August 2014 Second Edition

Interfaith Health Program Rollins School of Public Health Emory University

1518 Clifton Rd., NE CNR 8050 Atlanta, GA 30322 http://ihpemory.org

Established to actively promote the health and well-being of individuals and communities who face health disparities, the Interfaith Health Program (IHP) brings together a diverse community of scholars and public health practitioners to assure access to health programs and services.

Through alliances with national and global partners, IHP facilitates collaboration, provides training, builds networks, conducts research, and implements programs that improve the health and wellness of communities around the world. IHP’s work is rooted in respect for diverse religious beliefs and practices, justice, and human rights for all people.

Emory University, Interfaith Health Program l 2 Authors

John Blevins Associate Research Professor, Interfaith Health Program Rollins School of Public Health, Emory University

Emily Griswold Graduate Research Student Rollins School of Public Health, Emory University

Special thanks to the following individuals for their contributions:

Mimi Kiser Jill Olivier Associate Research Professor Director, International Religious Health Assets Interfaith Health Program Programme Rollins School of Public Health, Emory University University of Cape Town, South Africa

Deborah McFarland Trey Comstock Associate Professor Graduate Research Student Hubert Dept. of Global Health Rollins School of Public Health, Emory University Rollins School of Public Health, Emory University Alex Plum Michael Mugweru Graduate Research Student Director Rollins School of Public Health, Emory University Africa Christian Health Association Platform Secretariat Sarah Neale Graduate Research Student Faith Irene Wagaki Rollins School of Public Health, Emory University Christian Health Association of Karyn DeLuca James Setzer Communications Specialist Abt Associates Interfaith Health Program Rollins School of Public Health, Emory University Raphael Pundo Kenya Health Management Information Sandra Thurman Systems/AfyaInfo Director Interfaith Health Program Rollins School of Public Health, Emory University

CDC Staff

Renee Saunders Veronica Davison

3 l Emory University, Interfaith Health Program Executive Summary

This report provides a thorough overview of the contributions of faith-based health systems and health facilities to the provision of HIV services in Kenya. The substantial contributions of faith-based health systems to healthcare services have been well-established; however the scope of those contributions is not known. This report describes findings from the study of the faith-based health sector in Kenya, details the quantitative contributions of that sector to HIV service delivery, and describes the unique role of trust in faith-based health systems.

The first section of the report describes the methodology employed in conducting this study. That methodology combined quantitative analysis of service provision data with qualitative analysis of providers’ and consumers’ perceptions of trust as it relates to clinical care in faith-based facilities. The second section presents findings from the analysis of that service provision data (key findings are summarized below). The third section presents findings from key informant interviews and focus groups held at facilities affiliated with the Christian Health Association of Kenya (CHAK) on perceptions of trust and the impact of trust on treatment. The fourth and final section presents a case study of CHAK. The case study provides background on the organization and describes its efforts to develop a key supply chain for distributing medications and medical supplies, its integral role in health workforce education in Kenya, and its support of vital faith-based networks such as the African Christian Health Association Platform and the Ecumenical Pharmaceutical Network.

Key findings from this study include:

1. Faith-based health facilities are an integral part of healthcare delivery in Kenya, particularly for those who cannot access for-profit providers. They comprise 70.0% of non- governmental facilities in the not-for-profit sector.

Faith-based health facilities comprise 11.3% of all health facilities (public and private). Among facilities in the non-profit sector (both governmental and non-governmental), faith-based health facilities comprise 18.4% of all facilities. Among the non-governmental not-for-profit sector, 70.0% of facilities are faith-based. In other words, faith-based facilities comprise 70% of the non- governmental facilities that provide services to the public-at-large regardless of ability to pay.

2. Diverse religious traditions operate a number of faith-based health facilities.

The Christian Health Association of Kenya (Protestant) and the Kenya Episcopal Conference (Roman Catholic) operate large health systems. The Supreme Council of Kenyan Muslims also operates a number of health facilities. In addition, a number of independent faith-based organizations operate health facilities in Kenya.

3. Faith-based health facilities demonstrate a broad-based commitment to providing HIV services, especially in high prevalence areas where 67.6% of all faith-based facilities provide at least one HIV service.

Despite common perceptions that faith-based organizations are reluctant to provide services to people living with HIV/AIDS, a substantial proportion of faith-based health facilities offer at least one service in the areas of HIV prevention, treatment, or support.

Emory University, Interfaith Health Program l 4 4. Faith-based health systems provide a substantial proportion of services, including 58.6% of treatment visits and 60.7% of antiretroviral (ARV) treatment in .

Across the country, 22.0% of HIV treatment visits for those currently in care are provided by faith- based facilities. In high incidence counties, 26.5% of these visits are provided by faith-based facilities. Percentages for , like Nairobi, are especially impressive, with 54.1% of treatment visits and 67.6% of ARV treatment provided by faith-based facilities.

5. Faith-based health systems are a good investment.

Faith-based organizations received 5.8% of PEPFAR’s 2011 budget as primary partners. With those funds, they provided 8.6% of all services carried out by primary partners. While the cost per unit of service is unknown and one can reasonably assume that some services (e.g., providing ARVs) are much more costly than others (e.g., VCT), faith-based health programs accounted for 12.7% of all ARV provision funded by PEPFAR through its primary partners.

6. There is a strong need for further research and improved data reporting and management processes.

Discrepancies across the data sets examined in conducting this study raise questions regarding the current data platforms. While the platforms are significant resources providing useful user interfaces, health systems could benefit from capacity building for utilizing these platforms and managing their data.

7. Most patients and staff trust faith-based facilities. This is generated in unique ways and has lasting effects in key areas, such as in retention in care.

The trust generated by the FBO’s status in the community is linked to perceptions of quality care and good staff. History, personal experience, and word of mouth spread this impression throughout communities. Having a religious mission implies caring, comprehensive care among those who frequent such facilities.

8. Strong faith-based health systems develop programs far beyond service delivery.

For example, the Christian Health Association of Kenya plays in integral role in supply chain management systems in Kenya; in health workforce education; and in developing, sustaining, and strengthening innovative networks of faith-based programs across Sub-Saharan Africa.

A Way Forward

This study has yielded findings that can provide insights into the important contributions of faith-based health systems in sustainable, country-led HIV prevention, treatment, and support programs. While such knowledge is essential for maximizing those contributions, much is still not known. Ongoing study of the contributions of faith-based systems outside of Kenya is essential in order to determine both the common characteristics across individual countries and also the distinctions between those characteristics from country to country. Such study requires robust data management and reporting structures and the ongoing efforts to build and sustain those structures will be important.

5 l Emory University, Interfaith Health Program Table of Contents

Authors 3

Executive Summary 4-5

Glossary 7-8

Introduction 9-11

Methodology Employed in this Study 12-16

Findings: The Scope of Services Provided by Faith-based Health Facilities 17-29

Stories of Trust: A Qualitative Study of an HIV/AIDS Program 30-34

Case Study of the Christian Health Association of Kenya 35-39

Conclusion 40-41

Appendices 42-95

Emory University, Interfaith Health Program l 6 Glossary

ACHAP Africa Christian Health Association Platform

ARV/ARVs Antiretrovirals—the medications used to slow replication of the HIV virus in the body.

CCC Comprehensive Care Centre

CDC US Centers for Disease Control and Prevention

CHA Christian Health Association

CHAG Christian Health Association of Ghana

CHAK Christian Health Association of Kenya

CHAP CDC HIV/AIDS Program

CHAZ Churches Health Association of Zambia

CSSC Christian Social Services Commission

CVCT Couples Voluntary Testing and Counseling

DGHA Division of Global HIV/AIDS

DIFAEM Deutsches Institut für Ärztliche Mission—German Institute for Medical Mission

eHealth A web-based, searchable database of registered health facilities in Kenya. www.ehealth.or.ke

EPN The Ecumenical Pharmaceutical Network

FBOs Faith-based organizations. An organization that is influenced by stated religious or spiritual beliefs in its mission, history, and/or work.

HIV Human Immunodeficiency Virus

HTC HIV Testing and Counseling

ICCO Interchurch organization for development cooperation

IHP PPP Interfaith Health Program Public Private Partnership (of the Rollins School of Public Health at Emory University)

IMA World Interchurch Medical Assistance (IMA) World Health Health

IRB Institutional Review Board

KEC Kenya Episcopal Conference

7 l Emory University, Interfaith Health Program Glossary (CONTINUED)

KHIS Kenya Health Information System. A centralized database designed to capture and aggregate data related to health services in Kenya. www.hiskenya.org

MARP Most at-risk populations. Also known as key populations at elevated risk.

MEDS Mission for Essential Drugs and Supplies

M&E Monitoring and Evaluation

NACC National AIDS Control Council

NASCOP National AIDS/STI Control Programme

NGO Non-governmental organization

OGAC Office of the Global AIDS Coordinator, US Department of State

OSEELC L’oeuvre de santé de l’Eglise Evangélique Luthérienne au Cameroun—The Association of Evangelical Lutheran Churches in Cameroon

PEPFAR U.S. President’s Emergency Plan for AIDS Relief

PLHIV Person or People living with HIV/AIDS

PMTCT Prevention of mother-to-child transmission [of the HIV virus]

SANRU Santé Rurale, a partnership program of the Protestant Church of Congo (ECC) and Interchurch Medical Assistance (IMA

SUPKEM Supreme Council of Kenya Muslims

UCMB The Uganda Catholic Medical Bureau

UPMB The Uganda Protestant Medical Bureau

VCT Voluntary Counseling and Testing

WCC World Council of Churches

Emory University, Interfaith Health Program l 8 Introduction

In 2012, the President’s Emergency Plan for AIDS Relief (PEPFAR) convened a gathering of religious leaders from Kenya, Tanzania, Rwanda, and Uganda in an effort to strengthen the capacities of faith- based organizations in their contributions to strong, sustainable, country-led initiatives in HIV prevention, support, and treatment.1 Faith-based organizations have been long-standing PEPFAR partners, and their substantive and distinctive contributions are known. What is less well known is the scope of those contributions. While there are a number of references to faith-based health systems providing a significant proportion of health services (percentages cited can range from 33 to 70, depending on the geographic location and the citation source)2, such claims are rarely tied to a systematic assessment or investigation. The Division of Global HIV/AIDS (DGHA) at the US Centers for Disease Control and Prevention (CDC) is working with the Interfaith Health Program Public Private Partnership (IHP PPP) at Emory University to develop a study that documents the contributions of faith-based providers in order to build this evidence base in the provision of HIV prevention, treatment, and support services. This report describes the work carried out in the study, explaining both the quantitative and qualitative methods employed; describing key findings from those methods; and documenting the specific contributions of one, large, long-standing faith-based health system in Kenya in order to provide a more accurate description of the scope of the contributions of faith-based health systems.

Participants in the 2012 Consultation enumerated a set of key recommendations:

In order to leverage the unique role and function of FBOs, PEPFAR should:

1. Capitalize on the trust that has developed between FBOs and local communities to build stronger, more comprehensive, integrated HIV prevention efforts built not on stigmatization but on unconditional love.

2. Develop the capacity for FBOs to advocate for improved healthcare for all citizens and hold governments accountable.

3. Maximize the existing organizational infrastructure of faith-based health systems to reach communities impacted by HIV, including vulnerable, hard-to-reach, and most at-risk populations (MARPs).

4. Develop the capacity to communicate in ways that are relevant and meaningful to religious communities, donors, and governments.

5. Strengthen communities’ input and investment into FBO administration and programming.

1 A downloadable pdf file of the consultation report, A Firm Foundation: The PEPFAR Consultation on the Role of Faith- based Organizations in Sustaining Community and Country Leadership in the Response to HIV/AIDS, can be found at: http://ihpemory.org/publications/ihp-reports/ 2 Such citations are quite numerous. The PEPFAR report on the faith-based consultation lists various sources (see pp. 6- 7). In addition, many citations of such sources can be found in Tony Blair Faith Foundation (2011). Global Health and Africa: Assessing Faith Work and Research Priorities. London: Tony Blair Faith Foundation. The website of the Berkley Center at Georgetown University offers links to a large variety of research publications that reference the substantial role of faith-based health systems in delivering essential medical services. See http://berkleycenter.georgetown.edu/. Also, see Olivier, J. and Wodon, Q. (2012). Mapping, Cost, and Reach to the Poor of Faith-Inspired Health Providers in Sub- Saharan Africa. Washington, DC: The World Bank. 9 l Emory University, Interfaith Health Program

In order to build the capacity of FBOs, their employees, and volunteers, PEPFAR should:

6. Develop and make widely available mechanisms to support the organizational development of FBOs.

7. Increase FBOs’ capacities to develop and implement effective programs or to strengthen existing programs.

8. Expand FBO networks by bringing in new or previously unaffiliated FBOs and engaging other religious traditions.

9. Hold ineffective FBOs accountable.

10. Offer leadership development initiatives to better equip the next generation of leaders.

How this study addresses these key recommendations:

DGHA has been working to respond to these recommendations through a variety of initiatives. This study is one effort, specifically supporting the following recommendations:

• Capitalize on the trust that has developed between FBOs and local communities to build stronger, more comprehensive, integrated HIV prevention efforts built not on stigmatization but on unconditional love. This study examines the role of trust among both consumers and providers in the Christian Health Association of Kenya (CHAK), a large network of faith-based health programs in Kenya, by presenting findings from key informant interviews and focus groups. This qualitative analysis in conjunction with the facilities data analysis found in this report helps to make the case for the particular contributions of FBOs in regard to trust; in turn, this could support increased collaborations between FBOs and other governmental and nongovernmental partners.

• Develop the capacity for FBOs to advocate for improved healthcare for all citizens and hold governments accountable. By building the knowledge and evidence base of the scope of the contributions of faith-based health systems, the study presents findings that can be used to support such advocacy and capacity-building efforts.

• Develop the capacity to communicate in ways that are relevant and meaningful to religious communities, donors, and governments. In order to speak to diverse stakeholders, programs need to develop the capacity to employ frameworks relevant to particular audiences. Religious leaders may be able to employ religious language to speak to other people of faith but this language may be less useful to public health researchers, policy makers, and practitioners. This study offers partners from FBOs an opportunity to “make the case” for strong collaboration by demonstrating the important role of faith-based health systems to comprehensive service delivery.

Emory University, Interfaith Health Program l 10 • Develop and make widely available mechanisms to support the organizational development of FBOs. In order to develop such mechanisms governmental partners must understand the particular characteristics of FBOs and understand their existing and potential capacity. This allows for funding opportunities and partnerships to be developed to grow such capacities and address organizational challenges. This study helps the CDC to understand the scope of FBO contributions to HIV service delivery as a step to developing such mechanisms.

• Increase FBOs’ capacities to develop and implement effective programs or to strengthen existing programs. This study contributes to knowledge about the kinds of activities that FBOs can or already are doing well and to identify areas where FBO contributions are more limited.

• Expand FBO networks by bringing in new or previously unaffiliated FBOs and engaging other religious traditions. Within Kenya, most faith-based health systems have been developed and supported by various Christian traditions, both mainline Protestant and Roman Catholic. This report includes services offered by these providers from these traditions as well as those from other Christian traditions and from Muslim FBOs. See Appendix 1 for a list of FBOs registered through the eHealth facility database. See Appendix 3 for a county-by-county list of those that offer HIV services.

Describing the contributions of faith-based health systems helps to build the case for the important role of FBOs in sustained, effective, country-led responses to HIV/AIDS. Such efforts are crucial for building collaboration across sectors and assuring that effective FBOs play key leadership roles in HIV planning and service delivery. This report, then, is one of the ways that the CDC is working to strengthen collaboration with its faith-based partners and to continue its efforts to respond to the key recommendations that those partners provided in 2012.

11 l Emory University, Interfaith Health Program Methodology Employed in this Study

The Interfaith Health Program Public Private Partnership worked with the CDC to develop a mixed- method approach to gathering the data that are presented in this report. The methodology employs both quantitative and qualitative components, and the original proposed design was modified over the course of the program in response to unforeseen challenges in carrying out the approach as originally envisioned. The methodology was deigned to accomplish two key objectives:

Objective #1: Conduct a Country Level Assessment of Facility-Level Data Sources

This objective focuses on identifying key country-level datasets to assess FBO HIV health service delivery in Kenya. In developing action steps for meeting this objective, the IHP PPP staff consulted with public health researchers who are recognized experts in the areas of health systems, health information systems, and faith-based health systems. The team decided on the proposed scope and parameters of the assessment and made the following recommendations to DGHA staff at the CDC:

● Focus on relevant data sources pertaining to all HIV service delivery in the country regardless of funding source (e.g., Global Fund, UNAIDS, Government of Kenya, in addition to PEPFAR):

• Data would describe services across all sectors (faith-based, governmental, private, civil society). • Data would describe the scope of services provided by the faith-based sector, contributing to the knowledge related to the proportion of HIV services provided by FBOs

● Use PEPFAR data sources to provide specific data for an assessment of the percentage of all services that are funded through PEPFAR.

Activity #1: The IHP PPP staff worked with DGHA staff at CDC to secure the names of all named primary implementing partners working with the PEPFAR Country Office in Kenya. There were 143 primary partners listed, and upon review, IHP PPP staff identified 25 as FBOs. Having identified the primary partners, the IHP PPP staff developed a list of 16 (out of 36) essential indicators listed in the PEPFAR Next Generation Indicators Reference Guide3 upon which to focus the analysis. IHP PPP staff met with DGHA staff to discuss their rationale for the list. (See Appendix 5 for a matrix detailing the rationale for the indicators chosen). These indicators are:

1. Number of pregnant women with known HIV status

2. Number and percentage of HIV-positive pregnant women who received antiretrovirals to reduce risk of mother-to-child transmission during pregnancy

3. Number of males circumcised as part of the minimum package of MC for HIV prevention services

4. Number of people living with HIV/AIDS reached with a minimum package of Prevention with PLHIV interventions

3 The President’s Emergency Plan for AIDS Relief (2013). Next Generation Indicators Reference Guide, Version 1.2. Washington, DC: US Department of State. Emory University, Interfaith Health Program l 12 5. Number of the targeted population reached with individual and/or small group level interventions that are based on evidence and/or meet the minimum standards required

6. Number of the targeted population reached with individual and/or small group level preventive interventions that are primarily focused on abstinence and/or being faithful and are based on evidence and/or meet the minimum standards required

7. Number of MARP reached with individual and/or small group interventions that are based on evidence and/or meet the minimum standards required

8. Number of individuals receiving HIV testing and counseling services for HIV and received their test results

9. Number of eligible adults and children provided with a minimum of one core service

10. Number of HIV-positive adults and children receiving a minimum of one clinical service

11. Number of eligible clients who received food and/or other nutrition services

12. Number of adults and children with advanced HIV infection newly enrolled on ART

13. Number of adults and children with advanced HIV infection receiving antiretroviral therapy (CURRENT)

14. Percentage of adults and children known to be alive and on treatment 12 months after initiation of antiretroviral therapy

15. Number of testing facilities with capacity to perform laboratory tests.

16. Number of new health workers who graduated from a pre-service training institution

Working with DGHA staff, the IHP PPP staff submitted a request to the Office of the Global Aids Coordinator (OGAC), the headquarters staff of PEPFAR’s global programs, for annual data available for the last five years on these sixteen indicators for all primary implementing partners (both the 25 faith-based and the 118 non faith-based).

Activity #2: IHP PPP staff determined key national databases in Kenya that would be relevant to carry out the project. Two were identified: the eHealth database and the Kenya Health Information System (KHIS) database. The eHealth database is a web-based, searchable platform of health facilities registered with the Government of Kenya. This database generated a file of 9,428 health facilities with fields for 49 different data points. For the purposes of this study, the list was disaggregated by County to determine geographic location, Type to determine the level and variety of services offered, and Owner to determine which facilities are faith-based. The second database, the Kenya Health Information System (KHIS) database, is a web-based portal that allows registered users to access health delivery services data. Working with colleagues in Kenya, IHP PPP staff constructed a data file listing services on ten indicators (chosen as proxies for the PEPFAR indicators; in many instances, these indicators were similar or identical to the PEPFAR indicators) in all 47 counties in Kenya. This file listed every health facility by county and provided data related to the ten indicators. Facilities were included in the file even if they reported no data on HIV service delivery so that the complete list of facilities could be matched against that generated by eHealth.

13 l Emory University, Interfaith Health Program Activity #3: IHP PPP staff reviewed the data they had received, disaggregating the KHIS service delivery data by type of organization (faith-based or not). The KHIS data did not identify facilities by type, thus IHP PPP used the faith-based facilities list from eHealth to accomplish the disaggregation. Disaggregated data for each county was also entered into a composite data sheet for all counties to consolidate the national numbers for service delivery. In August 2013, IHP PPP staff became aware of a new HIV prevention strategic plan under development by the Government of Kenya, under the auspices of the National AIDS Control Council (NACC) and the National AIDS/STI Control Programme (NASCOP). IHP PPP staff was provided a draft version of the document detailing components of the plan entitled The HIV Prevention Revolution Roadmap.4 The new strategic plan clusters Kenya’s forty-seven counties into high-, medium-, and low-HIV incidence. IHP PPP staff also created data files for each cluster. Since the counties were clustered by incidence and prevalence rates but those rates were not available in the draft document, IHP PPP staff calculated incidence and prevalence rates for each county and for each cluster using data from the Kenya County Fact Sheets, 2nd edition5 since neither the eHealth nor the KHIS databases included these data.

The IHP PPP received two data files from PEPFAR, one from the Kenya Country Office and one from DGHA. The data file from the country office provided data on only 9 of the 25 primary partners identified and did not contain composite data for the 188 primary implementing partners listed. As such, this did not allow for a determination of the proportion of services provided by these nine FBOs. The data file from DGHA provided data on eight of the sixteen indicators for six of the twenty-five FBO primary partners. It also provided additional data on all primary partners so that the proportion of services provided by the six partners could be calculated. In addition, the DGHA data provided information on budget expenditures.

With the support of colleagues from CHAK, the IHP PPP team had access to aggregate data from the CDC HIV/AIDS Programme (CHAP). CHAP is a CDC program that provides funding to 51 health facilities offering HIV primary care services, 34 of which are FBOs. Indicators in this data set matched those in the KHIS but time periods were not consonant so there was no way to concatenate and cross-verify data from the two sources; however, discrepancies between the data reported in the two sets did raise questions about services data not being fully reported to the KHIS system.

Because of the gaps in data, the IHP PPP staff focused the study on the eHealth and KHIS sources. Findings from that data will be discussed in the Findings section below.

Objective #2: Conduct a Qualitative Study of FBO Distinctive Characteristics Regarding HIV Services

Activity #4: In order to determine a specific focus for the qualitative study, the IHP PPP staff conducted a systematic literature review of research using PubMed, Web of Knowledge, and EBSCO Complete databases, limiting the search to articles published between 2000-2013. The initial search produced a large number of citations; these were assessed for relevance to this project. Once key publications were identified, IHP PPP staff looked for sources cited by these key documents and for subsequent articles that cited the key documents. The review produced a small group of key documents representing a cross section of quantitative and mixed-method research, policy and program reports, and religious/theological reflections. An

4 National AIDS Control Council and National AIDS and STI Control Programme (2013). Kenya HIV Prevention Revolution Road Map. Nairobi: Government of Kenya. 5 Commission on Revenue Allocation (2013). Kenya County Fact Sheets, 2nd edition. Nairobi: Kenya Commission on Revenue Allocation. Emory University, Interfaith Health Program l 14 assessment of these documents led the IHP PPP staff to focus on trust as a factor for qualitative study. They chose to focus on trust as the subject of the qualitative study because this factor is often listed as a particular strength of faith-based organizations (see Appendix 6 for a list of keywords used to conduct the literature review and citations reviewed).

Activity #5: A student in the Masters of Public Health program at the Rollins School of Public Health developed a study plan consisting of key informant and focus group interview surveys. This was submitted to Emory’s Institutional Review Board (IRB) for approval. The student worked in a field placement with the Christian Health Association of Kenya (CHAK) in June and July of 2013. As part of her work, she conducted key informant interviews and held focus groups with both consumers and providers in a selected sample of CHAK facilities chosen to represent large urban, medium-sized city, and rural contexts.

Interviews and focus groups were recorded. Groups were conducted in English, Swahili, or Kikuyu with CHAK staff serving as translators/interpreters. All interviews were transcribed, with CHAK staff and Kenyan graduate students at Emory serving as interpreters for the non- English interviews. The transcripts were reviewed to identify key themes to complete the narrative analysis.

Figure 1 illustrates the various steps involved in both the quantitative and qualitative methodologies. Following both of these methodologies yielded a set of quantitative and qualitative data which form the basis of the findings presented in this report.

15 l Emory University, Interfaith Health Program Figure 1: Country Case Study Methodology

Emory University, Interfaith Health Program l 16 Findings: The Scope of Services Provided by Faith-based Health Facilities

Faith-based health facilities in Kenya are key resources in the country’s health service system. Using the eHealth database, the IHP PPP staff identified 1,072 faith-based (FB) health facilities in Kenya out of a total 9,428 facilities (including both public and private sector). FBOs comprise 11.3% of all health facilities. Of the faith-based facilities, 379 (35.3%) are owned by the Christian Health Association of Kenya (CHAK), 402 (37.5%) are owned by the Kenya Episcopal Conference (KEC) of the Roman Catholic Church, 12 (1.1%) are owned by the Supreme Council of Kenyan Muslims, and 280 (26.1%) are owned by other faith-based organizations. See Table 1 for a list of numbers and types of facilities in Kenya. For a complete table that includes the number and types of facilities listed in this table as “other” see Appendix 1: Number and Types of Health Facilities in Kenya. Appendix 2: Complete List of Faith-Based Facilities by FBO Network and Facility Type, contains an alphabetical list of the facilities owned by CHAK, KEC, SUPKEM, and Other Faith-Based Organizations; it also includes the province and county where each listed facility is located.

