 3: functionality categories and corresponding ranges of percentage scores*tab3 | Table 4: sample data entry template - community health unit functionality assessment*tab4 | Table 5: template for functionality scorecard for each community health unit*tab5 | Table 6: comparison of scores on community health units functionality elements between the first and seventh quarter*tab6 | Figure 1: changes in functionality status of community health units over a period of seven quarters*fig1 | ARTANEX:= DOI:=10.11694/pamj.supp.2016.25.2.10524