REVISED SCHEME OF SERVICE FOR NURSES

 

 REPUBLIC OF KENYA

MINISTRY OF HEALTH

 

Scheme of Service

For

Nursing Officers

And

Enrolled Nurses

 

Revised January 2012

 

 

 

 

 

 

 

 

 

 

 

 

 

1. AIM AND OBJECTIVES

  1. To provide for a well-defined career structure that will attract, motivate and retain suitably qualified Nursing Personnel in the civil Service.
  2. To provide for clearly defined job descriptions and specifications with clear delineation of duties and responsibilities at all levels in the career structure and service delivery, which will ensure proper deployment and utilization of nursing personnel.
  3. To establish standards for recruitment, training and advancement within the Scheme of Service on the basis of qualifications, knowledge, competence, merit and ability as reflected in work performance and results.
  4. To establish clear career paths for nurses in the civil service, that would reduce stagnation along the nursing career paths.
  5. To ensure appropriate career planning and succession management.
  6. To introduce and promote implementation of advanced nursing practice in Kenya.
  7. To motivate nurses by recognizing their administrative and technical roles in healthcare delivery.
  8. To facilitate the management of a transition period of nursing in Kenya.

 

2. TERMINOLOGIES

  1. Nursing Officer

Nursing Officer is the function title for a registered nurse or registered midwife.

  1. Registered Nurse

Registered Nurse is the professional title of a nurse trained at diploma and/or degree levels in accordance with the Nurses Act Cap 257 of the laws of Kenya, and the regulations thereto and/or whose name appears in any of the Registers maintained by the Nursing Council of Kenya as required by the Act. A registered nurse shall be a Kenya Registered Nurse (KRN) or a Kenya Registered Community Health Nurse (KRCHN), basic or post basic.

 

  1. Registered Midwife

Registered Midwife is the professional title of a nurse trained at diploma and/or degree levels to practice midwifery in accordance with the Nurses Act Cap 257 of the laws of Kenya, and the regulations thereto and/or whose name shall appears in any of the Registers maintained by the Nursing Council of Kenya as required by the Act.

 

  1. Enrolled Nurse

Enrolled Nurse is the function title of a nurse whose technical title is Enrolled Nurse, Enrolled Psychiatric (Mental Health) Nurse, and Enrolled Community Health Nurse trained at certificate level in accordance with the Nurses Act Cap 257 of the laws of Kenya and the regulations thereto (or any other nurse whose training and qualifications are recognized and equated at certificate level by the Nursing Council of Kenya) and whose name shall appear in any of the Rolls maintained by the Nursing Council as required by the Act.

 

i) Nurse Practitioner

The duties of a nurse practitioner are to provide nursing care/services to clients. The nurse practitioner is either a specialist or general/technical. A specialist nurse is one who has undergone an additional specialized course of training over and above the basic registered nurse/ midwife training programme.

 

C. Nurse Manager

A nurse manager is one who performs the duties of management and administration of nursing or health services and has been trained in management or leadership.

 

3. ADMINISTRATION AND TRAINING SCOPE OF THE SCHEME

 

a) Responsibility for Administration

The Scheme of Service will be administered by the Principle Secretary, Ministry of Health in conjunction with Public Service Commission and in consultation with the Principal Secretary, Ministry of State for Public Services. The Principle Secretary administering the Scheme will ensure that its provisions are strictly observed for fair and equitable treatment of officers under this scheme, and that the officers are confirmed in appointment on successful completion of their probation period as required by the COR.

 

b) Training Scope

In administering the Scheme, the Principle Principal Secretary will ensure that appropriate training opportunities and facilities are provided to assist serving officers acquire the necessary additional skills, qualifications (or specialization) and experience required for both efficient performance of their duties and advancement within the career structure. The officers will also be encouraged to undertake training privately for self-development. However, in all matters of training, the Principal Secretary administering the Scheme will consult the Principal Secretary, Ministry of State for Public Service.

 

4. NURSING FUNCTION AND OPERATIONS

a) Introduction

For the purpose of this scheme “Nursingmeans nursing and midwifery practices. Nursing functions entail both operational and administrative/ leadership functions. This Scheme introduces nurse specialist functions, and delineates operational and administrative functions in nursing to improve quality of care, improve staff motivation to continuing learning for quality care, and promote staff retention.

 

b) Operational Functions

Operational nursing function is providing care to meet the health needs of clients and communities that they are unable to meet due to physical or mental inability, or due to lack of adequate information, knowledge or skills. This encompasses provision of preventive, promotive, curative, and rehabilitative health care services in respect to physical, social, psychological and spiritual wellbeing of patients, members of their families and the community. It includes (but not limited to) conducting assessment and observations on patients; provision of care and physical support to clients and the sick using nursing process; conducting deliveries; constantly monitoring conditions of the sick; providing treatment to the sick; administering drugs, vaccines, and contraceptives; performing selected invasive procedures; working with other members of the healthcare team conducting complex medical/surgical procedures; providing health talks to the sick and their relatives; providing health education and promoting healthy living; classifying and maintaining confidential information relating to patients disease, admissions, care and treatment; carrying out research in the field of nursing and healthcare; ensure proper management of nursing commodities in the health sector; and developing nurses training syllabi and curriculum; and theoretical and practical training of students both in clinical areas and classrooms. Operational functions are either community-based or health facility-based.

 

c) Specialized Functions

Specialized nursing functions are technical functions with higher cognitive involvement and include advanced nursing practices (ANP) with limited prescriptive functions at the primary care levels. Areas of specializations include, but not limited to, Medical-Surgical Nursing and the sub-branches such as Renal Nursing, oncology nursing, Intensive Care Nursing (Acute Care Nursing), Anesthesiology Nursing, Operating Theatre Nursing, Trauma and Emergency Nursing, etc; Paediatric Nursing and Neonatology Care, Community Health Nursing and the sub-branches such as School Health, Home-Based Care, Family Health Nursing, Occupational Health and Safety, Community Midwifery, etc; Mental Health and Psychiatry Nursing; Midwifery and/or Reproductive Health and women’s health/wellness; HIV/AIDS & TB; Infection Prevention and Control/Epidemiology; Psychosocial Nursing; and commodity nursing amongst others.

 

d) Administrative Functions

Management functions are either nursing or healthcare focused.

Administrative functions involve management of nursing services; planning, supervising, and appraising nursing personnel; ensuring ethical and qualitative nursing practices; maintaining good discipline among nursing personnel; coordinating healthcare activities at points/units of healthcare delivery as well as in the health facility and at district, county and national levels; ensuring patients’ health-security while undergoing treatment; quantifying, setting standards, and evaluating quality of medical/surgical consumables and medical/surgical equipment; ordering stocks and keeping custody of capital and consumable goods and equipment at service delivery points/units/wards; keeping custody of patients and clients information and records at points of service delivery. In addition, administrative functions involve formulation, review and execution of nursing policies, objectives, standards and programmes in line with the wider health sector policies framework, and containing healthcare costs while ensuring cost-effectiveness of healthcare.

`

ii. Healthcare based administrative functions include heading multidisciplinary training college, heading a County or healthcare institution or programme etc.

 

e) Nursing Deployment and Functions

 Level 1: Community Health Care Services

The scope of practice for nurses at this level involve providing preventive, promotive, curative and rehabilitative health services to individuals and families at home. Specific functions include providing home-based care, school health activities in schools, comprehensive family health in homes; providing occupational healthcare at the workplace through occupational health programme; providing community midwifery services; and referring patients and clients with severe and complicated conditions to health facilities for comprehensive care. Nurses also train, work with, and supervise Community Health Workers (CHWs) in the provision of home-based care and other related health services among other duties. They will be responsible for nursing commodities for use in community health care services.

 

 Level 2: Dispensaries

The scope of practice at this level of healthcare involves providing ambulatory curative,

preventive and promotive healthcare services that include simple diagnosis, prescription and treatment of common diseases; providing health talks, health education and counseling services; administering drugs, vaccines, and contraceptives; performing simple surgical procedures; and referring clients with complex or severe conditions to higher treatment centres for comprehensive care and treatment; and perform any other duties as may be assigned. Ensure proper management of nursing commodities.

Level 3: Health Centres, Nursing Homes and Maternity Homes

Scope of practice at this level involves providing in-patient and ambulatory care that encompass curative, preventive and promotive healthcare services including meeting the physical health needs; administering drugs, vaccines, and contraceptives; assessing clients and conducting deliveries; continuous monitoring of clients and patients condition and only involving the clinical team as and when necessary; and providing health talks, health education and counseling services among other duties. Ensure proper management of nursing commodities.

Level: 4, 5, and 6: District/Sub-district, County and National Referral Hospitals

The scope of practice in a hospital setting is more labor intensive involves assessing clients’ physical, psychological, social and spiritual needs and provision of the health needs. This depends on the size and level of hospital, and types of health services being offered to clients and patients. Special units like Emergency Unit, Intensive Care Unit, Operating Theatre, Renal Units, and New born Units are most delicate, required high levels of concentration, and are most labor intensive.

Nurses working in these units require additional knowledge and skills for effective discharge of demanding responsibilities in caring for the clients and patients. Ensure proper management of medical nursing commodities.

 

f) Job Titles for Nurse Managers

  1. Wards/Units/Departments Manager

Controls the day-to-day activities of the ward/unit or department in respect to coordination of care and treatment of patients, which normally involve a large team of diverse health workers whose members operate at different time; supervises and co-ordinates nursing services at this level; holds inventory of all medical stores in the ward/unit including drugs, equipment and general supplies; and reports to the Nursing Officer in-charge daily.