Table 1: Number and percentage of faith-based health facilities

Type of Facility Total % FB

FB FB

EM

KEC

Total

Other

SUPK

CHAK Dispensary 283 232 5 160 680 4,293 15.8 Eye Centre 1 1 0 0 2 10 20.0 Health Centre 42 80 3 44 169 1,041 16.2 Health Programme 0 4 0 1 5 12 41.7 Maternity Home 2 1 0 0 3 48 6.3 Medical Clinic 26 25 2 32 85 3,013 2.9 Nursing Home 3 3 0 4 10 189 5.3 Other Hospital 14 48 1 22 85 235 36.2 Stand-Alone VCT Centre 7 7 1 17 32 154 20.8 Other (Specialty, government-only) 1 0 0 0 1 433 0.2 TOTAL 379 401 12 280 1,072 9,428 11.3

Among facilities in the public sector (both governmental and non-governmental), faith-based health facilities comprise 18.4% of all facilities. Among the non-governmental public sector, 70.0% of facilities are faith-based (Table 2).

Table 2: Number and percentage of faith-based health facilities in the public/non-governmental sector

Type of Facility Faith-Based Non Faith-Based TOTAL % FB Dispensary 680 199 879 77.4 Eye Centre 2 0 2 100.0 Health Centre 169 34 203 83.3 Health Project 0 6 6 0.0 Health Programme 5 3 8 62.5 Maternity Home 3 5 8 37.5 Medical Centre 0 4 4 0.0 Medical Clinic 85 120 207 41.1 Nursing Home 10 6 16 62.5 Other Hospital 85 7 92 92.4 Stand-Alone VCT Centre 32 73 105 30.5 Other (Specialty, government-only) 1 3 4 25.0 TOTAL 2 460 2 70.0

17 l Emory University, Interfaith Health Program Each of the faith-based networks—CHAK, KEC, and SUPKEM—provide a variety of services to people living with HIV or AIDS (PLHIV) with both CHAK and KEC providing the greatest percentage (19.5% and 59.6% respectively, Table 3). In addition, other faith-based organizations provided 20.5% of services to PLHIV. These other faith-based organizations are diverse, comprising programs run by Christian organizations not part of CHAK or independent, grass-roots FBOs (both Christian and Muslim).6 Table 3 provides numbers and percentages of treatment visits for PLHIV provided by faith-based organizations. See Appendix 2 for a county-by-county list of health facilities registered in the eHealth database, and the numbers and percentages of visits for PLHIV that these organizations provide in comparison to the total number of visits.

Table 3: Numbers of visits to faith-based facilities by PLHIV who are currently seen in care by FBOs

# of Treatment visits by % of total treated Organization # of Facilities PLHIV currently seen in by FBOs care by FBOs CHAK 62 209,688 18.9 KEC 123 630,525 56.9 Other Faith-Based 43 265,497 24.0 SUPKEM 2 1,741 0.2 TOTAL 212 1,107,451 100

Although FBOs have been perceived by some to avoid providing care to PLHIV because of judgmental attitudes, in fact a significant proportion of FBOs provide services. 16.4% of CHAK’s facilities provided treatment visits to PLHIV in 2012, the year that the data from KHIS reported on, as did 30.7% of KEC facilities, 16.7% of SUPKEM facilities, and 15.4% of other faith-based facilities. These percentages do not include additional services FBOs might offer such as voluntary counseling and testing (VCT), couples voluntary counseling and testing (CVCT), or prevention of mother-to-child transmission (PMTCT) services.

FBO provision of HIV services is striking in Nairobi, Mombasa, Turkana, , and Counties—all counties with high prevalence and incidence rates. In Nairobi, 67.4% (60 of 89) of FBOs provide at least one service to PLHIV compared to 37.0% of all facilities. In Mombasa, 50% of FBOs (7 of 14) provide at least one service, compared to 38.4% of all facilities. In Homa Bay, 85.2% of FBOs (23 of 27) provide at least one service; a majority of all types of facilities—79.5% (159 of 200)—provide such services in Homa Bay. Forty-five % of FBOs (18 of 40) provide services to PLHIV in , compared to 18.6% (27 of 145) of all facilities. Finally, in 85.7% of FBOs (12 of 14) provide HIV services, compared to 65.7% (94 of 143) of all facilities. See Appendix 3 for a list of numbers of facilities and numbers of treatment visits provided in each county.

Across the 47 counties that reported data to KHIS, faith-based facilities provide an average of 22.0% of HIV treatment visits (1,107,451 of 5,040,206 treatment visits) reported through the KHIS database. The percentage of visits provided by faith-based facilities ranged from a high of 58.6% in Nairobi to 0% in 7 counties (, , , , Nandi, Trans Nzoia, and Murang'a). Table 4 ranks Kenya’s counties from highest to lowest based on percentage of HIV treatment visits provided by faith-based facilities.

6 For a discussion of the various types of faith-based organizations, see A Firm Foundation: The PEPFAR Consultation on the Role of Faith-based Organizations in Sustaining Community and Country Leadership in the Response to HIV/AIDS, pp. 23-25. Available at http://ihpemory.org/publications/ihp-reports/ Emory University, Interfaith Health Program l 18 Table 4: Kenya counties ranked by percentage of total # of treatment visits by PLHIV provided by FBOs

# of treatment visits by # of treatment visits by COUNTY PLHIV currently seen in PLHIV currently seen in % offered by FBOs care care provided by FBOs Nairobi 720,087 422,139 58.6 Mombasa 219,412 118,617 54.1 Tharaka Nithi 29,908 13,470 45.0 Turkana 31,739 12,792 40.3 73,366 29,115 39.7 Meru 70,968 25,133 35.4 Kirinyaga 18,184 5,317 29.2 35,772 9,094 25.4 246,445 59,359 24.1 Kisumu 478,156 93,684 19.6 179,363 30,683 17.1 38,778 6,627 17.1 Homa Bay 470,952 76,945 16.3 28,116 4,511 16.0 128,038 18,821 14.7 Migori 356,197 51,608 14.5 Taita Taveta 23,186 3,016 13.0 112,949 13,995 12.4 Samburu 35,772 4,385 12.3 Nyandarua 34,365 4,195 12.2 Makueni 81,042 9,681 11.9 52,448 6,133 11.7 Laikipia 19,103 1,595 8.4 Busia 229,864 19,021 8.3 593,508 45,393 7.7 41,852 2,997 7.2 Embu 59,851 3,786 6.3 Tana River 1,685 93 5.5 Uasin Gishu 51,379 2,623 5.1 West Pokot 9,822 414 4.2 Elgeyo Marakwet 11,911 498 4.2 67,811 2,815 4.2 33,006 1,218 3.7 36,382 1,256 3.5 75,368 2,400 3.2 8,326 253 3.0 68,804 1,791 2.6 Baringo 23,761 576 2.4 Kisii 70,524 1,402 2.0 Isiolo 1,150 0 0.0 Garissa 3,955 0 0.0 Mandera 262 0 0.0 Wajir 82 0 0.0 Nandi 39,704 0 0.0 Trans Nzoia 89,820 0 0.0 Murang'a 37,033 0 0.0 0 0 0.0 TOTAL 5,040,206 1,107,451 22.0

19 l Emory University, Interfaith Health Program While faith-based facilities do indeed provide a great deal of HIV services in Kenya, the percentages vary across Kenya’s provinces. Table 5 illustrates, for example, that in the Northeast Province, where prevalence is quite low, no FBO registered in eHealth provided treatment visits to PLHIV. In contrast, 58.6% of such visits in Nairobi were provided by an FBO.

Table 5: Kenya provinces ranked by percentage of total # of treatment visits by PLHIV provided by FBOs

# of treatment visits by # of treatment visits by % offered Province PLHIV currently seen PLHIV currently seen in by FBOs in care care provided by FBOs North 4,299 0 0.0 602,320 55,608 9.2 183,882 18,642 10.1 2,037,148 271,847 13.3 Eastern Province 346,403 58,981 17.0 729,038 138,178 19.0 417,029 142,056 34.1 720,087 422,139 58.6 TOTAL 5,040,206 1,107,451 22.0

A New Prevention Strategy for Kenya

Kenya has begun to reformulate its HIV prevention strategy and The HIV Prevention Revolution Roadmap makes the case for a series of structural, biomedical, and behavioral interventions focused in high incidence counties (Figure 2).

Emory University, Interfaith Health Program l 20 Figure 2: The HIV Prevention Revolution Roadmap

Comprise 53.43% of Comprise 44.65% of infections Comprise 1.9% of infections infections Prevalence rate = Prevalence rate = 8.21%

Prevalence rate= .9% 2.93% Total pop.=10,521,543 Total Pop= 3,216,152 Total pop.=24,632,327 (27.25% of country) (8.33% of population) (63.8% of country) HighIncidence # people with # people with # people with HIV=863,600 HIV=28,200 HIV=721,400 Incidence rate=.55% Incidence rate= .11% Middle Incidence Incidence rate=.19% (Range: .26-.99%) (Range: .00%-.11%) (Range: .15-.25%) Incidence 9 Counties 7 Counties 31 Counties

Low

From national approach Timely data on High, Medium , Low Timely incidence to county clusters granularity of incidence cluster surveillance approach epidemics

From intervention driven By Key By bridging to populations driven By age group responses populations populations

From heavily biomedical Combination Faster integration dependent to a prevention mix of research Unified and combination of package by findings into coordinated R&D behavioural and cluster and policy and for HIV prevention structural populations practice

Fromhealth sector driven HIV prevention to Leverage political Leverage social Legal and HIV prevention is leadership movements structural reforms everyone's business

21 l Emory University, Interfaith Health Program This strategy prioritizes resources based on HIV incidence at the county level and divides Kenya’s forty-seven counties into clusters of high incidence (9), medium incidence (31) and low incidence (7).

Table 6: Kenya counties classified by HIV incidence according the country's new HIV prevention strategy.

High-Incidence Counties Medium-Incidence Counties Low-Incidence Counties

Nairobi, HomaBay, Kisumu, Nakuru, Kakamega, Kiambu, Garisa, Wajir, Mandera, West Siaya, Migori, Mombasa, Transzoia, Muranga, Machakos, Pokot, Tana River, Marsabit, Turkana, Busia, Kisii Kajiado, Makueni, Bomet, Uasin Lamu Gishu, Kitui, Meru, Bungoma, Kericho, Kwale, Nandi, Narok, Kilifi, Nyeri, Vihiga, Nyamira, Kirinyaga, Nyandarua, Taita Taveta, Tharaka, Embu, Baringo, Elgeyo Marakwet, Laikipia, Samburu, Isiolo

Faith-based health facilities provide 26.5% of HIV treatment services in the nine counties with the highest incidence rates that are the sites for focused interventions. Across the nine counties, faith- based health facilities are providing 27.9% of antiretroviral therapy; they are providing an impressive 60.7% of antiretroviral therapy in Nairobi and 67.3% in Mombasa. See Table 7 for further data on the county clusters, including population, incidence rate, and prevalence rate. See Tables 8a-c for information about the percentage of antiretroviral therapy (ART) services provided by faith-based facilities in each county.

Emory University, Interfaith Health Program l 22 Table 7: Kenya counties with population, incidence, prevalence, and visits arranged by incidence clusters

# of % of # of Treatment Treatment County Treatment Visits by Visits by Visits by PLHIV PLHIV # of % New % HIV County PLHIV Currently Currently PLHIV Prevalence Infections Incidence High cluster Population1 Medium cluster Currently Seen in Seen in 20111 Rate 2011 20111 Rate 2011 Low cluster Seen in Care Care Care 2 Provided by Provided by FBOs2 FBOs Nairobi 720,087 422,139 58.6 3,138,369 199,100 6.3 13,510 0.4 Mombasa 219,412 118,617 54.1 939,370 77,100 8.2 4,930 0.5 Turkana 31,739 12,792 40.3 855,399 51,200 6.0 3,210 0.4 Kisumu 478,156 93,684 19.6 968,909 113,000 11.7 7,100 0.7 Homa Bay 470,952 76,945 16.3 963,794 150,000 15.6 9,500 1.0 Migori 356,197 51,608 14.5 917,170 68,700 7.5 4,350 0.5 Kisii 70,524 1,402 2.0 1,152,282 73,300 6.4 4,580 0.4 Busia 229,864 19,021 8.3 743,946 30,800 4.1 1,940 0.3 Siaya 593,508 45,393 7.7 842,304 100,400 11.9 6,300 0.8 Tharaka Nithi 29,908 13,470 45.0 365,330 12,000 3.3 800 0.2 Vihiga 73,366 29,115 39.7 554,622 19,600 3.5 1,360 0.3 Meru 70,968 25,133 35.4 1,356,301 29,100 2.2 1,940 0.1 Kirinyaga 18,184 5,317 29.2 528,054 14,600 2.8 1,020 0.2 Narok 35,772 9,094 25.4 850,920 23,100 2.7 1,490 0.2 Kakamega 246,445 59,359 24.1 1,660,651 55,500 3.3 3,440 0.2 Bungoma 179,363 30,683 17.1 1,375,063 27,800 2.0 1,720 0.1 Bomet 38,778 6,627 17.1 891,835 18,700 2.1 1,250 0.1 Kitui 28,116 4,511 16.0 1,012,709 27,700 2.7 1,830 0.2 Kilifi 128,038 18,821 14.7 1,109,735 24,100 2.2 1,600 0.1 Taita Taveta 23,186 3,016 13.0 284,657 12,500 4.4 800 0.3 Nakuru 112,949 13,995 12.4 1,603,325 57,800 3.6 3,770 0.2 Samburu 35,772 4,385 12.3 223,947 6,400 2.9 450 0.2 Nyandarua 34,365 4,195 12.2 596,268 13,700 2.3 920 0.2 Nyeri 52,448 6,133 11.7 693,558 20,800 3.0 1,380 0.2 Laikipia 19,103 1,595 8.4 399,227 10,500 2.6 690 0.2 Kiambu 41,852 2,997 7.7 1,623,282 47,100 2.9 3,200 0.2 Embu 59,851 3,786 6.3 516,212 12,700 2.5 800 0.2 Uasin Gishu 51,379 2,623 5.1 894,179 28,600 3.2 1,830 0.2 Elgeyo Marakwet 11,911 498 4.9 369,998 8,400 2.3 570 0.2 Nyamira 67,811 2,815 4.2 598,252 18,700 3.1 1,300 0.2 Kajiado 33,006 1,218 3.7 687,312 22,200 3.2 1,380 0.2 Kwale 36,382 1,256 3.5 649,931 23,400 3.6 1,490 0.2 Machakos 75,368 2,400 3.2 1,098,584 33,600 3.1 2,180 0.2 Kericho 68,804 1,791 2.6 590,690 16,400 2.8 1,030 0.2 Baringo 23,761 576 2.4 555,561 13,400 2.4 910 0.2 Isiolo 1,150 0 0.0 143,294 3,200 2.2 230 0.2 Makueni 81,042 9,681 11.9 884,527 29,800 3.4 1,900 0.2 Nandi 39,704 0 0.0 752,965 22,100 2.9 1,380 0.2 Trans Nzoia 89,820 0 0.0 818,757 34,800 4.3 2,280 0.3 Murang'a 37,033 0 0.0 942,581 33,100 3.5 2,180 0.2 West Pokot 9,822 414 4.2 512,690 6,600 1.3 450 0.1 Lamu 8,326 253 3.0 101,539 800 0.8 10 0.0 Garissa 3,955 0 0.0 623,060 10,500 1.7 680 0.1 Tana River 1,685 93 5.5 240,075 2,600 2.0 120 0.0 Mandera 262 0 0.0 1,025,756 7,800 0.8 460 0.0 Wajir 82 0 0.0 661,941 800 0.1 10 0.0 Marsabit 0 0 0.0 291,166 1,700 0.6 110 0.0 National Totals 5,040,206 1,107,451 22.0 38,610,097 1,615,800 4.2 104,380 0.3 # High Cluster 3,170,439 841,601 10,521,543 863,600 55,420 % High Cluster 62.9 76.0 26.5 27.3 53.5 8.2 53.1 0.6 # Medium Cluster 1,845,635 265,090 24,632,327 721,400 47,120 % Medium Cluster 36.6 23.9 14.4 63.8 44.7 2.9 45.1 0.2 # Low Cluster 24,132 760 3,216,152 28,200 1,720 % Low Cluster 0.5 0.1 3.1 8.3 1.8 0.9 107 0.1 1 Kenya County Fact Sheets, 2013. Kenya Commission on Revenue Allocation. https://www.opendata.go.ke/Counties/County-Fact-Sheets-2nd-Ed- June-2013/qg44-68h8 2 Kenya Health Information System. Data generated June 2013

23 l Emory University, Interfaith Health Program Table 8a: Percentage of services provided by FBOs in high-incidence cluster counties

# HIV Total Total F(<15) F(15+) M(<15) M(15+) <1 year County Treatment Tested Currently Curr on Curr on Curr on Curr on Curr on Visits HIV on ART ART ART ART ART ART Nairobi 720,087 496,655 543,368 20,146 326,957 19,459 175,847 959 Provided by FB 422,139 229,833 329,557 13,163 196,866 11,833 107,042 653 % FB 58.6 46.3 60.7 65.3 60.2 60.8 60.9 68.1 Mombasa 219,412 137,052 199,610 8,875 115,072 8,947 66,473 242 Provided by FBO 118,617 33,599 134,839 6,898 78,025 6,902 42,881 133 % FB 54.1 24.5 67.6 77.7 67.8 77.1 64.5 55.0 Turkana 31,739 38,020 20,041 1,193 9,576 1,060 8,212 139 Provided by FB 12,792 22,110 7,957 4,107 2,739 513 2,739 56 % FB 40.3 58.2 39.7 42.9 33.4 48.4 33.4 40.3 Kisumu 478,156 173,145 333,338 17,396 188,960 17,325 108,279 1,378 Provided by FB 93,684 24,555 62,173 3,358 36,709 3,156 18,756 194 % FB 19.6 14.2 18.7 19.3 19.4 18.2 17.3 14.1 Homa Bay 470,952 134,965 283,892 16,100 161,645 13,487 91,262 1,398 Provided by FB 76,945 12,854 48,597 2,320 29,538 2,335 14,273 131 % FB 16.3 9.5 17.1 14.4 18.3 17.3 15.6 9.4 Migori 356,197 162,654 214,305 12,504 125,475 10,720 64,462 1,144 Provided by FB 51,608 10,943 40.563 1,800 23.927 2,114 12,697 25 % FB 14.5 6.7 18.9 14.4 19.1 19.7 19.7 2.2 Kisii 70,524 113,044 43,754 2,282 26,528 2,031 12,767 146 Provided by FB 1,402 3,067 710 44 419 71 168 8 % FB 2.0 2.7 1.6 1.9 1.6 3.5 1.3 5.5 Busia 229,864 61,697 172,753 7,958 107,560 7,333 49,363 539 Provided by FB 19,021 5,251 9,165 464 5,553 431 2,709 8 % FB 8.3 8.5 5.0 5.8 5.2 5.9 5.5 1.5 Siaya 593,508 119,202 424,929 21,979 244,782 21,673 135,001 1,494 Provided by FB 45,393 11,978 41,375 1,960 23,421 2,009 13,847 138 % FB 7.7 10.1 9.7 8.9 9.6 9.3 10.3 9.2 High Cluster Total 3,170,439 1,436,434 2,235,990 108,433 1,306,555 102,035 711,666 7,439 FB Totals 841,601 354,190 622,763 35,808 367,956 28,377 211,192 1,309 % FB 26.5 24.7 27.9 33.0 28.2 27.8 29.7 17.6

Emory University, Interfaith Health Program l 24 Table 8b: Percentage of services provided by FBOs in medium-incidence cluster counties

# HIV Total Total F(<15) F(15+) M(<15) M(15+) <1 year County Treatment Tested Currently Curr on Curr on Curr on Curr on Curr on Visits HIV on ART ART ART ART ART ART Tharaka Nithi 29,908 29,780 22,333 1,674 12794 1,467 6,313 85 Provided by FB 13,470 4,250 9,283 649 5485 599 2,524 26 % FB 45.0 14.3 41.6 38.8 42.9 40.8 40.0 30.6 Vihiga 73,366 41,849 51,261 2,644 31,269 3,110 13,936 302 Provided by FB 29,115 4,673 22,942 971 13,910 1,280 6,647 134 % FB 39.7 11.2 44.8 36.7 44.5 41.2 47.7 44.4 Meru 70,968 125,091 55,641 3,646 32,983 3,105 15,557 350 Provided by FB 25,133 21,071 20,387 1,603 12,190 1,377 5,197 20 % FB 35.4 16.8 36.6 44.0 37.0 44.3 33.4 5.7 Kirinyaga 18,184 16,038 13,599 614 8,282 674 4,006 23 Provided by FB 5,317 2,140 4,515 233 2,800 239 1,239 4 % FB 29.2 13.3 33.2 37.9 33.8 35.5 30.9 17.4 Narok 35,772 44,056 25,264 1,187 14,719 1,432 7,817 109 Provided by FB 9,094 9,475 5,397 330 3,238 388 1,431 10 % FB 25.4 21.5 21.4 27.8 22.0 27.1 18.3 9.2 Kakamega 246,445 139,100 162,699 8,586 100,448 7,955 45,334 376 Provided by FB 59,359 19,537 40,759 2,059 25,233 1,953 11,354 160 % FB 24.1 14.1 25.1 24.0 25.1 24.6 25.0 42.6 Bungoma 179,363 128,260 145,834 7,571 87,659 7,155 43,192 257 Provided by FB 30,683 15,541 28,147 1,834 17,728 1,776 6,768 41 % FB 17.1 12.1 19.3 24.2 20.2 24.8 15.7 16.0 Bomet 38,778 42,801 21,267 1,398 12,244 981 6,634 10 Provided by FB 6,627 6,075 6,317 354 3,567 331 2,065 0 % FB 17.1 14.2 29.7 25.3 29.1 33.7 31.1 0.0 Kitui 28,116 54,309 33,469 2,510 21,119 2,555 7,169 116 Provided by FB 4,511 3,145 3,020 262 1,921 257 566 14 % FB 16.0 5.8 9.0 10.4 9.1 10.1 7.9 12.1 Kilifi 128,038 146,759 99,160 6,000 62,738 6,146 24,100 176 Provided by FB 18,821 13,504 13,537 1,031 8,488 1,196 2,807 15 % FB 14.7 9.2 13.7 17.2 13.5 19.5 11.6 8.5 Taita Taveta 23,186 29,628 19,619 1,140 12,259 1,324 4,833 63 Provided by FB 3,016 1,379 2,437 170 1,566 170 529 2 % FB 13.0 4.7 12.4 14.9 12.8 12.8 10.9 3.2 Nakuru 112,949 125,164 93,245 5,313 53,070 4,439 30,310 113 Provided by FB 13,995 16,310 10,215 446 5,803 529 3,428 9 % FB 12.4 13.0 11.0 8.4 10.9 11.9 11.3 8.0 Samburu 35,772 8,508 4,481 274 2,669 358 1167 13 Provided by FB 4,385 1,083 621 44 366 58 144 9 % FB 12.3 12.7 13.9 16.1 13.7 16.2 12.3 69.2 Nyandarua 34,365 30,515 23,235 1,591 13,437 1,770 6,247 190 Provided by FB 4,195 5,260 5,475 408 3,082 439 1,378 168 % FB 12.2 17.2 23.6 25.6 22.9 24.8 22.1 88.4 Makueni 81,042 88,383 70,923 6,184 38,586 4,954 20,819 380 Provided by FB 9,681 13,911 7,418 428 4,148 561 2,257 24 % FB 11.9 15.7 10.5 6.9 10.8 11.3 10.8 6.3 Nyeri 52,448 45,825 55,271 3,214 32,617 3,200 16,132 108 Provided by FB 6,133 3,347 5,781 406 3,407 302 1,605 61 % FB 11.7 7.3 10.5 12.6 10.4 9.4 9.9 56.5

25 l Emory University, Interfaith Health Program Laikipia 19,103 22,636 19,157 1,120 11,541 1,226 5,238 32 Provided by FB 1,595 1,230 423 40 236 30 113 4 % FB 8.4 5.4 2.2 3.6 2.0 2.4 2.2 12.5 Kiambu 41,852 39,665 36,431 1,853 21,812 1,864 10,884 18 Provided by FB 2,997 2,749 2,597 130 1,613 150 703 1 % FB 7.2 6.9 7.1 7.0 7.4 8.0 6.5 5.6 Embu 59,851 59,478 49,613 3,370 30,050 3,035 13,038 120 Provided by FB 3,786 3,156 4,401 288 2,621 307 1,174 11 % FB 6.3 5.3 8.9 8.5 8.7 10.1 9.0 9.2 Uasin Gishu 51,379 16,328 44,626 2,475 25,548 2,289 14,251 63 Provided by FB 2,623 3,632 2,491 310 1,346 223 599 13 % FB 5.1 22.2 5.6 12.5 5.3 9.7 4.2 20.6 Elgeyo Marakwet 1,1911 26,628 10,566 464 6,480 618 2913 91 Provided by FB 498 1,881 225 3 175 18 29 0 % FB 4.2 7.1 2.1 0.6 2.7 2.9 1.0 0.0 Nyamira 67,811 124,603 5,4640 2,422 33,029 2,375 16,406 408 Provided by FB 2,815 7,860 1,482 60 920 108 385 9 % FB 4.2 6.3 2.7 2.5 2.8 4.5 2.3 2.2 Kajiado 33,006 111,067 43,757 2,166 27,219 2,220 12,061 91 Provided by FB 1,218 33,085 928 25 570 52 281 0 % FB 3.7 29.8 2.1 1.2 2.1 2.3 2.3 0.0 Kwale 36,382 43,816 25,673 1,714 16,545 1,519 5,778 117 Provided by FB 1,256 1,035 668 4 410 70 184 0 % FB 3.5 2.4 2.6 0.2 2.5 4.6 3.2 0.0 Machakos 75,368 84,230 79,168 6,451 45,217 5,160 22,083 257 Provided by FB 2,400 7,234 5,354 595 2,878 439 1,431 11 % FB 3.2 8.6 6.8 9.2 6.4 8.5 6.5 4.3 Kericho 68,804 83,094 40,182 2,181 22,048 2,094 13,828 31 Provided by FB 1,791 6,831 4,156 419 2,044 440 1,251 2 % FB 2.6 8.2 10.3 19.2 9.3 21.0 9.0 6.5 Baringo 23,761 16,777 18,174 1,132 11,049 1,181 4,758 54 Provided by FB 576 1,309 270 11 154 16 87 2 % FB 2.4 7.8 1.5 1.0 1.4 1.4 1.8 3.7 Isiolo 1,150 5,735 295 25 138 45 70 17 Provided by FB 0 985 0 0 0 0 0 0 % FB 0.00 17.2 0.0 0.0 0.0 0.0 0.0 0.0 Nandi 39,704 69,654 32669 1596 19317 1571 9942 243 Provided by FB 0 2,441 0 0 0 0 0 0 % FB 0.00 3.50% 0.0 0.0 0.0 0.0 0.0 0.0 Trans Nzoia 89,820 52,359 71,370 4,211 44,069 3,989 18,920 181 Provided by FB 0 7,419 0 0 0 0 0 0 % FB 0.00% 14.17% 0.0 0.0 0.0 0.0 0.0 0.0 Murang'a 37,033 36,707 37,290 2,166 21,843 2,080 11,149 52 Provided by FB 0 606 0 0 0 0 0 0 % FB 0.00 1.65 0.0 0.0 0.0 0.0 0.0 0.0 Medium Cluster Total 1,845,635 1,888,843 1,409,953 86,892 872,798 81,891 414,885 4,446 FB Totals 265,090 222,154 186,438 13,113 125,899 13,308 56,176 750 % FB 14.4 11.8 13.2 15.1 14.4 16.3 13.5 16.9

Emory University, Interfaith Health Program l 26 Table 8c: Percentage of services provided by FBOs in low-incidence cluster counties

# HIV Total Total F(<15) F(15+) M(<15) M(15+) <1 year County Treatment Tested Currently Curr on Curr on Curr on Curr on Curr on Visits HIV on ART ART ART ART ART ART West Pokot 9,822 28,464 8,533 467 5,189 476 2,388 13 Provided by FB 414 4,505 378 17 173 28 160 0 % FB 4.2 15.8 4.4 3.6 3.3 5.9 6.7 0.0 Lamu 8,326 14,664 5,664 370 3,349 299 1,624 22 Provided by FB 253 285 169 16 110 9 32 2 % FB 3.0 2.0 3.0 4.3 3.3 3.0 2.0 9.1 Garissa 3,955 10,859 2,093 170 1,264 132 524 3 Provided by FB 0 0 0 0 0 0 0 0 % FB 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Mandera 262 5,871 408 0 184 22 202 0 Provided by FB 0 0 0 0 0 0 0 0 % FB 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Wajir 82 10,322 200 0 7 108 10 75 Provided by FB 0 0 0 0 0 0 0 0 % FB 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Marsabit No data 590 229 15 132 21 61 0 Provided by FB No data 590 229 15 132 21 61 0 % FB No data 100.0 100.0 100.0 100.0 100.0 100.0 0.0 Tana River 1,685 6,135 2,041 92 1,256 144 544 5 Provided by FB 93 2,656 105 0 47 0 58 0 % FB 5.5 43.2 5.1 0.0 3.7 0.0 10.7 0.0 Low Cluster Total 24,132 76,905 19,168 1,114 11,381 1,202 5,353 118 FB Totals 760 8,036 881 48 462 58 311 2 % FB 3.1 10.4 4.6 4.3 4.1 4.8 5.8 1.7

27 l Emory University, Interfaith Health Program UNANSWERED QUESTIONS AND LIMITATIONS OF THE DATA

The figures presented above demonstrate the important and substantial role that FBOs and faith- based health systems play in a sustained response to HIV and AIDS in Kenya. While there is no way to measure what proportion of these programs were made possible through the support of the United States government through the President’s Emergency Plan for AIDS Relief (PEPFAR), the data provided by PEPFAR and DGHA do raise interesting issues which are described below.

