April - June 2014

Delivering lifesaving treatment

More than 41,000 people living with HIV have been enabled to receive care and treatment in the five counties covered by APHIAplus Nuru ya Bonde. In 2013, a total of 24,325 adults and children with HIV were on anti- retroviral treatment, while the rest received various forms of clinical care and support, including counselling and help to improve their lives and those of their families. “We have made significant progress USAID Assistant Administrator for Global Health, Dr. Ariel Pablos-Mèndez, hands over health towards universal access to HIV commodities to Cabinet Secretary James Macharia as national and county officials look on. treatment while reducing transmission and strengthening systems,” says Dr Joel Rakwar, the project’s Associate USAID gives equipment and Director for Clinical Services. “Our aim in the next one year is to reduce the number of new infections supplies for maternal health to less than 5 percent while ensuring most people who are HIV positive nited States Agency for International Development (USAID) Assistant have access to appropriate care and UAdministrator for Global Health, Dr. Ariel Pablos-Mèndez, recently visited two support,” he says. “We will also focus Ministry of Health facilities supported by APHIAplus Nuru ya Bonde Project. on prevention among key populations.” During the visit on March 17th, Dr. Pablos-Mèndez first toured Maai Mahiu health centre, In its fourth year, the project will build where he interacted with service providers. They briefed him on primary health care on its achievements and continue to services, including outpatient services and basic care for women in pregnancy. support multiple HIV-related services. He later visited Sub-County Hospital accompanied by ’s Cabinet Secretary “We are planning to reach 300,000 for Health, Mr. James Macharia and other national and county government officials. people with HIV counselling and In a brief ceremony at the hospital, the Assistant Administrator handed over maternal and testing, including more than 100,000 child health commodities worth over Sh129 million ($1.5 million) to Cabinet Secretary for pregnant women,” says Dr Rakwar. Health, Mr. James Macharia. Another key target is to ensure at least 80 percent of pregnant with HIV The equipment, part of which was received at Naivasha Hospital, has been distributed to are enrolled to receive prevention of 6,500 health facilities across Kenya. mother-to-child transmission services. Dr. Pablos-Mèndez announced USAID’s commitment to ending preventable child and In addition, the project will use mobile maternal deaths in a generation. “USAID has identified 24 priority countries including phones and work with community Kenya, in which it will provide financial assistance focusing primarily on supporting national health workers to help patients adhere governments to provide women’s informed choice in the use of family planning and to medication and take up other maternity care, improve access to and utilization of quality maternal and newborn care services they need. services and to strengthen health systems,” he said. For sustainability, the project will In 2013, USAID invested $40 million in family planning, maternal, newborn and child health, support more health facilities to offer and nutrition services in Kenya. anti-retroviral treatment and orient Mr. Macharia said provision of free maternity services in public health hospitals had reduced health care workers to effectively maternal deaths by 8.5 percent since the government abolished fees for women delivering monitor patients to ensure treatment in hospital, almost a year ago. works for them. With USAID support, APHIAplus Nuru ya Bonde project works with the Ministry Health to The project will work with the national improve the quality of health services in 520 health facilities in Baringo, , , Health Commodities and Services Ngong and Laikipia counties. The project also works with communities to encourage Management project to ensure reliable individuals to seek health services when in need. supplies to points of care. Contact: [email protected] Contact: Joel Rakwar, [email protected]

INSIDE: Life Skills Education empowering youth P. 2 Women improving lives P.3 Strengthening local organizations P. 4 1 Supporting life skills education in schools

With support from USAID, APHIAplus Nuru ya Bonde and Ministry of Education train teachers to mainstream subject and start vibrant clubs

hree girls sneak out of school and go to Thave fun in town. They enjoy themselves and dance away the time as their fellow pupils sit exams. One of the rebel girls realizes their folly and goes back to school. Eventually, the rest return. They confess their wayward ways and vow to take their studies seriously. This is the sequence of a skit performed by peer