  1. Nursing Services Manager of Hospital

Is the manager of nursing services: plans, co-ordinates and supervises nursing services in the hospitals; reports to the Chief Executive Officer on daily basis and to the County Nursing Officer periodically; deploys nursing personnel and appraises their performance.

 

  1. Nurse Manager  of Dispensary

Responsible for health services in the dispensary. Supervises staff in the dispensary; holds inventory of stores in the dispensary; liaises with dispensary management committee; and reports to the Divisional Nurse manager.

 

  1. Nurse Manager of Health Centre

Responsible for nursing services in the health centre. Supervises nursing staff in the health centre; holds inventory of stores in the health centre; liaises with Health Centre Management Committee; and reports to the Divisional Nurse Manager.

 

  1. Divisional Nurse Manager

Divisional Nurse Manager will supervise facility and community-based nursing services that are being provided at divisional level; and appraise nurses and Community Health Workers (CHWS) who provide health care services in the Division. The officer reports to the District Director General of Nursing Services.

 

  1. District Director of Nursing Services

The manager of nursing services in the District health facilities (i.e. health centers, dispensaries and community health units); plans, co-ordinates and supervises nursing services in the District and reports to the County  Director General of Nursing Services periodically; deploys nursing personnel across the District’s health facilities and appraises their performance. Will ensure proper management of nursing commodities in the district.

 

  1. County Director of Nursing Services

 

County Director General of Nursing Services will be responsible to the County Director General of Health for organization, control and coordination of nursing services at the county level. Major responsibilities will entail: Management of ambulance services; Community nursing and midwifery; Supervision and implementing of nursing policies; Supervision of nursing services in county health facilities and management of nursing commodities within the county.

 

  1. Director General  of Nursing Services

The head of nursing services in the country; provide strategic direction in nursing education, research and practice in the country andreports to the Director General of Health.

 

5. GRADING STRUCTURE AND SCOPE OF DUTIES AND RESPONSIBILITIES

 

5.1. NURSING OFFICERS

a) Grading Structure for Nursing Officers

This Scheme of Service for Nurses has two grading structures for nurses’ career progression as follows:

  1. All nurses will enter service as nurse practitioners. Thereafter each nurse progresses by common cadre as nurse practitioner, reaching a level at which those with leadership and management potentials will be identified, trained and allowed to progress further within the structure as nurse managers. Progression will be on the basis of management qualifications and experience gained above the basic nursing training and responsibilities. The establishments and vacancies declared under this structure will be pegged on specific work stations and administrative offices.
  2. A parallel structure on technical functions is established, beginning with the title of Nursing Officer III Job Group “J” (entry point for Diploma holders). This progression structure has eight technical progression steps ending at Chief Nurse Specialist Job Group “T”. Degree holders would enter at Job Group “M” (interns) or Job Group “N” (post intern), as each case may apply. Progression will be on the basis of technical qualifications, technical responsibilities and vacancies pegged on work stations. A technical officer in Job Group “T” may, however, upon meeting necessary requirements, be appointed to the post of Director General of Nursing, Job Group “U”.

 

 

 

The table below provides details on this two tire scheme.

 

Proposed Administrative Designation Job Group Proposed Technical Designation
 

J

Nursing Officer III
 

K

Nursing Officer II
 

L

Nursing Officer I
 

M

Senior nursing Officer III
 

N

Senior nursing Officer II
 

P

Nurse Specialist III / Senior Nursing Officer I
Ass. Deputy Director General of Nursing Services

Q

Nurse Specialist II
Senior Ass. Deputy Director General of Nursing Services

R

Nurse Specialist I
Deputy Director General of Nursing Services

S

Senior Nurse Specialist
Senior Deputy Director General of Nursing Services

T

Chief Nurse Specialist
Director General of Nursing Services

U

 
Director General of Health

V

 

 


b) Conversion to the new grading structure

Serving Officers will adopt and convert to the new designations and grading structure as follows:

Existing Designations

[as in DPM.2/5/2A VOL.V/(53)]

Job Group Proposed Administrative Designations New Job Group Proposed Technical/specialist Designations
Nursing Officer III H  

J

Nursing Officer III
Nursing Officer II J  

K

Nursing Officer II
Nursing Officer I K  

L

Nursing Officer I
Senior nursing Officer L  

M

Senior nursing Officer III
Assistant Chief Nursing Officer M  

N

Senior nursing Officer II
Senior ACNO N  

P

Senior Nursing Officer I/ Nurse Specialist III
Deputy Chief Nursing Officer P Ass. Deputy Director General of Nursing Services

Q

Nurse Specialist II
Snr. Deputy Chief Nursing Officer Q Senior Ass. Deputy Director General of Nursing Services

R

Nurse Specialist I
Chief Nursing Officer R Deputy Director General of Nursing Services

S

Senior Nurse Specialist
    Senior Deputy Director General of Nursing Services

T

Chief Nurse Specialist
    Director General of Nursing Services

U

 
    Director General of Health

V

 

 

The grades of Nursing III/II/I and Senior Nursing Officer III (Job Groups “J/K/L/M”) for Diploma holders and Nursing Officer I/Senior Nursing Officer III/Senior Nursing Officer II/ Senior Nursing Officer I (Job Groups “M/N/P”) for degree holders and Nurse Specialist III/ Nurse Specialist II (Job Groups P/Q) for Nurse specialists will form a common establishment for the purpose of this Scheme of Service.

 

Serving Officers will adopt and convert as appropriate to the new grading structure and designation though they may not be in possession of the requisite qualifications and/or experience stipulated in the Scheme of Service. However, for advancement later within the career structure after the commencement of this scheme, officers must possess the prescribed minimum qualifications and/or experience required for appointment and/or advancement to higher grades.

 

Serving Officers in Job Groups “P/Q/R” will however translate to either technical or administrative functions in corresponding titles on the basis of their existing suitability at the time of commencement of this Scheme, and will apply to the Principal Secretary, Ministry of Health for such translation and whose decision, in consultation with Public Service Commission, will be final.

 

5.2. ENROLLED NURSES

a) Proposed Grading Structure for Enrolled Nurses

This Scheme of Service establishes Five (5) grades for Enrolled Nurses who will be designated and graded as follows:

 

b) Conversion to the new grading structure

Serving officers will adapt and convert to this new designation and grading structure as follows:

 

Present Designation J/G New Designation

J/G

Enrolled nurse III G Enrolled nurse III

H

Enrolled nurse II H Enrolled nurse II

J

Enrolled nurse I J Enrolled nurse I

K

Senior Enrolled Nurse K Deputy Senior Enrolled nurse

L

    Senior Enrolled nurse

M

 

The grades of Enrolled nurse III/II/I/DSEN/SEN, Job Groups H/J/K/L/M for certificate holders will form a common establishment for the purpose of this Scheme of Service.

 

Serving Officers will adopt and convert as appropriate to the new grading structure and designation though they may not be in possession of the requisite qualifications and/or experience stipulated in this Scheme of Service. However, for advancement within the career structure after the commencement of this scheme, officers must posses the prescribed minimum qualifications and/or experience required for appointment and/or advancement to higher grades.

 

6. ENTRY INTO THE SCHEME OF SERVICE

a) Direct Appointment (Nursing Officers)

Direct appointment will normally be made in the grades of Nursing Officer III, Job Group ‘J’; Senior Nursing Officer III (for intern degree holders), Job Group “M”; and Senior Nursing Officer II, Job Group “N” (for post-intern degree holders) provided the candidate is in possession of the minimum qualifications stipulated for these grades. In exceptional cases, however, direct appointment may be made beyond these grades by the Public Service Commission on the recommendation of the Principal Secretary, Ministry of Health and in consultation with the Principal Secretary, Ministry of State for Public Service on the required appointment to the grades.

 

b) Direct Appointment (Enrolled Nurse)

Direct entry for Enrolled Nurses will normally be made in the grade of Enrolled Nurse III, Job Group “H” provided the candidate is in possession of the minimum qualifications stipulated for that grade. In exceptional cases, however, direct appointment may be made beyond that grade by the Public Service Commission on the recommendation of the Principal Secretary, Ministry of Health and in consultation with the Principal Secretary, Ministry of State for Public Service on the required appointment to the grades.

 

c) Upgrading

Where an officer in the grades of Enrolled Nurses have undergone a course and obtained a relevant diploma or degree as recognized in this Scheme, that officer shall be upgraded to the appropriate level as defined in the Scheme. Similarly, and officer with relevant diploma within this scheme shall be upgraded in accordance with the Scheme upon obtaining a relevant degree. Any such upgrading shall be subject to Section 7 of this Scheme

 

d) Incremental Credit

Incremental credits for approved experience acquired after obtaining the prescribed minimum qualifications for the grade may be awarded at the rate of one increment for each year of approved experience provided that the maximum of the scale is not exceeded. In granting incremental credits, any period of service or experience stipulated as a basic requirement for appointment to a particular grade will be excluded.

 

7. ADVANCEMENT WITHIN THE SCHEME

The Scheme of Service sets out the minimum qualifications and/or experience required for advancement and/or appointment from one grade to another. It is emphasized, however, that these are the minimum requirements which entitle an officer to be considered for appointment and/or promotion. In addition, advancement from one grade to another will depend on: -

 

a) Existence of a vacancy in the authorized establishment;

b) Merit and ability as reflected in work performance and results; and

c) The approval of the Public Service Commission.

