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USAID AFYA PWANI QUARTERLY PROGRESS REPORT JULY-SEPTEMBER 2017 This publication was produced for review by the United States Agency for International Development. It was prepared by Dr Eileen Mokaya, Chief of party, Afya Pwani. USAID AFYA PWANI FY 2017 Q4 PROGRESS REPORT 1st July 2017– 30th September 2017 Award No: Aid-615-C-16-00002 Prepared for Mr. Vincent Ojiambo United States Agency for International Development/Kenya C/O American Embassy United Nations Avenue, Gigiri P.O. Box 629, Village Market 00621 Nairobi, Kenya Prepared by Pathfinder International-Kenya The Watermark Business Park, Karen, Fountain Court, 1st Floor Ndege Road, off Langata Road P. O. Box 1996 – 00502 Karen NAIROBI, KENYA Office : +254-20-3883142/3/4 Mobile : +254-733-618359/+254-722-516275 Fax : [+254 20] 2214890 www.pathfinder.org DISCLAIMER The authors’ views expressed in this report do not necessarily reflect the views of the United States Agency for International Development or the United States Government. USAID AFYA PWANI PROGRESS REPORT Q4 July-September 2017 i I. AFYA PWANI EXECUTIVE SUMMARY ................................................................................... 7 II. KEY ACHIEVEMENTS (QUALITATIVE IMPACT) ................................................................. 10 SUB-PURPOSE 1: INCREASED ACCESS AND UTILIZATION OF QUALITY HIV SERVICES10 Output 1.1: Elimination of Mother to Child Transmission (eMTCT):....................................................................... 10 Output 1.2: HIV Care and Support Services ............................................................................................................. 18 Output 1.3: HIV Treatment Services ........................................................................................................................ 22 Output 1.4 HIV Prevention and HIV Testing and Counseling ................................................................................... 31 Output 1.5: Tuberculosis/HIV Co-infection Services ............................................................................................... 34 SUB-PURPOSE 2: INCREASED ACCESS AND UTILIZATION OF FOCUSED MNCH and FP, WASH and NUTRITION ..... 38 Output 2.1: Maternal, Newborn and Health services ............................................................................................. 39 Output 2.2: Child Health Services ........................................................................................................................... 45 Output 2.3 Family Planning Services and Reproductive Health (FP and RH) .......................................................... 47 Output 2.4 Water, Sanitation and Hygiene (WASH) ............................................................................................... 53 Output 2.5 Nutrition................................................................................................................................................ 57 SUB-PURPOSE 3: STRENGTHENED AND FUNCTIONAL COUNTY HEALTH SYSTEMS ................................................ 62 Output 3.1 Partnerships for Governance and Strategic Planning ...................................................................... 62 Output 3.2: Human Resources for Health (HRH)..................................................................................................... 66 Output 3.3 a): Health Products and Technologies (HPT)......................................................................................... 67 Output 3.3 b): Health Products and Technologies- Facility Report ......................................................................... 70 Output 3.4: Monitoring and Evaluation Systems .................................................................................................... 74 III. ACTIVITY PROGRESS (QUANTITATIVE IMPACT) ............................................................ 76 IV. CONSTRAINTS AND OPPORTUNITIES ................................................................................. 77 V. PERFORMANCE MONITORING................................................................................................ 79 VI. PROGRESS ON CROSS CUTTING THEMES: GENDER AND YOUTH ................................ 90 VII. PROGRESS ON ENVIRONMENTAL MITIGATION AND MONITORING ......................... 97 VIII. PROGRESS ON LINKS TO OTHER USAID PROGRAMS ................................................... 97 IX. PROGRESS ON LINKS WITH GOK AGENCIES ...................................................................... 98 X. PROGRESS ON USAID FORWARD ........................................................................................... 99 XI. SUSTAINABILITY AND EXIT STRATEGY ............................................................................. 