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 in six sites, 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.

• 403 clients are now receiving ongoing anti-retroviral therapy
• around 2,600 pregnant women received services to prevent HIV transmission to their children
• a further 1,500 HIV positive people were treated for opportunistic infections 
• over 20,000 people have been tested for HIV

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 challenging stigma and discrimination and 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.

People living with HIV have become more financially independent through income generating activities organised by the support groups. As the groups increase in confidence and skills, they have been able to secure loans to support their small businesses.

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. The strong community ownership of the project ensured that support group members and community health workers continued their roles, now within the camps.

They succeeded in providing services including psychosocial support, drug adherence counselling, VCT 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.

A partnership was also established with Nairobi Women’s Hospital to refer survivors of gender based violence during the unrest, particularly from the camps. FHOK staff members were trained in post trauma counselling and caring for women that had been raped.

What next?

FHOK is continuing to provide and strengthen the quality of its integrated services. A pharmacovigilance programme will be developed in the coming year and laboratory tests will be made cheaper and more easily available.

Want to find out more?

Contact
innovation@ippf.org
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.