"INTRODUCTION Cherangani sub-county hospital is found in Trans-Nzoia County which is one of the 14 countiesin the former rift valley province. The facility is in Cherangani constituency Kchibora, townshipalong Kitale-Eldoret Road via Kachibora –Ziwa. The facility has the following departments,public health department, MCH with PITC which refers to HIV testing and counseling that isrecommended to persons attending health care facilities as a standards component of medicalcare in counties with a generalized HIV epidemic, OPD services Biomedical department,Comprehensive care clinic and other services offered .The departments provided has several staffs for instance public health department we haveSCCSFP who is in charged of community strategy in the sub county as well as my supervisor.SCPHO who is in charge of community health units and CHV’s who are in charge of units withaccordance’s with the Kenta Community Health Policy 2016-2030.Sub- county health management team Co-ordinates all health matters at the sub-county levelwhich includes community health management services. The role of sub-county healthmanagement team includes planning and resource allocation, distribution of supplies, trainingand health education. CHVS is a member of the community selected by their communities toimprove the communities health and well being and to facilitates the referrals of individuals afterbasic training. Each Community health unit has the minimum number of CHVS required to servea certain size of Households or population as stipulated in the most current guidelines. The mainduties of CHV includes give out key health messages to household, registration of house ofhouseholds, give talks to community on matters pertaining health thereby improvement anddisease prevention, refer cases to respective clinic facilities, participate to report to and healthproblems they have encountered that needs to be brought to the attention of higher levels.Increase awareness on how to prevent non-communicable diseases by encouraging communityon proper diet, at least increasing their physical activity, maintaining their weight and reducingon the consumption of harmful substance such as alcohol. Encouraging the community on theaccess of portable water and good hygiene practice such as hand washing.Community health volunteers also provides the life supporting and basic curative services withan objective of preventing, detecting and providing early treatment for illness in the community1 CHVs and CHEWs ensures that they prevent childhood diseases and improvement of childhealth through immunization. SCCSFP is the overall supervisor of the CHVs and CHEWS and he is among the sub-countyhealth management team. Supports and supervise CHEWs in aassigned task and ensure they giveout a desirable outputs and outcomes. Co-ordinates and reviewing of the community healthvolunteer’sdata. Provide the linkage to the committee of county government and nationalgovernment creation of policies that govern community health. Resource mobilization andallocation, procurement and planning it as well. The contact address of the facility is Cheranganysub-county hospital P.O BOX 125-30200 KITALE.2 6. ACTIVITIES i. UNDER FOOD INSPECTION The main objective of maintaining good health standards in food industry is to promotehealth prevent diseases and improve on the business. The requirements are achievableand its mandatory. Failure to comply with any one of them venders the owner of thebusiness and food handle liable for prosecution under public health CAP 242. Theactivities undertaken while at the industrial attachment includes inspection of building inwhich food is being handled and this building should have:a. Hard, smooth and impervious floors for easy cleaning and avoid lodging or accumulationof food particles.b. Smooth, hard and well painted walls with bright oil paints to avoid dust setting on thewalls.c. Adequate ventilation and lighting for proper air circulation.d. The building should be provided with ceiling and panted to keep off dusts e. Roofing should be made of GCI sheets f. The adjacent buildings should not be a source of contamination to the food.We checked also that the water being used in any food premise should be potable and palatablei.e safe for use and potable and palatable i.e. safe for use and fit for human consumption.Concerning food handlers, they must be of good habits and clean at all the times when handlingfood. They should be wearing protective clothing when on duty. We make sure that all kind offoodpremise shouldhave hand washing facilities, they should be provided next to the toilet, inthe dinning room or next to the dinning room .Sanitary facility was also a requirement during period of inspection, this facility should beprovided adequately, I door for male customers with a urinals and door for female customers allwith a cleansing material.3 ii. Concerning liquid and solid wastes management. We give out statutory notices that all solid wastes should be collected in a container (Not cartonbox) and properly disposed off at convenient time. There must be a waste food bin in all foodpremises.All waste waters should be drained into a sewer line, septic tank or soak away pit no disposal ofwaste water into open drain, according to the public health act CAP 242 section 126 which saysno person shall dispose off solid or liquid sewage or sewage effluent in such