Together for better health in Western Province MOPHS –APHIA II Western launch the “door to door” HIV Testing

Demographic Health Survey (KDHS) report. There are over 243,000 people living with HIV and AIDS yet only 41,000 are enrolled in any form of care. This is an indication that over 200,000 people in Western province are living with HIV and AIDS but are not receiving any form of treatment, care and support. The Provincial AIDS Sexually Transmitted Infections Coordinator (PASCO) Dr. John Aswani is emphatic that the exercise will help contribute to an increase in the number of children and couples being tested for HIV, access care and support and facilitate referrals for those already tested positive in the community. It is expected that 50% of the eligible population will be reached with this counseling and testing in the selected districts. The initiative has started bearing fruits. In A VCT counselor testing a man in his house at Budonga village, Kakamega Central district the four districts targeted in the first phase, 84,515 were tested with 2,189 testing he AIDS, Population and Health The first phase was undertaken in Kakamega positive. 22,454 children were tested with Integrated Assistance Program in Central, Bungoma South, Butere and Hamisi 143 testing positive. TWestern Province (APHIA II Western) districts. The districts were selected based in partnership with the Ministry of Public on the number of individuals tested and At Mukuyuni, Bumula South District the Health and Sanitation has initiated the home counseled for HIV. The targeted communities counselors encountered a bed ridden client. based HIV counseling and testing (HHCT) agreed to give their support by mobilizing He had not been taken to the hospital because with the aim of reaching out to the exposed people for HIV counseling and testing, his family thought he had been bewitched. individuals at the households and enrolling guiding the health care providers to homes The health workers counseled him and with them into care and support programmes. and providing security to the health officials. the support of his wife, he accepted to be The initiative dubbed “door to door” has been tested. He had chest complications and he The home counseling and testing comes rolled out in areas where there is low uptake was referred to Bungoma district hospital for against the backdrop of increased HIV of counseling and testing services and where comprehensive treatment. stigma associated with HIV is high. The health prevalence in the Western province. According care providers physically move from home to the Kenya Aids Indicator Survey (KAIS) During the exercise, individuals who need to home to offer HHCT services. Within this report only 30% of the adults know their HIV further consultation are referred to a nearest setting the HHCT services are initiated by the status. The KAIS report (2008) indicates that Comprehensive Care Centre or health facility provider, but the client has the right to decline HIV prevalence rate in the province stands for assistance with the help of community the test. at 5.8% up from 4.9% in the 2003 Kenya based health volunteers. AW page page • Improving Community - Health Facility Linkages 2 • Expanding Prevention Through Mass Media 8 • Improving Facility - Based Services 3 • Expanding Care and Support to Families 9 • Imroving Community Prevention Activities 4-5 • Engancing Care and Support to PLWAs & OVC 10 Inside this • Pictorials 6 • USAID Team Visit to APHIA II Western 11 issue • Stregnthening Workplace Health Programmes 7 Improving Community - Health facility linkage

Linking Health Services to the Family Safer Community

Left: Mothers Through the Youth listening to a health oaz Okumu, age 24, is a volunteer youth coordinator talk from a peer family from Matioli Sub-location in Kakamega North facilitator at the BDistrict. Boaz has taken the lead role in promoting facility waiting bay. better health in his area by mobilizing people to seek services at health centres. He works hand in hand with Bottom: Michael health facility personnel to provide health education Wajuma, Tamlega during outreaches in the hard to reach areas. This effort sub-location assistant has earned him admiration at Bukura Health Centre. chief addresses the Christopher interviews Boaz: peer family facilitators during a feedback Christopher: What do you understand as the concept of meeting at the change in matters concerning health and accessibility to dispensary. health facility?