FBOs have been criticized for the ways they have contributed to further stigmatization and marginalization for some people who are most vulnerable to HIV infection or for disease progression for those who are infected. These “most at-risk populations” (MARPs—also called key populations) have indeed experienced such stigma from a large number of people in religious communities.7 In light of this, some public health researchers and practitioners may view faith-based efforts at outreach to key populations with some degree of suspicion.8 It may come as some surprise, then, that just under 10% of funds (8.5% to be precise) directly allocated to MARP programs in Kenya in 2011-2013 were provided to one faith-based program, Hope Worldwide. With that funding, Hope Worldwide reached 17,574 (not known if numbers are duplicated or unduplicated) “MARP with individual and/or small group interventions that are based on evidence and/or meet the minimum standards required.” This number is undoubtedly higher, though the connections between PEPFAR funding to large governmental and nongovernmental networks which disburse that funding to a broad spectrum of in- country programs (including faith-based programs) cannot be traced. Nonetheless, the data from DGHA do demonstrate a broader set of responses from FBOs to key populations than might originally be assumed.

Whether the programs of faith-based health systems represent a sound investment is impossible to definitively answer. However, the budgetary data provided by DGHA show that FBOs were direct grantee recipients for 5.8% of PEPFAR’s 2011 budget. With those funds, they provided 8.6% of all services. While the cost per unit of service is unknown and one can reasonably assume that some services (e.g., providing ARVs) are much more costly than others on a per unit basis (e.g., VCT), faith-based health programs accounted for 12.7% of all ARV provision funded by PEPFAR through its primary partners even though FBOs received only 5.8% of funds. This supports the assumption that FBOs represent a sound investment, delivering services in a cost efficient manner.

The CHAP data provided by CHAK give evidence regarding the reliability of the KHIS data, at least in regard to HIV and AIDS services. The CHAP data provide information on service delivery for 15 governmental, 34 faith-based, and two private health facilities funded by the CDC to provide HIV clinical treatment services from October 2012-March 2013. Of the 34 faith-based facilities with data on HIV service delivery reported in CHAP, 14 of these have no data on HIV service delivery in the KHIS. These discrepancies support some subjective concerns regarding gaps in the KHIS data. For example, KHIS shows no faith-based HIV service delivery in eight counties (see Table 9):

7 For the impact of religious beliefs on MARPs, particularly in the context of PEPFAR, see Scott H. Evertz (2010). How Ideology Trumped Science: Why PEPFAR Failed to Meet Its Potential. Washington, DC: The Center for American Progress and the Council for Global Equality. Also, see Helen Epstein. (2007). The Invisible Cure: Africa, the West and the Fight Against AIDS. New York: Farrar, Straus, and Giroux. See, especially, chapter 11 in Epstein. 8 The IHP PPP will be publishing a report on best practices of select faith-based organizations in their work with key populations. Forthcoming, 2014. Emory University, Interfaith Health Program l 28 Table 9: According to KHIS data, no HIV treatment visits are provided by FBOs in these counties.

# of treatment visits by # of treatment visits by % offered COUNTY PLHIV currently seen in PLHIV currently seen in by FBOs care care provided by FBOs Garissa 3,955 0 0.0 Isiolo 1,150 0 0.0 Mandera 262 0 0.0 Murang'a 37,033 0 0.0 Nandi 39,704 0 0.0 Trans Nzoia 89,820 0 0.0 Wajir 82 0 0.0

Four of the eight counties are in the low-incidence cluster and four are in the medium-incidence cluster (see Appendix 6). Further, KHIS shows no faith-based HIV service delivery in the entire Northeastern province. Given the well-developed and long-standing faith-based health system networks in Kenya, these data at minimum raise questions as to whether data on services are being reported to KHIS. Finally, in regard to the aggregate country-level data from KHIS, the discrepancy between the mean percentage of services provided by FBO’s (22.0%) and the median (7.4%) demonstrate just how skewed the data are to a small cluster of counties. While this is to be expected in regard to actual numbers of PLHIV (the high percentage counties are also largely those with high numbers of PLHIV), this would not be expected regarding the percentage of county-specific services provided by FBOs. This leads one to wonder whether the data reporting systems or the administrative capacity of FBOs are simply better established in urban areas and high-incidence areas than they are in low-incidence and rural areas.

There is no way with the existing data to answer these questions but they certainly form a basis for further investigation. If such discrepancies truly are the result of less well-developed mechanisms for reporting and administrative support, then capacity building is urgent, especially since Kenya is implementing a new strategic prevention plan relying on these data.

29 l Emory University, Interfaith Health Program Stories of Trust: A Qualitative Study of an HIV/AIDS Program

FBOs such as CHAK provide a significant proportion of the health care in Kenya.9 This includes HIV/AIDS services.10 It is widely believed that FBOs have unique advantages over the public health sector11, namely moral and ethical standing in the community (trust), access to hard-to-reach populations, and human resource capabilities.12 However, these advantages and their impact on quality of care are seldom interrogated.13

Trust, both at the interpersonal and systems levels, may play a significant role in quality of care, adherence to treatment, and health outcomes.14 Respectful care, fairness, and prioritization of patients’ needs are all components of trust15; additional components may exist, which implies that there is more to be understood about trust and its resultant behaviors and attitudes in the health care setting.16 While trust is often measured through surveys and questionnaires,17 open-ended, qualitative investigations can yield subjective experiences, constructs, and priorities that can improve programs and develop more culturally appropriate scales for future research.18

In 2011, there were about 1.6 million people living with HIV in Kenya. Although the prevalence in adults is 6.2%, in many groups it is much higher. For example, it is 18.3% in injecting-drug users,

9 Barbara T.E. Schmid, Elizabeth Thomas, Jill Olivier, and James R. Cochrane. (2008). The Contribution of Religious Entities to Health in Sub-Saharan Africa. Capetown: African Religious Health Assets Programme. 10 Rosemary Morgan, Andrew Green, and Jelke Boesten. (2013). Aligning faith-based and national HIV/AIDS prevention responses? Factors influencing the HIV/AIDS prevention policy process and response of faith-based NGOs in Tanzania. Health Policy Plan. 11 Emma Tomalin. (2012). Thinking about faith-based organisations in development: where have we got to and what next? Development in Practice, 22(5-6), 689-703 12 Alyson B. Lipsky. (2011). Evaluating the strength of faith: Potential comparative advantages of faith-based organizations providing health services in sub-Saharan Africa. Public Administration and Development, 31(1), 25-36.. 13 Anna A. Amirkhanyan, Hyun Joon Kim, and Kristina T. Lambright. (2009). Faith-Based Assumptions About Performance Does Church Affiliation Matter for Service Quality and Access? Nonprofit and Voluntary Sector Quarterly, 38(3), 490-521. 14 Joshua P. Vogel, Ana P. Betran, Mariana Widmer, Joao Paulo Souza, Ahmet M. Gulmezoglu, Armando Seuc, . . . and Mario Merialdi. (2012). Role of faith-based and nongovernment organizations in the provision of obstetric services in 3 African countries. Am J Obstet Gynecol, 207(6), 495 e491-497. 15 David H. Thom, Kurt M. Ribisl, Anita L. Stewart, and Douglas A. Luke. (1999). Further validation and reliability testing of the Trust in Physician Scale. The Stanford Trust Study Physicians. [Research Support, Non-U.S. Gov't]. Med Care, 37(5), 510-517. 16 Lucy Gilson, Natasha Palmer, and Helen Schneider. (2005). Trust and health worker performance: exploring a conceptual framework using South African evidence. Soc Sci Med, 61(7), 1418-1429. 17 Lucy Gilson. (2006). Trust in health care: theoretical perspectives and research needs. [Review]. J Health Organ Manag, 20(5), 359-375. 18 Catherine Campbell, Kerry Scott, Claudius Madanhire, Constance Nyamukapa, and Simon Gregson. (2011). A 'good hospital': nurse and patient perceptions of good clinical care for HIV-positive people on antiretroviral treatment in rural Zimbabwe--a mixed-methods qualitative study. Int J Nurs Stud, 48(2), 175-183. Emory University, Interfaith Health Program l 30 29.3% in commercial sex workers, and 18.2% in men who have sex with men.19 These groups face additional social stigma and legal barriers that increase their risk.

CHAK, through its member health facilities, provides comprehensive HIV/AIDS prevention, care and treatment services. The strategies engaged include behavior change communication, pediatric and adult ARV treatment, PMTCT, voluntary counseling and testing, home-based care including palliative care, Post-Exposure Prevention/Prophylaxis (PEP) and management of opportunistic infections.20 In the context of HIV/AIDS in Sub-Saharan Africa, referral to and retention in care plays a crucial role in reducing morbidity and mortality. Trust, generated by the moral and ethical standing purported as a unique advantage of FBOs, may serve as an important mediator in the relationship between patients and providers. Exploring trust may provide real-world input, from patients and providers themselves, on the comparative advantages offered by FBOs and what they mean in practical terms in the context of HIV/AIDS.

This study used qualitative research methods to explore perceptions of trust in an HIV/AIDS context in a Kenyan FBO. Through in-depth informant interviews and focus groups with key informants, we aimed to answer these questions:

1. How does trust mediate referral and retention to HIV/AIDS care in a Kenyan FBO? 2. How does trust influence perceptions of Kenyan FBOs’ health services?

Answering these questions will provide valuable information on the subjective perception of FBO- provided care in Kenya, lend depth and detail to service utilization data, and generate lessons learned for the Christian Health Association of Kenya. CHAP represents a project invested in strong partnerships, community-based treatment, monitoring and evaluation, and capacity building. What does this look like on a day-to-day basis? How do providers negotiate high retention standards with offering compassionate care in impoverished communities? This case study, though small, offers a valuable perspective. Location, Design, and Methods CHAK and the IHP PPP identified three Comprehensive Care Centres (CCC) as sites for this work. All were large hospitals which hosted several satellite sites. Mater Hospital is in the South B neighborhood of Nairobi, surrounded by both middle-class enclaves and some of the city’s largest informal settlements. Kikuyu Hospital is located just outside of Nairobi and is situated near one of the first Presbyterian missions in East Africa. Mwea Mission Hospital, just over 100 kilometers northeast of Nairobi, is surrounded by fertile pastures and rice paddies. Both Mater and Mwea are affiliated with the Roman Catholic Church, while Kikuyu is tied to the Presbyterian Church of East Africa. In addition, the CCC at Mater is managed by a Sister from Ireland and receives funding from several European donor agencies as well as CHAK. CHAK incorporated Catholic facilities into the CHAP project, although these facilities are generally run under the auspices of the Kenya Episcopal Conference (KEC). This collaborative relationship is longstanding, but in this particular situation it began under CHAP’s predecessor program, AIDSRelief. Prior to the end of the AIDSRelief program in 2011, Catholic Relief Services and a number of international organizations managed the nationwide project. Leadership transitioned to Kenya-based entities in 2011. Since KEC and CHAK facilities coexist geographically, the two organizations chose to split the country by provinces.

19 Jane Goudge and Lucy Gilson. (2005). How can trust be investigated? Drawing lessons from past experience. Soc Sci Med, 61(7), 1439-1451. 20 Mark A. Hall, Elizabeth Dugan, Beiyao Zheng, and Aneil K. Mishra. (2001). Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? [Research Support, Non-U.S. Gov't;Review]. Milbank Q, 79(4), 613-639, v. 31 l Emory University, Interfaith Health Program Reporting to the individual conferences continues, but management of the HIV program goes through the leading partner rather than the ecumenical parent organization.

The project gathered data through semi-structured interviews and focus groups. Each method had a prepared guide and questions, but the order in which they were asked, the exact wording, and the variety covered in each session varied according to the participant. The focus groups also included drawing and ranking activities designed to elicit the group’s priorities. The sessions all addressed the care provided at that clinic, concepts of trust, and perceptions of religiously affiliated hospitals.

Before beginning work at each site, we sat with key staff to discuss the project, our goals, and how we could best serve the clinic and not disrupt their daily activities. This greatly helped recruiting, which was done by a staff member or the receptionist at the clinic. Staff would ask patients, or each other, if they wished to participate in an interview or a focus group. We took great care to ensure that we did not interfere with clinic visits, work, or errands. Each participant was fully briefed about the study and promised complete confidentiality. When only the Emory student was present, the staff sought out participants who were fluent in English; otherwise, multi-lingual CHAK staff interpreted as necessary. Results Thirteen clients and 13 staff across the three sites took part in the interviews. One focus group of community health workers included 18 people, while the other two—one of unaffiliated clients, the other of a support group—each held eight. The sessions yielded over 20 hours of recordings covering far more than the status of FBOs, the meaning of trust, and how HIV care was influenced by both. They also touched on stigma, how people perceive their illness, how FBOs can influence positive changes in their communities, and the Kenyan health care system more broadly. The data provide crucial insights into how three hospitals within the same program have adapted to serve their clients.

While their settings were diverse, each CCC was tasked with providing not only testing and drugs, but a wide array of additional services aiming to retain people in care and reduce the morbidity from HIV/AIDS. The CCCs approached this task with similar ardor, but nuances in their approach were intriguing. Recognizing that poverty played a serious role in their clients’ lives, Mater CCC developed a support system for economic empowerment, including microcredit and business training. A long- term view toward these efforts was also evident.

“…we take you through the journey realizing yourself with what you can easily do, and what you can easily sustain, that is very, mm, very acceptable in your society, like you can find that others come and tell us that, ah, the business that is highly booming in my region is selling the local brew. We can’t support you in that. Others will come and tell us that, likely what I think that I can do as a source of income, that can highly fetch, ah adequate money for my family, is selling paraffin, and with the region that we are serving, the slum, there is rampant fire, so we won’t help you start a paraffin business. Others will say that, I would wish to do charcoal business. Already, that is harm to the society.”—Male, community team, Mater

Mwea and Kikuyu did not have such mature programs, if they had them at all.

“Economic needs? We can’t help so much, but where we can help, we can help. Yeah. We tell them to share what they have with their friends who have no food, but economic needs, I say we can’t help much, yeah.” –Female nurse, Mwea

Emory University, Interfaith Health Program l 32 Counseling, linkages with the community, and health education were key components at each clinic. All programs included heavy outreach into communities with long, comprehensive home visits. These were seen as integral to retaining patients in care and meeting their needs appropriately. This hands- on approach was appreciated by patients with rare exceptions.

“I don’t like being home visited, because of the, whatever, stigma related with those people who come to visit you and then, you’ll find that someone will visit you and tomorrow, … to someone else. Though, in supporting someone’s treatment, according to me, I would say it’s, it has been good.”—Female patient, Kikuyu

Going out into the neighborhood to help patients at their homes was one example of the delicate balance CCCs had to achieve. Stigma, trust, and the interpersonal relationships between patients and providers were closely linked. Because of the hands-on approach, the personality of the provider played an important role in clients’ acceptance of treatment and their disease. While drugs, supplies, and good facilities factored very high in patients’ estimation of their care (particularly for focus groups), staff members themselves were often seen as the driving force behind quality care.

“. . . because, because of these people I’m still living. . . . I could have not been here, yeah. From that, that time when I was very sick. I was bedridden, but I didn’t, didn’t know my status, yeah. From that moment I get tested I said “this is the end of my life.” Mm. It was the end of my life by then. But I got courage from this Mater CC. They brought me up, encouraged me, knowledged me with so many things.” -- Female patient, Mater [emphasis by the author]

The trust generated by the FBO status in the community is tightly linked to quality care and good staff. History, personal experience, and word of mouth spread this impression throughout communities. Having a religious mission implies caring, comprehensive care among those who frequent such facilities.

Just as a good relationship with providers built trust—which led to openness, sharing of personal stories, and forgiveness, these qualities were in evidence during home visits, where social workers remained encouraging and positive when faced with deception from patients. Interactions devoid of these qualities had the very real potential to sour a patient on care.

“…like for example if I fail to come for my clinic, I would be called, and I’m asked the reason as to why I wasn’t able to come for the clinic, only, when you explain, it’s as if you’re missing drugs. You know? As if you’re not adherent to your drugs. So, when you’re coming back to the clinic, when you come…after two, three days, you find that… there’s someone who will handle you in a nice way, but there’s someone else who will like harass you because you didn’t come for, for that day, your appointment, maybe you didn’t get permission from work and you are like, ‘what should I do?’ And yet I have extra drugs. Because when you go to the pharmacy, there’s no balancing of the drugs.” -- Female patient, Kikuyu

This patient later described how being treated poorly by one staff member caused her to lose faith in her ability to handle her disease, almost leading her to leave the facility. Her experience, fortunately, was the exception. Most patients talked very positively about the close, open relationship they had with providers. This trust encouraged them to share their worries, which in turn helped providers give better treatment. Reciprocal openness such as this was of particular importance when linking patients to resources in the community, support groups, and in health education sessions.

Interestingly, though patients were very trusting of their providers, providers often shared mixed feelings about trusting their patients. Most of these concerns centered on dishonesty from patients.

33 l Emory University, Interfaith Health Program “Because there are clients who will tell you things but actually you will come to know that they are not telling you the truth. Like when they come they will tell you ‘I got extra drugs,’ but when you go to the file…You will realize they’re not telling you the truth.” -- Female nurse, Kikuyu

Building an open, supportive relationship with clients was important, but so was professionalism, which meant maintaining a certain distance, skepticism, and benevolent authority.

When asked what they would change about their facility, patients often asked for more formal support for their support groups (such as grants), additional education programs, or access to food or transport assistance. Providers wanted their clinics to have longer opening hours to accommodate working clients, exchange opportunities with other facilities (training in general was highly appreciated), more educational materials for their at-risk groups, and more flexibility regarding salaries. Many staff members were dissatisfied with the salaries offered by their facilities, or they thought they failed to reflect the workload and effort they were undertaking. Others were resigned or appreciative. This subject has profound implications for programs and retention of good staff; while many recognize they have “signed on” to a lower paying yet more satisfying job, they nonetheless bristle at the status quo where management insists this must always be the case.

Participants were asked which group was most at-risk or vulnerable to getting HIV in their communities. Responses covered nearly all segments of the population; surprisingly, only one participant volunteered a group -- commercial sex workers -- considered most at-risk by PEPFAR and other international donors. Possible reasons for this paucity could be lack of awareness, a disconnection between donors and providers, or differing interpretations of who belongs to a particular community. Most at-risk populations, according to the PEPFAR definition, were also seldom discussed at CHAK. This could be due to the program’s focus, chance, or the institution’s own preferences. The implications of this difference in classification are not known, but could be explored more in the future.

Emory University, Interfaith Health Program l 34 Case Study of the Christian Health Association of Kenya

The Christian Health Association of Kenya (CHAK) serves faith-based organizations in Kenya and beyond through technical assistance, capacity building, and coordination of large projects. CHAK works as an advocate and coordinator in the realms of health policy and quality health service delivery. The organization promotes networking of FBOs within Kenya and with other Christian Health Associations in Africa, as well as internationally. Its member facilities—563 organizations across all of Kenya—receive technical support, trainings, and assistance with monitoring and evaluation (M&E). CHAK also serves as the primary recipient of donor funds on behalf of its member sites. Trustees and committees oversee a staff of about 60 people, both in the General Secretary’s office (henceforth “Secretariat”) and the CHAK Guesthouse. The Guesthouse functions both as a hotel and as a conference center for faith-based groups throughout East Africa. The Secretariat encompasses the departments of Health Services, Institutional Development, Finance and Administration; the departments of Health-Management Information Systems, Communications, Monitoring and Evaluation, and Human Resources are combined into one larger unit.21 CHAK also provides direct support to member facilities, which must be a health-focused organization sponsored by a Protestant church.22 Each organization pays an annual fee of 500 KSH ($5.71 USD). Some programs, such as the CDC HIV/AIDS Program (CHAP), incorporate Catholic facilities as well. Mission and Objectives

CHAK’s mission is to facilitate provision of quality healthcare services among its member units through advocacy, health-systems strengthening, networking, and innovative health programs. It aims to ensure that health services are accessible, equitable, affordable and sustainable, as a witness to the healing ministry of Christ. This facilitative role is guided by Christian values and professional ethics and aligned with national policies. Financial Situation

CHAK’s financial profile reflects its assumption of large, donor-funded projects, namely the follow-on project to AIDSRelief, the CDC-CHAK HIV/AIDS Program (CHAP), which began in October 2011.23 The first year of the project saw CHAK coordinating $2.2 million USD in funds. CHAK’s net worth has grown in ten years from 20 million KSH (valued at $253,254 USD on 1/1/2002) in 2002 to 180 million KSH in 2012 (valued at 1,384,580 USD on 1/1/2012). While the CHAP project represented the largest source and expenditure of funds by far in 2012 (42%), other donors supported its efforts in a variety of projects. Donors included APHIA Plus, Packard Foundation, CRS, GIZ, the Global Fund, Open Society Institute, EED, and others. Meanwhile, the CHAP project represents a partnership with the University of Maryland Medical School, Futures Group, the Catholic Medical Missions Board, and the Mission for Essential Drugs and Supplies (MEDS). In total, approximately $5.2 million USD in funds were received in 2012.24

In addition to its extensive health services activities, CHAK has a number of partnerships with faith- based partners and its members’ organizations to provide essential programs in support of improved health services. These include MEDS, Health Workforce Education, Africa Christian Health Association Platform, and the Ecumenical Pharmaceutical Network. These partnerships are detailed below.

21 http://www.chak.or.ke/fin/index.php/chak-downloads/finish/5-other-downloads/40-chak-organogram. 22 http://www.chak.or.ke/fin/index.php/membership/membership-qualifications. 23 http://www.chak.or.ke/fin/index.php/component/content/article/18-latest-news/54-hiv-aids-services 24 All data from this section from CHAK’s 2012 Annual Report. 35 l Emory University, Interfaith Health Program 1. MEDS

MEDS is a partnership between CHAK and the Kenya Conference of Catholic Bishops. It provides medicines, supplies, and procurement and quality assurance services to more than 1,800 health facilities in Kenya, including private, faith-based, and public facilities. MEDS also serves over 20 facilities outside of Kenya in Eastern and Central Africa.25 The organization has worked diligently to improve its supply chain capabilities over the years. Indeed, over 95% of clients were “very satisfied” with MEDS’ turnaround times. Turnaround times are expected to be within one day within 60 kilometers of Nairobi, and within two days for other locations. An automated system with a user-friendly customer service interface that allows the customer to plan and predict delivery plays an important role in this success. MEDS also has several backup contracts negotiated in case of stock-outs. These allow more than 99% of orders to be fulfilled immediately. In case a stock-out occurs, MEDS will absorb many of these costs while it renegotiates with suppliers. The goal is to make sure supplies are delivered on time. According to MEDS managers, each employee works to ensure this happens, and this ethos drives much of MEDS’ success.26

2. Health Workforce Education

Seventeen medical training colleges and universities are member institutions of the CHAK network. All of these provide nursing education with six offering degree programs and the other 11 offering diploma programs. Kenya Methodist University is the first private university in Kenya to offer the Bachelor of Medicine and Bachelor of Surgery degrees at its Meru campus, with Maua Methodist Hospital serving as the primary teaching hospital. CHAK’s medical training programs produce well-trained graduates; of the institutions with graduates receiving the highest scores on diploma examinations, eight of the top 10 were CHAK institutions. Seven CHAK hospitals are accredited to provide internship education for medical students, and in 2012, these hospitals provided internship training for medical doctors. With funding from CDC/PEPFAR, CHAK has implemented a Pre-Service Education Strengthening Program to integrate HIV clinical education into medical training colleges and institutions.