99 XII. SUBSEQUENT QUARTER’S WORK PLAN ................. ERROR! BOOKMARK NOT DEFINED. USAID AFYA PWANI PROGRESS REPORT Q4 July-September 2017 ii XIV. ACTIVITY ADMINISTRATION .......................................................................................... 101 XV. SUCCESS STORIES ................................................................................................................. 101 Figure 1 Number of ANC Clients Tested for HIV Oct 2016-Sept 2017 ...................................... 10 Figure 2 PMTCT HAART and HEI Prophylaxis Oct 2016-Sept 2017 ........................................ 12 Figure 3 RTK reporting rates July -Sept 2017................................................................................ Figure 4 ART uptake for pregnant women and HEI prophylaxis July –Sept 2017 ...................... 14 Figure 5 Comparing Q4 TX_CUR against APR targets ............................................................. 23 Figure 6 Afya Pwani Treatment Cascade ....................................................................................... Figure 7 Test and Start July -Sept 2017 ..................................................................................... 24 Figure 8 Afya Pwani Improved VL uptake Oct 2016-Sept 2017 ................................................ 27 Figure 9 Trend Analysis for the 1st and 4th ANC Visits October 2016 to September 2017 39 Figure 10 Trends in SBA and live births October 2016-June 2017 ............................................. 43 Figure 11 Trends in maternal deaths, stillbirths and Neonatal deaths October 2016 and September 2017 44 Figure 12 Trends in Child Health Indicators October 2016-September 2017 .............................. 45 Figure 13 : Trends in Diarrhea Cases Managed at facilities in the 7 sub-counties for Oct 2016 to June 2017 .................................................................................................. 46 Figure 14 Uptake of FP Services, New clients and re-visits for Oct-Dec 2016, Jan-Mar 2017, Apr-Jun 2017 ................................................................................................ 47 Figure 15 Trends in FP method mix for the period Oct 2016 – June 2017 .................................. 48 Figure 16 Trends in CYP for October 2016 – September 2017 .................................................. 48 Figure 17 Distribution of CYP by Method for October 2016 – September 2017 ......................... 49 Figure 18 Contraception commodity reporting trends (June 2016 - May 2017) .......................... 53 Figure 19 Afya Pwani Underweight Trend Analysis Oct 2016- Sept 2017 ................................. 61 Figure 20 Stunting Trends Oct 2016- Sept 2017 ........................................................................ 62 Figure 21 Health Budgetary Allocation for FY 2015/16, 2016/17 and 2017/18 for Kilifi, Kwale, Lamu, Mombasa and Taita Taveta Counties ............................................... 64 Figure 22: Mombasa Indicator tracking data by County TWG ................................................... 68 Figure 23 HIV Laboratory Commodity Reporting Rates ............................................................ 68 Figure 24 Coast DHIS2 Commodity reporting rates................................................................... 69 Figure 25 Kongowea Health Center Commodity Management Performance .............................. 71 Figure 26 Kisauni Health Center Commodity Management Performance ................................... 72 Figure 27 Comparative Commodity Management Indicator Analysis for Afya Pwani Facilities Visited Twice (Q1 to Q4) ........................................................................ 73 Figure 28 Comparison of EMR DQA Findings .......................................................................... 74 Figure 29 Comparison of 1st and 4th ANC ................................................................................ 76 Figure 30 FY 17: Average Annual Reporting Rates for Major Reports ............................................. Figure 31 Kwale County EMR Uptake August 2017 ................................................................. 90 USAID AFYA PWANI PROGRESS REPORT Q4 July-September 2017 iii ACRONYMS AND ABBREVIATIONS AIDS Acquired Immune Deficiency Syndrome ANC Antenatal Care APH Antepartum Hemorrhage APHIA AIDS, Population and Health Integrated Assistance APHIAplus AIDS, Population and Health Integrated Assistance-People-centered, local universal access and sustainability ART Antiretroviral Therapy ARV Antiretroviral ASRH Adolescent Sexual Reproductive Health AYLHIV Adolescents and Youth Living with HIV AYSRH Adolescent and Youth Sexual Reproductive Health BEmONC Basic Emergency Obstetric and Newborn Care CASCO County AIDS and STI Control
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