he peer family program Community health volunteers Boaz: For a very long time community members have introduced by APHIA II Western supported by APHIA II Western not been seeking health services due to the entrenched Thas brought a remarkable mobilize residents through continuous traditional beliefs that whenever you fall sick the first improvement in service utilization peer family health discussion, public option is to visit the traditional herbalists/witch doctors. at Tamlega Dispensary. Through the barazas and health outreaches igniting We have lost many people due to this but the situation is help of 21 peer family facilitators remarkable response, enthusiasm and slowly changing for the better. The worst affected have (also known as community health excitement from the community. been the youth and even parents. With increased health volunteers) uptake of services has challenges such as HIV and other preventable diseases I steadily gone up. This is evident in the The community health volunteers cannot sit back but deliver basic health messages to my number of skilled deliveries reported also support facility staff to serve at the facility. clients which encourages more clients people to adopt healthy seeking behavior and access help from health facilities. According to the nurse in-charge, to come to the health facility. They Philomena Sande, “there was low voluntarily provide daily health talks Christopher: What strategies have you employed in uptake of maternal and child health at the facility waiting bay, clean the driving this change in the community? (MCH) services. Most pregnant facility and assist the two nurses to mothers have been seeking help weigh babies, keep records and trace Boaz: We have been able to mobilize the youth in the sub from traditional birth attendants. By clients scheduled for revisits. location. Meetings are held weekly to map out our health January 2009, no skilled deliveries agenda which focuses on outreaches. This approach has had been registered at the facility and Creating demand is a core priority of this was worrying. We realized that APHIA II Western, as is promoting good women avoided coming to the health working relationship between the pg 4 col 1 facility because they spent more time facility and the community members. at the facility waiting to be attended “This is expected to continue as to in an environment perceived to sensitization is intensified through be unsupportive. Some women only family discussion which engages made single visits to the ANC clinic a father, a mother and children,” The AIDS, Population and Health to obtain a card just in case of later says Iddi Juma a community health Integrated Assistance Program in Western complications.” volunteer. AW Province (APHIA II Western) is a four-year cooperative agreement between USAID and PATH. The PATH-led team is comprised of four strategic partners: Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), JHPIEGO, Society for Women and AIDS in Kenya (SWAK), and World Vision. Vision To enhance the skills and confidence of residents of Western Kenya to be able to meet their health needs through quality facility-based services, strengthened community networks, and community norms that promote, support, and sustain healthy behaviours, as well as increase demand for health services.

 Newsletter Issue 2 Improving Facility Based Services Sept - Dec

PMTCT – A Lifeline to Family Heath

”It was not easy to accept it, but Western in Western province. For all the the good thing is that both of women attending ANC, 95 percent receive us had attended the antenatal counseling and voluntarily accept to be care clinic,” he says. “We both tested for HIV. In addition, there is an increase tested positive for HIV. The nurse of male partners who turn up to know advised us on how to take care of ourselves and the unborn baby “PMTCT services can through PMTCT.” now be accessed in His wife was put on antiretroviral drugs. The baby Haggai was more than 266 health delivered by a skilled attendant and also put on treatment facilities supported by immediately after birth for six APHIA II Western” weeks. “We were so scared of his health,” the mother says, “but we their HIV status through PMTCT. This is an thank God that he is doing fine.” important achievement towards involving Baby Haggai was tested thrice for men in PMTCT utilization. HIV, but was found to be negative as a result of the drugs and care According to APHIA II Western reports, 37 he was given immediately after percent of infants exposed to HIV successfully birth. received PMTCT services. Mechanisms are in place to enroll children infected with Dismas and family during a postnatal clinic at Through PMTCT, Dismas and his HIV on pediatric antiretroviral treatment Kakamega Provincial General Hospital wife deal with the aspects of being immediately. HIV-positive, including AW “Utilization of prevention of mother-to-child how to disclose their HIV transmission (PMTCT) health services for status. They have joined a PMTCT pregnant mothers has significantly improved. support group at the health facility. At the start of the APHIA II Western project The support group provides an in 2007, 43 health facilities were offering opportunity for them to share Project Intervention Areas these services which were characterized experiences and challenges with by inadequate infrastructure, limited staff The project works in three result areas; other couples. capacity and inconsistent supply of essential Result 1 improves and expands facility based health drugs,” narrates Beatrice Misoga, Assistant APHIA II Western is collaborating services by building the capacity of staff through with both Ministries of Health to PMTCT Program Officer for APHIA II Western. training and supportive supervision and improving train health workers and community Dismas, a 47 year old married man with facility infrastructure, equipment, and suppliers. health volunteers to involve men eight children, escorted his wife for a routine and the entire community in PMTCT strengthens linkages between facilities and antenatal care (ANC) check-up at Kakamega Result 2 uptake. the communities they serve, as well as promotes Provincial General Hospital for the first time. health seeking, health behaviors, and supportive Awareness campaigns to promote He had been encouraged by a community attitudes through discussion groups, work site health volunteer at Shitungu village, in utilization of PMTCT are conducted programmes, in and out-of-school youth activities, Kakamega Central to support his four month through discussion groups in radio, and Magnet Theatre performances. pregnant wife to access health services at villages and family focused the nearest health facility. interventions such as married Result 3 builds upon the extended family network to adolescent groups, peer family care for people living with HIV and AIDS and orphans During the visit, Dismas was accorded a programme, radio, support groups, and vulnerable children by training affected families warm reception at the clinic. “The nurse integrated health outreaches and on home based care, psychosocial and legal support, acknowledged my support and explained Magnet Theatre performances. transition planning, and loss and bereavement. to me the different services offered at the facility for couples expecting a baby. She To date, PMTCT services can be Monitoring and evaluation enhances strategic counseled us and requested if we could be accessed in more than 266 health tracking of project objectives at all level through tested for HIV,” recalls Dismas. facilities supported by APHIA II standardized data management and reporting.  Improving Community Prevention Activities