 

8. RECOGNISED QUALIFICATIONS

 

a) Registered Nurse/ midwife

The following are the recognized qualifications for the purpose of this Scheme of Service: -

  1. Hold a Diploma or a Degree in Registered Nursing/ midwife from a recognized nursing training institution and in possession of a registration certificate issued by the Nursing Council of Kenya
  2. Is in good professional standing with the Nursing Council of Kenya

 

b) Enrolled Nurses

The following are the recognized qualifications for the purpose of this Scheme of Service.

  1. Hold a certificate in Enrolled nursing from a recognized nursing training institution and in possession of enrolment certificate issued by the Nursing council of Kenya
  2. Is in good professional standing with the Nursing Council of Kenya

 

c) Specialist Nurses

Registered Nurses/ midwives in possession of postgraduate certificate or diploma, masters or doctorate in a relevant field in any nursing subspecialty as recognized by the Nursing Council of Kenya or health management and leadership

 

9. IMPLEMENTATION OF THE SCHEME OF SERVICE

The Scheme of Service will become operational with effect from 1st July 2012. On implementation, all serving officers will automatically become members of the Scheme. Taking cognizant that academic development in Nursing in Kenya is at its transitional stages the implementation of certain sections of this Scheme will be implemented at the discretion of the Principal Secretary, Ministry of Health in consultation with the Principal Secretary, Ministry of State for Public Service on the required appointment to the grades.

 

10. JOB AND APPOINTMENT SPECIFICATIONS FOR ENROLLED NURSES

 

10.1. ENROLLED NURSE III/II/I/DSEN/SEN: JOB GROUP H/J/K/L/M

 

A. JOB SUMMARY:

This is the entry grade into the Enrolled nurses cadre into this Scheme of Service. Work involves a variety of duties and responsibilities of limited scope and complexity and is performed with appropriate guidance and supervision by a Nursing Officer or Senior enrolled nurse. Duties and responsibilities include planning and executing nursing care to individuals or groups of patients or clients at the community level in homes and schools, and health facilities. An enrolled nurse of this level is expected to observe and carry out specific nursing procedures; conduct deliveries; give health talks and health education; and refer cases as appropriate.

 

  1. Health Facility Enrolled Nurse

Key Result Areas

  1. Assess patients and clients and establish health care needs daily and as necessary.
  2. Develop health care interventions plan and implement.
  3. Provide appropriate healthcare service; e.g. immunization, PMTCT, ante-natal care, delivery, administration of treatment, dispensing drugs, etc.
  4. Provide health education and counseling on identified health problems and socio-economic problems related to health.
  5. Refer patients and clients appropriately.
  6. Facilitate patients’ admission and discharge in a health centre.
  7. Evaluate healthcare outcomes to patients/clients and write individualized report
  8. Accompany patients during referrals.
  9. Maintain records on patients/clients personal and health condition/care data.
  10. Keep clinical environment tidy and safe
  11. Provide safety for in-patients belongings
  12. Ensure efficiency and safety of assigned nursing commodities

 

Standard of Performance

  1.   i.            Daily attendance records
  2. Care notes
  3. Nursing commodity inventory
  4. Referral records
  5. Monitoring and Evaluation reports
  6. Infection prevention Standard Operating Procedures

 

  1. School Health Enrolled Nurse

Key Result Areas

  1. Screen school children/students and staff to identify healthcare needs.
  2. Plan and implement individualized healthcare interventions on identified health problems, which may include prescription and administration of treatment for minor ailments, counseling and/or health education.
  3. Advice teachers and parents on appropriate handling of children with disability, chronic health condition or special health conditions.
  4. Refer complicated cases as appropriate for further care and treatment.
  5. Provide continuity of care for children who have undergone some care and treatment elsewhere.
  6. Evaluate healthcare outcomes to patients/clients and write individualized report.
  7. Maintain records on patients/clients personal and health condition/care data.
  8. Write visit reports on each school visited or periodic report on assigned school.
  9. Ensure efficiency and safety of assigned nursing commodities.
  10. Guide and orient junior staff, students and unskilled health workers.

 

Standard of performance

  1. schools visited within a given period
  2. children screened and treated for various common ailments
  3. health preventive and promotive interventions put in place

 

 

  1. Family Health Enrolled Nurse

Key Result Area

  1. Conduct home visiting and conduct client/patient follow up on discharged patients.
  2. Assess the health status of the patient/client and family members and identify health needs.
  3. Plan healthcare interventions and partner with patient/family to implement the interventions.
  4. Treat minor ailments and administer prescribed medications.
  5. Provide home-based care services such as home delivery and physical care.
  6. Provide health education and counseling to patient/client and family on identified health problems and socio-economic issues related to their health.
  7. Refer the patient/client as appropriate.
  8. Induct Community Health Workers and/or family members of home care for the patient.
  9. Train, educate and supervise Community Health Workers on home-based care.
  10. Evaluate healthcare outcomes to patients/clients and write individualized report.
  11. Maintain records on patients/clients personal and health condition/care data.
  12. Write reports on each health visit made per family.
  13. Ensure efficiency and safety of assigned nursing commodities.
  14. Guide and orient junior staff, students and Community Health Workers.

 

Standard of Performance

  1. Records of family health-related services rendered
  2. Nursing commodity inventory
  3. Referral records
  4. Monitoring and Evaluation reports

 

B. REQUIREMENTS FOR APPOINTMENT:

For appointment to the grade of Enrolled Nurse III, Job Group “H”, candidate must:-

I. Hold a certificate in Enrolled nursing from a recognized nursing training institution and in possession of enrolment certificate issued by the Nursing council of Kenya

II. Is in good professional standing with the Nursing Council of Kenya.

For appointment into subsequent job groups (J/K/L/M), officers will be required to serve in the preceding job group for a period of three years and be in good professional standing with the Nursing Council of Kenya.

 

 

10.2 JOB AND APPOINTMENT SPECIFICATIONS FOR NURSING OFFICERS

 

10.2.1. NURSING OFFICER III, II, I, JOB GROUPS “J, K, L, M”

A. JOB SUMMARY:

The entry grade into the Nursing Officers’ Cadre will be Nursing Officer III (Job Group J).  Areas of deployment will include health care facility or community setting. Duties and responsibilities involve assessing patients’ needs and planning, executing and evaluating nursing care to individual patients or clients at an outpatient department or ward in a hospital and health centre. In addition the officer is be expected to admit and discharge patients in an in-patient setting; give health talks and counseling to clients, patients and members of their families; administer drugs, vaccines/sera and contraceptives; and guide and counsel junior staff. Besides, the officer is expected to maintain documentation of activities undertaken, events and occurrences, and observation made. They are also expected to ensure efficiency and security of assigned nursing commodities.

 

The key result areas and standard of performance for nursing officers in common cadre establishment in the various deployment areas are as follows:

 

Health Facilities

Key Result Areas

  1. Assess patients and clients and establish health care needs daily and as necessary.
  2. Plan health care interventions daily and as necessary, and implement.
  3. Diagnose simple common health conditions, prescribe, and administer treatment.
  4. Provide appropriate healthcare service; e.g. immunization, PMTCT, ante-natal care, delivery, administration of treatment, dispensing drugs, etc.
  5. Provide health education and counseling to patients and clients on identified health problems and socio-economic issues related to their health.
  6. Refer patients and clients appropriately.
  7. Facilitate patients’ admission and discharge.
  8. Evaluate healthcare outcomes to patients/clients and write individualized report.
  9. Maintain records on patients/clients personal and health condition/care data.
  10. Keep clinical environment tidy and safe.
  11. Provide safety for in-patients belongings.
  12. Ensure efficiency and safety of assigned nursing commodities.
  13. Guide and orient junior staff, students and unskilled health personnel.

Standard of Performance

  1.   i.            Duty rosters
  2. Work plans
  3. Daily attendance records
  4. Nursing care notes
  5. Nursing commodity inventory
  6. Drug inventories in the area of deployment
  7. Nursing rounds
  8. Referral records
  9. Monitoring and Evaluation reports
  10. Infection prevention Standard Operating Procedures

School Health

Key Result Areas

  1. Screen school children/students and staff to identify healthcare needs
  2. Plan and implement individualized healthcare interventions on identified health problems, which may include prescription and administration of treatment for minor ailments, counseling and/or health education.
  3. Refer complicated cases as appropriate.
  4. Advice teachers and patients on appropriate handling of children with disability or chronic health condition.
  5. Provide continuity of care to children who have undergone some care and treatment elsewhere.
  6. Evaluate healthcare outcomes to patients/clients and write individualized report.
  7. Establish school health programs and referral strategies
  8. Conduct school diagnostic surveys
  9. Maintain records on patients/clients personal and health condition/care data.
  10. Keep clinical environment tidy and safe.
  11. Provide safety for in-patients belongings.
  12. Ensure efficiency and safety of assigned nursing commodities.

Standard of performance

  1. Work plans on school health programs
  2. Schools visited within a given period
  3. Children screened and treated for various common ailments
  4. Health preventive and promotive interventions put in place
  5. Monitoring and evaluation reports.

