Why is this work important?
In 2004 only 64,000 of the 240,000 people living with HIV who were eligible, were receiving the anti retroviral therapy (ART) they needed.
Most of the ART sites are urban based, stand alone services.
Stigma, service cost and distance are major barriers between people and the treatment that would have such an impact on their quality of life, reducing illness and allowing them to return to work.
Only 10% of those receiving ART are women and yet HIV prevalence is higher among women than men.
What is innovative about this project?
This project is pioneering the integration of HIV and sexual and reproductive health services as a sustainable and cost effective way of expanding access to HIV prevention, treatment and care.
Women and young people are the traditional clients of FHOK and are already using family planning and other services in their communities.
- HIV positive people are finding it easier to use comprehensive services that provide them with voluntary counselling and testing, anti-retroviral therapy, home based care and the full range of sexual and reproductive health services.
- FHOK is increasing its expertise in providing specialist HIV services. This includes the concept of pharmacovigilance, new to Kenya, to monitor adverse drug events among ART clients.
- The project is working closely with the government to gain their support and to promote the integration of HIV and other sexual and reproductive health services.
How is the strategy working?
Functional integration of HIV and SRH services means that one doctor or nurse can provide all of the services, without the need for referral.
This has significantly increased utilization of both types of service, because it reduces the stigma around HIV and builds trust between the client and the provider.
During 2007:
- over 8000 people were tested for HIV
- around one thousand pregnant women received services to prevent HIV transmission to their children
- a further 1000 HIV positive people were treated for opportunistic infections
- 242 clients were receiving ongoing anti-retroviral therapy
Half of the project’s community health workers are themselves living with HIV, and this has been critical to encouraging others to get tested and be prepared to talk more openly about their status.
Psychosocial support groups also meet regularly at each site.
They are empowering people living with HIV to deal with the day to day issues that affect them such as understanding their treatment and good nutrition.
‘Treatment buddies’ visit clients receiving ART and treatment for tuberculosis.
This system has resulted in high levels of adherence to the sometimes complicated drug regimes.
Outstanding achievements
Project activities in the communities were disrupted at the end of 2007 and early 2008 because of political unrest, particularly in Western Kenya.
Many people were forced to flee their homes and were living in temporary camps where they could no longer access the project’s services.
FHOK acted quickly, partnering with the Red Cross and the government.
They succeeded in providing services within the camps including psychosocial support, drug adherence counselling and referral for anti-retroviral drugs.
FHOK’s prompt response prevented clients from having their HIV treatment disrupted and avoided the damaging effect this would have had on their health.
What next?
FHOK continues to use their experience from this project to feed into HIV policy and service provision throughout the country.
This is being achieved through their membership of the National Integration Technical Working Group, chaired by the Ministry of Health.
The support groups of people living with HIV are being broadened and strengthened to include income generation activities.
Want to find out more?
Contact
innovation@ippf.org
The IPPF Africa Region Office
Family Health Options Kenya (FHOK)
An IPPF Innovation Fund project implemented by Family Health Options Kenya (FHOK) and supported by the Elton John Foundation.