from pg 2 Safer Community Through the Youth

been very successful as we focus on the gaps identified in the community and plan out a mechanism of ensuring that people get the basic health services. Apart from the outreaches we hold health talks with the youth in church, public barazas and health clubs in schools. After the meetings we assign ourselves duties. Christopher: Are there any achievements in what you have been doing so far? Boaz: Yes, there are many successes made so far. In Shiribo village, pregnant mothers were not attending antenatal clinics at Bukura Health Centre and mainly relied on the traditional birth attendants during delivery. But now the MCH clinic at Bukura Health Centre is one of the busiest with mothers taking their children for immunization. Expectant mothers now visit the antenatal care clinic more than twice unlike the past when they disappeared back to the community after the first visit to obtain ANC card. Several mothers have also delivered at the health facility and this has gone along with the uptake of prevention of mother to child transmission (PMTCT) health service. Boaz, a Youth Community Health Volunteer in Bukura, Kakamega Central “I cannot sit back but Excerpts from community

deliver basic health “I am impressed with the level of Attitudes and practices for involvement of Tamlega Sublocation members of the community messages to my people” residents in seeking ways to improve and health staff are changing in their health. Through the support of respect to use of health services. APHIA II Western, whom we partnered For example, most residents used with in sensitizing community to turn to the traditional birth Christopher: What challenges have you faced so members with the help of peer family attendants whom they perceived far in addressing community health issues especially facilitators utilization of health services to be offering better services among the youth? has increased. When I compare my than the services offered at the Boaz: We have limited materials to use for raising reports for the last six months, various dispensary. We have, however, awareness. When planning to carry out an outreach achievements have been made in talked to each other with the it takes some time in organizing and mobilizing the relation to conflict resolution involving help of the community health youth in a particular area in order to participate. It is members of the same family. In addition, volunteers; we improvised a not an easy task. the number of mothers seeking services delivery room with a delivery bed at the health facility has increased where mothers are being helped Christopher: What do you expect for this community and has helped to reduce the cases of to deliver babies safely. The TBA’s in the coming years? death among children. I used to register have also been reached to help Boaz: If more youth are going to voluntarily involve an average of 6 to 10 deaths among refer all pregnant mothers to the in community health then we will be able to push children every month but this has gone facility and we have been able to for better health. We are, however, moving on and down to 2 to 4 cases for the past three conduct ten deliveries ever since we intend to train and sensitize youth on various months. We are not relenting and we are the facility was opened to the health issues. We want everyone in this area to seek soldiering on.” public.” treatment promptly and prevent infection at all Michael Wajuma Tamlega, Sub- Pepela Margaret, a nurse times. AW Location Assistant Chief at Tamlega Dispensary  Improving Community Prevention Activities Newsletter Issue 2 Sept - Dec