 

Family Health

Key Result Areas

  1. Conduct home visiting and follow up discharged patients/clients.
  2. Assess the health status of the patient/client and family and identify health care needs.
  3. Plan health care interventions and partner with the patient/client and family to implement the interventions.
  4. Treat minor ailments and administer prescribed medications.
  5. Provide home-based care services such as home delivery and other care.
  6. Provide health education and counseling on identified health problems and socio-economic problems related to health.
  7. Refer the patient/client as appropriate.
  8. Induct Community Health Workers and/or family members of home care for the patient.
  9. Train, educate and supervise Community Health Workers on home care.
  10. Evaluate healthcare outcomes to patients/clients and write individualized report.
  11. Maintain records on patients/clients personal and health condition/care data.
  12. Maintain records on personal health related information on patients/clients
  13. Keep clinical environment tidy and safe.
  14. Provide safety for in-patients belongings.
  15. Ensure efficiency and safety of assigned nursing commodities.

Standard of Performance

  1. Work plans for family health services
  2. Records of family health-related services rendered
  3. Nursing commodity inventory
  4. Referral records
  5. Monitoring and Evaluation reports

 

B. REQUIREMENTS FOR APPOINTMENT:

For appointment to the grade of Nursing Officer III, Job Group “J”, candidate must:

I. Hold a diploma in registered nursing or midwifery from a recognized nursing training institution and in possession of registration certificate issued by the Nursing council of Kenya

II. Is in good professional standing with the Nursing Council of Kenya.

For appointment into subsequent job groups (/K/L/M), officers will be required to serve in the preceding job group for a period of three years and be in good professional standing with the Nursing Council of Kenya.

 

10.2.2. SENIOR NURSING OFFICER III (NURSING OFFICER INTERN), JG “M”

 

A. DUTIES AND RESPONSIBILITIES:

This will be the entry point for direct appointment of graduates with a bachelors degree in nursing. An officer at this level is expected to assess, plan, execute and evaluate nursing care at an out-patient department or a ward in a hospital or at the community; provide support and health education to patients and relatives, and be a team leader of nurses providing care to a group of patients in a ward, out-patient or within a community setting. A Nursing Officer Intern will work under the mentorship of a more experienced senior officer to acquire relevant practical skills. The Officer reports to the immediate team leader of the working group and to the Nurse Manager of the Ward/Department/Unit as the case applies.

 

The key result areas and standard of performance for nursing officer interns in the various deployment areas are as follows:

Health Facility

Key Result Areas

  1. Assess patients and clients and establish health care needs daily and as necessary.
  2. Plan health care interventions daily and as necessary, and implement.
  3. Diagnose simple common health conditions, prescribe, and administer treatment.
  4. Provide appropriate healthcare service; e.g. immunization, PMTCT, ante-natal care, delivery, administration of treatment, dispensing drugs, etc.
  5. Provide health education and counseling to patients and clients on identified health problems and socio-economic issues related to their health.
  6. Refer patients and clients appropriately.
  7. Facilitate patients’ admission and discharge
  8. Evaluate healthcare outcomes to patients/clients and write individualized report.
  9. Maintain records on patients/clients personal and health condition/care data.
  10. Keep clinical environment tidy and safe.
  11. Provide safety for in-patients belongings.
  12. Ensure efficiency and safety of assigned nursing commodities.
  13. Guide and orient junior staff, students and unskilled health personnel.
  14. Nursing care improvement processes
  15. Appropriate deployment of staff in unit.

Standard of Performance

  1. Duty rosters for staff in unit
  2. Work plans
  3. Discharge plans
  4. Daily attendance records
  5. Nursing care notes
  6. Nursing commodity inventory
  7. Drug inventories in the area of deployment
  8. Nursing rounds
  9. Referral records
  10. Nursing Audit reports
  11. Staff development needs assessment, plans and records
  12. Nurse student supervisory reports
  13. Monitoring and Evaluation reports
  14. Infection prevention Standard Operating Procedures

 

District/ County Health Office

Key Result Areas

  1. Accompany district Director General of Nursing services in supervision of rural health and community nursing services in the area.
  2. Accompany district Director General of Nursing services in meetings of DHMT, EEC, and District Drug and Therapeutic committee
  3. Appraises divisional Nurses and Nurse in-charges of health centers and dispensaries on job performance
  4. Interprets, communicates and oversees implementation of nursing policies and standards.
  5. Plans, supervises implementation of and evaluated nursing services in health centers, dispensaries and community within the area.
  6. Ensures quality nursing related reproductive health services (including family planning and midwifery service) are provided.
  7. Orders and distributes vaccines, contraceptives, and other commodities required by nurses in their daily activities.

 

Standard of Performance

  1. Nursing Audit reports
  2. Staff development needs assessment, plans and records
  3. Monitoring and Evaluation reports

 

B. Requirements for Appointment:

For direct appointment to the grade of Nursing Officer Intern, a candidate must be in possession of Bachelor of Science (BSc N) in Nursing or Bachelor of Nursing (BN) degree from a recognized University and be in good standing with the Nursing Council of Kenya.

 

10.2.3. SENIOR NURSING OFFICER II, JOB GROUP “N”

A. JOB SUMMARY:

Work at this level involve planning, implementing and evaluating nursing care at the community level, or hospital unit or out-post unit. It also involves teaching students and updating staff on new trends in patient and client care. In addition, the officer may coordinate Continuing Education activities or be an assistant to a nurse-researcher. A nurse at this level will be deployed to take charge of a community health unit or hospital unit or logistics department.

The officer is expected to produce daily activity reports on care and, as the case may apply, reports to the Divisional Nursing Officer or the nursing officer in-charge of the health facility.

 

a) Nursing officer in-charge of Hospital unit

Key Result Areas

  1. Provide leadership a team of nurses in a health centre
  2. Supervise and guide junior enrolled nurses
  3. Supervise and guide students during their practical experience in clinical areas
  4. Guide and orient junior staff, students and Community Health Workers
  5. Assess patients and clients and establish specific health care needs.
  6. Develop health care interventions, and plans and implements the interventions.
  7. Evaluate healthcare outcomes and makes report.
  8. Provide appropriate healthcare service to clients (e.g. immunization, ante-natal care, delivery, treatment, dispenses drugs, etc).
  9. Provide health education and counseling on identified health problems and socio-economic problems related to health.
  10. Maintain records on patients/clients personal and health condition/care data.
  11. Maintain records on personal health related information on patients/clients.
  12. Keep clinical environment tidy and safe.

 

Standard of Performance

  1. Efficient delivery of nursing care in the unit
  2. Nursing care audits in the unit
  3. Performance appraisal of staff in the unit
  4. Customer satisfaction surveys in the unit

 

B. Requirements for Appointment:

 

a) Direct appointment

For direct appointment to the grade of Senior Nursing Officer II, Job Group “N”, a candidate:

  1.           i.            must be in possession of Bachelor of Science in Nursing (BScN) or Bachelor of Nursing (BN) degree from a recognized University;
  2.         ii.            has completed one year internship or as may be prescribed by the Nursing Council of Kenya;
  3.       iii.            Is in possession of registration certificate issued by the Nursing Council of Kenya and is in good professional standing.

 

b) Promotion

For appointment to the grade of Senior Nursing Officer II, an officer must:-

  1. Have served in the grade of Senior Nursing Officer III (Job Group “M”), in the case of diploma holders, for at least three (3) years,
  2. Shown professional competence in planning, organizing and discharging nursing duties at that level;
  3. Is in good professional standing.

 

10.2.4. SENIOR NURSING OFFICER I, JOB GROUP “P”

A. JOB SUMMARY:

A nursing officer at this level will take charge of a department in a hospital or supervise and coordinate nursing and community services within a division. Duties and responsibilities assigned to the officer will include holding inventory of commodities and equipment, coordinating and auditing nursing care to patients, coordinating other healthcare providers, supervising nurses in the units comprising the department or commodities and logistics and ensuring delivery of quality nursing services. The officer reports to the Nursing Officer in charge of the hospital. The divisional nurse reports to the District Director General of Nursing Services.

 

b) Divisional Nurse

Key Result Areas

  1. Provides leadership to all nurses in health facilities and community health units within the division.
  2. Attends community health committee meetings.
  3. Facilitates improvement of nurses’ welfare.
  4. Appraise nurses attached to community units on job performance.
  5. Coordinate and supervise health related campaigns in the division
  6. Plans for out reach health services within the division.
  7. Orders and distributes vaccines, contraceptives, and other commodities required by CHEWs in the division.

Standard of Performance

  1. Health programmes in the division
  2. Distribution lists of nursing commodities and other supplies
  3. Supervisory reports
  4. Performance appraisal reports of nursing personnel and CHEWS in the division

Nursing Officer in-charge of a hospital department

Key Result Areas

  1. Holds the inventory of capital and perishable investment in the ward/department.
  2. Allocates patients/duties to nursing staff daily and evaluates daily output of each nursing staff.
  3. Conducts ward round daily by self, with other nurses, or in the company of at least a clinician.
  4. Co-ordinates nursing and medical/surgical interventions on patient care and treatment.
  5. Appraises nursing staff periodically as the case applies.
  6. Coordinates diagnostic and other services that interconnect the ward and other departments
  7. Facilitates collection of any fee payable to hospital/health facility by clients/patients.
  8. Deliver quality nursing services to every patients/clients.
  9. Measures patients/client satisfaction periodically, produces report and uses the report to improve quality of care.
  10. Writes daily and periodic reports on care and treatment and outcomes of care/treatment.
  11. Facilitates staff rotation, retention, progression, and job satisfaction.
  12. Facilitates staff training and competency enhancement

 

Nursing Officer in-charge of Logistics and Commodities in a hospital

Key Result Areas

  1.         i.          Initiate procurement on nursing commodities through the nursing officer in charge.
  2.       ii.          Do technical evaluation for nursing commodities before procurements and pre delivery samples before receiving the goods.
  3.     iii.          Receive all the nursing delivered to the facility.
  4.     iv.          Sample goods in the store after procurement and do a technical evaluation.
  5.       v.          Do quantification of nursing commodities and make appropriate orders both to KEMSA and any other source.
  6.     vi.          Supervise the usage of nursing at the end user points.
  7.   vii.          Make sure that all the records of nursing both at the store and end user points are up to date.
  8. Check the stock status of nursing and advice the nursing officer in charge and the hospital administration.
  9.     ix.          Do continuous education to the staff on matters related to nursing commodities.
  10.       x.          Do accurate inventory management.
  11.     xi.          Supervise the storage conditions of nursing commodities
  12.   xii.          Conduct studies periodically on commodity utilization trends and make reports.