a manner or in sucha position as to cause or be likely to cause dampeners in any building or part there of or toendanger the purity of any water supply or to create any nuisance. Where there is no sewer manhole should be provided. We advise the premise owners on importance of proper liquid wastedisposals and they concur with us i.e. public health officers. Improper disposal of wastesencourages water borne diseases such as cholera which has recently out break in our cityNairobi. Some of the premises such as Hotels, bars and Restaurants mostly generates wasteswhich scatters all over, we try as muchas possible to mobilize and sensitize the food handlerson proper and procedural ways to curb up with the liquid and solid wastes. Some of the solidwastes are generated by the business premises, we try to give notices to thoseownersthatwhoeverdispose off, the closure/seizure of the business according to the public health act. Anypremise should not be a source of wastes contamination. Any wastes should be managedaccordingly. We encourage the traders in the markets to have the soak away pits, pits, privy,septic tanks, cesspits and sewer as far as wastes disposals order to comply with thoserequirements of the public health officer or to remove any nuisance shall unless he satieties thecourt that he has used all diligence to carry out such order, be guilty of an offence and liable to afine. iii. Under HIV/STI divisions.On matters concerning about HIV/STI I managed to visits the PITC and to be taught how totests, Interprets the results and how to councils the clients. HIV/STI is a major problem to thecommunity. Despite the milestone, undertaken by the sub-county hospital the HIV prevalence inthe county is higher compared to someneighboring counties. The contributory factors that hasemerge as a learning outcome during my industrial attachment includes low uptake of PMTCT,VCT and ART services, social cultural practices and behavioral factors, high levels of poverty,4 multiple sexual partners and drugand substances abuse. The Sub-county hospital has adequateCCC with adequate skilled staffs for instancecounsellers and this has helped in reduction andaccessibility of HIV/STI services. The coordination ofAMPHAT plus with the sub-countyhealth management team has really helped in prevention and reduction of HIV/STIs in thecommunity.The CHV has also helped in tracing and referral of defaulters to the facilityespecially those onPMTC, also they build a supportive environment and after information to address and reducestigma and discrimination at community level. We didn’t manage to conduct screening ofHIV/AIDS and STI’s at the community levels due to unaffordable circumstances the HIVpolicy,coordination and financing in the sub-county hospital includes the National IDS control council(NACC) and subsequent formation of National AIDS and STI program (NASCOP) and KenyaNational AIDS strategic plan. We congratulate theKitale AIDS program for which trains a traineron matters portaging behavioral change in combination with HIV/AIDS, Prevention andreduction. During my industrial period I realized that there is an important reason for HIV testingwhich includes, reduction of stigma, discordance, and PMTCT. It is important to counsel thosewho tests HIV positive and HIV negative. iv. On matters concerning control andprevention of infectious diseases at the facility. We manage to visits the county hospital whereby who were taught on the following issues;a) Waste management:It involves the proper management of generated waste, it should be practiced in the entirefacility. All facilities should be provided with the incinerators, burning chamber wherebyinfections wastes should be disposed off. Non-infectious wastes should be put on firethrough open burning. ? Segregation of wastes such as pathological waste should be done routinely.? There must be policy and regulations regarding solid wastes in the facility.? Staffs in mortuary and postmortem should be provided with wearing protectiveclothing and gloves before perfuming test. Lab coats must be worn at all timesand removed when taking meals or leaving the facility.5 ? Staffs in mortuary and postmortem should be provide with wearing protectiveclothing and gloves before performing test. Lab coats must be worn at all timesand removed when taking meals or leaving the facility.b) Policy of hand washing Washing hands before beginning any procedure and in between patients. Hand washingbasins and portable water should be provided at the facility paper towels and bars soapsshould be provided.Disinfectants should be provided for disinfection of transient micro-organisms, which isalcohol basedc) Occupational health and safety The following are component of occupation health and safety I. Health II. Welfare III. Safety Every new staff at the facility should be vaccinated against Hepatitis B because it is contagiousdisease, vaccine should be given to the new staff due to water available at the facility.On regards to safety the facility should provide:a. Safety of staffs by providing PEPS incase of any pricks.b. Facility should provide trolleys and wheel chairs and conductions of the facilities shouldbe favorable.There should be welfare of the staffs which entails the continuous medical education new staffincoming in X-ray room should work for only 3 hours a day and the mechanisms to take care ofin the facilities.6 "