Calm assured in Lukume village as Married Adolescent programme takes root issue and promised to join the dialogue session some time. From then he developed interest and further followed me to one of the meetings. He was astonished to meet some of his male village mates together with their wives seated and deeply engulfed into the dialogue sessions. The topic of discussion was on family planning,” recalls Jael. “The discussions were amazing, I learnt a lot just listening to people sharing their experiences then finally the facilitator gave us highlights on family planning. I then discovered that I had been investing a lot of energy beating my wife yet we could resolve our differences through talking as couples. I have since changed my lifestyle, no more Jael and John, a married couple and members of the Lukume married adolescent group quarrels and anytime I have pending issues with my wife we sit down and have a any men in Western Province who often run to him following domestic discussion like adults,” concludes John. practice male dominance behaviors quarrels between them and their husbands. Msuch as wife beating and looking The married adolescent programme focuses down upon women as objects without minds. In a small village of Lukume, the area sub chief Mr. Malik Maina Shanzu, accounts “early child-bearing endangers vividly the numerous young married women members! the lives of young adolescent girls and that of their children.” “The peer family discussions have One such family who had to solve their on young married girls between the age created a sense of belonging domestic quarrels at the sub-chief’s office 14-24 as primary beneficiaries while their to families participating in is that of John and Jael Machikwa from husbands and parents in-law are secondary the programme. Apart from Lukume. Previously John had little time to beneficiaries. The program recognizes that increasing the level of health spend with Jael but with the introduction of early child-bearing endangers the lives information and communication the married adolescents program in the area of the young adolescent girls and that of skills among family members, we their relationship has been reawakened to a their children. In addition they often face have initiated income generating better, loving and admirable one. emotional and physical changes that are activities to help reduce over sometimes misunderstood by their partners, dependency of families on “My husband used to drink so much and he which can also lead to problems in couple one source of income. Families could not listen to anything from me. He communication and gender based violence. have round robin fund-raising even attended disco dances in Kakamega programmes which have helped town every Friday night and offered little In Western Province the married adolescent start projects such as goat rearing, assistance to the family. As a woman I had programme engages over 45,000 married poultry keeping and horticulture. no right to question his behavior and I adolescent girls through 15 faith-based Such activities are important to received regular beating on enquiring of his organizations. The Ministry of Public Health support families to earn money whereabouts,” recounts Jael. and Sanitation provides technical assistance which is used to overcome One day after attending the weekly married as well as follow up and trainings on domestic hardships and remain adolescents dialogue session, I requested reproductive health issues, and promotes healthy. him to help in discussing a question assigned mutual fidelity among young married couples. To provide some livelihood for Etyang Catherine, a to me by the discussion group’s facilitator. At first, he took no interest but after some days I the impoverished girls, Lukume married peer family facilitator at asked the same question. He tried to discuss adolescent group has initiated a mushroom Tamlega Sub-location it out but the answers were not satisfactory. project, set up two bee hives and a vegetable He listened to me as I explained the health plot. AW  Pictorials

1

4

2

3 5

1. Left in red sweater, Zelpher an OVC being supported by APHIA II Western and family outside their reconstructed house in Ëmuhaya District 2. Seated 3rd from right, PATH Vice President - Corporate Services Mr. Eric Walker and other guests visit Andeka Male Support Group in Emuhaya District 3. Left, Dr. Shaeen Lakha of Hilton Foundation and PATH Country Director Rikka Trangsrud being briefed by a nutrition counsellor at the comprehensive care centre - Kakamega PGH 4. Participants at the radio planning workshop developing messages for Jua Afya Yako radio programme 5. Members of a Magnet Theatre troupe performing during an outreach in Vihiga District

 Strengthening Workplace Health Programmes Newsletter Issue 2 Sept - Dec

Nzoia Sugar Company implements HIV & AIDS policy

Employees of Nzoia sugar company during a health dialogue session with the help of a work site motivator trained by APHIA II Western