 

Standard of performance

  1.   i.            Adequate supply of quality nursing commodities
  2. Rational use of nursing commodities

 

B. REQUIREMENT FOR APPOINTMENT:

For appointment to this grade, an officer must have:-

  1. Served in the grade of Senior Nursing Officer II (Job Group “N”) for a minimum of three (3) years;
  2. Be in possession of at least a management and/or leadership certificate in addition to the basic Diploma or Degree in Nursing.
  3. Demonstrated considerable experience, professional competence and administrate capability in organizing nursing services at that level.
  4. Be in good professional standing

 

10.2.5. ASSISTANT DEPUTY DIRECTOR GENERAL OF NURSING SERVICES, JOB GROUP “Q”

A. JOB SUMMARY:

A nursing officer working at this level shall perform the duties of Nursing Officer in-charge of level four hospitals or deputize the Nursing Officer in-charge of a level five hospitals or District Director General of Nursing Services.

Duties and responsibility of the Nursing Officer in-charge of a level four hospital entails assessing, planning, coordinating, supervising and evaluating nursing services.

 

a) Nursing Officer I/C (Level four hospital)

Key Result Areas

  1. Ensure delivery of quality nursing services in the facility.
  2. Advises the Chief Executive Officer and the Hospital Management Team on nursing matters.
  3. Chair the hospital feeding committee
  4. Deputize the chairman of the Hospital Tender Committee.
  5. Attend and participate in the hospital Executive Expenditure Committee.
  6. Maintain professional discipline among nursing personnel working within the hospital.
  7. Supervise nurse managers coordinating units and wards/departments within the hospital.
  8. Appraise nursing managers under immediate supervision while overseeing the appraisal of other nurses within the hospital.

Standard of performance

  1. Efficient delivery of nursing services
  2. Performance appraisal of nursing personnel in the facility
  3. Quality assurance of health eservices in the facility
  4. Availability of nursing commodities

 

c) Deputy District Director General of Nursing Services

 

Key Result Areas

i. Provides leadership to all nurses in health centers, dispensaries and communities

ii. Coordinate reproductive health services in the district

iii. Interprets, communicates and oversees implementation of nursing policies and standards.

iv. Plans, supervises implementation of and evaluated nursing services in health centers, dispensaries and community within the District.

v. Ensures quality child health nursing services (including immunization) are provided

vi. Ensures quality nursing related reproductive health services (including family planning and midwifery service) are provided.

vii. Ensures all HIV/AIDs and nutrition services related to nursing are provided to the people.

viii. Supervises private nurse practitioners in the district and the unskilled service providers like CBHWs, and CBDs, and is responsible for ensuring their competence, efficiency, and effectiveness in delivering nursing services.

ix. Orders and distributes vaccines, contraceptives, and other commodities required by nurses in their daily activities.

Standard of performance

  1. Efficient delivery of nursing services in the district
  2. Performance appraisal of nursing personnel in the district
  3. Quality assurance of health services in the district
  4. State of reproductive health services in the district

 

d) Deputy Nursing Officer I/C of Level Five Hospital

Key Result Areas

  1. Link nursing teams and other members of the healthcare teams.
  2. Advise the Chief Executive Officer and the Hospital Management Team on nursing matters.
  3. Chair the hospital feeding committee
  4. Deputize the chairman of the Hospital Tender Committee.
  5. Attend and participates in the hospital Executive Expenditure Committee.
  6. Maintain professional discipline among nursing personnel working within the hospital.
  7. Supervise nurse managers coordinating units and wards/departments within the hospital.
  8. Appraise nursing managers under immediate supervision while overseeing the appraisal of other nurses within the hospital
  9. Interpret, communicate and oversee implementation of nursing policies and standards.
  10. Institute a monitoring and evaluation framework for nursing services in the facility.

Standard of performance

  1. Efficient delivery of nursing services
  2. Performance appraisal of nursing personnel in the facility
  3. Quality assurance of health eservices in the facility
  4. Availability of nursing commodities

 

B. REQUIREMENT FOR APPOINTMENTS:

  1. For appointment to this grade, an officer must have:-
  2. Served in the grade of Senior Nursing Officer I (Job Group “P”) for at least two (2) years;
  3. Demonstrated considerable experience, professional competence and administrate capability in organizing nursing services at that level.
  4. Be in possession of a masters degree in nursing or health management or leadership course
  5. Be in good professional standing

 

 

10.2.6. SENIOR ASSISTANT DEPUTY DIRECTOR GENERAL OF NURSING SERVICES, JOB GROUP “R”

 

JOB SUMMARY:

A nursing Officer working at this level may be appointed to perform the duties of Nursing Officer in charge of a level five hospital, District Director General of Nursing Services or deputize the County Director General of Nursing services.

Duties and responsibilities entail assessing, planning, coordinating, supervising and evaluating nursing services in the hospital or health services in the region.

a)      District Director of Nursing Services

  1. Provide leadership to all nurses in health centers, dispensaries and communities
  2. Coordinate reproductive health services in the district
  3. Update and build the capacity of all nurses in health centers, dispensaries and communities
  4. Attend meetings of DHMT, EEC, and District Drug and Therapeutic committee
  5. Facilitate improvement of nurses’ welfare in the district
  6. Appraise divisional Nurses and Nurse in-charges of health centers and dispensaries on job performance
  7. Post and or transfer nurses in health facilities and community health units within the district in consultation with the nursing officer in-charge of the district hospital
  8. Appoint and post Nurse in-charges for dispensaries and health and divisional nurse in collaboration with the nursing officer in-charge of the district hospital.
  9. Interpret, communicate and oversee implementation of nursing policies and standards.
  10. Plan and supervise implementation of and evaluation of nursing services in health facilities and community within the District.
  11. Ensure quality child health nursing services (including immunization) are provided
  12. Ensure quality nursing related reproductive health services (including family planning and midwifery service) are provided.
  13. Ensure all HIV/AIDs and nutrition services related to nursing are provided to the people.
  14. Supervise private nurse practitioners in the district and unskilled service providers like CBHWs, and CBDs, and is responsible for ensuring their competence, efficiency, and effectiveness in delivering nursing services.
  15. Orders and distributes vaccines, contraceptives, and other commodities required by nurses in their daily activities.

Standard of performance

  1. Efficient delivery of nursing services
  2. Rational distribution of nursing personnel
  3. Performance appraisal of nursing personnel in the district
  4. Distribution of nursing commodities

 

b) Nursing Officer I/C of Level Five Hospital

  1. Ensure efficient and effective delivery of nursing services in the facility.
  2. Advise the Chief Executive Officer and the Hospital Management Team on nursing matters.
  3. Chair the hospital feeding committee
  4. Deputize the chairman of the Hospital Tender Committee.
  5. Attend and participate in the hospital Executive Expenditure Committee.
  6. Maintain professional discipline among nursing personnel working within the hospital.
  7. Supervise nurse managers coordinating units and wards/departments within the hospital.
  8. Appraise nursing managers under immediate supervision while overseeing the appraisal of other nurses within the hospital
  9. Ensure efficient and effective referral of patients between lower levels of care and the hospital
  10. Maintain professional discipline among nursing personnel working in the hospital
  11. Ensure periodic filling nursing staff returns as required

 

C. REQUIREMENT FOR APPOINTMENTS:

For appointment to this grade, an officer must have:-

iv. Served in the grade of Senior Nursing Officer I (Job Group “N”) for at least three (3) years;

v. Demonstrated considerable experience, professional competence and administrate capability in organizing nursing services at that level.

vi. Has undergone a management related training

vii. Be in good professional standing

 

10.2.7. SENIOR ASSISTANT DEPUTY DIRECTOR GENERAL OF NURSING SERVICES, JG “R”

A. JOB SUMMARY

A nursing officer working at this level may be appointed to perform the duties of the Nursing Officer in-charge of a County Hospital, County Director General of Nursing services.

Duties and Responsibilities of the County Director General of Nursing Services entails managing and supervising nursing services in the county; advising the County Director of Health together with the respective County Health Management Team on nursing matters; distribution and deployment of nursing personnel within the county; supervising distribution of nursing commodities; ensuring the delivery of quality nursing services within the county; participating in healthcare policy formulation; and interpreting and communicating healthcare policies.

The Officer reports to the Director General of County Health Services within the County; and to the Director General of Nursing or Senior Deputy Director General of Nursing as the case may apply on technical matters of nursing policies and standards.

 

a)      Nursing Officer in-charge of a County Referral Hospital

Key Result Areas

  1. Effective and efficient delivery of nursing services in the facility.
  2. Advise the Chief Executive Officer and the Hospital Management Team on nursing matters.
  3. Chair the hospital feeding committee
  4. Deputize the chairman of the Hospital Tender Committee
  5. Attend and participate in the hospital Executive Expenditure Committee.
  6. Maintain professional discipline among nursing personnel working within the hospital.
  7. Supervise nurse managers coordinating units and wards/departments within the hospital.
  8. Appraise nursing managers under immediate supervision while overseeing the appraisal of other nurses within the hospital
  9. Ensure efficient and effective referral of patients between lower levels of care and the hospital.
  10. Ensures periodic filling nursing staff returns as required.