3. Africa Christian Health Association Platform

The African Christian Health Association Platform (ACHAP) Secretariat is housed at CHAK. It serves as the coordinating body for 26 CHAs across 17 countries in Sub-Saharan Africa. The ACHAP was created at the 2007 biennial CHA Conference in Bagamayo, Tanzania. The Secretariat is charged with building the CHA network to support a stronger voice in advocacy and to facilitate technical support, capacity building, networking and communication. For further information on the ACHAP Secretariat, visit: http://www.africachap.org/x5/

ACHAP has a number of key programmatic and collaborating partners:

PROGRAMMATIC PARTNERS

The Ecumenical Pharmaceutical Network The Ecumenical Pharmaceutical Network of Kenya (EPN) is an independent, non-profit, apolitical Christian organization that addresses pharmaceutical issues in the church health care system, particularly in resource poor settings. The network was started in 1981 as a programme within the Christian Medical Commission of the World Council of Churches (WCC)

25 http://www.meds.or.ke/who_we_are.html 26 Jonathan Kiliko, MEDS, personal communication. Emory University, Interfaith Health Program l 36 based in Geneva Switzerland. To learn more about the activities of EPN, visit: www.epnetwork.org

The Uganda Protestant Medical Bureau The Uganda Protestant Medical Bureau (UPMB) is an umbrella, private, not-for-profit, faith- based organization of Protestant Churches and church-related organizations involved in health care in Uganda. Started in 1957, UPMB is involved in advocacy and lobbying for policy on behalf of its members, capacity building, publicity and networking, and support and supervision. To learn more about the Uganda Protestant Medical Bureau, visit: http://www.upmb.co.ug/

The Uganda Catholic Medical Bureau The Uganda Catholic Medical Bureau (UCMB) was established in 1955 with the main purpose of overseeing the procurement of drugs and medical equipment and to distribute to the units grants. In 1979, the Catholic Medical Bureau and the Protestant Medical Bureau jointly established a drug procurement agency: the Joint Medical Stores (JMS). The JMS is now an autonomous organization, with a representative of the founding bodies (the UPMB and the UCMB) on the Board. To learn more about the work of the Uganda Catholic Medical Bureau (UCMB) visit: http://www.ucmb.co.ug/index.php

Santé Rurale Santé Rurale (SANRU) is a partnership program of the Protestant Church of Congo (ECC) and Interchurch Medical Assistance (IMA World Health) to improve health care in Democratic Republic of the Congo (DRC) through health zone development, especially in rural areas. To learn more about SANRU visit: http://www.sanru.org/about_sanru.htm

L’oeuvre de santé de l’Eglise Evangélique Luthérienne au Cameroun (OSEELC) The Association of Evangelical Lutheran Churches in Cameroon The Association of Evangelical Lutheran Churches in Cameroon (OSEELC) is an umbrella body that comprises three district hospitals and 17 health centres. OSEELC members help its member units implement various programs ranging from monitoring and evaluation, communication, human resource and financial management, maintenance of bio-medical equipment, Health Management Information System, and logistics. To learn more about the work of OSEELC, visit: http://www.oseelc.org/

Bethesda — Benin Bethesda is a faith-based hospital started in Benin in 1990 by the Council of Churches of Benin with an aim to "improve the physical and social wellbeing of the individual and the family at accessible and reduced rates". Today the hospital offers services such as pediatrics, odontology, ophthalmology, and kinesitherapy and offers training programs in human resource, financial, and material management, as well as infrastructure and equipment management. For more about BETHESDA hospital, visit: http://www.bethesdabenin.org/

Christian Social Services Commission, Tanzania The Christian Social Services Commission, Tanzania (CSSC) is an umbrella body that brings together the Tanzania Episcopal Conference (TEC), representing the Catholic Church, and Christian Council of Tanzania (CCT), representing about 14 Protestant Churches and 10 church-related organizations. CSSC is involved in fostering ecumenical cooperation in matters regarding social services provided by Tanzanian Churches, lobbying and advocacy with government towards improving the environment for provision of church related services among other

37 l Emory University, Interfaith Health Program things. CSSC is also involved in education through the establishment of various schools. For more information on the work of CSSC visit: http://www.cssc.or.tz.

Christian Health Association of Ghana The Christian Health Association of Ghana (CHAG) is an umbrella organization that coordinates the activities of the Christian health institutions and Christian churches’ health programmes in Ghana. It is a body through which all or most of the Christian church-related health facilities /programmes liaise with the Ministry of Health to ensure proper collaboration and complementation of the government efforts at providing for the health needs of Ghanaians. For more information on the work of CHAG, visit: http://www.chag.org.gh/

Churches Health Association of Zambia The Churches Health Association of Zambia (CHAZ), was created in 1970 as an umbrella organization to represent work done by Church health institutions in Zambia. CHAZ complements government efforts in the delivery of quality healthcare by bringing to the health sector human, material, financial resources, innovation, and more importantly, Christian love and care. The membership is comprised of hospitals, health centres, faith-based organizations and community based programs. Altogether, these institutions are responsible for over 50% of formal health services in the rural areas of Zambia and about 30% of health care in the country as a whole. There are 135 affiliates representing 16 different churches both Catholic and protestant, with a majority of them based in rural areas of Zambia. For more information, visit: http://www.chaz.org.zm/

COLLABORATING PARTNERS

IMA World Health IMA World Health is a nonprofit FBO that provides health care services and products to people in need around the world. IMA works primarily in developing nations, where an estimated 30- 60% of health care is provided by FBOs. To learn more about the activities of IMA World Health, visit: www.imaworldhealth.org

World Council of Churches The World Council of Churches (WCC) brings together 349 churches, denominations and church fellowships in more than 110 countries and territories throughout the world. It represents over 560 million Christians and includes most of the world's Orthodox churches, scores of denominations from such historic traditions of the Protestant Reformation as Anglican, Baptist, Lutheran, Methodist and Reformed, as well as many united and independent churches. The WCC has also sponsored various programs of the Africa CHA's forum, including the recently held conference of FBOs in Dar-es-Salaam, Tanzania. For more information on the World Council of Churches, visit: http://www.oikoumene.org/

The Global Fund The Global Fund was created to finance the fight against AIDS, tuberculosis, and malaria. These diseases kill over 6 million people each year, and the numbers are growing. More recently it supported the meeting of Africa CHAs by helping bring together the heads of the CHAs during the Global Fund-FBO meeting held in Dar-es-Salaam. At this meeting, the Global Fund outlined initiatives to support the fight against these three diseases, specifically in African countries. For more information on the work of the Global Fund, visit: http://www.theglobalfund.org/en

Emory University, Interfaith Health Program l 38 The German Institute for Medical Mission eV (DIFAEM) The German Medical Mission (DIFAEM) was established in 1906 with the aim of attaining three goals: 1) the procurement and distribution of drugs, 2) local production of drugs, and 3) raising awareness. To learn more about the work of DIFAEM, visit: http://www.difaem.de/en/home.

ICCO ICCO is an inter-church organization for development cooperation. It gives global financial support and advice to local organizations and networks that work for better access to basic facilities, initiating sustainable economical development and enhancing peace and democracy. It works closely with civil society organizations, including development organizations, educational organizations and businesses. To learn more, visit: http://www.icco.nl/

Cordaid Cordaid offers expertise in emergency aid and structural poverty eradication. It has a network of almost a thousand partner organizations in 36 countries in Africa, Asia and Latin America. To learn more on CORDAID visit: https://www.cordaid.org/en/about-us/?mId=10182

MISEREOR MISEREOR was founded in 1958 as an agency "against hunger and disease in the world". It is mandated by the Catholic Church in Germany to fight the causes of hardship and misery in the forms of hunger, disease, poverty and other forms of human suffering, thus enabling the people affected to lead a life of human dignity. This is in addition to promoting justice, freedom, reconciliation and peace in the world. To learn more on MISEREOR, visit: http://www.misereor.org/about-us.html

The Global Health Workforce Alliance The Global Health Workforce Alliance was created in 2006 as a common platform for action to address the crisis of health worker shortage worldwide. The Alliance is a partnership of national governments, civil society, international agencies, finance institutions, researchers, educators and professional associations dedicated to identifying, implementing and advocating for solutions. To learn more, visit: http://www.who.int/workforcealliance/about/en/

4. Ecumenical Pharmaceutical Network (EPN)

EPN is comprised of 81 faith-based member organizations from more than 30 countries committed to the provision of quality pharmaceutical services as a means to achieving global goals and targets on health and access to medicines. EPN institutions are committed to the delivery of just and compassionate quality pharmaceutical services by focusing on four strategic areas: 1) access to and rational use of medicines; 2) HIV and AIDS care and treatment; 3) professionalization of pharmaceutical services; and 4) pharmaceutical information sharing. CHAK provided office space for EPN until November of 2013; through CHAK’s support and capacity- building efforts, the EPN moved into their own facilities in the Kilimani area of Nairobi.

39 l Emory University, Interfaith Health Program Conclusion

This report describes work carried out in 2013 by the Interfaith Health Program Public Private Partnership in collaboration with the Division of Global HIV/AIDS of the US Centers for Disease Control and Prevention. The collaboration sought to assess the scope of services provided by the faith-based health sector in Kenya employing a mixed-method methodology. Findings from the assessment demonstrate the key role that faith-based health systems play in healthcare delivery in Kenya, particularly for those who cannot access for-profit providers. They comprise 70.0% of non- governmental facilities in the not-for-profit sector. As a whole, faith-based health facilities demonstrate a broad-based commitment to providing HIV services, especially in high prevalence areas where two- thirds of all faith-based facilities provide at least one HIV service in the high prevalence counties. Further, faith-based health systems provide a substantial proportion of services, including 58.6% of treatment visits and 63.9% of antiretroviral (ARV) treatment in Nairobi.

Interviews with a purposive sample of patients and staff from faith-based facilities demonstrate that FBOs are perceived to be trusted entities in their local communities. Such trust is generated and sustained by experiences of quality care and caring staff by members in the community.

This report contributes to the evidence base of faith-based health facilities and their services. Such research provides important information regarding the proportion of services provided by the faith- based sector by conducting quantitative assessments of service provision rather than the anecdotal claims regarding the percentage of services provided by FBOs. This project was developed to assess the accuracy of such anecdotal claims and it has demonstrated that faith-based health systems do indeed provide a substantial proportion of services and fill vital roles.

This project examined these issues only in the context of Kenya and only in regard to HIV service data. Assessments in other countries will be important to add to the knowledge of the scope of HIV services that faith-based health facilities provide. Such knowledge can be useful for maximizing the contributions of faith-based programs as part of comprehensive, sustainable, and effective HIV services in a number of countries, particularly in those with higher HIV prevalence.

The findings from this study can provide insights into the important contributions of faith-based health systems in sustainable, country-led HIV prevention, treatment, and support programs. The methodology of quantitative assessment and qualitative analysis is useful for understanding the scope of services provided by the faith-based sector as well as perceptions regarding the quality of those services. While public health and policy leaders have known that faith-based health systems play integral roles in health services delivery, the scope of their contributions is not well researched. This study has provided some assessment of those contributions in one country but the information presented here is very context-specific. Such contributions will vary in scope in other countries and the perception of those contributions in local contexts will also vary. If the distinctive contributions of FBOs are to be maximized, further study of their contributions in countries outside of Kenya is essential. The following four action steps could support such efforts:

1. Continue to build the knowledge base of the contributions of the faith-based health sector across the PEPFAR platform.

The substantial contributions of faith-based health facilities to HIV service delivery are not unique to Kenya. In order to maximize those contributions in support of sustainable, effective, country-led initiatives, similar reports should also be completed in other countries in which PEPFAR works.

Emory University, Interfaith Health Program l 40 2. Continue to build data management and reporting structures, both in Kenya and in other countries.

The KHIS and eHealth data management systems are important resources in Kenya, helping aggregate large amounts of data. The analysis of these data is necessary to guide program delivery and strategic planning. Strengthening these systems in Kenya is a sound investment and such systems should be developed and/or strengthened in other countries as well.

3. Build the capacity of all organizations, including faith-based health facilities, to contribute to those reporting structures.

Discrepancies across various data sets examined in this study and the strong possibility of missing data in these databases point to the need to build the capacity of HIV service organizations to report data to these structures in an efficient and timely manner. These organizations would benefit from training and technical assistance in relation to data management and reporting.

4. Mobilize the unique capacities of faith-based systems in support of sustainable, evidence- based models of prevention, treatment, and care.

Faith-based organizations are not the only organizations to enjoy the trust of local communities. However, the characteristics of trust in FBOs are different from trust in other organizations. These characteristics represent powerful resources that could be mobilized to strengthen the provision of HIV services.

41 l Emory University, Interfaith Health Program Appendices

1. Number and Type of Health Facilities in Kenya (both faith-based and non faith-based)

2. Faith-Based Facilities by Facility Type, FBO Network, and County

3. Number of Visits to Service Providers by PLHIV and Number of Health Facilities (both faith- based and non faith-based)

4. Number of Visits by PLHIV Currently Seen in Care by FBOs by Facility, County, and FBO Network

5. Matrix of Selected PEPFAR Indicators and Rationale for Their Inclusion

6. Databases Accessed and Keyword Searches Used to Conduct the Literature Review

Emory University, Interfaith Health Program l 42 Appendix 1

Number and Types of Health Facilities in Kenya (faith-based and non faith-based), eHealth Kenya

Type of Facility

CHAK KEC SUPKEM* Other FB* Total*FB FBNon Total** Total facilities % FB facility Blood Bank 0 0 0 0 0 1 1 0.0 Dental Clinic 0 0 0 0 0 30 30 0.0 Dispensary 283 232 5 160 680 3,613 4,293 15.8 Eye Centre 1 1 0 0 2 8 10 20.0 Eye Clinic 0 0 0 0 0 3 3 0.0 Funeral Home 0 0 0 0 0 1 1 0.0 Health Centre 42 80 3 44 169 872 1,041 16.2 Health Programme 0 4 0 1 5 7 12 41.7 Health Project 0 0 0 0 0 7 7 0.0 Hospital (District) 0 0 0 0 0 138 138 0.0 Hospital (Sub District) 0 0 0 0 0 132 132 0.0 Hospital (Other) 14 48 1 22 85 150 235 36.8 Laboratory 0 0 0 0 0 50 50 0.0 Maternity Home 2 1 0 0 3 45 48 6.3 Medical Centre 0 0 0 0 0 19 19 0.0 Medical Clinic 26 25 2 32 85 2,928 3,013 2.8 National Referral Hospital 0 0 0 0 0 3 3 0.0 Nursing Home 3 3 0 4 10 179 189 5.3 Provincial General Hospital 0 0 0 0 0 9 9 0.0 Radiology Unit 0 0 0 0 0 9 9 0.0 Regional Blood Transfusion Centre 0 0 0 0 0 1 1 0.0 Regional Health Training Centre 0 0 0 0 0 1 1 0.0 Stand-Alone Training Inst. in Health 0 0 0 0 0 6 6 0.0 Stand-Alone VCT Centre 7 7 1 17 32 122 154 20.8 Other (Not In List) 1 0 0 0 1 22 23 4.3 TOTALS 379 401 12 280 1072 8,356 9,428 11.3

* IHP PPP staff identified sixteen organizations mistakenly listed in the eHealth system as non-governmental; they are faith- based. The above table includes these organizations as faith-based facilities. Fifteen organizations were included under “Other Faith-Based” and one, SUPKEM (Liverpool) was included under SUPKEM. The organizations are Dispensary: Hope World Wide Kenya Mukuru Clinic;, Health Centre: Bomu Medical Centre (Mariakani); Medical Clinic: Lea Toto Clinic (Nairobi West), Lea Toto Clinic Kariobangi South, Nyumbani Diagnostic Laboratory and Medical Clinic, Lea Toto Kawangware, Lea Toto Kibera; Other Hospital: Bomu Medical Hospital (Changamwe); VCT Centre (Stand-Alone): Hope World Wide (), Hope Worldwide Htc Centre, Hope Worldwide Kenya VCT (Makadara), Lea Toto Dagoretti, Our Lady of Perpetual Sisters VCT (Bondo), St Johns Ambulance, Lea Toto Mwiki. **The eHealth database offers the following categories for kinds of health facilities: academic (31), armed forces (24), Christian Health Association of Kenya (379), community (120), community development fund (41), company medical service (87), humanitarian agency (3), Kenya Episcopal Conference (402), local authority (112), local authority T fund (5), Ministry of Health (4050), non-governmental organization (300), other faith-based (280), other public institution (78), parastatal (18), private enterprise (institution) (1362), private practice—clinical officer (470), private practice—general practitioner (362), private practice—medical specialist (142), private practice—nurse/midwife (925), private practice (unspecified) (222), state corporation (4), Supreme Council for Kenyan Muslims (12).

43 l Emory University, Interfaith Health Program Appendix 2

Faith-Based Facilities by Facility Type, FBO Network, and County

The eHealth web portal offers extensive information on each of these facilities, including street and postal addresses, contact information, and range of services offered. Go to www.ehealth.or.ke and enter the facility name in the “search” function.

Christian Health Association of Kenya (CHAK) Facilities

DISPENSARY Name Province County Acc&S Kariua Dispensary Central Murang'a ACK Dispensary (Isiolo) Eastern Isiolo ACK Kanunga Dispensary Central Kiambu ACK CHBC Clinic Eastern Kitui Africa Inland Church Dispensary North Eastern Wajir AIC Dispensary (Isiolo) Eastern Isiolo AIC Ebenezer Rift Valley Baringo AIC Gituru Dispensary Central Murang'a AIC Mukaa Dispensary Eastern Makueni AIC Mununga Dispensary Central Murang'a AIC Parkview Dispensary Rift Valley Nakuru Aposta Dispensary Rift Valley Turkana Apostles Clinic Western Kakamega Aro (SDA) Dispensary Nyanza Siaya Arsim Lutheran Dispensary Rift Valley Samburu Assumption of Mary Dispensary Central Kiambu Assururiet (SDA) Dispensary Rift Valley Uasin Gishu Atemo Health Centre Nyanza Homa Bay B/Valley (PCEA) Clinic Eastern Embu Bethsaida (AIC) Clinic (Nakuru) Rift Valley Nakuru Bethsaida (PCEA) Dispensary (Nyeri) Central Nyeri Butonge Dispensary Western Bungoma Cargo Human Care Clinic Central Kiambu Caritas Mariah Central Kiambu Catholic Mission Dispensary North Eastern Wajir Ccs (ACK) Dispensary Eastern Meru Ccs Macumo Clinic Eastern Embu Chamakanga Mission Western Vihiga Chavogere Mission Western Vihiga Chemasiri (ACK) Dispensary Western Busia Chonesus Clinic Nairobi Nairobi Christian Community Services Clinic Base Central Kirinyaga Christian Community Services Wang'uru Dispensary Central Kirinyaga Churo Dispensary Rift Valley Baringo Chwele Friends Dispensary Western Bungoma Curran Dispensary Eastern Kitui Daba (AIC) Dispensary Coast Tana River Divine Mercy Kithatu Dispensary Eastern Meru Dr. Arthur (PCEA) Dispensary Rift Valley Nakuru EAPC Kigumo Clinic Eastern Embu Elburgon (PCEA) Dispensary Rift Valley Nakuru Eliye Springs (AIC) Dispensary Rift Valley Turkana Emmanuel Kigari (ACK) Dispensary Eastern Embu Ethi Dispensary Rift Valley Laikipia Fountain Medical Clinic Rift Valley Nakuru