or a while now, Nzoia Sugar Company The initiative started by advocating for A memorandum of understanding was has been faced with the challenge of meaningful management support to activate drawn between APHIA II Western and Nzoia Fimplementing a workplace HIV and AIDS the existing HIV and AIDS workplace policy. Sugar Company. The company set up a HIV policy. This policy is intended to contribute The objectives of the policy include: and AIDS prevention committee to oversee to fighting HIV within its own workforce as the implementation of its Behavior Change - To mobilize employees and the surrounding well as the surrounding community. Community (BCC) activities and offer advice. community in the fight against HIV/AIDS The committee has established dialogue As a key player in the sugar industry, Nzoia pandemic. groups to discuss various health issues within Sugar Company has a workforce of over 1,250 - To protect the human rights and dignity of the community. permanent employees, 5,000 casual laborers HIV/AIDS infected workers. and an affiliation of 27,842 sugar cane So far 70 worksite motivators have been - To avoid discrimination against those farmers. The behavior of this large workforce trained to reach out to employees and their workers infected with the HIV virus. is heavily influenced by the workplace norms families with messages on HIV and AIDS, and policies, necessitating a comprehensive - To foster a spirit of understanding and malaria, tuberculosis, reproductive health HIV and AIDS program to help minimize compassion for HIV/AIDS infected and and family planning, gender and drug abuse. related risks. affected. The worksite motivators facilitate health - To ensure the confidentiality of HIV discussions during working hours. “We started witnessing a worrying trend testing and promote the availability of within the company,” says Brian Keya, the One of the core successes of the program has confidential counseling and testing based training officer at Nzoia Sugar Company. been reducing stigma and opening dialogue on informed consent. “We started loosing employees every month on HIV related issues amongst the employees due to the pandemic, and this was greatly - To ensure the confidentiality of HIV and the community around Nzoia. The affecting our manpower and output at the testing and promote the availability of utilization of counseling and testing service company.” confidential counseling and testing based at Nzoia Sugar Company’s health facility on informed consent and to provide has also gone up with 1397 clients enrolling As a result, the company partnered with other support services to the HIV positive on ART. 306 pregnant mothers have also APHIA II Western to help promote behavior clients. successfully gone through PMTCT. change and provision of care and treatment AW - To improve economic impact of HIV/AIDS within the workplace and surrounding on the company. community.  Enhancing Prevention through Mass Media

Tracking the Jua Afya Yako Radio Programme n order to expand and strengthen preventative and health seeking Ibehavior in Western Province, APHIA II Western team in partnership with West FM began broadcasting the Jua Afya Yako radio programme. This mass media component complements existing behavior change communication (BCC) activities by reinforcing HIV and AIDS, tuberculosis, malaria, maternal child health, reproductive health, family planning and gender messages. The Jua Afya Yako (JAY) radio programme is broadcast every Monday from 7.30 PM to 8.00 PM. The program targets both young and old. The radio programming follows a design framework that includes 48 episodes and incorporates elements of interaction with community members, entertainment and health education. The topics so far covered are gender, pediatric ART, counseling and testing for HIV, adolescent reproductive health, sexuality, tuberculosis, malaria and family planning. Members of a peer family group during a health discussion at Kisangula village, Vihiga district The community members are progressively engaged in the radio programme through All the radio topics are scripted in advance by second phase which involves magnification community recordings which feature the media team and reviewed by the MOH of success from the community on the experiences encountered by residents and a technical team at APHIA II Western. changes they have seen in their life since the around the topic of discussion. Drama, short Once approval is granted the radio episodes inception of the APHIA II Western project. poems, music, call-in, SMS and radio spots are either pre-recorded or transmitted live are all weaved into the show to make it more Over 400,000 residents of Western Province, in Kiswahili on West FM (94.9) – a local radio interactive and lively. Nyanza, and Rift Valley are being reached station based in Bungoma town. every Monday with health messages The Jua Afya Yako programme is in its through the JAY programme. AW Thank you for JAY Radio!

“My wife used to refer to the radio programme as ‘Watu wa APHIA II’ (the people of APHIA II) and this prompted me to develop keen interest on the radio programmes. I must confess the radio programme has greatly improved communication between members of my family. We have learnt a lot, through the programme I have taken all my children and grandchildren to be tested for HIV. They are my life, they mean everything to me and what better way to protect their life than let them know their status? Thank you, USAID-APHIA II Western.” Protus Simiyu, Webuye peer family member  Expanding Care and Support to Families Newsletter Issue 2 Sept - Dec