Standard of performance

  1. Efficient delivery of nursing services
  2. Performance appraisal of nursing personnel
  3. Availability of nursing commodities

 

b) County Director of Nursing Services

Key Result Areas

  1. Represents the Director General of Nursing Services at the County.
  2. Ensures matters on welfare of nurses are addressed appropriately.
  3. Oversees deployment of nurses within health facilities across the county.
  4. Monitors availability and utilization of essential nursing commodities and equipment in health care settings across the county.
  5. Ensures that all nurses working within the county are appraised regularly;
  6. Ensures that Nursing standards and ethics are maintained among nurses working within the county.
  7. Assist the Director General of Nursing in reviewing and/or formulating relevant nursing policies, standards and guidelines
  8. Assist the Director General of Nursing in evaluating implementation of nursing policies, procedures, programmes, and standards and guidelines;
  9. Assist the Director General of Nursing in developing and reviewing training schemes and programmes for nurses;
  10. Facilitates the reviews/formulation of specifications of essential nursing commodities and equipment
  11. Advices the County Director of Health on Nursing and midwifery matters within the County.

 

Standard of performance

  1. Efficient delivery of nursing services
  2. Rational distribution of nursing personnel
  3. Performance appraisal of nursing personnel in the county
  4. Distribution of nursing commodities

 

B. REQUIREMENT FOR APPOINTMENTS:

For appointment to this grade, an officer must have:

  1. A bachelors degree in nursing from a recognized university
  2. A masters degree in a relevant field to nursing
  3. A certificate in management or leadership course from a recognized institution; or Senior Management Course at Kenya Institute of Administration and evidence of skills in project management.
  4. Served in the grade of Assistant Deputy Director General of Nursing (JG “Q”) for at least two (2) years;
  5. Shown a high degree of professional competence and administrative capability as well as possess broad experience in interpreting of health policies and programmes.
  6. Be in good professional standing.

10.2.8. DEPUTY DIRECTOR GENERAL OF NURSING SERVICES, JG “S”

 

JOB SUMMARY

A nursing Officer at this level shall be appointed to head a health program or division in the directorate of nursing services at the national level in the Ministry of Health.

 

a)      Deputy Director, Division of Nursing Education

Key Result Areas

  1. Advice the Director General of Nursing on matters related to nursing education and capacity building
  2. Coordinate all activities related to development and capacity building of nursing personnel
  3. Carry out annual training needs assessment and projections for improvement of nursing skills for efficient service delivery

 

Standard of Performance

  1. Nursing education and capacity building programmes
  2. Number of Training needs assessment carried out

 

b)     Deputy Director, Division of Nursing Research

Key Result Areas

  1. Advice the Director General of Nursing Services on state of nursing services in the country
  2. Advice the Director General of Nursing on the situation of nursing human resource in the country
  3. Set agenda for nursing research in the country

Standard of Performance

  1. State of nursing personnel
  2. Nursing research agenda and activities

 

c)      Deputy Director, Division of Community Health Nursing

Key Result Areas

  1. Advice the Director General of nursing services on matters related to community health and psychiatry nursing practices in the country
  1. Coordination of the to community health and psychiatry nursing policies, programmes and guidelines in the country
  2. Determine the future operations to meet to improve to community health and psychiatry nursing in the country.
  3. Ensure that all individuals, groups and partners work together to achieve the same objectives.
  4. Capacity building of nurses on the relevant subject matter
  5. Participate in monitoring and evaluation of to community health and psychiatry nursing activities in the country.

 

d)     Deputy Director, Division of Midwifery

Key Result Areas

  1. Advice the Director General of nursing services on matters related to midwifery practices in the country
  2. Coordination of the midwifery policies, programmes and guidelines in the country
  3. Determine the future operations to meet to improve midwifery services in the country.
  4. Ensure that all individuals, groups and partners work together to achieve the same objectives.
  5. Capacity building of nurses on  the relevant subject matter
  6. Participate in monitoring and evaluation of midwifery activities in the country.

Standard of Performance

  1. Training programmes in midwifery
  2. Evaluation of midwifery practices in the country

 

e)      Deputy Director, Division of Nursing Commodities

Key Result Areas

  1. Advice the Director General of Nursing services on matters related to nursing commodities in the health sector
  2. Determine the needs for nursing commodities in government owned health facilities
  3. Ensure that nursing commodities procured are of required quality

Standard of Performance

  1. Training programmes in nursing commodities
  2. Evaluation of state of nursing commodities in the country

 

f)       Deputy Director, Division of General Nursing

Key Result Areas

  1. Coordinate overall general nursing services to improve quality of nursing care in accident and emergency, medical, surgical and pediatric services.
  2. Review, formulate and disseminate policies, procedure and guidelines on general nursing services.
  3. Provide technical advice on professional attributes pertaining to general nursing practice.
  4. Assesses and develop training programs to enhance and improve quality of general nursing care in accident and emergency, medical, surgical and pediatric nursing services.
  5. Receive and compile monthly, quarterly and annual reports for the general nursing services.

 

Standard of Performance

  1. Training programmes in general nursing, accident and emergency, medical, surgical and pediatric nursing
  2. Evaluation of general nursing care in the country

 

B. REQUIREMENT FOR APPOINTMENT

For appointment to this grade an officer must have:

For appointment to this grade, an officer must have:

  1. A bachelors degree in nursing from a recognized university
  2. A masters degree in the relevant field to nursing (Nursing, Midwifery, education, community health, psychiatry, commodity management and Management or leadership)
  3. A certificate in management or leadership course from a recognized institution; or Senior Management Course at Kenya Institute of Administration and evidence of skills in project management.
  4. Served in the grade of Senior Assistant Deputy Director General of Nursing (JG “Q”) for at least two (2) years;
  5. Shown a high degree of professional competence and administrative capability as well as possess broad experience in interpreting of health policies and programmes.
  6. Be in good professional standing.

 

10.2.9. SENIOR DEPUTY DIRECTOR GENERAL OF NURSING, JOB GROUP “T”

A. JOB SUMMARY:

A Senior Deputy Director General of Nursing deputizes the Director General of Nursing on national nursing duties and responsibilities. An officer at this level may be deployed to head nursing services in a different ministry or government agency other than the Ministry of Health. In such a case the officer will be reporting to the technical head responsible for health matters in that Ministry on the daily functions and to the Director General of Nursing Services on policy issues pertaining to Nursing and Midwifery.

 

a)      Senior Deputy Director General of Nursing – Administration; Directorate of Nursing Services

Key Result Areas

  1. Deputizes the Director General of Nursing and performing duties that may be delegated by the director.
  2. Represent the Director General of Nursing in various ministerial administrative committees.
  3. Ensures nurses welfare matters are addressed appropriately on behalf of the Director General of Nursing.
  4. Oversees deployment of nurses across the country on behalf of the Director General of Nursing.
  5. Oversees distribution of nursing commodities and equipment across the country on behalf the Director General of Nursing.
  6. Advising on the implementation of the Scheme of Service for Nurses; handling performance appraisal; and maintenance of Nursing standards and ethics.

 

Standards of Performance

  1. Ministerial administrative committees attended.
  2. Staff satisfaction surveys
  3. Distribution of nursing commodities
  4. Appraisal of nursing personnel
  5. Review of scheme of service for nursing personnel

 

b)     Senior Deputy Director General of Nursing – Policy and guidelines; Directorate of Nursing Services

Key Result Areas

  1. Assist the Director General of Nursing in reviewing and/or formulating relevant nursing policies, standards and guidelines
  2. Assist the Director General of Nursing in evaluating implementation of nursing policies, procedures, programmes, and guidelines;
  3. Assist the Director General of Nursing in developing and reviewing training schemes and programmes for nurses;
  4. Represent the Director General of Nursing in various ministerial technical committees.
  5. Facilitates the reviews/formulation of specifications of essential nursing and medical/surgical commodities and equipment on behalf of the Director.
  6. Participate in curriculum development and evaluation of health workers’ training programmes on behalf of the Director.

Standards of Performance

  1. Review and/or formulate relevant nursing policies, standards and guidelines
  2. Develop and review training schemes and programmes for nurses;
  3. Review and formulate specifications of essential nursing commodities
  4. curriculum development and evaluation

 

c)      Senior Deputy Director General of Nursing – Standards and Ethics; Directorate of Nursing Services

Key Result Areas

  1. Assist the Director General of Nursing in reviewing and/or formulating relevant nursing policies and guidelines related to standards and ethics of nursing and midwifery practice with reference to regulatory framework;
  2. Assist the Director General of Nursing in reviewing and/or formulating relevant nursing policies and guidelines related to standards and ethics of nursing and midwifery education,
  3. Assist the Director General of Nursing in evaluating implementation of nursing policies, procedures, programmes, and guidelines;
  4. Assist the Director General of Nursing in developing and reviewing training schemes and programmes for nurses;
  5. Represent the Director General of Nursing in various ministerial technical committees.
  6. Facilitates the reviews/formulation of specifications of essential nursing and medical/surgical commodities and equipment on behalf of the Director.
  7. Oversee and coordinate activities of the department of nursing towards meeting performance targets
  8. Oversee performance appraisal of nursing personnel in the department and lower levels in he ministry of medical services.