Emory University, Interfaith Health Program l 44 Gaitu Dispensary Eastern Meru Gangara Dispensary Eastern Meru Gathiruini (PCEA) Dispensary Central Kiambu Gatumbi (SDA) Dispensary Central Kirinyaga Gatura (PCEA) Dispensary Central Nyeri Gaturi Dispensary Eastern Meru Gietai (AIC) Dispensary Nyanza Nyamira Githanga (ACK) Dispensary Central Murang'a Githuani (ACK) Dispensary Central Kirinyaga Githure (ACK) Dispensary Central Kirinyaga Gitundu (ACK) Dispensary Central Nyeri Good Samaritan (ACK) Medical Clinic Central Nyeri Grace Medical Centre Rift Valley Kajiado Health For All (ACK) Clinic Rift Valley Kajiado Hope Compassionate (ACK) Dispensary Nyanza Homa Bay Huruma (NCCK) Dispensary Nairobi Nairobi Igandene Dispensary Eastern Meru Illaut Dispensary Eastern Marsabit Iriga Dispensary Eastern Tharaka Nithi Itugururu Dispensary Eastern Tharaka Nithi Jesmond (ACK) Dispensary (Mburi) Central Kirinyaga Kaanwa Dispensary Eastern Tharaka Nithi Kagai (PCEA) Dispensary Rift Valley Nakuru Kagumo Live Giving Dispensary/Laboratory Central Kirinyaga Kagwathi (SDA) Dispensary Central Murang'a Kahuhia (ACK) Clinic Central Murang'a Kahuho I (AIC) Dispensary Central Nyandarua Kaiani (ABC) Dispensary Eastern Machakos Kajiado (AIC) Dispensary Rift Valley Kajiado Kajiampau Dispensary Eastern Tharaka Nithi Kalacha (AIC) Dispensary Eastern Marsabit Kamagambo Dispensary Nyanza Migori Kamasengere Dispensary Nyanza Homa Bay Kambui (PCEA) Dispensary Central Kiambu Kamburu (PCEA) Dispensary Central Kiambu Kamukuywa (ACK) Dispensary Western Bungoma Kangagetei Dispensary Rift Valley Turkana Kanjora (PCEA) Dispensary Central Nyeri Kanyenyaini ACK Dispensary Central Murang'a Karaini (ACK) Dispensary Central Kirinyaga Karia Dispensary Eastern Meru Kariakomo Dispensary Eastern Tharaka Nithi Karimonga Dispensary Eastern Meru Karura (SDA) Dispensary Central Kiambu Kathangariri (ACK) Clinic Eastern Embu Kathera Dispensary Eastern Meru Kemera Dispensary (Manga) Nyanza Nyamira Kenya Assemblies of God Medical Clinic (Kag Naivas) Rift Valley Nakuru Khulwanda Dispensary Western Bungoma Kiamagunyi (ACK) Clinic Central Kirinyaga Kiamiriru MCK Dispensary Eastern Meru Kiamuriuki Dispensary Eastern Tharaka Nithi Kiandegwa (Methodist Church of Kenya) Dispensary Central Kirinyaga Kiangondu Dispensary Eastern Tharaka Nithi Kianjokoma (ACK) Trinity Clinic Eastern Embu Kiaruhiu (PCEA) Health Centre Central Nyeri Kibera Chemi Ya Uzima Clinic Nairobi Nairobi Kibini Hill (PCEA) Dispensary Rift Valley Kajiado Kids Alive Dispensary Central Nyeri 45 l Emory University, Interfaith Health Program Kigogo Dispensary Eastern Tharaka Nithi Kihumbuini (PCEA) Dispensary Central Kiambu Kihuro (ACK) Dispensary Central Murang'a Kikambala Catholic Medical Clinic Coast Kilifi Kilgoris (Cog) Dispensary Rift Valley Narok Kimunyu (PCEA) Dispensary Central Kiambu Kiriani Dispensary Eastern Tharaka Nithi Kiriari (ACK) Dispensary Eastern Embu Kirigara (MCK) Dispensary Eastern Meru Kitundu (SDA) Dispensary Eastern Makueni Kiu (AIC) Dispensary Eastern Makueni Kokwototo Dispensary Rift Valley Baringo Kolanya Salvation Army Dispensary Western Busia Kopanga Dispensary Nyanza Migori Kyasila (AIC) Dispensary Eastern Machakos Kyome (AIC) Dispensary Eastern Kitui Kyumbe (AIC) Dispensary Eastern Makueni Lankia (PCEA) Dispensary Central Kiambu Liter (AIC) Dispensary Rift Valley Elgeyo Marakwet Logologo AIC Dispensary Eastern Marsabit Lokwatubwa (Pag) Dispensary Rift Valley Turkana Loltulelei Friends Dispensary Rift Valley Samburu Lopur Dispensary (Turkana West) Rift Valley Turkana Loyapat Dispensary Rift Valley Turkana Luciel Dispensary Nyanza Migori Lwandeti Dispensary Western Kakamega Magenka Dispensary Eastern Tharaka Nithi Magundu Dispensary Eastern Tharaka Nithi Magutu (PCEA) Dispensary Central Nyeri Magwagwa (SDA) Dispensary Nyanza Nyamira Mahiga (PCEA) Dispensary Central Nyeri Majengo (PCEA) Clinic Eastern Embu Makandune Dispensary Eastern Meru Makutano (PCEA) Medical Clinic (Trans Nzoia East) Rift Valley Trans Nzoia Malanga (AIC) Dispensary Coast Kilifi Manyatta (SDA) Dispensary Nyanza Homa Bay Maragua (African Christian Churches and Schools) C Central Murang'a Matare Mission Dispensary Nyanza Migori Mathakwaini (PCEA) Dispensary Central Nyeri Matutu Dispensary Nyanza Nyamira Mbiri (ACK) Dispensary Central Kirinyaga (ACK) Dispensary Eastern Kitui Mbooni (AIC) Dispensary Eastern Makueni Mbwinjeru Methodist Dispensary Eastern Meru MCK Kathuine Dispensary Eastern Meru MCK Kiirigu Dispensary Eastern Tharaka Nithi MCK Mbwinjeru Dispensary Eastern Meru Mihuti Dispensary (Muranga North) Central Murang'a Minugu Dispensary Eastern Tharaka Nithi Mission of Mercy Clinic Western Bungoma Mitunguu Ccs Dispensary Eastern Meru Mukangu (ACK) Dispensary Eastern Embu Mukeu (AIC) Dispensary Central Nyandarua Mukurwe (PCEA) Medical Clinic Central Kiambu Mulwanda Dispensary Western Kakamega Mung'ang'a (ACK) Dispensary Central Kirinyaga Mununga Dispensary Central Murang'a Murambani Dispensary Eastern Tharaka Nithi Muthambi Dispensary Eastern Tharaka Nithi Emory University, Interfaith Health Program l 46 Muthithi (PCEA) Dispensary Central Murang'a Muthwani (AIC) Dispensary Eastern Machakos Mutira (ACK) Dispensary Central Kirinyaga Mutukanio ACK Dispensary Rift Valley Nakuru Mutulu (AIC) Dispensary Eastern Kitui Mutunguru PCEA Dispensary Eastern Meru Nakaalei Dispensary Rift Valley Turkana Namarei Dispensary (Marsabit South) Eastern Marsabit Namboboto Dispensary Western Busia Nanam Dispensary Rift Valley Turkana Napusimoru Dispensary Rift Valley Turkana Natira Dispensary Rift Valley Turkana Ndarugu (PCEA) Dispensary Rift Valley Nakuru Nderema Dispensary Nyanza Nyamira Ndoleli MCK Dispensary Eastern Meru Nduriri (AIC) Dispensary Central Kiambu Ngaremara Dispensary Eastern Isiolo Ngecha Orthodox Dispensary Central Kiambu Ngelani (AIC) Dispensary Eastern Machakos Ngeru Dispensary Eastern Tharaka Nithi Ngiriambu (ACK) Dispensary Central Kirinyaga Nguruki-Iruma Dispensary Eastern Tharaka Nithi Njoro (PCEA) Dispensary Rift Valley Nakuru Nkabune Dispensary Eastern Meru Nkuene (ACK) Dispensary Eastern Meru Nkunjumu Dispensary Eastern Meru Nyabikaye Dispensary Nyanza Migori Nyabikomu Dispensary Nyanza Nyamira Nyabondo Rehabilitation Centre Nyanza Kisumu Nyagani Dispensary Eastern Tharaka Nithi Nyagesenda Dispensary Nyanza Kisii Nyagichenche (SDA) Dispensary Nyanza Kisii Nyakach (AIC) Dispensary Nyanza Kisumu Nyamakoroto Dispensary Nyanza Nyamira Nyanchwa Dispensary Nyanza Kisii Nyandiwa Baptist Dispensary Nyanza Homa Bay Nyasore Dispensary Nyanza Kisii Nyeri Hill (PCEA) Dispensary Central Nyeri Nyumbani Village Catholic Dispensary Eastern Kitui Nzoia (ACK) Dispensary Western Kakamega Ogada Dispensary Nyanza Migori Ogande Dispensary Nyanza Homa Bay Olasiti (AIC) Dispensary Rift Valley Narok Olkalou (ACK) Dispensary Central Nyandarua Olooltoto Dispensary Rift Valley Narok Orinie (AIC) Clinic Rift Valley Kajiado Orthodox Dispensary Nairobi Nairobi Our Lady of Mercy (Magumu) Central Nyandarua Oyani (SDA) Dispensary Nyanza Migori PCEA Gateway Central Kirinyaga PCEA Karero Dispensary Rift Valley Kajiado PCEA Karungaru Dispensary Eastern Tharaka Nithi PCEA Kasasule Dispensary Eastern Makueni PCEA Dispensary Eastern Makueni PCEA Kiengu Disp/Mat Eastern Meru PCEA Kuwinda Health Clinic Nairobi Nairobi PCEA Mwangaza Dispensary Rift Valley Nakuru Presbyterian Ttc Rubate Health Centre Eastern Tharaka Nithi Prisca Wakarima (ACK) Dispensary Central Murang'a 47 l Emory University, Interfaith Health Program Ranen (SDA) Dispensary Nyanza Migori Rangwe (SDA) Dispensary Nyanza Homa Bay Redeemed Medical Clinic Eastern Machakos Riakworo Dispensary Nyanza Nyamira Rotu Dispensary Rift Valley Baringo Ruiga (MCK) Dispensary Eastern Meru Rumangao Dispensary Coast Taita Taveta Rurii (ACK) Dispensary Central Nyandarua Rwathe Dispensary Central Murang'a Sabasaba Catholic Dispensary Central Murang'a Samaria (AIC) Mission Dispensary Rift Valley Kajiado Segera Mission Dispensary Rift Valley Laikipia Siyiapei (AIC) Dispensary Rift Valley Narok Soysambu (ACK) Dispensary Western Bungoma Springs of Life Lutheran Dispensary Nairobi Nairobi St Andrews Kabare (ACK) Dispensary Central Kirinyaga St Anne (ACK) Dispensary Central Murang'a St Barnabas Dispensary Nyanza Migori St James Anglican Church of Kenya Kiaritha Dispensary Central Kirinyaga St John Marieni Dispensary Eastern Meru St Johns Thaita (ACK) Dispensary Central Kirinyaga St Joseph's Shelter of Hope Coast Taita Taveta St Jude Catholic Dispensary Rift Valley Uasin Gishu St Luke Kihuro (ACK) Dispensary Central Murang'a St Marks Dispensary (Kariene) Eastern Meru St Mary (ACK) Dispensary (Ngariama) Central Kirinyaga St Mary (ACK) Mugumo Dispensary Central Kirinyaga St Mary Magdalene Kanjuu Dispensary Central Kirinyaga St Paul Ithiki (ACK ) Dispensary Central Murang'a St Paul Kiamuri (ACK) Dispensary Central Murang'a St Peters (ACK) Dispensary Central Kiambu St Peter's (ACK) Medical Clinic Central Kiambu St Peters Gaitheri (ACK) Dispensary Central Murang'a St Philips (ACK) Dispensary Ndiriti Central Kirinyaga St Stephen's Kiandagae (ACK) Dispensary Central Kirinyaga St Theresa Dispensary Coast Kilifi Sugarbaker Memorial Clinic Central Nyeri Syongila (ACK) Dispensary Eastern Kitui Tabuga (PCEA) Dispensary Rift Valley Nakuru Tata Hannah (African Christian Churches and School Central Murang'a Tena (PCEA) Clinic Nairobi Nairobi Thumaita (ACK) Dispensary Central Kirinyaga Tinganga (PCEA) Dispensary Central Kiambu Titila (AIC) Dispensary Coast Tana River Trinity Githiga (ACK) Dispensary Central Murang'a Tumaini Medical Clinic (Marsabit) Eastern Marsabit Tunawanjali Clinic Eastern Machakos Turi (PCEA) Dispensary Rift Valley Nakuru Turi AIC Health Centre Rift Valley Nakuru Ukuu MCK Dispensary Eastern Meru Waso AIPCA Dispensary (Isiolo) Eastern Isiolo Watamu (SDA) Dispensary Coast Kilifi Weithaga (ACK) Dispensary Central Murang'a Weru Dispensary Eastern Tharaka Nithi Wire Dispensary Nyanza Homa Bay Word of Faith Church Dispensary Coast Mombasa Wusi-Wutesia (ACK) Dispensary Coast Taita Taveta Ziwa SDA Rift Valley Uasin Gishu

Emory University, Interfaith Health Program l 48 EYE CENTRE Name Province County Sabatia Eye Hospital Mission Western Vihiga HEALTH CENTRE Name Province County Alale (AIC) Health Centre Rift Valley West Pokot Bibirioni Health Centre Central Kiambu Eldama Ravine (AIC) Health Centre Rift Valley Baringo Embu Children Clinic Eastern Embu Engos Health Centre Rift Valley Narok Eronge Health Centre Nyanza Nyamira Gatab Health Centre Eastern Marsabit Getongoroma Health Centre Nyanza Migori Imara Health Centre Nairobi Nairobi Ime (AIC) Health Centre Rift Valley Nakuru Itando Mission of Hope and Health Centre Western Vihiga Itibo Mission Health Centre Nyanza Nyamira Kaboson Health Centre Rift Valley Bomet Kaigat (SDA) Health Centre Rift Valley Nandi Kalokol (AIC) Health Centre Rift Valley Turkana Kamung'ang'a (ACK) Dispensary Central Murang'a Kebeneti (SDA) Health Centre Rift Valley Kericho Kebirigo Mission Health Centre Nyanza Nyamira Khasoko Health Centre Western Bungoma Kimng'oror (ACK) Health Centre Rift Valley Nandi Kipsigon (FGC) Health Centre Western Bungoma Komotobo Mission Health Centre Nyanza Migori Lokichar (RCEA) Health Centre Rift Valley Turkana (AIC) Health Centre Rift Valley Turkana Lokori (AIC) Health Centre Rift Valley Turkana Mangima SDA Health Centre Nyanza Homa Bay Matongo Health Centre Nyanza Nyamira Monianku Health Centre Nyanza Kisii Mulango (AIC) Dispensary Eastern Kitui (AIC) Medical Centre Rift Valley Nakuru Nakuru West (PCEA) Health Centre Rift Valley Nakuru Namasoli Health Centre Western Kakamega Namoruputh (Pag) Dispensary Rift Valley Turkana Ndalat (PCEA) Health Centre Rift Valley Nandi Nyambare Health Centre Nyanza Siaya Nyamira Adventist Health Centre Nyanza Nyamira Omorembe Health Centre (Gucha) Nyanza Kisii Oriang (SDA) Health Centre Nyanza Homa Bay PCEA Upendo Health Centre Rift Valley Nakuru Rangenyo Health Centre Nyanza Nyamira Reusse Troyer Health Centre Nyanza Migori Riokindo Health Centre Nyanza Kisii St Francis Health Centre Eastern Meru MATERNITY HOME Name Province County Sori Lakeside Nursing and Maternity Home Nyanza Migori St Assisi Sisters of Mary Immaculate Nursing Home Eastern Machakos

49 l Emory University, Interfaith Health Program MEDICAL CLINIC ACK Nyandarua Medical Clinic Central Nyandarua ACK Tumaini Medical Clinic Central Nyeri Brase Clinic and Eye Centre Nyanza Migori Canaan (ACK) Medical Clinic Rift Valley Nakuru Church Army Medical Clinic Nairobi Nairobi Coptic Medical Clinic Nairobi Nairobi Cornerstone Clinic Nairobi Nairobi Cura (ACK) Medical Clinic Central Kiambu Rapha Medical Centre Rift Valley Uasin Gishu Fountain Medical Centre Rift Valley Narok Kamahindu (AIC) Medical Centre Central Kiambu Kings Medical Centre (Deliverance) Nakuru Rift Valley Nakuru Mpc Mobile Clinic Coast Mombasa Msomi Complex Medical Clinic Nyanza Migori New Life Mission Rotary Clinic Rift Valley Kajiado PCEA Clinic (Ngundo) Nairobi Nairobi PCEA Dandora Clinic Nairobi Nairobi PCEA Kayole Parish Health Centre Nairobi Nairobi PCEA Pipeline Clinic Nairobi Nairobi Rafiki Clinic Central Kiambu Rapha Mission Clinic Nairobi Nairobi Ruiri MCK Medical Centre Eastern Meru SDA Health Services Likoni Road Clinic Nairobi Nairobi St Stephen's Children Clinic Gatondo Eastern Embu Vigombonyi SDA Clinic Coast Taita Taveta Wangema (African Christian Churches and Schools) C Central Murang'a NURSING HOME Name Province County Itierio Nursing Home Nyanza Kisii Mt Kenya (ACK) Hospital Central Kirinyaga The Hope Medical Centre-Awasi Nyanza Kisumu OTHER HOSPITAL Name Province County Chogoria (PCEA) Hospital Eastern Tharaka Nithi Coptic Hospital (Ngong Road) Nairobi Nairobi Dolphil Nursing & Maternity Home Nyanza Siaya Githumu Hospital Central Murang'a Kapsowar (AIC) Hospital Rift Valley Elgeyo Marakwet Kendu Adventist Hospital Nyanza Homa Bay Kijabe (AIC) Hospital Central Kiambu Kima Mission Hospital Western Vihiga Maseno Mission Hospital Nyanza Kisumu Maua Methodist Hospital Eastern Meru St Ann Hospital Eastern Meru St Orsola Mission Hospital Eastern Tharaka Nithi Tenwek Mission Hospital Rift Valley Bomet Tumutumu (PCEA) Hospital Central Nyeri VCT CENTRE (STAND-ALONE) Name Province County AIC Liten VCT Rift Valley Kericho Bomet Youth Friendly Centre Rift Valley Bomet Keringet Youth Friendly Centre Rift Valley Nakuru Mulot VCT Rift Valley Narok PCEA Silanga Church VCT Nairobi Nairobi Redeemed Gospel Church VCT Eastern Tharaka Nithi Shauri Moyo Baptist VCT Centre Nairobi Nairobi Emory University, Interfaith Health Program l 50 Kenya Episcopal Conference Facilities

DISPENSARY Name Province County Amungeti Catholic Dispensary Eastern Meru Ancilla Catholic Dispensary Rift Valley Uasin Gishu Annunciation Catholic Dispensary Central Kiambu Antubangai Catholic Dispensary Eastern Meru ASN Upendo Village Dispensary Rift Valley Nakuru Awasi Mission Dispensary Nyanza Kisumu Bar Korwa Dispensary Nyanza Kisumu Catholic Dispensary Rift Valley Samburu Baraka Medical Centre Nairobi Nairobi Barsaloi Catholic Dispensary Rift Valley Samburu Benedict XVI Dispensary Central Nyandarua Burnt Forest Catholic Dispensary Rift Valley Uasin Gishu Catholic Dispensary (Isiolo) Eastern Isiolo Catholic Dispensary Kariobangi Nairobi Nairobi Catholic Mission Dispensary Makueni Eastern Makueni Catholic University Dispensary Nairobi Nairobi Cheera Dispensary Eastern Tharaka Nithi Consolata Shrine Dispensary (Deep Sea Nairobi) Nairobi Nairobi Cordis Maria Dispensary Central Kiambu Cotolengo Centre Nairobi Nairobi D Comboni Mission Eastern Machakos Difathas Catholic Dispensary Central Kirinyaga Dirib Gombo Dispensary Eastern Marsabit Divine Mercy Catholic Dispensary Eastern Machakos Don Bosco Catholic Dispensary Central Murang'a Dreams Centre Dispensary (Langata) Nairobi Nairobi EDARP Donholm Clinic Nairobi Nairobi EDARP Ruai Clinic Nairobi Nairobi Embul - Bul Catholic Dispensary Rift Valley Kajiado Enoosupukia Dispensary Rift Valley Narok Eshisiru Catholic Dispensary Western Kakamega Fr Baldo Cath Disp Central Nyandarua Fr Meru Dispensary Eastern Meru Gachua Catholic Dispensary Eastern Meru Gaichanjiru Hospital (Satellite) Central Murang'a Gatanga Dispensary Central Kiambu Gaturi Catholic Parish Dispensary Central Murang'a Gertrude Dispensary Eastern Embu Giakaibei Catholic Dispensary Central Nyeri Giriama Mission Dispensary Coast Kilifi Gitoro Dispensary Eastern Meru Gitunduti Catholic Dispensary Central Nyeri Good Shepherd Ang'iya Nyanza Homa Bay Helpers of Mary Dispensary Rift Valley Nakuru Holy Cross Dispensary Central Kiambu Holy Family Dispensary Central Nyandarua Holy Family Oriang Mission Dispensary Nyanza Homa Bay Hongwe Catholic Dispensary Coast Lamu Imarba Dispensary Rift Valley Kajiado Juluk Dispensary Rift Valley Turkana

51 l Emory University, Interfaith Health Program Kabichbich Miss Dispensary Rift Valley West Pokot Kachoda Dispensary Rift Valley Turkana Kadem Tb & Leprosy Dispensary Nyanza Migori Kagio Catholic Dispensary (Mary Immaculate Catholic) Central Kirinyaga Kagioini Catholic Dispensary Central Nyeri Kagwe Catholic Dispensary Central Kiambu Kaheti Dispensary & Maternity Central Nyeri Kaliluni (AIC) Dispensary Eastern Machakos Kalobeyei Dispensary Rift Valley Turkana Kambi Garba Dispensary Eastern Isiolo Kambi Ya Juu Catholic Dispensary (Isiolo) Eastern Isiolo Kambu Catholic Dispensary Eastern Makueni Kapelibok Dispensary Rift Valley Turkana Kaplomboi Dispensary Rift Valley Bomet Kapnyeberai Dispensary Rift Valley Nandi Karare Dispensary Eastern Marsabit Karatina Catholic Dispensary Central Nyeri Kargi Dispensary Eastern Marsabit Karima Catholic Dispensary Central Nyeri Karinga Mission Central Kiambu Kariobangi EDARP Nairobi Nairobi Kataboi Dispensary Rift Valley Turkana Kathonzweni Catholic Dispensary Eastern Makueni Kebaroti Dispensary Nyanza Migori Kerugoya Catholic Dispensary Central Kirinyaga Kevote Catholic Dispensary Eastern Embu Kibwezi Catholic Dispensary Eastern Makueni Kimangao Dispensary Eastern Kitui Kipsaraman Dispensary Rift Valley Baringo Kivuli Dispensary Nairobi Nairobi Kokiselei Dispensary Rift Valley Turkana Korr Dispensary Eastern Marsabit Kutus Catholic Dispensary Central Kirinyaga Lemoru Trinity Rift Valley Uasin Gishu Letea Dispensary Rift Valley Turkana Lodokejek Dispensary Rift Valley Samburu Lokore Dispensary Rift Valley Turkana Lowarengak Dispensary Rift Valley Turkana Macalder Mission Dispensary Nyanza Migori Machaka Mission Dispensary Eastern Meru Maikona Dispensary Eastern Marsabit Makindu Catholic Dispensary Eastern Makueni Maraa Catholic Dispensary Eastern Meru Catholic Dispensary Rift Valley Samburu Maria Dominica Dispensary Nairobi Nairobi Marigat Catholic Mission Rift Valley Baringo Mariira Catholic Dispensary Central Murang'a Mary Immaculate Dispensary (Eldoret East) Rift Valley Uasin Gishu Mary Immaculate Dispensary (Laikipia East) Rift Valley Laikipia Catholic Dispensary Eastern Machakos Matiliku Catholic Dispensary Eastern Makueni Mbiriri Catholic Dispensary Central Nyeri Mbitini Catholic Dispensary Eastern Makueni Mercy Mission Medical Dispensary Eastern Makueni Mercy Mobile Clinic (Kipkelion) Rift Valley Kericho

Emory University, Interfaith Health Program l 52 Merti Catholic Dispensary Eastern Isiolo Meru Children’s Clinic Eastern Meru Metaburo Health Centre Nyanza Kisii Miambani Catholic Eastern Kitui Mikindani Catholic Dispensary Coast Mombasa Mitunguu Catholic Dispensary Eastern Meru Mivumoni (Catholic) Dispensary Coast Kwale Morijo Dispensary Rift Valley Samburu Mother Ippolata Mukuru Clinic Nairobi Nairobi Mother of Mercy (Machakos) Eastern Machakos Catholic Dispensary Eastern Marsabit Mrima (Catholic) Dispensary Coast Kwale Mugunda Mission Dispensary Central Nyeri Mujwa Dispensary Eastern Meru Mukuru Mmm Clinic Nairobi Nairobi Mulot Catholic Dispensary Rift Valley Narok Mworoga Catholic Dispensary Eastern Meru Nachukui Dispensary Rift Valley Turkana Nadapal Dispensary Rift Valley Turkana Napeililim Dispensary Rift Valley Turkana Nariokotome Dispensary Rift Valley Turkana Narumoru Catholic Dispensary Central Nyeri Ncunga Catholic Dispensary Eastern Meru Nerkwo Dispensary Rift Valley Elgeyo Marakwet Ngandu Catholic Dispensary Central Nyeri Ngarua Catholic Dispensary Rift Valley Laikipia Njambini Catholic Dispensary Central Nyandarua Nthagaiya Catholic Dispensary Eastern Embu Nthambiro Catholic Dispensary Eastern Meru Nuu Catholic Dispensary Eastern Kitui Nyabururu Dispensary Nyanza Kisii Nyagwethe Dispensary Nyanza Homa Bay Catholic Dispensary Central Nyandarua Nyamonye Mission Dispensary Nyanza Siaya Oljororok Catholic Dispensary Central Nyandarua Olmoran Catholic Dispensary Rift Valley Laikipia Oloropil Dispensary Rift Valley Narok Olps Clinic Nyanza Kisumu Oropoi Dispensary Rift Valley Turkana Othaya Catholic Dispensary Central Nyeri Our Lady of Lords Dispensary Rift Valley Uasin Gishu Our Lady of Lourdes Dispensary (Gucha) Nyanza Kisii Pand Pieri Community Health Centre Nyanza Kisumu Parua Dispensary Rift Valley West Pokot Passenga Dispensary Central Nyandarua Psigor Dispensary Rift Valley West Pokot Quadalupe Sisters Roret Rift Valley Kericho Ruchu Dispensary Central Murang'a Rumuruti Catholic Dispensary Rift Valley Laikipia Sacred Heart Dispensary (Nzaikoni) Eastern Machakos Sacred Heart Kangaita Catholic Dispensary Central Kirinyaga Sacred Heart Mission Dispensary Central Nyeri Sagana Catholic Dispensary Central Kirinyaga Salawa Catholic Mission Dispensary PHC Rift Valley Baringo Sererit Catholic Dispensary Rift Valley Samburu

53 l Emory University, Interfaith Health Program Sipili Catholic Dispensary Rift Valley Laikipia Sirimba Dispensary Western Busia Sisto Mazoldi Dispensary (Rongai) Rift Valley Nakuru Springs of Patmos Health Services Central Kiambu St Aloysius Gonzaga School Dispensary Nairobi Nairobi St Andrews Cc Rironi Dispensary Central Kiambu St Anne Kariene Dispensary Eastern Meru St Anne Mida Catholic Dispensary Coast Kilifi St Anthony Lemek Dispensary Rift Valley Narok St Barkita Dispensary Utawala Nairobi Nairobi St Basil's Catholic Dispensary Eastern Embu St Boniface Dispensary Rift Valley Nandi St Bridget's Mother & Child Nairobi Nairobi St Bridgit Kalemunyang Dispensary Rift Valley Turkana St Catherine's Napetet Dispensary Rift Valley Turkana St Charles Lwanga Dispensary Central Kiambu St Christopher Dispensary Rift Valley Kajiado St Francis of Assisi Dispensary Central Kiambu St Hellens Clinic Nyanza Migori St John Baptist Ikalaasa Mission Dispensary Eastern Machakos St John Catholic Dispensary (Nyeri North) Central Nyeri St John's Dispensary (Kithoka) Eastern Meru St Joseph Brothers Central Nyeri St Joseph Catholic Dispensary (Igembe) Eastern Meru St Joseph Catholic Dispensary (Laikipia East) Rift Valley Laikipia St Joseph Catholic Dispensary () Central Kiambu St Joseph Mission Dispensary Chumvini Coast Taita Taveta St Joseph W Dispensary (Westlands) Nairobi Nairobi St Joseph's Boys National School Disp Rift Valley Trans Nzoia St Joseph's Dispensary (Dagoretti) Nairobi Nairobi St Joseph's Dispensary (Machakos) Eastern Machakos St Joseph's Girls High School Disp Rift Valley Trans Nzoia St Joseph's The Worker Rift Valley Narok St Kevina Dispensary Rift Valley Uasin Gishu St Kizito Mission Eastern Machakos St Martin De Porres (Static) Rift Valley Nakuru St Mary’s Msabaha Catholic Dispensary Coast Kilifi St Mary's Dispensary Eastern Machakos St Mary's Dispensary (Lugari) Western Kakamega St Mary's Health Unit Chelelemuk Western Busia St Mary's Nguviu Dispensary Eastern Embu St Mathews and Sarah Dispensary Central Nyandarua St Michael (Miaani) Mission Dispensary Eastern Machakos St Michael Dispensary Rift Valley Elgeyo Marakwet St Michael Dispensary (Kangaita) Central Nyeri St Monica Catholic Dispensary (Nguutani) Eastern Kitui St Monica Dispensary Central Nyeri St Monica's Nakwamekwi Dispensary Rift Valley Turkana St Odilia's Dispensary Nairobi Nairobi St Patrick’s Dispensary Coast Mombasa St Patrick's Kanamkemer Dispensary Rift Valley Turkana St Paul Dispensary Nyanza Siaya St Paul’s Ejinja Dispensary Western Kakamega St Peter's Catholic Dispensary (Ng'onyi) Eastern Meru St Raphael Dispensary Rift Valley Trans Nzoia