Defying old age in a fight against HIV and AIDS

Unfortunately the situation enrolled me into the home based care never got any better. The programme supported by USAID APHIA pain in my body became II Western through a local organization persistent, I sweated a lot. called REEP. One morning I woke up to find greyish black patches Through the HBC programme I have gained on my thighs, my heart skills and opportunities to better sustain skipped a bit wondering my life at home whenever I become ill. I what could be wrong. have joined a support group at Khunyangu Hospital, where we normally meet on a I called on one of my close weekly basis to talk and learn how to live friends who happened to positively. be my neighbor, seeking his advice on my situation. He Our support group has achieved major talked to a friend of his who break through in dealing with stigma worked at a nearby hospital associated with HIV and AIDS in our village. and after examining me Whenever we lose any of our members we he advised me to go to openly talk about it. This has really helped Busia District Hospital for more people to openly talk about their HIV treatment. At the hospital I status. Isn’t that wonderful?” was counseled and tested. At 89, Silvanus Olunga has taken it The tests came back upon himself to advocate against wife positive and my CD4 count inheritance. He says “Ndugu mambo Members of a peer family group during a health discussion at Kisangula village, Vihiga district was very low. I had to be ya kupeleka bibi achana nayo hapo ni admitted in hospital for moto utachomeka, nilichomeka na sitaki further examination. At first uchomeke” (My brother, the idea of I could not believe what inheriting someone is not good. It is an Silvanus Olunga 89 years old, living the doctor was saying and open fire you will burn.) AW I asked him “daktari, mzee positively with HIV. kama mimi anatoa wapi ukimwi si hii ni ugonjwa ya ighty nine years old Silvanus Olunga vijana?” (Doctor, where can hails from Magombe Village in Butula an old man like me get HIV? I thought it’s a “Daktari, EDivision Nambale District. Olunga disease for the young generation!) is the oldest member of his community I stayed in the hospital ward for a day living positively with HIV. He became ill mzee kama then decided to escape. I’d rather die after inheriting a woman who had lost in my own compound rather than in her husband to AIDS. Despite his age he a hospital. “Eeh! Shetani akikuingilia accepted his status, has been enrolled mimi unakuwa na akili? Shetani alitokea pahali on ART and has become a big champion fulani akaninyanganya, ubongo wangu,na against wife inheritance and discrimination alinichapa kweli” (When the devil attacks anatoa wapi related to HIV. you cannot think straight, he came from “I had been married before for well past nowhere and he got me). ukimwi? 21 years but lost my wife in 1983. We were I started experiencing complications that blessed with three kids all who are still alive. made me very worried to the point of My troubles began when I left my boma resorting to suicide. One day a community Si hii ni (homestead) to go inherit a woman who health worker visited me at home and had lost her husband in a nearby village. informed me that they had traced my We stayed together for two months, then I ugonjwa ya records from Busia District Hospital and later went back to my home.” convinced me to go back for treatment. All was well until one day I started feeling The doctors enrolled me for ART and I now vijana!” funny in my body but brushed off the feel better. feeling owing it to fatigue and old age. The community health workers have also

