APHIA II Western Newsletter (Issue 2)
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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. 2 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.