educators at Siana Primary Boarding School, Photo: G. Obanyi Narok, to teach positive values among their Peer educators perform a dance at Siana Primary Boarding School. They use song and drama to pass messages about responsible behviour. peers. Such skits are some of activities of the school’s health club. The decision was a turning point for teachers and pupils at “These skits are developed and performed by the pupils the school. themselves as a way to provide solutions to problems they After the first few lessons, pupils realized that they had the face,” says the school principal, Wilson Totolo. “The peer power to shape their own lives. Seventy-five boys and 110 educators have been equipped with knowledge and skills to girls volunteered to be trained as peer educators and later teach other students to make healthy choices.” formed the health club. Siana is one of 278 primary and secondary schools that The peer educators lead weekly sessions to teach their APHIAplus Nuru ya Bonde projects is supporting to fellow pupils about making responsible choices through implement the national curriculum on life skills education. discussions, drama and other interactives activities. Health clubs are a flagship activity of the curriculum. Occasionally, they are given an opportunity to address the The project works with the Ministry of Education to sensitize school assembly. train teachers to effectively integrate life skills education in Other activities include gardening and environmental school activities, including health clubs. conservation. As a result of the project’s support, life skills lessons have “They are able to organize themselves even in the absence been incorporated into the school timetable, ensuring lessons of teachers,” says the principal. “The club’s activities have are systematically covered for maximum benefit. given especially the girls more confidence and help pupils “Previously, the slot for LSE (life skills education) was used cope better with emotions.” by teachers of subjects such as maths for extra lessons,” Number of primary according to Grace Passian, one of two teachers trained in and secondary schools the school. 278 supported to provide Upon returning to school after training, Grace and her quality lifeskills education colleague, Daniel Kilerai, briefed the principal, who called a meeting of all teachers to discuss how best to deliver life Students to skills education. benefit from LSE 50,000 mentorship in 2015. In the discussion, led by Grace and Daniel, the teachers resolved to put LSE on the school timetable. Contact: Richard Odindo, [email protected]

Four Pillars: A comprehensive approach to keep girls in school By supporting delivery of n Loitoktok, County, drop out of school. Four Pillars has “life skills education, we IAPHIAplus Nuru ya Bonde is been successfully used by FHI 360 in have established an entry implementing a comprehensive County to ensure girls transition point in schools for other through school. program to keep vulnerable girls in programs including water, school using the Four Pillars model. At first, 20 schools have been sanitation and hygiene, This approach combines the four selected for this program, which will pillars of mentorship, scholarships, later roll out to more schools. agricultureand even services professional development for teachers Community consultations have taken such as deworming.” and community involvement to tackle place and teachers trained to start - Richard Odindo, Associate Director, problem problems that cause girls to implementing the program. APHIAplus Nuru ya Bonde

2 Photo: Photo: S. Achar

Members of Toloita Women’s Group with a social worker (second left) after a meeting to discuss their income-generating activities. Women’s group improving lives Members pull together to sustain themselves and their families

oloita is the central pillar that holds up a traditional their lives have changed immensely. “For instance, last TKalenjin hut. This is the name that 12 women from a year, we never had any external financial support but village in Koibatek, chose for their self- through loans, we have been able to keep our children in help group. school!” The women, including widows living with HIV, felt that the To further increase their incomes, Toloita group members name described their life experiences and aspirations. keep chickens and grow potatoes on a one-acre plot that It was an awareness meeting for caregivers that prompted they leased. the women to form the group. The meeting was organized The members share tasks. While some cultivate the crops by Women Fighting AIDS in Kenya (WOFAK), a local on the farm, others care for the chickens and sell eggs or implementing partner supported by APHIAplus Nuru ya buy and resell milk, fruits and beans. Bonde Project, at Tulwamoi village, Mumberes division in APHIAplus Nuru ya Bonde linked the group with the Koibatek District, Baringo County. Women Enterprise Fund, which loaned them Sh50,000 to “The women approached us and wanted to know out how boost their business. they could form a support group,” says WOFAK’s Keziah In addition, the project has provided their children with Abequer. uniforms, mattresses and blankets. Some children have WOFAK helped the women to establish a group and been shortlisted to get school fees. register it with the then Ministry of Gender, Sports, Culture Mary and the Tulwamoi women are now full of hope. Just and Social Services. The group was also enrolled to benefit as their name, they are pillars of strength for their families. from APHIAplus Nuru ya Bonde support for the orphaned and vulnerable children (OVC). Story by Silas Achar A priority for women was to pull together and sustain themselves and their families. They started a merry- Role of support groups crucial go-round savings scheme to help each other before the project introduced them to table banking or Small Internal upport groups are very important for people Lending Community (SILC) approach to enable them save Sliving with HIV. In such groups people encourage and lend money to each other in a more organized way. and advise one another on ways to cope with their “The teacher (SILC agent) taught us on how members condition. could contribute and borrow and refund the money with These groups also provide practical support to improve interest,” she said. their members’ livelihoods. They pool resources and SILC is an economic empowerment concept where start businesses that provide income for various needs. members of a community or group save and loan each other money. The activity is guided by a constitution and Support groups are also an avenue through which strict rules. In every meeting, usually once a month, each individuals access services such as group counselling member contributes an agreed amount. Loans are also and health education. given out during the meetings. In APHIAplus Nuru ya Bonde, PLHIV groups leaders are Groups are trained in SILC by an agent from the project trained to reach their members with prevention with who also advises groups in income-generating activities positives messages that empower them to live healthy and links them to sources of support. and protect others from infection with the virus.