Emory University, Interfaith Health Program l 54 St Raphael's Clinic Nairobi Nairobi St Teresa Catholic Dispensary Central Kirinyaga St Teresa Olokirikirai Dispensary Rift Valley Narok St Therese Dispensary Rift Valley Kajiado St Thomas The Apostle Athi Catholic Dispensary Eastern Meru St Veronica Dispensary Mukurweini Central Nyeri Stgetrude Dispensary Rift Valley Uasin Gishu Suguta Marmar Catholic Dispensary Rift Valley Samburu The Mater Hospital Buruburu Nairobi Nairobi Thome Catholic Dispensary Rift Valley Laikipia Timau Catholic Dispensary Eastern Meru Tinganga Catholic Dispensary Central Kiambu Todonyang Dispensary Rift Valley Turkana Diani Catholic Dispensary Coast Kwale Ulanda Dispensary Nyanza Migori Warazo Jet Catholic Dispensary Central Nyeri Zombe Catholic Dispensary Eastern Kitui DISTRICT HOSPITAL Name Province County Tabaka Mission Hospital Nyanza Kisii EYE CENTRE Name Province County Dom Spark Eastern Meru HEALTH CENTRE Name Province County Aluor Mission Health Centre Nyanza Siaya Amukura Mission Health Centre Western Busia Archers Post Health Centre Rift Valley Samburu Arror Health Centre Rift Valley Elgeyo Marakwet Asumbi Health Centre Nyanza Homa Bay Baricho Catholic Health Centre Central Kirinyaga Chepterit Mission Health Centre Rift Valley Nandi Chesoi Health Centre Rift Valley Elgeyo Marakwet Chimoi Health Centre Western Kakamega Diwopa Health Centre Nairobi Nairobi EDARP Soweto Health Centre Nairobi Nairobi Endo Health Centre Rift Valley Elgeyo Marakwet Fatima Health Centre (Lenkism) Rift Valley Kajiado Fr. Andrian Heath Centre Rift Valley Kajiado Gatunga Health Centre Eastern Tharaka Nithi Gekano Health Centre (Manga) Nyanza Nyamira Holy Spirit Health Centre Rift Valley Nakuru Holy Trinity Health Centre (Mai Mahiu) Rift Valley Nakuru Huruma Health Centre (Laikipia East) Rift Valley Laikipia Ichagaki (Mission) Health Centre Central Murang'a Isibania Mission Health Centre Nyanza Migori Kalimoni Hospital (Ruiru) Central Kiambu Kasikeu Catholic Health Centre Eastern Makueni Katangi Mission Health Centre Eastern Machakos Kianyaga Catholic Health Centre Central Kirinyaga Kibabii Health Centre Western Bungoma Koru Mission Health Centre Nyanza Kisumu Health Centre Eastern Marsabit Maria Immaculate Health Centre Nairobi Nairobi 55 l Emory University, Interfaith Health Program Maria Teressa Nuzzo Health Centre Coast Lamu Mawego Health Centre Nyanza Homa Bay Mbaga Health Centre Nyanza Siaya Mikinduri Health Centre Eastern Meru Mirogi Health Centre Nyanza Homa Bay Misyani Catholic Health Centre Eastern Machakos Moi's Bridge Catholic Rift Valley Uasin Gishu Mother Franciscan Mission Health Centre Rift Valley Nandi Mother Kevin Dispensary (Catholic) Rift Valley Nakuru Mukothima Health Centre Eastern Tharaka Nithi Nakwamoru Health Centre Rift Valley Turkana Ng'iya Health Centre Nyanza Siaya North Horr Health Centre Eastern Marsabit Nyang'oma Mission Health Centre Nyanza Siaya Ol-Malaika Health Centre Rift Valley Kajiado Rangala Health Centre Nyanza Siaya Raruowa Health Centre Nyanza Homa Bay Reuben Mukuru Health Centre Nairobi Nairobi Ritumbe Health Centre Nyanza Kisii Rombo Health Centre Rift Valley Kajiado Ruiri Catholic Health Centre Eastern Meru Sega Dispensary Nyanza Siaya Sengera Health Centre (Gucha) Nyanza Kisii South Horr Catholic Health Centre Rift Valley Samburu St Angela Kingeero Clinic Central Kiambu St Angela Merici Health Centre (Kingeero) Nairobi Nairobi St Antony Health Centre Rift Valley Nakuru St Antony's Abossi Health Centre Rift Valley Narok St Barbara Mosocho Health Centre Nyanza Kisii St Camillus Health Centres Central Kiambu St Charles Lwanga Health Centre Western Kakamega St Clare Bolo Health Centre Nyanza Kisumu St Elizabeth Chiga Health Centre Nyanza Kisumu St Elizabeth Lorugum Health Centre Rift Valley Turkana St Elizabeth Lwak Mission Health Centre Nyanza Siaya St Francis Tinga Health Centre (Kipkelion) Rift Valley Kericho St John Cottage Health Centre Rift Valley Nakuru St Joseph's Nyansiongo Health Centre Nyanza Nyamira St Kizito Health Centre Nyanza Migori St Luke's Health Centre (Mbita) Nyanza Homa Bay St Mary Health Centre (Kiserian) Rift Valley Kajiado St Mary's Health Centre (Mbita) Nyanza Homa Bay St Monica Rapogi Health Centre Nyanza Migori St Paul's Health Centre Nyanza Homa Bay St Theresa Thatha Mission Dispensary Eastern Machakos St Theresa's Riiji Health Centre Eastern Meru St Vincent De Paul Health Centre Nyanza Kisumu Tonga Health Centre Nyanza Homa Bay Tuuru Catholic Health Centre Eastern Meru Uradi Health Centre Nyanza Siaya Verna Health Centre Nyanza Migori HEALTH PROGRAMME Name Province County Comboni Missionary Sisters Health Programme Nairobi Nairobi Lokori Primary Health Care Programme Rift Valley Turkana Emory University, Interfaith Health Program l 56 Nadapal Primary Health Care Programme Rift Valley Turkana St Mary's Kalokol Primary Health Care Programme Rift Valley Turkana MATERNITY HOME Name Province County Fatima Maternity Hospital Rift Valley Kajiado MEDICAL CLINIC Name Province County Assumption Sisters Mbooni Clinic Eastern Makueni Asumbi Annex Dispensary Nyanza Homa Bay Bethsaida Catholic Dispensary Central Kiambu Brother Andre Clinic Nairobi Nairobi Catholic Archdiocese of Mombasa CHBC & AIDS Relief Coast Mombasa Christamarianne Medical Clinic (Suneka) Nyanza Kisii Dandora (EDARP) Clinic Nairobi Nairobi Disciples of Mercy Clinic Nyanza Kisumu EDARP Komarock Health Centre Nairobi Nairobi EDARP Njiru Clinic Nairobi Nairobi Good Shepherd Medical Clinic Eastern Embu Likoni Catholic Dispensary Coast Mombasa Makadara Mercy Sisters Dispensary Nairobi Nairobi Mama Maria Clinic Nyanza Migori Muthale Mission Hospital Satellite Clinic Eastern Kitui Reinha Rosary Medical Clinic (Githunguri) Nairobi Nairobi Sr. Rhoda Medical Clinic Eastern Meru St Alice (EDARP) Dandora Nairobi Nairobi St Claire Dispensary Western Busia St Joseph (EDARP) Clinic Nairobi Nairobi St Lawrence Dispensary Central Nyandarua St Raphael Arch Medical Rift Valley Uasin Gishu Stella Maris Medical Clinic Coast Mombasa The Mater Embakasi Clinic Nairobi Nairobi The Mater Hospital Satellite Central Kiambu NURSING HOME Name Province County Mother Amadea Health Centre Coast Mombasa St Damiano Nursing Home Western Bungoma St Joseph Nursing Home Nairobi Nairobi OTHER HOSPITAL Name Province County Bishop Kioko Catholic Hospital Eastern Machakos Catholic Hospital Wamba Rift Valley Samburu Chesongoch Health Centre Rift Valley Elgeyo Marakwet Christamarianne Mission Hospital Nyanza Kisii Chuka Cottage Hospital Eastern Tharaka Nithi Consolata Hospital (Nkubu) Eastern Meru Consolata Kyeni Hospital Eastern Embu Consolata Mission Hospital (Mathari) Central Nyeri Cottolengo Mission Hospital Eastern Meru Gaichanjiru Hospital Central Murang'a Holy Family Mission Hospital Githunguri Central Kiambu Holy Family Nangina Hospital Western Busia Immaculate Heart Hospital Kereita Central Kiambu Immaculate Heart of Mary Hospital Central Kiambu

57 l Emory University, Interfaith Health Program Jamaa Mission Hospital Nairobi Nairobi Kakuma Mission Hospital Rift Valley Turkana Kalimoni Hospital (Thika) Central Kiambu Kaplong Hospital Rift Valley Bomet Laisamis Hospital Eastern Marsabit Mary Help of The Sick Hospital Central Kiambu Mary Immaculate Hospital (Nyeri North) Central Nyeri Matercare Maternity Hospital Eastern Isiolo Matuu Mission Hospital Eastern Machakos Muthale Mission Hospital Eastern Kitui Mission Hospital Eastern Kitui Mutuati Catholic Hospital Eastern Meru Mwea Mission (Our Lady of Lourdes) Hospital Central Kirinyaga Nazareth Hospital Central Kiambu Nazareth Hospital (Ruiru) Central Kiambu North Kinangop Catholic Hospital Central Nyandarua Nyabondo Mission Hospital Nyanza Kisumu Oll Mwea Hospital Clinic Embu (Satellite) Eastern Embu Ortum Hospital Rift Valley West Pokot Ruaraka Uhai Neema Hospital Nairobi Nairobi Sololo Mission Hospital Eastern Marsabit St Camillus Mission Hospital Nyanza Migori St Francis Community Hospital (Kasarani) Nairobi Nairobi St Joseph Hospital Rift Valley Narok St Joseph Mission Hospital Nyanza Migori St Luke’s Cottage Hospital Eastern Meru St Mary's Hospital () Western Kakamega St Mary's Hospital (Naivasha) Rift Valley Nakuru St Mary's Mission Hospital Nairobi Nairobi St Monica Hospital Nyanza Kisumu St Mulumba Mission Hospital Central Kiambu St Theresa Kiirua Hospital (Kiirua) Eastern Meru The Mater Hospital Mukuru Nairobi Nairobi Tigania Hospital Eastern Meru VCT CENTRE (STAND-ALONE) Name Province County Babadogo (EDARP) Nairobi Nairobi Boma La Tumaini VCT Rift Valley Kajiado Cdn VCT Rift Valley Nakuru Huruma (EDARP) Nairobi Nairobi Mathare 3A (EDARP) Nairobi Nairobi St Augustine Youth Friendly Centre Rift Valley Turkana St Martin Catholic Social Apostolate Central Nyandarua

Supreme Council of Kenyan Muslims (SUPKEM) Facilities

DISPENSARY Facility Name Province County Al-Faruq Dispensary North Eastern Garissa Algadir Medical Clinic Rift Valley Nakuru Crescent Medical Aid (Jamia Towers) Nairobi Nairobi Nyeri (Islamic Foundation) Clinic Central Nyeri Young Muslim Dispensary North Eastern Garissa

Emory University, Interfaith Health Program l 58 HEALTH CENTRE Facility Name Province County Alfalah Nursing Home Eastern Isiolo Ama (Africa Muslim Agency) Clinic Central Kiambu Bashal Islamic Community Health Initiative North Eastern Garissa MEDICAL CLINIC Facility Name Province County Jamia Medical Centre Western Kakamega Mukuru Crescent Clinic Nairobi Nairobi OTHER HOSPITAL Facility Name Province County Tawfiq Muslim Hospital Coast Kilifi

Other Faith-Based Facilities

DISPENSARY Name Province County ABC Thange Dispensary Eastern Makueni AIC Biribiriet Dispensary Rift Valley Trans Nzoia AIC Kalamba Dispensary Eastern Makueni Aina Onlus Eastern Meru Amakuriat Dispensary Rift Valley West Pokot Assumption Sisters Dispensary Rift Valley Elgeyo Marakwet Bible Faith Church Medical Services Dispensary Rift Valley West Pokot Bindura Dispensary Rift Valley Uasin Gishu Boyani Dispensary Western Vihiga Bujumba Dispensary Western Busia Bukwala SDA Dispensary Western Kakamega Bura Mission Clinic Coast Taita Taveta Ccs Kiritiri Clinic Eastern Embu Changara Calvary Dispensary Western Busia Chebaiwa Dispensary Rift Valley Uasin Gishu Chebukaka Dispensary Western Bungoma Chebwai Mission Dispensary Western Kakamega Chelelemuk Dispensary Western Bungoma Chepareria (SDA) Dispensary Rift Valley West Pokot Chepnyal Dispensary Rift Valley West Pokot Cheppemma (AIC) Dispensary Rift Valley Nakuru Chesinende (Elck) Dispensary Rift Valley Kericho Chesta Dispensary Rift Valley West Pokot Chumvi Dispensary Rift Valley Laikipia Consolata Clinic Rift Valley Nakuru Diguna Dispensary Rift Valley Nandi Divine Mercy Dispensary Coast Taita Taveta Divine Mercy Eldoro (Catholic) Dispensary Coast Taita Taveta Don Bosco Clinic Eastern Embu Enkitoria Dispensary Rift Valley Narok FGC of Kenya Medical Centre Rift Valley Nakuru Future Life Dispensary Nyanza Siaya Gachika Orthodox Medical Clinic Central Nyeri Gatugi Mission Dispensary Central Nyeri Gituamba (AIPCA) Dispensary Central Kiambu Hekima Dispensary Rift Valley Nakuru 59 l Emory University, Interfaith Health Program Holy Rosary Ikinu Dispensary Central Kiambu Huruma Dispensary Rift Valley Nakuru Huruma Mobile Clinic Rift Valley Nakuru Iiani Catholic Dispensary Eastern Kitui Ingotse Dispensary Western Kakamega Ipcc Kaimosi Dispensary Rift Valley Nandi Jesus The Healer Clinic Western Kakamega Jumia Medical Clinic Rift Valley Uasin Gishu Kabebero AIPCA Dispensary Central Nyeri Kacheliba Mobile Clinic Rift Valley West Pokot Kajiado Christian Medical Centre Rift Valley Kajiado Kanyangi Mission Dispensary Eastern Kitui Kapkagaron Dispensary Rift Valley Nandi Kapkitony Dispensary Rift Valley Elgeyo Marakwet Kapkoi Mission Dispensary Rift Valley Trans Nzoia Kapsang'ar Dispensary Rift Valley West Pokot Kapsirichoi Dispensary Rift Valley Nandi Karaba Wango Dispensary Eastern Embu Karda Dispensary Rift Valley Narok Katakani Dispensary Eastern Kitui Keyian SDA Dispensary Rift Valley Narok Kichaka Simba Dispensary Coast Kwale Kihuti Orthodox Clinic Central Nyeri Kipsaos Dispensary Rift Valley Elgeyo Marakwet Kipsitet Baptist Dispensary Rift Valley Kericho Kirie Mission Clinic Eastern Embu Kiserian Dispensary Rift Valley Baringo Mobile Clinic Rift Valley Trans Nzoia Kithima (ABC) Dispensary Eastern Machakos Kiwawa (Acck) Dispensary Rift Valley West Pokot Koloch Dispensary Rift Valley Nandi Kolongolo M Dispensary Rift Valley Trans Nzoia Korokou Dispensary Rift Valley West Pokot Kyanika Dispensary Eastern Kitui Lea Toto Community Mukuru Reuben Nairobi Nairobi Life Care Ministry Clinic Central Kiambu Life Water Ndege Mobile Clinic Rift Valley Nakuru Little Flower Dispensary Central Nyeri Live With Hope Rift Valley Kericho Liviero Dispensary Eastern Embu Lutaso Dispensary Western Kakamega Maji Moto Dispensary (Narok South) Rift Valley Narok Maliera Mission Dispensary Nyanza Siaya Mangu (Aip) Dispensary Central Kiambu Mararianta Dispensary Rift Valley Narok Marich Dispensary Rift Valley West Pokot Maridadi RCEA Medical Centre Rift Valley Trans Nzoia Mary Finch Dispensary Rift Valley Kericho Mary Immaculate Sisters Dispensary Nairobi Nairobi Marynoll Dispensary Coast Tana River Masaba Dispensary Western Kakamega Materi Girls Dispensary Eastern Tharaka Nithi Matumaini Dispensary Rift Valley Nakuru Mikeu PCEA Medical Centre Rift Valley Nakuru Mogotio Dispensary Rift Valley Baringo

Emory University, Interfaith Health Program l 60 Most Precious Blood Sisters Dispensary Central Kiambu Mulutu Mission Dispensary Eastern Kitui Munyange (AIPCA) Dispensary Central Nyeri Murkwijit Dispensary Rift Valley West Pokot Musanda (ACK) Clinic Western Kakamega Musoa SDA Dispensary Eastern Makueni Muthetheni Mission Health Centre Eastern Machakos Mutito Catholic Dispensary Eastern Kitui Mutune Dispensary Eastern Kitui Mwina Methodist Dispensary Coast Tana River Naikara Dispensary Rift Valley Narok Nairasirasa Dispensary Rift Valley Narok Nasolot Dispensary Rift Valley West Pokot Neema Hospital (Ruiru) Central Kiambu Ngito Dispensary Rift Valley Narok Ngosuani Dispensary Rift Valley Narok Nolasit Dispensary Rift Valley Kajiado Nturumeti Dispensary Rift Valley Narok Nyagowa Elck Dispensary Nyanza Homa Bay Nyina Wa Mumbi Dispensary Nairobi Nairobi Oldonyorok (Cog) Dispensary Rift Valley Narok Olendeem Dispensary Rift Valley Narok Olenkasurai Dispensary Rift Valley Narok Patrician Dispensary Rift Valley Uasin Gishu PCEA Honi Dispensary Central Nyeri PCEA Mau-Summit Health Centre Rift Valley Nakuru Ripples International Dispensary Eastern Meru Sa/Ahf Kithituni Health Clinic Eastern Makueni Sacred Heart Dispensary Central Kiambu Salama (Baptist) Nursing Home Eastern Makueni Sekerr Dispensary Rift Valley West Pokot Shianda Baptist Clinic Western Kakamega Shirikisho Dispensary Nyanza Homa Bay Shirikisho Methodist Dispensary Coast Tana River Sironoi SDA Dispensary Rift Valley Nandi Sochoi (AIC) Dispensary Rift Valley Nandi Sondany Dispensary Rift Valley West Pokot St Andrews Orthodox Clinic Western Kakamega St Ann Lioki Dispensary Central Kiambu St Brigid’s Girls High School Dispensary Rift Valley Trans Nzoia St Clare Dispensary Rift Valley Nakuru St Gertrude Dispensary Rift Valley Uasin Gishu St John Orthodox Dispensary Kahuho Central Kiambu St Joseph Dispensary (Kabaa) Eastern Machakos St Joseph Kavisuni Dispensary Eastern Kitui St Joseph Mukasa Dispensary Nairobi Nairobi St Joseph School (Kabaa) Eastern Machakos St Ladislaus Dispensary Rift Valley Uasin Gishu St Marys Dispensary (Mwala) Eastern Machakos St Mary's Kapsoya Dispensary Rift Valley Uasin Gishu St Mercelline Roo Dispensary (Suba) Nyanza Homa Bay St Peter Orthodox Church Dispensary Central Kiambu St Peter Orthodox Kanjeru Dispensary Central Kiambu St Philip’s Mukomari Western Kakamega St Stephen (ACK) Cura Dispensary Central Kiambu

61 l Emory University, Interfaith Health Program St Teresa's Parish Dispensary Nairobi Nairobi St Ursula Dispensary Rift Valley Trans Nzoia Subuku Dispensary (Molo) Rift Valley Nakuru Tarasaa Catholic Dispensary Coast Tana River Tawheed Dispensary Coast Kilifi Tuina Dispensary Rift Valley West Pokot Union Medical Dispensary Coast Kilifi Upec Chebaiywa Dispensary Rift Valley Uasin Gishu Victorious Living Ministries (Vlm) Dispensary Western Bungoma Watanu SDA Dispensary Coast Kilifi Wema Catholic Dispensary Coast Tana River What Matters Mission Dispensary Rift Valley Nakuru Zion Community Clinic Coast Kilifi HEALTH CENTRE Name Province County Acef Ena Health Centre Eastern Embu Agc Baby Health Centre Rift Valley Nakuru Blessed Louis Palazzolo Health Centre Central Kiambu Bushiangala Health Centre Western Kakamega Butula Mission Health Centre Western Busia Buyangu Health Centre Western Vihiga Christ The Healer Western Kakamega Cmf Aitong Health Centre Rift Valley Narok Dreamland Mc Health Centre Western Bungoma Elwak Health Centre North Eastern Mandera Entasekera Health Centre Rift Valley Narok Eregi Mission Health Centre Western Kakamega Ewaso Ngiro Health Centre Rift Valley Narok Holy Transfiguration Orthodox Health Centre Central Kiambu Kaiboi Mission Health Centre Rift Valley Nandi Kapkoi Health Centre Rift Valley Elgeyo Marakwet Kaptama (Friends) Health Centre Western Bungoma Ken Ame Health Centre Rift Valley Uasin Gishu Kimende Orthodox Mission Health Centre Central Kiambu Kobujoi Mission Health Centre Rift Valley Nandi Langas RCEA Rift Valley Uasin Gishu Loving Care (MCK) Health Centre Rift Valley Kajiado Mercy Health Centre Rift Valley Uasin Gishu Mercy Mission Health Centre Nairobi Nairobi Mundoli Health Centre Western Kakamega Ngarariga Health Centre Central Kiambu Ngecha (PCEA) Health Centre Central Kiambu Nyang'ori Health Centre Western Vihiga Orthodox Maternity and Health Centre Central Kiambu Revival Home Based Care Clinic Nairobi Nairobi St Angela Melici Health Centre Central Kiambu St Brigitas Health Centre Rift Valley Uasin Gishu St Elizabeth Health Centre Rift Valley Narok St Francis Health Centre (Nairobi North) Nairobi Nairobi St Francis Health Centre (Nakuru Central) Rift Valley Nakuru St Gabriel Health Centre Central Kiambu St Pius Musoli Health Centre Western Kakamega St Raphael Health Centre Coast Tana River Talek Health Centre Rift Valley Narok Tei Wa Yesu Health Centre Eastern Kitui Emory University, Interfaith Health Program l 62 Thessalia Health Centre Rift Valley Kericho Vision Peoples Inter Health Centre Nairobi Nairobi Wesley Health Centre Rift Valley Nakuru HEALTH PROGRAMME Name Province County Our Lady's Hospice Central Kiambu MEDICAL CLINIC Name Province County All Nation Medical Clinic Rift Valley Nakuru Ashburn Ohuru Clinic Nyanza Siaya CFW Clinic Central Kiambu Cidi Mukuru Clinic Nairobi Nairobi Corner Chaani Medical Clinic Coast Mombasa Cornerstone Baptist Clinic Western Busia Divine Mercy Kariobangi Nairobi Nairobi Glory Ministry Medical Clinic Rift Valley Nakuru Grace Medical Care Centre Western Bungoma Hope World Wide Nakuru Rift Valley Nakuru Jordan Baptist Medical Clinic Western Bungoma Kag-Sombo Medical Clinic Coast Tana River Kenya Assemblies of God Medical Clinic Eastern Meru Kijabe (AIC) Hospital Marira Medical Clinic Central Kiambu Kithituni Health Care Clinic Eastern Makueni Mary Immaculate Clinic Mukuru Nairobi Nairobi Mt Zion Mission Medical Clinic Rift Valley Trans Nzoia Nazarene Medical Clinic (Kitui West) Eastern Kitui Pefa Mercy Medical Centre Central Kiambu Renguti (PCEA) Women's Guild Clinic Central Kiambu Ruai (SDA) Clinic Nairobi Nairobi Sgrr Medical Clinic Nairobi Nairobi St John's Community Centre Nairobi Nairobi St Martin De Porres (Mobile) Rift Valley Nakuru St Thadeus Medical Clinic Western Bungoma St Veronica EDARP Clinic Nairobi Nairobi St Vincent Catholic Clinic Nairobi Nairobi NURSING HOME Name Province County Coptic Nursing Home Western Vihiga Mary Immaculate Cottage Hospital (Mombasa) Coast Mombasa Matata Nursing Hospital Nyanza Homa Bay St Jane Nursing Home Nyanza Kisumu OTHER HOSPITAL Name Province County Ahmadiya Hospital Western Kakamega AIC Litein Mission Hospital Rift Valley Kericho Cure (AIC) International Children's Hospital Central Kiambu Kaimosi Mission Hospital Western Vihiga Kikoko Mission Hospital Eastern Makueni Kikuyu (PCEA) Hospital Central Kiambu Kiminini Cottage Hospital Rift Valley Trans Nzoia Kipchimchim M Hospital Rift Valley Kericho Kiria-Ini Mission Hospital Central Murang'a Lugulu Friends Mission Hospital Western Bungoma 63 l Emory University, Interfaith Health Program Mercy Hospital Rift Valley Baringo Mewa Hospital Coast Mombasa Mukumu Hospital Western Kakamega Mwihila Mission Hospital Western Kakamega Oasis Mission Hospital Central Kiambu Plateau Hospital Rift Valley Uasin Gishu Provide International Korogocho Nairobi Nairobi Sayyida Fatimah Hospital Coast Mombasa Sikh Temple Hospital Eastern Makueni St Luke's (ACK) Hospital Kaloleni Coast Kilifi Suleman Farooq Memorial Centre Eastern Makueni VCT CENTRE (STAND-ALONE) Name Province County Adventist Centre For Care and Support (Westlands) Nairobi Nairobi Hope Community VCT Nairobi Nairobi Kiminini Pag VCT Rift Valley Trans Nzoia Kisiwani VCT Coast Mombasa Nuru Lutheran Media Ministry Nairobi Nairobi Ololulunga VCT Rift Valley Narok PCEA VCT Rift Valley Nakuru Revival Baptist VCT Centre Rift Valley Nakuru World Provision VCT Eastern Machakos Zinduka Clinic Nairobi Nairobi

Emory University, Interfaith Health Program l 64 Appendix 3

Number of Visits to Service Providers by PLHIV and Number of Health Facilities (both faith-based and non faith-based), KHIS data * Not identified as an FBO in the eHealth database but verified as an FBO by IHP.

Baringo County

All Facilities FB Facilities % FB facilities Total facilities 189 10 5.3 # of visits by HIV patients currently seen in care 23,761 573 2.4 # of facilities providing at least one HIV service 67 4 6.0 % providing HIV services 35.5 40.0

Faith-based Facilities Providing at Least One HIV Service Eldama Ravine (AIC) Health Centre Mercy Catholic Hospital Kipsaraman Dispensary Mogotio Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. A.I.C Ebenezer Kokwototo Dispensary Churo Dispensary Marigat Catholic Mission Kiserian Dispensary Salawa Catholic Mission Dispensary PHC

Bomet County

All Facilities FB Facilities % FB facilities Total facilities 117 4 3.4 # of visits by HIV patients currently seen in care 38,778 6,627 17.1 # providing at least one HIV service 75 3 4.0 % providing HIV services 64.1 75.0

Faith-based Facilities Providing at Least One HIV Service Kaboson Health Centre Kaplong Hospital Tenwek Mission Hospital

Faith-based Facilities in the County. No HIV services reported to KHIS. Kaplomboi Dispensary

Bungoma County

All Facilities FB Facilities % FB facilities Total facilities 150 19 12.7 # of visits by HIV patients currently seen in care 179,363 30,683 17.1 # providing at least one HIV service 121 12 9.9 % providing HIV services 80.7 63.2

Faith-based Facilities Providing at Least One HIV Service Butonge Dispensary Khasoko Health Centre Chebukaka Dispensary Kibabii Health Centre Dreamland MC Health Centre Lugulu Friends Mission Hospital Jordan Baptist Medical Clinic Mission of Mercy Clinic Kamukuywa (ACK) Dispensary St Damiano Nursing Home Kaptama (Friends) Health Centre St Thadeus Medical Clinic

Faith-based Facilities in the County. No HIV services reported to KHIS. Chelelemuk Dispensary Grace Medical Care Centre Chwele Friends Dispensary Khulwanda Dispensary

65 l Emory University, Interfaith Health Program Kipsigon (FGC) Health Centre Victorious Living Ministries (VLM) Dispensary Soysambu (ACK) Dispensary

Busia County

All Facilities FB Facilities % FB facilities Total facilities 100 4 4.00% # of visits by HIV patients currently seen in care 229,864 19,021 8.27% # providing at least one HIV service 65 4 6.15% % providing HIV services 65.00% 100.00%

Faith-based Facilities Providing at Least One HIV Service Amukura Mission Health Centre Butula Mission Health Centre Holy Family Nangina Hospital Namboboto Dispensary

Faith-based Facilities in the County. All registered faith-based facilities are providing some type of HIV service.