 

 

Standards of Performance

  1. Formulate relevant nursing policies and guidelines related to standards and ethics of nursing and midwifery practice with reference to regulatory framework;
  2. Evaluate implementation of nursing policies, procedures, programmes, and guidelines;
  3. Coordinate activities of the department of nursing;
  4. Support professional and technical personnel to enhance their capacity;
  5. Participate in the development of national policies, strategic plans, programs and specialized tasks in the Ministry.

 

B. REQUIREMENTS FOR APPOINTMENT:

For appointment to this grade, an officer must have;

  1. A Bachelor of Science in Nursing (BScN) or Bachelor of Nursing (BN)
  2. Masters Degree in Nursing or Public Health or Community Health or a Management related course from a recognized training institution.
  3. A diploma or certificate in Health Service Management from a recognized institution
  4. Served in the grade of Deputy Director General of Nursing (JG ‘S’) or Chief Nurse Specialist (JG “S”) for at least two (2) years;
  5. Shown a high degree of professional competence and administrative capability as well as possess broad experience in formulation of health policies and programmes;
  6. Be in good professional standing.

 

10.2.10. DIRECTOR GENERAL NURSING SERVICES, JOB GROUP “U”

A. JOB SUMMARY:

 

The Director General of Nursing is the head of nursing services and is based at the Ministry of Medical services HQs. The officer is responsible to the Principal Secretary, Ministry of Medical Services on all matters pertaining to nursing services including research, education and practice. duties and responsibilities involve formulation, implementation, co-ordination and evaluation of nursing policies, standards, procedures and programmes in the health sector; participating in health sector policy development, nursing strategic direction design, and performance evaluation; participating in the development and review of training programmes for nurses and other health workers; advising the Principal Secretary on the operationalisation of the Scheme of Service for Nursing Personnel; undertaking performance appraisal for nursing personnel; and maintaining high nursing standards, ethics and professionalism among nursing staff.

In addition the officer is responsible for advising the Nursing Council of Kenya on policy matters in health care and the Kenya Medical Training board on training needs and professional development of nurses for the country.

The Officer reports to the Director General of Health on nursing and midwifery matters in the country.

Key Result Areas

i.            Advice on overall planning, direction and development of nursing services including midwifery, community health, and psychiatry nursing;

ii.            Provision of specialized opinion in the relevant areas of specialization in nursing at the national level;

iii.            Provision of national guidelines for standards of nursing in the relevant specialization for both clinical and community health practice;

iv.            Training to the support nursing personnel;

v.            Participation in the development of national plans and programs in the Ministry.

 

 

Standards of Performance

i.            Advice the Director General of Health on the status of nursing functions and services at national level, especially on strategic imperatives;

ii.            Give specialized opinion on nursing matters;

iii.            Give direction and guidelines on relevant areas during development of new and review of existing nursing standards and guidelines;

iv.            Support professional and technical personnel to enhance their capacity;

  1. Participate in the development of national policies, strategic plans, programs and specialized tasks in the Ministry.

 

B. REQUIREMENTS FOR APPOINTMENT:

For appointment to the grade of Director General of Nursing, an Officer must have:-

  1. A Bachelor of Science in Nursing (BScN) or Bachelor of Nursing (BN) degree,
  2. A Masters Degree in Nursing or Public Health or a Masters degree in a Management related course from a recognized university.
  3. A higher diploma in a management related course from a recognized training institution.
  4. Served in the grade of Senior Deputy Director General of Nursing (JG “T”) for at least two (2) years;
  5. Shown a high degree of professional competence, administrative capability as well as a broad working experience in the formulation of Health Policies and Programmes and in the general development of nursing services in the Ministries of Health.
  6. Be in good professional standing

 

10.2.11. DIRECTOR GENERAL OF HEALTH, JOB GROUP “V”

A. JOB SUMMARY:

The Director-General of Health is the overall custodian of the health of all citizens in the country. He is the overall head of the technical arm of the Health Ministry and, therefore, the chief Government Health Advisor on issues relating to all health statutes, their interpretation, implication and application. The officer is answerable to the Principal Secretary for executing the following roles:  inter linkage and integration of the technical arm with the administrative and political arms of the Ministry, effective coordination of all the activities of the technical health services, spearheading and overseeing the formulation and implementation of health policies and programs, resource mobilization for ministerial development plans,   and hence assists the Principal Secretary and the Cabinet Secretary to realize the country’s ministerial vision, mission and goals in the overall provision of health services in the country.

 

Key Result Areas

  1. Advice on interpretation, implication and application of all health statutes;
  2. Coordination of all the activities of the technical health services;
  3. Formulation and implementation of all health policies, strategic plans and programs;
  4. Resource mobilization for ministerial development plans with the assistance of the Principal Secretary.

 

Standard of Performance

  1. Compliance with the health statutes as entrenched in the Constitution
  2. Integrity and diligence in strategic direction of ministry of health
  3. Planning, Organizing and Coordinating of ministry of health technical activities to be performed in conformity with set plans, schedules, targets, budgets, and to the highest standards possible in order to achieve desired ministerial goals and objectives

 

B. REQUIREMENTS FOR APPOINTMENT:

For appointment to this grade, the officer must:

For appointment to the grade of Director General of Health, an Officer must have:-

  1. A Bachelors degree in a health discipline
  2. A Masters Degree in Nursing or Public Health or a Masters degree in a Management related course from a recognized university.
  3. A higher diploma in a management related course from a recognized training institution.
  4. Served in the grade of Director General in one of the directorates in the health ministry for at least two (2) years or have comparable experience in the private sector
  5. Shown a high degree of professional competence, administrative capability as well as a broad working experience in the formulation of Health Policies and Programmes
  6. Be in good professional standing

 


10.3. JOB AND APPOINTMENT SPECIFICATIONS FOR NURSE SPECIALISTS (SPECIALISED DUTIES AND RESPONSIBILITIES)

 

10.3.1. NURSE SPECIALIST III, JOB GROUP “P”

A. JOB SUMMARY:

A nursing officer working at this level will provide higher technical advice in a nursing field of specialty at community, district hospital or county hospital levels of healthcare delivery; it involves planning, executing, and evaluating care to patients and/or clients with a health problem in a specific nursing field of practice; conducting research; providing technical guidance to other officers; giving lectures during Continuing Education sessions to staff on care and treatment of individuals with health problems in that particular field of nursing; providing technical training to student nurses during clinical experience; and conducting practical assessment to students.

The officer will develop reports periodically and report to the District Director of Nursing Services or the Nursing Officer in-charge of the hospital as the case applies, for administrative purposes and to Senior Specialist for technical consultation in area of specialty.

 

a) Community

Key Result Areas

  1. Consultant on Community Health Nursing: Conduct studies and disseminate findings on community health nursing related issues and Facilitate training/update nurses and other healthcare workers on community health practices.
  2. Special Health Programmes: conduct studies and disseminate findings on community health nursing related issues; Facilitate training/update nurses and other healthcare workers on community health practices.

Standard of Performance

  1. Number of community diagnosis studies conducted as evidenced by reports
  2. Health programmes initiated in the community

 

b)  Hospitals

Key Result Areas

  1. Continuing education: Conduct training needs assessment of nurses and other health workers; Develop training/update/induction programme for nurses and other healthcare workers; Evaluate in-house training programmes and produce periodical reports.
  2. Special Health Interventions: Conduct studies and disseminate findings on community health nursing related issues; Facilitate training/update nurses and other healthcare workers on community health practices.

Standard of Performance

  1. Number of relevant diagnostic studies conducted as evidenced by reports
  2. Health programmatic interventions  initiated in the facility

 

B. REQUIREMENTS FOR APPOINTMENT:

For appointment to the grade of Nurse Specialist III, an officer must:-

  1. Have served in the grade of Senior Nursing Officer III (Job Group “M”for at least one (1) year for degree holders or Senior nursing officer III (Job group “L” ) for at least two (2) years for diploma holders;
  2. Have shown professional competence and ability to communicate well to others; and
  3. Be in possession of at least a postgraduate diploma or a Master degree in specific field of nursing practice.

 

10.3.2. NURSE SPECIALIST II, JOB GROUP “Q”

 

A. JOB SUMMARY:

A nursing officer working at this level will provide technical advice in a nursing field of specialty at national levels of healthcare delivery including national referral hospitals. Work involves assisting the Chief Nurse Specialist in designing, interpreting, and evaluating healthcare policies; and designing, implementing and evaluating healthcare programmes. The officer will also provide technical guidance to officers at lower levels of care; conduct research; and give lectures to staff on prevention, care and treatment of health problems during workshops, seminars, and other continuing education sessions. In addition, the officer may give lectures, practical training, and conduct practical assessment of students in that field of nursing; and participate or provide leadership in syllabi and curriculum development and review.

The officer will develop reports periodically and report to the District Director of Nursing Services or the Nursing Officer in-charge of the hospital or the County Director of Nursing Services as the case applies for administrative purposes and to Chief Specialist for technical consultation in the area of specialty.

 

a) District and County Hospitals

Key Result Areas

  1. Continuing education: Conduct training needs assessment of nurses and other health workers; Develop training/update/induction programme for nurses and other healthcare workers; Evaluate in-house training programmes and produce periodical reports.
  2. Commodity Management: Conduct studies periodically on commodity utilization trends and make reports; Collect data on quality issues related to commodity supplies and present report for specification reviews; Advice hospital management (procurement, storage, distribution and use) on commodity procurement.
  3. Special Health Programmes: Conduct studies and disseminate findings on community health nursing related issues; Facilitate training/update nurses and other healthcare workers on community health practices.