Since they began the SILC in June 2012, Mary said that Contact: Simon Makori, [email protected] 3 @aphiaplusnuru /APHIAplus nuru ya bonde

DATA SNAPSHOP: 2013 u Rahab Warui (left) is one of 37 trained mentor mothers assigned to 29 121,930 pregnant women counselled health facilities through APHIAplus and tested for HIV and received their Nuru ya Bonde support. The mentors results. counsel women living with HIV who want to have children and encourage 632 community health volunteers those who are pregnant to enrol trained to promote preventive health for prevention of mother-to-child behaviours, identify, refer or manage transmission (PMTCT) services. There complications. are plans to recruit 33 more mentors.

477 service outlets provide HIV Photo: G. Obanyi testing and counselling. 420,566 people were counselled Building stronger local organizations and tested for HIV testing and received their results at facility level. to better serve their beneficiries 420 service outlets providing eliverance Church in is on the front lines of Kenya’s AIDS prevention of mother-to-child Dresponse, providing care and support services for orphans and vulnerable transmission of HIV (PMTCT) children under the age of 18, through its “We Care Development Programme.” services. Like many programs run by small, community- or faith-based organizations, its activities were not always well-planned and the program team often did not know adults and children with 41,036 exactly how many children it was helping in any given month. advanced HIV infection who have ever started on anti-retroviral therapy. This began to change, thanks to the interventions of two USAID-funded projects: the FANIKISHA Institutional Strengthening Project and APHIAplus Nuru ya Bonde. 75 per cent of HIV-positive patients FANIKISHA is strengthening the capacity of national Kenyan organizations and their with TB started TB treatment. affiliates to provide a strong community health response. In May 2013, FANIKISHA partnered with APHIAplus Nuru ya Bonde to offer a series 275,050 women of child-bearing of workshops to 18 local implementing partners, including Deliverance Church. age (15-49 years) using a modern Together, these organizations provide care and support services to about 80,000 family planning method. orphans and vulnerable children. The workshops helped to map the organizations’ 10,055 pregnant women received capacity gaps, and to develop plans to build their capacity in weak areas such as insecticide-treated nets. project management and performance monitoring so they could better serve their beneficiaries. 41,350 women attended at least “Together with FANIKISHA, we were able to identify our local implementing four antenatal ANC visits. partners’ capacity needs in performance monitoring—how they collected quality data and used it for reporting—as well as human resources and administration, 70 per cent (207,739) of children resources mobilization, management and sustainability,” said Rachael Manyeki, who under 5 years received Vitamin A manages Nakuru County for APHIAplus Nuru ya Bonde. from US Government-supported Delinah Wakio, a project coordinator at Deliverance Church agrees. “The training programs. enabled us to gain useful skills in developing focused annual work plans and detailed scopes of work,” she says. (Story courtesy of FANIKISHA Project)

Contact: Charity Muturi-Njeru, [email protected] Contact: Rachael Manyeki; [email protected] Story courtest of FANIKISHA Project APHIAplus Nuru ya Bonde Strategic Partners Family Health International (FHI 360) Catholic Relief Services (CRS) is the lead Liverpool VCT, Care and Treatment is responsible for overall program partner in home-based and community care provides technical assistance for provision management, technical leadership, for families affected by HIV, and in support of community-based HIV testing and strengthening HIV counselling and testing, for orphans and vulnerable children. counselling, sexual and gender-based PMTCT, reproductive health and family Gold Star Kenya provides technical violence. planning, MNCH in facilities, capacity assistance to the private sector to provide National Organization of Peer Educators building of local implementing partners and quality HIV clinical care and other services, (NOPE) promotes healthy behaviours coordination of M&E activities. and HIV prevention for most-at-risk among marginalized youths and links them Amref Health Africa is the lead partner in populations. to services offered at health facilities. roll-out of the Community Strategy.

AIDS, Population and Health Integrated Assistance (APHIAplus) program is funded by the President’s Emergency Fund for AIDS Relief through USAID. It aims to empower people lead healthier lives by increasing access to high quality HIV and AIDS, reproductive health, family planning, maternal and child health services.

Thanks to APHIAplus Nuru ya Bonde staff and partners as well as community Contacts: Ruth Odhiambo, Director, APHIAplus Nuru ya Bonde, members who shared their stories for this issue. [email protected] or George Obanyi, Information Officer, P.O. Box 13208-20100 Nakuru; [email protected] 4 Regional Offices: Narok, , and Ngong.