Elgeyo-Marakwet County

All Facilities FB Facilities % FB facilities Total facilities 124 11 8.9 # of visits by HIV patients currently seen in care 11911 498 4.2 # providing at least one HIV service 84 7 8.3 % providing HIV services 67.7 63.6

Faith-based Facilities Providing at Least One HIV Service Arror Health Centre Kipsaos Dispensary Assumption Sisters Dispensary Liter (AIC) Dispensary Kapkoi Health Centre Nerkwo Dispensary Kapsowar (AIC) Hospital

Faith-based Facilities in the County. No HIV services reported to KHIS. Endo Health Centre Kapkitony Dispensary St Michael Dispensary

Embu County

All Facilities FB Facilities % FB facilities Total facilities 143 23 16.1 # of visits by HIV patients currently seen in care 59,851 3,786 6.3 # providing at least one HIV service 90 16 17.8 % providing HIV services 14.0 69.6

Faith-based Facilities Providing at Least One HIV Service Acef Ena Health Centre Gertrude Dispensary B/Valley (PCEA) Clinic Kiriari (ACK) Dispensary CCS Kiritiri Clinic Kirie Mission Clinic Consolata Kyeni Hospital Liviero Dispensary Don Bosco Clinic Mukangu (ACK) Dispensary EAPC Kigumo Clinic Nthagaiya Catholic Dispensary Embu Children Clinic OLL Mwea Hospital Clinic Embu (Satellite) Emmanuel Kigari (ACK) Dispensary St Marys Nguviu Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. CCS Macumo Clinic Good Shepherd Medical Clinic Emory University, Interfaith Health Program l 66 Karaba Wango Dispensary Kianjokoma (ACK) Trinity Clinic Kathangariri (ACK) Clinic Majengo (PCEA) Clinic Kevote Catholic Dispensary

Garissa County

All Facilities FB Facilities % FB facilities Total facilities 113 3 2.7 # of visits by HIV patients currently seen in care 3,955 0 0 # providing at least one HIV service 19 0 0.0 % providing HIV services 16.8 0.0

Faith-based Facilities Providing at Least One HIV Service None Reported

Faith-based Facilities in the County. No HIV services reported to KHIS. Al-Faruq Dispensary Bashal Islamic Community Health Initiative Young Muslim Dispensary

Homa Bay County

All Facilities FB Facilities % FB facilities Total facilities 200 27 13.5 # of visits by HIV patients currently seen in care 470,952 76,945 16.3 # providing at least one HIV service 159 21 13.2 % providing HIV services 79.5 77.8

Faith-based Facilities Providing at Least One HIV Service Asumbi Health Centre Nyagwethe Dispensary Atemo Health Centre Ogande Dispensary Good Shepherd Ang'iya Raruowa Health Centre Holy Family Oriang Mission Dispensary Shirikisho Dispensary Kamasengere Dispensary St Luke's Health Centre (Mbita) Kendu Adventist Hospital St Mary's Health Centre (Mbita) Mangima SDA Health Centre St Mercelline Roo Dispensary (Suba) Manyatta (SDA) Dispensary St Paul's Health Centre Matata Nursing Hospital Tonga Health Centre Mawego Health Centre Wire Dispensary Nyagowa ELCK Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Asumbi Annex Dispensary Nyandiwa Baptist Dispensary Hope Compassionate (ACK) Dispensary Oriang (SDA) Health Centre Mirogi Health Centre Rangwe (SDA) Dispensary

Isiolo County

All Facilities FB Facilities % FB facilities Total facilities 47 10 21.3 # of visits by HIV patients currently seen in care 1,150 0 0 # providing at least one HIV service 31 8 25.8 % providing HIV services 66.0 70.0

Faith-based Facilities Providing at Least One HIV Service ACK Dispensary (Isiolo) Kambi Garba Dispensary AIC Dispensary (Isiolo) Kambi ya Juu Catholic Dispensary (Isiolo) Alfalah Dispensary Ngaremara Dispensary Catholic Dispensary (Isiolo) Waso AIPCA Dispensary (Isiolo) 67 l Emory University, Interfaith Health Program Faith-based Facilities in the County. No HIV services reported to KHIS. Matercare Maternity Hospital Merti Catholic Dispensary

Kajiado County

All Facilities FB Facilities % FB facilities Total facilities 229 5 2.2 # of visits by HIV patients currently seen in care 33,006 1,218 3.7 # providing at least one HIV service 135 5 3.7 % providing HIV services 59.0 100.0

Faith-based Facilities Providing at Least One HIV Service Embul-Bul Catholic Dispensary PCEA Smyrna Kajiado (AIC) Dispensary Rombo Health Centre Centre of Hope Medical Clinic

Faith-based Facilities in the County. All registered faith-based facilities are providing some type of HIV service.

Kakamega County

All Facilities FB Facilities % FB facilities Total facilities 255 29 11.4 # of visits by HIV patients currently seen in care 246,445 59,359 24.1 # providing at least one HIV service 171 21 12.3 % providing HIV services 67.1 72.4

Faith-based Facilities Providing at Least One HIV Service Ahmadiya Hospital Mukumu Hospital Bushiangala Health Centre Mulwanda Dispensary Chebwai Mission Dispensary Mundoli Health Centre Chimoi Health Centre Mwihila Mission Hospital Eregi Mission Health Centre Namasoli Health Centre Eshisiru Catholic Dispensary St Charles Lwanga Health Centre Ingotse Dispensary St Mary's Dispensary (Lugari) Jamia Medical Centre St Mary's Hospital (Mumias) Lutaso Dispensary St Paul’s Ejinja Dispensary Lwandeti Dispensary St Pius Musoli Health Centre Masaba Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Apostles Clinic Nzoia (ACK) Dispensary Christ The Healer Shianda Baptist Clinic Jesus the Healer Clinic St Andrew's Orthodox Clinic Musanda (ACK) Clinic St. Philips Mukomari

Kericho County

All Facilities FB Facilities % FB facilities Total facilities 194 13 6.7 # of visits by HIV patients currently seen in care 68,804 1,791 2.6 # providing at least one HIV service 136 11 8.1 % providing HIV services 70.1 84.6

Faith-based Facilities Providing at Least One HIV Service AIC Litein Mission Hospital Chesinende (ELCK) Dispensary AIC Liten VCT Kebeneti (SDA) Health Centre Barotion (AIC) Dispensary Kipchimchim M Hospital Emory University, Interfaith Health Program l 68 Mary Finch Dispensary St Francis Tinga Health Centre (Kipkelion) Mercy Mobile Clinic (Kipkelion) Thessalia Health Centre Quadalupe Sisters Roret

Faith-based Facilities in the County. No HIV services reported to KHIS. Kipsitet Baptist Dispensary Live With Hope

Kiambu County

All Facilities FB Facilities % FB facilities Total facilities 437 77 17.6 # of visits by HIV patients currently seen in care 41,852 2,997 7.2 # providing at least one HIV service 61 13 21.3 % providing HIV services 14.0 16.9

Faith-based Facilities Providing at Least One HIV Service Blessed Louis Palazzolo Health Centre Karura (SDA) Dispensary Cargo Human Care Nazareth Hospital (Ruiru) Gathanga Dispensary Pefa Mercy Medical Center Gathiruini (PCEA) Dispensary Sacred Heart Dispensary Gituamba Dispensary St Joseph Catholic Dispensary Holy Family Catholic Mission Tinganga Catholic Dispensary Kambui (PCEA) Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. ACK Kanunga Mary Helper Of The Sick Ngarariga Health Centre AMA (Africa Muslim Agency) Clinic Most Precious Blood Sisters Dispensary Annunciation Catholic Dispensary Most Precious Medical Clinic Assumption of Mary Dispensary Mukurwe (PCEA) Medical Clinic Bethsaida Medical Clinic (Gatundu) Nazareth Hospital Bethsaida Medical Clinic (Thika) Nduriri (AIC) Dispensary Bibirioni Health Centre Neema Hospital (Ruiru) Caritas Mariah Ngarariga Health Centre Cura (ACK) Medical Clinic Ngecha (PCEA) Health Centre Cura Medical Clinic Ngecha Orthodox Dispensary Cure (AIC) international Children's Hospital Orthodox Maternity & Health Centre Holy Cross Dispensary Orthodox Maternity and Health Centre Holy Cross Dispensary Our Lady's Hospice Holy Rosary Ikinu Dispensary Renguti (PCEA) Women's Guild Clinic Immaculate Heart Hospital Kereita Springs of Patmos Immaculate Heart of Mary Hospital St Andrews CC Rironi Kagwe Catholic Dispensary St Andrews CC Rironi Dispensary Kalimoni Hospital (Ruiru) St Angela Kingeero Clinic Kalimoni Hospital (Thika) St Angela Melici Health Centre Kamahindu (A.I.C) Medical Centre St Ann Lioki Dispensary Kamburu (PCEA) Dispensary St Francis of Assisi Dispensary Karinga Mission St Gabriel Health Centre Kijabe (AIC) Hospital St John Orthodox Dispensary Kahuho Kijabe (AIC) Hospital Marira Medical Clinic St Joseph (ACK) Kanyariri Dispensary Kikuyu (PCEA) Hospital St Paul University Dispensary Kimende Orthodox Mission Health Centre St Peter's (ACK) Medical Clinic Kimende Orthodox Mission Health Centre and Maternity St. Charles Lwanga Dispensary Kimunyu (PCEA) Dispensary St. Stephen (ACK) Cura Dispensary Lankia (PCEA) Dispensary St. Mulumba Mission Hospital Life Care Ministry Clinic St. Peter Orthodox Church Dispensary Mangu (AIP) Dispensary The Mater Hospital Thika Satellite Mary Help of the Sick Hospital Tinganga (PCEA) Dispensary

69 l Emory University, Interfaith Health Program

All Facilities FB Facilities % FB facilities Total facilities 233 12 5.2 # of visits by HIV patients currently seen in care 128,038 18,821 14.7 # providing at least one HIV service 120 9 7.5 % providing HIV services 51.5 75.0

Faith-based Facilities Providing at Least One HIV Service Bomu Medical Centre (Mariakani) St Theresa Dispensary Giriama Mission Dispensary Tawfiq Muslim Hospital Kikambala Catholic Medical Clinic Union Medical Dispensary Malanga (AIC) Dispensary Watamu (SDA) Dispensary St Luke's (ACK) Hospital Kaloleni

Faith-based Facilities in the County. No HIV services reported to KHIS. St Anne Mida Catholic Dispensary St Marys Msabaha Catholic Dispensary Tawheed Dispensary

Kirinyaga County

All Facilities FB Facilities % FB facilities Total facilities 242 37 15.3 # of visits by HIV patients currently seen in care 18,184 5,317 29.2 # providing at least one HIV service 69 13 18.9 % providing HIV services 28.5 34.3

Faith-based Facilities Providing at Least One HIV Service Baricho Catholic Health Centre Kianyaga Catholic Health Centre Christian Community Services Clinic Base Kerugoya Mt. Kenya (ACK) Hospital Difathas Catholic Dispensary Mwea Mission (Our Lady Of Lourdes) Hospital Githuani (ACK) Dispensary PCEA Gateway Kagio Catholic Dispensary (Mary Immucate Catholic Sagana Catholic Dispensary Dispensary) St Mary Magdalene Kanjuu Dispensary Kiandegwa (Methodist Church Of Kenya) Dispensary St. Mary (ACK) Mugumo Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Gatumbi (SDA) Dispensary St Andrew's Kabare (ACK) Dispensary Githure (ACK) Dispensary St James Anglican Church Of Kenya Kiaritha Dispensary Jesmond (ACK) Dispensary (Mburi) St Johns Thaita (ACK) Dispensary Kagumo Live Giving Dispensary/Laboratory St Mary (ACK) Dispensary (Ngariama) Kairini Dispensary St Mary Health Clinic Kiamagunyi (ACK) Clinic St Mary Laboratory (Mwea) Kutus Catholic Dispensary St Mary Magdalene Kanjuu Dispensary Mbiri (ACK) Dispensary St Philips (ACK) Dispensary Ndiriti Mung'ang'a (ACK) Dispensary St Stephen's Kiandagae (ACK) Dispensary Mutira (ACK) Dispensary St Teresa Catholic Dispensary Ngiriambu (ACK) Dispensary St. Mary (ACK) Mugumo Dispensary Sacred Heart Kangaita Catholic Dispensary Thumaita (ACK) Dispensary

Emory University, Interfaith Health Program l 70

All Facilities FB Facilities % FB facilities Total facilities 154 16 10.4 # of visits by HIV patients currently seen in care 70,524 1,402 2.0 # providing at least one HIV service 125 11 8.8 % providing HIV services 81.2 68.8

Faith-based Facilities Providing at Least One HIV Service Christamarianne Medical Clinic (Suneka) Our Lady of Lourdes Dispensary (Gucha) Christamarrianne Hospital Riokindo Health Centre Itierio Nursing Home Ritumbe Health Centre Nyabururu Dispensary Sengera Health Centre (Gucha) Nyachenge Dispensary St Barbara Mosocho Health Centre Omorembe Health Centre (Gucha)

Faith-based Facilities in the County. No HIV services reported to KHIS. Metaburo Health Centre Nyanchwa Dispensary Monianku Health Centre Tabaka Mission Hospital Nyagichenche (SDA) Dispensary

Kisumu County

All Facilities FB Facilities % FB facilities Total facilities 143 14 9.8 # of visits by HIV patients currently seen in care 478,156 93,684 19.6 # providing at least one HIV service 94 12 12.8 % providing HIV services 65.7 85.7

Faith-based Facilities Providing at Least One HIV Service Aga Khan Hospital (Kisumu)* Nyakach (AIC) Dispensary Awasi Mission Dispensary OLPS Clinic Bar Korwa Dispensary Pand Pieri Community Health Centre Disciples of Mercy Clinic St Clare Bolo Health Centre Maseno Mission Hospital St Elizabeth Chiga Health Centre Nyabondo Mission Hospital St Monica Hospital

Faith-based Facilities in the County. No HIV services reported to KHIS. St Jane Nursing Home The Hope Medical Centre-Awasi

Kitui County

All Facilities FB Facilities % FB facilities Total facilities 309 27 8.7 # of visits by HIV patients currently seen in care 28,116 4,511 16.0 # providing at least one HIV service 102 7 6.9 % providing HIV services 33.0 25.9

Faith-based Facilities Providing at Least One HIV Service Curran Dispensary Muthale Mission Hospital Iiani Catholic Dispensary Mutomo Mission Hospital Katakani Dispensary St. Joseph Kavisuni Dispensary Kimangao Dispensary Tei Wa Yesu Health Centre Mulango (AIC) Health Centre Zombe (AIC) Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. ACK Mwingi CHBC Clinic Kyanika Dispensary Kanyangi Mission Dispensary Kyome (AIC) Dispensary 71 l Emory University, Interfaith Health Program Mbitini (ACK) Dispensary Nazarene Medical Clinic Miambani Catholic Nuu Catholic Dispensary Mulutu Mission Dispensary Nyumbani village Catholic Dispensary Muthale satellites St Monica Catholic Dispensary (Nguutani) Mutito Dispensary Syongila (ACK) Dispensary Mutulu (AIC) Dispensary Zombe Catholic Dispensary Mutune Dispensary

Kwale County

All Facilities FB Facilities % FB facilities Total facilities 99 4 4.0 # of visits by HIV patients currently seen in care 36,382 1,256 3.5 # providing at least one HIV service 70 3 4.3 % providing HIV services 70.7 75.0

Faith-based Facilities Providing at Least One HIV Service Kichaka Simba Dispensary Mrima (Catholic) Dispensary Ukunda Diani Catholic Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Mivumoni (Catholic) Dispensary

Laikipia County

All Facilities FB Facilities % FB facilities Total facilities 94 11 11.7 # of visits by HIV patients currently seen in care 19,103 1,595 8.4 # providing at least one HIV service 65 9 13.9 % providing HIV services 69.2 81.8

Faith-based Facilities Providing at Least One HIV Service Ethi Dispensary Segera Mission Dispensary Huruma Health Centre (Laikipia East) Sipili Catholic Dispensary Mary Immaculate Dispensary (Laikipia East) St Joseph Catholic Dispensary (Laikipia East) Olmoran Catholic Dispensary Thome Catholic Dispensary Rumuruti Catholic Dispensary Faith-based Facilities in the County. No HIV services reported to KHIS. Chumvi Dispensary Ngarua Catholic Dispensary

Lamu County

All Facilities FB Facilities % FB facilities Total facilities 47 2 4.3 # of visits by HIV patients currently seen in care 8,326 253 3.0 # providing at least one HIV service 30 2 6.7 % providing HIV services 63.8 100.0

Faith-based Facilities Providing at Least One HIV Service Hongwe Catholic Dispensary Maria Teressa Nuzzo Health Centre

Faith-based Facilities in the County. All registered faith-based facilities are providing some type of HIV service.

Emory University, Interfaith Health Program l 72

All Facilities FB Facilities % FB facilities Total facilities 309 29 9.4 # of visits by HIV patients currently seen in care 75,368 2,400 3.2 # providing at least one HIV service 170 13 7.7 % providing HIV services 55.0 44.8

Faith-based Facilities Providing at Least One HIV Service D Comboni Mission Misyani Mission Health Centre Bishop Kioko Catholic Hospital Muthetheni Mission Health Centre Matuu Mission Hospital Muthwani (AIC) Dispensary Kaiani Dispensary Sacred Heart Dispensary (Nzaikoni) Kaliluni (AIC) Dispensary St John Baptist Ikalaasa Mission Dispensary Katangi Health Centre World Provision Centre VCT () Masii Catholic Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Divine Mercy Catholic Dispensary St Joseph School (Kabaa) Kithima (ABC) Dispensary St Joseph's Dispensary (Machakos) Kyasila (AIC) Dispensary St Kizito Mission Mother of Mercy (Machakos) St Mary's Dispensary Ngelani (AIC) Dispensary St Marys Dispensary (Mwala) Redeemed Medical Clinic St Michael (Miaani) Mission Dispensary St Assisi Sisters of Mary Immaculate Nursing Home St Theresa Thatha Mission Dispensary St Joseph Dispensary (Kabaa) Tunawanjali Clinic

Makueni County

All Facilities FB Facilities % FB facilities Total facilities 225 29 12.9 # of visits by HIV patients currently seen in care 81,042 9,681 11.9 # providing at least one HIV service Unknown 20 Unknown % providing HIV services Unknown 69.0

Faith-based Facilities Providing at Least One HIV Service ABC Thange Dispensary Kiu (AIC) Dispensary AIC Kalamba Dispensary Kyumbe (AIC) Dispensary AIC Mukaa Dispensary Makindu Catholic Dispensary Assumption Sisters Mbooni Clinic Matiliku Catholic Dispensary Catholic Mission Dispensary Makueni Mbitini Catholic Dispensary Kambu Catholic Dispensary Mbooni (AIC) Dispensary Kasikeu Catholic Health Centre PCEA Kasasule Dispensary Kathonzweni Catholic Dispensary Sa/Ahf Kithituni Health Clinic Kibwezi Catholic Dispensary Salama (Baptist) Nursing Home Kikoko Mission Hospital Sikh Temple Hospital Kitundu (SDA) Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Assumption Sisters Mbooni Clinic Kithituni Health Care Clinic Mercy Mission Medical Dispensary Mitini Miracle Revival Church Clinic Mumo (AIC) Health Centre Musoa SDA Dispensary PCEA Kibwezi Dispensary Suleman Farooq Memorial Centre Thwake Community Dispensary

73 l Emory University, Interfaith Health Program

All Facilities FB Facilities % FB facilities Total facilities 72 0 0.0 # of visits by HIV patients currently seen in care 262 0 0.0 # providing at least one HIV service 11 0 0.0 % providing HIV services 15.3 0.0

No faith-based facilities of any type listed in eHealth.

Marsabit County

No data in the KHIS system for the selected indicator.

Faith-based Facilities Providing at Least One HIV Service Tumaini Medical Clinic (Marsabit)

Faith-based Facilities in the County. No HIV services reported to KHIS. Dirib Gombo Dispensary Logologo Dispensary Gatab Health Centre Loiyangalani Health Centre Illaut Dispensary Maikona Dispensary Kalacha (AIC) Dispensary Moyale Catholic Dispensary Karare Dispensary Namarei Dispensary (Marsabit South) Kargi Dispensary North Horr Health Centre Korr Dispensary Sololo Mission Hospital Laisamis Hospital

Meru County

All Facilities FB Facilities % FB facilities Total facilities 403 64 15.9 # of visits by HIV patients currently seen in care 70,968 25,133 35.4 # providing at least one HIV service 161 36 22.4 % providing HIV services 40.0 56.3

Faith-based Facilities Providing at Least One HIV Service Amungeti Catholic Dispensary Mitunguu CCS Dispensary Antubangai Catholic Dispensary MMH Ndoleli Dispensary CCS (ACK) Dispensary Mujwa Dispensary Consolata Hospital (Nkubu) Nkabune Dispensary Cottolengo Mission Hospital Nthambiro Catholic Dispensary Divine Mercy Kithatu Dispensary PCEA Kiengu Disp/Mat Gachua Catholic Dispensary Ripples International Dispensary Gaitu Dispensary Ruiri Catholic Health Centre Gitoro Dispensary St Ann Hospital Karia Dispensary St Anne Kariene Dispensary Karimonga Dispensary St Francis Health Centre Kathera Dispensary St John Marieni Dispensary Kenya Assemblies of God Medical Clinic St Joseph Catholic Dispensary (Igembe) Kiamiriru MCK Dispensary St Luke’s Cottage Hospital Kirigara (MCK) Dispensary St Theresas Riiji Health Centre Makandune Dispensary St. Theresa Hospital (Kiirua) Maua Methodist Hospital Timau Catholic Dispensary Mikinduri Health Centre Tuuru Catholic Health Centre

Faith-based Facilities in the County. No HIV services reported to KHIS. Aina Onlus Gaturi Dispensary Dom Spark Igandene Dispensary Fr Meru Dispensary Machaka Mission Dispensary Gangara Dispensary Maraa Catholic Dispensary Emory University, Interfaith Health Program l 74 Mbwinjeru Methodist Dispensary Nkunjumu Dispensary MCK Kathuine Dispensary Ruiga (MCK) Dispensary MCK Mbwinjeru Dispensary Ruiri MCK Medical Centre Meru Children’s Clinic Ruiri Medical Clinic Mitunguu Catholic Dispensary St Marks Dispensary (Kariene) MUTUATI CATHOLIC MISSION HOSPITAL ST THOMAS THE APOSTLE ATHI CATHOLIC Mutunguru PCEA Dispensary St. John's Dispensary (Kithoka) Mworoga Catholic Dispensary St. Peter's Catholic Dispensary (Ng'onyi) Ncunga Catholic Dispensary Tigania Hospital Nkuene (ACK) Dispensary UUkuu MCK Dispensary

Migori County

All Facilities FB Facilities % FB facilities Total facilities 191 26 13.6 # of visits by HIV patients currently seen in care 356,197 51,608 14.5 # providing at least one HIV service 131 18 13.7 % providing HIV services 68.6 69.2

Faith-based Facilities Providing at Least One HIV Service Getongoroma Dispensary Oyani (SDA) Dispensary Isibania Mission Health Centre Reusse Troyer Health Centre Kadem TB & Leprosy Dispensary Sori Lakeside Nursing and Maternity Home Komotobo Mission Health Centre St Barnabas Dispensary Kopanga Dispensary St Joseph Mission Hospital Macalder Mission Dispensary St Kizito Health Centre Matare Mission Dispensary St Monica Rapogi Health Centre Nyabikaye Dispensary Ulanda Dispensary Ogada Health Centre Verna Health Centre

Faith-based Facilities in the County. No HIV services reported to KHIS. Brase Clinic and Eye Centre Mama Maria Clinic Kamagambo Dispensary Msomi Complex Medical Clinic Kebaroti Dispensary Ranen (SDA) Dispensary Luciel Dispensary St Camillus Mission Hospital

Mombasa County

All Facilities FB Facilities % FB facilities Total facilities 311 14 4.5 # of visits by HIV patients currently seen in care 219,412 118,617 54.1 # providing at least one HIV service 78 7 21.3 % providing HIV services 25.1 50.0

Faith-based Facilities Providing at Least One HIV Service Bomu Medical Centre (Likoni)* Mikindani Catholic Dispensary Bomu Medical Hospital (Changamwe)* Mother Amadea Health Centre Likoni Catholic Dispensary Sayyida Fatimah Hospital Mewa Hospital

Faith-based Facilities in the County. No HIV services reported to KHIS. Catholic Archdiocese of Mombasa CBHC & AIDS Relief Mary Immaculate Cottage Hospital (Mombasa) Project (Mbungoni Satellite) St. Patrick’s Dispensary Corner Chaani Medical Clinic Stella Maris Dispensary Kisiwani Vct Word of Faith Church Dispensary

75 l Emory University, Interfaith Health Program Murang’a County

All Facilities FB Facilities % FB facilities Total facilities 288 31 10.8 # of visits by HIV patients currently seen in care 37,033 0 0.0 # providing at least one HIV service 84 5 6.0% % providing HIV services 29.2 16.1