Standard of Performance

  1. Number of relevant diagnostic studies conducted as evidenced by reports
  2. Health programmatic interventions  initiated in the facility

 

C. REQUIREMENTS FOR APPOINTMENT:

For appointment to the grade of Nurse Specialist II, an officer must:-

  1. Have served in the grade of Nurse Specialist III (Job Group “P”) for at least two (2) years;
  2. Have shown professional competence and ability to communicate well to others;
  3. Be in possession of a bachelors degree in nursing from a recognized institution
  4. Be in possession of at least a postgraduate diploma or a Master degree in specialist field of nursing practice.

 

10.3.3. NURSE SPECIALIST I, JOB GROUP “R”

A. JOB SUMMARY:

A nursing officer working at this level will provide top level technical advice in a nursing field of specialty at national levels of healthcare delivery including national referral hospitals; work involves providing leadership in designing, interpreting, and evaluating healthcare policies in a specific nursing field of practice; and designing, implementing and evaluating healthcare programmes in such field of nursing practice. The officer will also provide technical guidance to officers at lower levels of care; conduct nursing research; and give lectures to staff on prevention, care and treatment of health problems in that particular field of nursing during workshops, seminars, and other continuing education sessions.

The officer will develop reports periodically and report to the County Director of Nursing Services or Director of Nursing Services in the national referral health facility or directly to the Director General of Nursing as the case applies for administrative purposes.

 

Key Result Areas

  1. Practice Policies and Standards: Develop relevant programme policies, standards and guidelines; Disseminate programme policy, standards and guidelines
  2. Planning: Set up programs objectives; Develop programme guiding principles and strategic framework for the program; Develop programme agenda dissemination.
  3. Programme Dissemination and Capacity Building: Sensitize nurses, nurse managers and other health workers on programme contents and strategy; Train other nurses and health workers on programme agenda and activities; Evaluate, make report and disseminate programme performance.

Standard of Performance

  1. Number of relevant policy guidelines developed
  2. Dissemination reports

 

B. REQUIREMENTS FOR APPOINTMENT:

For appointment to the grade of Nurse Specialist I an officer must:

  1. Have served in the grade of Senior Nurse Specialist II for at least two (2) years;
  2. Be in possession of a Master degree in a relevant field of Nursing;
  3. Have shown a high degree of professional competence and capability as well as possess broad experience in formulation of nursing policies and developing health programmes.

 

10.3.4. SENIOR NURSE SPECIALIST, JOB GROUP “S”

A. JOB SUMMARY:

A nursing officer working at this level will provide top level technical advice in a nursing field of specialty at national levels of healthcare delivery including national referral hospitals; work involves providing leadership in designing, interpreting, and evaluating healthcare policies in a specialized field of nursing practice; and designing, implementing and evaluating healthcare programmes in such field of nursing practice. The officer will also provide technical guidance to officers at lower levels of care; conduct nursing research; and give lectures to staff and nurse students on prevention, care and treatment of health problems in that particular field of nursing during workshops, seminars, and other continuing education sessions. In addition, the officer may give lectures, practical training, and conduct practical assessment of students in that field of nursing; and participate or provide leadership in syllabi and curriculum development and review.

The officer will develop reports periodically and report to the Director of Nursing Services in the national referral hospital or directly to the Director General of Nursing as the case may apply for administrative purposes.

 

Key Result Areas

  1. Practice Policies and Standards: Develop relevant programme policies, standards and guidelines; Disseminate programme policy, standards and guidelines
  2. Planning: Set up programs objectives; Develop programme guiding principles and strategic framework for the program; Develop programme agenda dissemination.
  3. Programme Dissemination and Capacity Building: Sensitize nurses, nurse managers and other health workers on programme contents and strategy; Train other nurses and health workers on programme agenda and activities; Evaluate, make report and disseminate programme performance.

Standard of Performance

  1. Number of relevant diagnostic studies conducted as evidenced by reports
  2. Number of relevant policy guidelines developed

 

 

B. REQUIREMENTS FOR APPOINTMENT

For appointment to the grade of Senior Nurse Specialist an officer must:

  1. Have served in the grade of Senior Nurse Specialist I for at least two (2) years;
  2. Be in possession of a Master degree in a relevant field of Nursing;
  3. Have shown a high degree of professional competence and capability as well as possess broad experience in formulation of nursing policies and developing health programmes.

 

14.5. CHIEF NURSE SPECIALIST, JOB GROUP “T”

C. JOB SUMMARY:

A nursing officer working at this level will provide top level technical advice in a nursing field of specialty at national levels of healthcare delivery including national referral hospitals; work involves providing leadership in designing, interpreting, and evaluating healthcare policies in a specific nursing field of practice; and designing, implementing and evaluating healthcare programmes in such field of nursing practice. The officer will also provide technical guidance to officers at lower levels of care; conduct nursing research; and give lectures to staff on prevention, care and treatment of health problems in that particular field of nursing during workshops, seminars, and other continuing education sessions. In addition, the officer may give lectures, practical training, and conduct practical assessment of students in that field of nursing; and participate or provide leadership in syllabi and curriculum development and review.

The officer will develop reports periodically and report to the County Nursing Officer or directly to the Director General of Nursing as the case applies for administrative purposes.

 

Key Result Areas

  1. Practice Policies and Standards: Develop relevant programme policies, standards and guidelines; Disseminate programme policy, standards and guidelines
  2. Planning: Set up programs objectives; Develop programme guiding principles and strategic framework for the program; Develop programme agenda dissemination.
  3. Strategic direction in advanced nursing practice: be involved in strategy formulation in Advanced Nursing Practice. Advice the Director General of Nursing Services in Advanced Nursing Practice.
  4. Programme Dissemination and Capacity Building: Sensitize nurses, nurse managers and other health workers on programme contents and strategy; Train other nurses and health workers on programme agenda and activities; Evaluate, make report and disseminate programme performance.

Standard of Performance

  1. Number of relevant research studies conducted as evidenced by reports
  2. Health programmatic interventions  developed

 

D. REQUIREMENTS FOR APPOINTMENT:

For appointment to the grade of Chief Nurse Specialist an officer must:

  1. Have served in the grade of Senior Nurse Specialist for at least two (2) years;
  2. Be in possession of a Master degree in a Specialized field of Nursing;
  3. Be in possession of a post-graduate diploma in management and leadership course
  4. Have shown a high degree of professional competence and capability as well as possess broad experience in formulation of nursing policies and developing health programmes.
  5. Participated or provided leadership in syllabi and curriculum development and review.

 


Appendix 1

PROPOSED POSTS FOR NURSING OFFICERS

DESIGNATED POST ESTABLISHED POSTS

JOB GROUP

PLACEMENT
Director General of Nursing Services

1

U

Stationed at MoH HQs
Senior Deputy  Director General of Nursing Services

3

T

3 at MoH HQ
Chief Nurse Specialist

5

1 at MoH HQs and 4 at National referral hospitals (KNH, MTRH, National Spinal Injury and Mathari Hospital)
Deputy Director General of Nursing Services

20

S

6 at HQs, 10 national programs and 4 in-charge of national referral hospitals
Senior Nurse Specialist

60

At national referral hospitals and programs
Senior Ass. Deputy Director General of Nursing Services

70

R

County Directors of Nursing Services
Nurse Specialist I

280

4 per each county hospital
Ass. Director of Nursing  Services

520

Q

250  District Director of Nursing Services, 200 NO I/Cs district hospitals, 70 Deputy Directors of unty Nursing Services
Nurse Specialist II

500

In hospitals offering specialized nursing services
Senior Nursing Officer I(Graduate)

300

P

Health centres, divisions, low volume district hospitals, and units in large hospitals
Senior Nursing Officer I(Diploma)

1,200

Nurse Specialist III

2000

Specialized units in hospitals and community
 Senior Nursing Officer II(Graduate)

1,200

N

In-charge of wards in hospitals and health centres
Senior Nursing Officer II (Diploma)

2,000

Senior Nursing Officer III(Graduate)

3,000

M

For health facilities and community nursing services
Senior Nursing Officer III (Diploma)

5,000

Nursing Officer I ( Intern)

1000

L

Nursing Officer I

25,000

L

Nursing Officer II

K

Nursing Officer III

J

TOTAL

42,159

 

 


PROPOSED ESTABLISHMENT FOR ENROLLED NURSES

 

Enrolled Nurses cadre is being phased out through a deliberate training programme to convert the existing Enrolled Nurses workforce into registered nurses. Those converted should be allowed to move with their posts while new recruitment is to continue to replace those retiring.

 

 

Current Title Current Posts Job Group Proposed Title

 

Proposed  Posts Proposed Job Group Remarks
Senior Enrolled Nurse K 50 Senior Enrolled Nurse

M

3,000 Take charge of 3000 dispensaries.
————————– ——— ———- Deputy Senior EN

L

3,000 Deputize in the 3000 dispensaries
Enrolled Nurse I J  

13,340

Enrolled Nurse I

K

 

6,800

For community health services at the community health units, school health, dispensaries, and health centres.
Enrolled Nurse II H Enrolled Nurse II

J

Enrolled Nurse III G Enrolled Nurse III

H

TOTAL 13,390     12,800  

 

 

 

One comment

  1. Stephen okeyo says:

    This is great expose. But what does it mean for training curriculum reforms especially with view on harmonization?

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