 Expanding Care and Support to Families

Households adopt livelihood activities as a safety net measure

rphaned and vulnerable children to start and manage a business. rabbit) and is now using it to raise income and people living with HIV face by charging 50 shillings for each doe By introducing them to the best agricultural numerous challenges in accessing (female rabbit) inseminated. This income O practices and use of gardening tool kits and their basic needs such as food, shelter, has enabled her meet her household organic farming they learn how to make clothing, education and good health. This needs. limited space in their gardens productive. has left many of them vulnerable surviving The participants who were trained as one day at a time. The HIV pandemic has trainers of trainers then later trained played a key role in this situation with members of their support groups and set many young children dropping out of up various businesses. school to take care of their ailing parents and siblings. Many of these children are Patrick Itsavo is one of the 430 caregivers “introducing willing to go to school but have to stay at from Ndoleho support group in Bungoma home to fend for their families. and has been trained by APHIA II Western families to better on organic farming technologies. He was In an effort to sustainably address these given vegetable seeds that he cultivated challenges, APHIA II Western, through the in his farm as well as supported members safety net programme, has started capacity agricultural of the community by replicating the same. building initiatives targeting the OVCs and The initiative is paying off and as Patrick their households in crop and livestock puts it he is “greening his village.” All the practices production with a focus on organic farming OVCs and PLWHAs under his support and kitchen gardening. group have a reason to smile. They now improves life” In 2008, 430 community health workers have access to plenty of vegetables which (CHW) and persons living with HIV and AIDS they use for their own consumption and to (PLWHAs) were trained in business skills, sell to generate income. The ALPHA CBO in Butere-Mumias started entrepreneurship, organic farming and Lucy, an Ambassador of Hope working as a merry-go-round initiative to help sustain kitchen gardening. The capacity building a CHW, is in charge of 18 OVCs in SOET in themselves on a day to day basis. Through initiative trains the CHWs and PLWHAs on MT. Elgon. She takes care of a buck (a male their Chama group all fifteen members the role of business in the society and how have managed to buy a sheep. Apart from putting their training skills into use, the 37,000 orphaned and vulnerable children being supported by the project have received poultry to help meet their basic needs. In Malakisi a household with four OVCs are happy. Having received four hens from the project they decided to rear them. As at March 2009, this household had a hen with young chicks, and a young she goat. The households’ house, which previously did not have a roof, has been renovated through APHIA II Western efforts to care for OVCs and their households. AW

Isaac Ochani, a business skill trainee, at his vegetable farm in West Bunyore, Emuhaya District

10 USAID Team visit APHIA II Western Newsletter Issue 2 Sept - Dec

Left: USAID officials Dr. Maurice Maina and Kate Vorley visiting Amatsi CBO in Budalangi, being supported by APHIA II Western project Below: USAID and APHIA II Western officials visit married adolescent seedling nursery in Mt. Elgon District

onor the United States Agency and had an opportunity for International Development to review some the health D(USAID) Kenya team recently visited systems put in place to Western Province to review the progress of ensure clients access HIV APHIA II Western project implementation counseling and testing, and to deliberate on the quarter eight RH, PMTCT, malaria and TB. report. The facility has recorded a commendable increase The USAID team led by Dr. Maurice Maina, in child immunization. (Cognizant Technical Officer, USAID) and Community health The field visit elicited an in-depth several representatives from USAID, the volunteers attached to the facility are paid examination of how an online intensive Ministry of Public Health and Sanitation, lunch allowance as a motivation to help in referral network helps link services to the Ministry of Medical Services and APHIA defaulter tracing. patients within Lugulu Mission Hospital. II Western project, first toured activities Patients are monitored and linked from being undertaken in addressing the health Mt. Elgon was also visited despite the past one department to other services in the needs of the people of Western Province. land disagreement pitting the government hospital. APHIA II Western collaborates forces and a local based militia force The first stop was at the Amatsi CBO in with private and mission health facilities to and forcing many residents to flee the Budalangi. Amatsi CBO is amongst 24 help scale-up of quality service delivery. area. It was a relief for the district health community based organizations receiving management team to interact with the During the deliberations of the quarterly funds and support from APHIA II Western to visitors and take stock of how to jump-start report the Dr. Maurice Maina noted that implement the home-based care program. health activities that had stalled during the the project has performed well in most The CBO supports more than 2,300 conflict. Generally, activities were averagely areas except for a few components that orphans and vulnerable children within on course after normalcy had returned to still need improvement like pediatric ART Budalangi. The OVCs are supported with the area. uptake, integration of family planning health education, psychosocial support,

into HIV/TB screening and comprehensive household materials, house renovations, The team visited the married adolescents’ support for OVCs. school items and other personal materials. activities in Kapsokwony. APHIA II Western The team paid a courtesy call to the nearby is reaching out to adolescent young girls The USAID - funded AIDS, Population and Makunda Secondary School which has and boys in marriage through the married Health Integrated Assistance Program admitted 82 orphans (60 boys and 22 girls) adolescent programme . The married (APHIA II Western), is a four year project receiving support through Amatsi CBO. adolescent group in Mt.Elgon engage in aiming to enable the residents meet various income generating activities like their health needs. The project has been The next stop was at the Matayos health tree planting, horticulture, a baking and successfully implemented for the past facility in Funyula District. The team maize farming. three years. interacted with the health facility staff AW

11 Pre-press - Artpro Graphic