Faith-based Facilities Providing at Least One HIV Service Githanga (ACK) Dispensary Muthithi (PCEA) Dispensary Gituru Dispensary Tata Hannah (African Christian Churches and Schools) Kiria-ini Mission Hospital Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Acc&s Kariua Dispensary Mununga Dispensary ACK Gaitheri Nginda (PCEA) Medical Clinic ACK St Paul Kiamuri Dispensary Prisca Wakarima (ACK) Dispensary Don Bosco Catholic Dispensary Ruchu Dispensary Gaichanjiru Hospital Rwathe Dispensary Gaturi Catholic Parish Dispensary Sabasaba Catholic Dispensary Githumu Hospital St Anne (ACK) Dispensary Ichagaki (Mission) Health Centre ST. LUKE KIHURO (ACK) DISPENSARY Kagwathi (SDA) Dispensary St. Peters Gaitheri (ACK) Dispensary Kahuhia (ACK) Clinic TRINITY GITHIGA (ACK) DISPENSARY Kamung'ang'a (ACK) Dispensary Wangema (African Christian Churches And Schools) Kihuro (ACK) Dispensary Clinic Mariira Catholic Dispensary Weithaga (ACK) Dispensary Mihuti Dispensary (Muranga North)

Nairobi County

All Facilities FB Facilities % FB facilities Total facilities 651 89 13.7 # of visits by HIV patients currently seen in care 720,087 422,139 58.6 # providing at least one HIV service 241 59 24.5 % providing HIV services 37.0 66.3

Faith-based Facilities Providing at Least One HIV Service Babadogo (EDARP) Kariobangi EDARP Baraka Dispensary (Nairobi) Kibera Chemi Chemi ya Uzima clinic Brother Andre Clinic Kivuli Dispensary Catholic University Dispensary Lea Toto Kibera* Chonesus Clinic Lea Toto Mukuru Reuben Comboni Missionary Sisters Health Programme Mukuru Makadara Mercy Sisters Dispensary Coptic Hospital (Ngong Road) Maria Immaculate Health Centre Coptic Medical Clinic Mary Immaculate Clinic Mukuru Conerstone Clinic Mary Immaculate Sisters Dispensary Crescent Medical Aid (Jamia) Murang'a Road Mathare 3A (EDARP) Dandora (EDARP) Clinic Melchezedek Hospital* Diwopa Health Centre Mukuru MMM Clinic Dreams Center Dispensary (Langata) Nuru Lutheran VCT EDARP Donholm Dispensary Nyina Wa Mumbi Dispensary EDARP Komarock Health Centre Reuben Mukuru Health Centre EDARP Njiru Clinic Revival Home Based Care Clinic EDARP Soweto Health Centre Ruai (EDARP) Clinic Hope World Wide Kenya Mukuru Clinic* Shauri Moyo EDARP Hope Worldwide Kenya VCT (Makadara)* Soweto Kayole PHC Health Centre* Huruma (EDARP) St Alice (EDARP) Dandora Clinic Huruma (NCCK) Dispensary St Barkita Dispensary Utawala Jamaa Mission Hospital* St Bridget's Mother & Child Emory University, Interfaith Health Program l 76 St Francis Community Hospital St Raphael's Clinic St Francis Health Centre (Nairobi North) St Teresa's Parish Dispensary St Johns Ambulance* St Vincent Catholic Clinic St Joseph Mukasa Dispensary St. Odilia's Dispensary St Joseph Nursing Home St. Veronica EDARP St Joseph W Dispensary (Westlands) The Mater Hospital Mukuru St Mary's Mission Hospital Zinduka Clinic

Faith-based Facilities in the County. No HIV services reported to KHIS. Church Army Medical Clinic PCEA Kuwinda Health Clinic CIDI Mukuru Clinic PCEA Pipeline Medical Clinic Consolata Shrine Dispensary PCEA Silanga Church VCT Cotolengo Center Provide International Korogocho Divine Mercy Clinic Reinha Rosary Clinic Hope Community VCT Ruai (SDA) Clinic Imara Health Centre SDA Health services Likoni Road Clinic Maria Dominica Dispensary St Angela Merici Health Centre (Kingeero) Mercy Mission Health Centre St Joseph's Dispensary (Dagoretti) Mother Ippolata Mukuru Clinic St. Aloysius Gonzaga School Dispensary Mukuru Crescent Clinic Tena (PCEA) Clinic Orthodox Dispensary The Mater Embakasi Clinic PCEA Clinic (Ngundo) The Mater Hospital Buruburu PCEA Dandora Clinic Vision Peoples Inter Health Centre PCEA Kayole Parish Health Centre

Nakuru County

All Facilities FB Facilities % FB facilities Total facilities 359 53 14.8 # of visits by HIV patients currently seen in care 112,949 13,995 12.4 # providing at least one HIV service 234 34 14.5 % providing HIV services 65.2 64.2

Faith-based Facilities Providing at Least One HIV Service AIC Parkview Dispensary Mother Kevin Dispensary (Catholic) Algadir Medical Clinic Mutukanio ACK Dispensary Bethsaida (AIC) Clinic (Nakuru) Naivasha (AIC) Medical Centre Canaan (ACK) Medical Clinic Nakuru West (PCEA) Health Centre Elburgon (PCEA) Dispensary Ndarugu (PCEA) Dispensary Fountain Medical Clinic Njoro (PCEA) Dispensary Glory Ministry Medical Clinic PCEA Mwangaza Dispensary Hekima Dispensary PCEA Upendo Health Centre Helpers of Mary Dispensary Revival Baptist VCT Centre Holy Spirit Health Centre Sisto Mazoldi Dispensary (Rongai) Holy Trinity Health Centre (Mai Mahiu) St Antony Health Centre Ime (AIC) Health Centre St Clare Dispensary Kenya Assemblies of God Clinic (Naivasha) St John Cottage Health Centre Keringet Youth Friendly Centre St Martin De Porres (Static) Kings Medical Centre (Deliverance) Nakuru St Mary's Hospital (Gilgal) Life Water Ndege Mobile Clinic Turi (PCEA) Dispensary Matumaini Dispensary Turi AIC Health Centre

Faith-based Facilities in the County. No HIV services reported to KHIS. AGC Baby Health Centre Huruma Mobile Clinic CDN vct Kagai (PCEA) Dispensary Cheppemma (AIC) Dispensary Mikeu P.C.E.A. Medical Centre Consolata Clinic PCEA Mau-Summit Health Centre Dr. Arthur (PCEA) Dispensary PCEA VCT FGC of Kenya Medical Centre St Francis Health Centre (Nakuru Central) Huruma Dispensary St Martin De Porres (Mobile)

77 l Emory University, Interfaith Health Program Subuku Dispensary (Molo) Wesley Health Centre Tabuga (PCEA) Dispensary What Matters Mission Dispensary Tenwek Mobile

Nandi County

All Facilities FB Facilities % FB facilities Total facilities 177 16 9.0 # of visits by HIV patients currently seen in care 39,704 0 0.0 # providing at least one HIV service 122 9 7.4 % providing HIV services 68.9 56.3

Faith-based Facilities Providing at Least One HIV Service Chepterit Mission Health Centre Kobujoi Mission Health Centre Kaiboi Mission Health Centre Koloch Dispensary Kapnyeberai Dispensary Mother Franciscan Mission Health Centre Kapsirichoi Dispensary St Boniface Dispensary Kimng'oror (ACK) Health Centre

Faith-based Facilities in the County. No HIV services reported to KHIS. Diguna Dispensary Ndalat (PCEA) Health Centre IPCC Kaimosi Dispensary Sironoi SDA Dispensary Kaigat (SDA) Health Centre Sochoi (AIC) Dispensary Kapkagaron Dispensary

Narok County

All Facilities FB Facilities % FB facilities Total facilities 155 33 21.3 # of visits by HIV patients currently seen in care 35,772 9,094 25.4 # providing at least one HIV service 65 14 20.0 % providing HIV services 41.9 39.4

Faith-based Facilities Providing at Least One HIV Service CMF Aitong Health Centre Nturumeti Dispensary Entasekera Health Centre Oldonyorok (COG) Dispensary Ewaso Ngiro Health Centre Olendeem Dispensary Fountain Medical Centre Ololulunga VCT Maji Moto Dispensary (Narok South) St Elizabeth Health Centre Naikara Dispensary St. Antony's Abossi Health Centre Ngito Dispensary Talek Health Centre

Faith-based Facilities in the County. No HIV services reported to KHIS. Engos Health Centre Ngosuani Dispensary Enkitoria Dispensary Olasiti (AIC) Dispensary Enoosupukia Dispensary Olenkasurai Dispensary Karda Dispensary Olooltoto Dispensary Keyian SDA Dispensary Siyiapei (AIC) Dispensary Kilgoris (COG) Dispensary St Anthony Lemek Dispensary Mararianta Dispensary St Joseph Hospital Mulot Catholic Dispensary St Teresa Olokirikirai Dispensary Mulot Stand Alone VCT ST' Joseph's the Worker Nairasirasa Dispensary

Emory University, Interfaith Health Program l 78

All Facilities FB Facilities % FB facilities Total facilities 270 16 5.9 # of visits by HIV patients currently seen in care 67,811 2,815 4.2 # providing at least one HIV service 227 15 6.6 % providing HIV services 84.1 93.8

Faith-based Facilities Providing at Least One HIV Service Eronge Health Centre Matutu Dispensary Gekano Health Centre (Manga) Nyabikomu Dispensary Gietai (AIC) Dispensary Nyamakoroto Dispensary Itibo Mission Health Centre Nyamira Adventist Dispensary Kebirigo Mission Health Centre Rangenyo Health Centre Kemera Dispensary (Manga) Riakworo Dispensary Magwagwa Health Centre St Joseph's Nyansiongo Health Centre Matongo Health Centre

Faith-based Facilities in the County. No HIV services reported to KHIS. Nderema Dispensary

Nyandarua County

All Facilities FB Facilities % FB facilities Total facilities 144 20 13.9 # of visits by HIV patients currently seen in care 34,365 4,195 12.2 # providing at least one HIV service 42 5 11.9 % providing HIV services 29.2 25.0

Faith-based Facilities Providing at Least One HIV Service North Kinangop Catholic Hospital Our Lady of Mercy (Magumu) Mukeu (AIC) Dispensary OUR LADY OF MERCY DISPENSARY Njambini Catholic Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Benedict Xvi Dispensary Olkalou (ACK) Medical Clinic Bethsaida (PCEA) Dispensary (Nyandarua) P.A.C.E (AIC) Dispensary Fr Baldo Cath. Disp Passenga Dispensary Holy Family Dispensary Rurii (ACK) Dispensary Kahuho (AIC) Dispensary ST LAWRENCE DISPENSARY Nyahururu Catholic Dispensary St Mathews and Sarah Dispensary Nyandarua (ACK) Captain St. Martin Catholic Social Apostolate Oljororok Catholic Dispensary

Nyeri County

All Facilities FB Facilities % FB facilities Total facilities 414 41 9.9 # of visits by HIV patients currently seen in care 52,488 6,133 11.7 # providing at least one HIV service 100 5 5.0 % providing HIV services 24.2 12.2 Faith-based Facilities Providing at Least One HIV Service Consolata Mission Hospital (Mathari) St Joseph Brothers Mahiga (PCEA) Dispensary Tumutumu (PCEA) Hospital Munyange (AIPCA) Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. ACK Tumaini Medical Clinic Gachika Orthodox Medical Clinic Bethsaida (PCEA) Dispensary (Nyeri) Gatugi Mission Dispensary 79 l Emory University, Interfaith Health Program Gatura (PCEA) Dispensary Mathakwaini (PCEA) Dispensary Gitundu (ACK) Dispensary Mbiriri Catholic Dispensary Gitunduti Catholic Dispensary Mugunda Mission Dispensary Good Samaritan (ACK) Medical Clinic Narumoru Catholic Dispensary Kabebero AIPCA Dispensary Ngandu Catholic Dispensary Kagioini Catholic Dispensary Nyeri (Islamic Foundation) Clinic Kaheti Dispensary & Maternity Nyeri Hill (PCEA) Dispensary Kanjora (PCEA) Dispensary Othaya Catholic Dispensary Karatina Catholic Dispensary PCEA Honi Dispensary Karima Catholic Dispensary Sacred Heart Mission Dispensary Kiaruhiu (PCEA) Health center St John Catholic Dispensary (Nyeri North) Kids Alive Dispensary St Michael Dispensary (Kangaita) Kihuti Orthodox Clinic St Monica Dispensary Little Flower Dispensary St Veronica Dispensary Mukurweini. Magutu (PCEA) Dispensary Sugarbaker Memorial Clinic Mary Immaculate Hospital (Nyeri North) Witima Catholic Dispensary

Samburu County

All Facilities FB Facilities % FB facilities Total facilities 74 12 16.2 # of visits by HIV patients currently seen in care 35,772 4,385 12.3 # providing at least one HIV service 39 8 20.5 % providing HIV services 52.7 66.7

Faith-based Facilities Providing at Least One HIV Service Archers Post Health Centre Loltulelei Friends Dispensary Barsaloi Catholic Dispensary Maralal Catholic Dispensary Catholic Hospital Wamba Sererit Catholic Dispensary Lodokejek Dispensary Suguta Marmar Catholic Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Arsim Lutheran Dispensary Baragoi Catholic Dispensary Morijo Dispensary South Horr Catholic Health Centre

Siaya County

All Facilities FB Facilities % FB facilities Total facilities 168 17 10.1 # of visits by HIV patients currently seen in care 593,508 45,393 7.7 # providing at least one HIV service 140 15 10.7 % providing HIV services 83.3 88.2 Faith-based Facilities Providing at Least One HIV Service Aluor Mission Health Centre Nyamonye Mission Dispensary Ashburn Ohuru Clinic Nyang'oma Mission Health Centre Dolphil Nursing & Maternity Home Our Lady of Perpetual Sisters VCT (Bondo) Future Life Dispensary Rangala Health Centre Maliera SDA Dispensary Sega Dispensary Mbaga Health Centre St Elizabeth Lwak Mission Health Centre Ng'iya Health Centre St Paul Dispensary Nyambare Health Centre Uradi Health Centre

Faith-based Facilities in the County. No HIV services reported to KHIS. Aro (SDA) Dispensary St Luke's Clinic

Emory University, Interfaith Health Program l 80 Taita Taveta County

All Facilities FB Facilities % FB facilities Total facilities 84 8 9.5 # of visits by HIV patients currently seen in care 23,186 3,016 13.0 # providing at least one HIV service 56 2 3.6 % providing HIV services 66.7 25.0

Faith-based Facilities Providing at Least One HIV Service Divine Mercy Eldoro (Catholic) Dispensary St Joseph's Shelter of Hope

Faith-based Facilities in the County. No HIV services reported to KHIS. Bura Mission Clinic St Joseph Mission Dispensary Chumvini Divine Mercy Dispensary Vigombonyi SDA Clinic Rumangao Dispensary Wusi-Wutesia (ACK) Dispensary

Tana River County

All Facilities FB Facilities % FB facilities Total facilities 57 9 15.8 # of visits by HIV patients currently seen in care 1,685 93 5.5 # providing at least one HIV service 29 4 13.8 % providing HIV services 50.9 44.4

Faith-based Facilities Providing at Least One HIV Service Mwina Dispensary Tarasaa Catholic Dispensary Shirikisho Methodist Dispensary Wema Catholic Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Daba (AIC) Dispensary St Raphael Health Centre Kag-Sombo Medical Clinic Titila (AIC) Dispensary Marynoll Dispensary

Tharaka Nithi County

All Facilities FB Facilities % FB facilities Total facilities 113 30 26.6 # of visits by HIV patients currently seen in care 29,908 13,470 45.0 # providing at least one HIV service 56 15 26.8 % providing HIV services 49.6 50.0

Faith-based Facilities Providing at Least One HIV Service Cheera Dispensary Mukothima Health Centre Chogoria (PCEA) Hospital Ngeru Dispensary Chuka Cottage Hospital P.C.E.A Karungaru Dispensary Itugururu Dispensary Presbyterian TTC Rubate Health Centre Kariakomo Dispensary St Orsola Mission Hospital Magundu Dispensary Thanantu Faith Clinic Dispensary MCK Kiirigu Dispensary Weru Dispensary Minugu Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Gatunga Health Centre Kigogo Dispensary Iriga Dispensary Kiriani Dispensary Kaanwa Dispensary Magenka Dispensary Kajiampau Dispensary Materi Girls Dispensary Kiamuriuki Dispensary Murambani Dispensary Kiangondu Dispensary Muthambi Dispensary 81 l Emory University, Interfaith Health Program Nguruki-Iruma Dispensary Redeemed Gospel Church Nyagani Dispensary

Trans Nzoia County

All Facilities FB Facilities % FB facilities Total facilities 102 13 12.8 # of visits by HIV patients currently seen in care 89,820 0 0.0 # providing at least one HIV service 64 10 15.6 % providing HIV services 62.8 76.9

Faith-based Facilities Providing at Least One HIV Service Kapkoi Mission Dispensary Maridadi RCEA Medical Centre Kiminini PAG VCT Mt Zion Mission Medical Clinic Kitale Mobile Clinic Seed of Hope Medical Clinic Kolongolo M Dispensary St Raphael Dispensary Makutano (PCEA) Medical Clinic (Trans Nzoia East) St Ursula Dispensary Faith-based Facilities in the County. No HIV services reported to KHIS. AIC Biribiriet Dispensary Kiminini Cottage Hospital St Brigids Girls High School Dispensary

Turkana County

All Facilities FB Facilities % FB facilities Total facilities 145 40 27.6 # of visits by HIV patients currently seen in care 31,379 12,792 40.3 # providing at least one HIV service 27 18 66.7 % providing HIV services 18.6 45.0

Faith-based Facilities Providing at Least One HIV Service Kakuma Mission Hospital Namoruputh (PAG) Dispensary Kalokol (AIC) Health Centre Nariokotome Dispensary Kangagetei Dispensary St Augustine Youth Friendly Centre Kataboi Dispensary St Bridgit Kalemunyang Dispensary Lokichar (RCEA) Health Centre St Catherine's Napetet Dispensary Lokichogio (AIC) Health Centre St Elizabeth Lorugum Health Centre Nadapal Dispensary St Mary's Kalokol Primary Health Care Programme Nadapal Primary Health Care Programme St Monica's Nakwamekwi Dispensary Nakwamoru Health Centre St Patrick's Kanamkemer Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Aposta Dispensary Lokwatubwa (PAG) Dispensary Eliye Springs (AIC) Dispensary Lowarengak Dispensary Juluk Dispensary Loyapat Dispensary Kachoda Dispensary Nachukui Dispensary Kalobeyei Dispensary Nakaalei Dispensary Kapelibok Dispensary Nanam Dispensary Kokiselei Dispensary Napeililim Dispensary Letea Dispensary Napusimoru Dispensary Lokore Dispensary Natira Dispensary Lokori (AIC) Health Centre Oropoi Dispensary Lokori Primary Health Care Programme Todonyang Dispensary

Emory University, Interfaith Health Program l 82 Uasin Ngishu County

All Facilities FB Facilities % FB facilities Total facilities 185 25 13.7 # of visits by HIV patients currently seen in care 51,379 2,623 5.1 # providing at least one HIV service 71 8 24.9 % providing HIV services 38.4 32.0

Faith-based Facilities Providing at Least One HIV Service Burnt Forest Catholic Dispensary Plateau Hospital Kename Dispensary St Brigitas Health Centre Langas RCEA St Jude Catholic Dispensary Patrician Dispensary St Ladislaus Dispensary

Faith-based Facilities in the County. No HIV services reported to KHIS. Ancilla Catholic Dispensary Moi's Bridge Catholic Assururiet (SDA) Dispensary Our Lady of Lords Dispensary Bindura Dispensary St Gertrude Dispensary Chebaiwa Dispensary St Kevina Dispensary Eldoret Rapha Medical Centre St Mary's Kapsoya Dispensary Jumia Medical Clinic St Raphael Arch Medical Lemoru Trinity Upec Chebaiywa Dispensary Mary Immaculate Dispensary (Eldoret East) Ziwa SDA Mercy Health Centre

All Facilities FB Facilities % FB facilities Total facilities 100 2 2.0 # of visits by HIV patients currently seen in care 73,366 29,115 39.7 # providing at least one HIV service 64 2 3.1 % providing HIV services 64.0 100.0

Faith-based Facilities Providing at Least One HIV Service Coptic Nursing Home Kaimosi Mission Hospital

Faith-based Facilities in the County. No HIV services reported to KHIS.

Wajir County

All Facilities FB Facilities % FB facilities Total facilities 111 0 0.0 # of visits by HIV patients currently seen in care 82 0 0.0 # providing at least one HIV service 24 0 0.0 % providing HIV services 21.6 0.0

There are no data for faith-based facilities in in KHIS.

West Pokot County

All Facilities FB Facilities % FB Total facilities 89 20 22.5 # of visits by HIV patients currently seen in care 9,822 414 4.2 # providing at least one HIV service 52 13 25.0 % providing HIV services 58.4 65.0

Faith-based Facilities Providing at Least One HIV Service Alale (AIC) Health Centre Bible Faith Church Medical Services Dispensary Amakuriat Dispensary Chepareria (SDA) Dispensary

83 l Emory University, Interfaith Health Program Chepnyal Dispensary Psigor Dispensary Chesta Dispensary Sekerr Dispensary Marich Dispensary Sondany Dispensary Murkwijit Dispensary Tuina Dispensary Ortum Hospital

Faith-based Facilities in the County. No HIV services reported to KHIS. Kabichbich Miss Dispensary Korokou Dispensary Kacheliba Mobile clinic Nasolot Dispensary Kapsang'ar Dispensary Parua Dispensary Kiwawa (ACCK) Dispensary

Emory University, Interfaith Health Program l 84 Appendix 4

Number of Visits by PLHIV Currently Seen in Care by FBOs by Facility, County, and FBO Network Visit numbers from KHIS and organization name from eHealth Kenya

# of visits by PLHIV currently FBO FACILITY NAME FBO Network seen in care by FBOs BARINGO Kipsaraman Dispensary 155 KEC Mercy Hospital 421 Other BOMET Kaboson Health Centre 131 CHAK Tenwek Mission Hospital 6,496 CHAK BUNGOMA Dreamland MC Health Centre 1 Other Kaptama (Friends) Health Centre 1,845 Other BUSIA Amukura Mission Health Centre 53 KEC Butula Mission Health Centre 193 Other Holy Family Nangina Hospital 18,380 KEC Namboboto Dispensary 395 CHAK ELGEYO-MARAKWET Arror Health Centre 256 KEC Kapsowar (AIC) Hospital 242 CHAK EMBU Acef Ena Health Centre 454 Other Consolata Kyeni Hospital 3,325 KEC OLL Mwea Hospital Clinic Embu (Satellite) 7 KEC HOMA BAY Asumbi Health Centre 15,157 KEC Good Shepherd Ang'iya 1,860 KEC Holy Family Oriang Mission Dispensary 12,694 KEC Kendu Adventist Hospital 29,456 CHAK Manyatta (SDA) Dispensary 80 CHAK Matata Nursing Hospital 10,812 Other Ogande Dispensary 1,023 CHAK Raruowa Health Centre 157 KEC Shirikisho Dispensary 816 Other St Mercelline Roo Dispensary(Suba) 2,205 Other St Paul's Health Centre 2,391 KEC Tonga Health Centre 294 KEC KAJIADO Embul - Bul Catholic Dispensary 230 KEC Kajiado (AIC) Dispensary 79 CHAK Rombo Health Centre 197 KEC KAKAMEGA Chimoi Health Centre 448 KEC Eregi Mission Health Centre 135 Other Jamia Medical Centre 1,525 SUPKEM Mukumu Hospital 24,277 Other Mulwanda Dispensary 510 CHAK

85 l Emory University, Interfaith Health Program Mundoli Health Centre 383 Other Namasoli Health Centre 5,371 CHAK St Charles Lwanga Health Centre 59 KEC St Mary's Hospital (Mumias) 26,651 KEC KERICHO AIC Litein Mission Hospital 1,791 CHAK KIAMBU Nazareth Hospital (Ruiru) 914 KEC Sacred Heart Dispensary 720 Other St Joseph Catholic Dispensary 759 KEC Tinganga Catholic Dispensary 604 KEC KILIFI Bomu Medical Centre (Mariakani) 11,693 Other Giriama Mission Dispensary 82 KEC Malanga (AIC) Dispensary 1,608 CHAK St Luke's (ACK) Hospital Kaloleni 5,217 Other St Theresa Dispensary 5 KEC Tawfiq Muslim Hospital 216 SUPKEM KIRINYAGA Mt. Kenya (ACK) Hospital 383 CHAK Mwea Mission (Our Lady Of Lourdes) Hospital 4,934 KEC KISII Christamarrianne Hospital 526 KEC Nyabururu Dispensary 100 KEC Omorembe Health Centre (Gucha) 476 CHAK Our Lady of Lourdes Dispensary (Gucha) 26 KEC Riokindo Health Centre 164 CHAK Ritumbe Health Centre 42 KEC Sengera Health Centre (Gucha) 168 KEC KISUMU Awasi Mission Dispensary 4,845 KEC Disciples of Mercy Clinic 3,308 KEC Maseno Mission Hospital 11,669 CHAK Nyabondo Mission Hospital 26,542 KEC Nyakach (AIC) Dispensary 3,430 CHAK OLPS Clinic 2,584 KEC Pand Pieri Community Health Centre 23,028 KEC St Elizabeth Chiga Health Centre 15,793 KEC St Monica Hospital 2,485 KEC KITUI Mulango (AIC) Health Centre 279 CHAK Mutomo Mission Hospital 1,863 KEC St. Joseph Kavisuni Dispensary 46 Other Tei Wa Yesu Health Centre 1,064 Other Zombe (AIC) Dispensary 1,259 CHAK KWALE Ukunda Diani Catholic Dispensary 1256 KEC LAIKIPIA Olmoran Catholic Dispensary 19 KEC Segera Mission Dispensary 12 CHAK Sipili Catholic Dispensary 1,114 KEC St Joseph Catholic Dispensary (Laikipia East) 448 KEC Thome Catholic Dispensary 2 KEC

Emory University, Interfaith Health Program l 86 LAMU Hongwe Catholic Dispensary 217 KEC Maria Teressa Nuzzo Health Centre 36 KEC MACHAKOS Bishop Kioko Catholic Hospital 912 KEC D Comboni Mission 1,032 KEC Kaiani Dispensary 8 CHAK Matuu Mission Hospital 448 KEC MERU Consolata Hospital (Nkubu) 9,523 KEC Cottolengo Mission Hospital 4,639 KEC Gitoro Dispensary 81 KEC Maua Methodist Hospital 9,573 CHAK St. Theresa Hospital (Kiirua) 1,317 KEC MIGORI Getongoroma Dispensary 153 CHAK Isibania Mission Health Centre 26 KEC Kadem TB & Leprosy Dispensary 1,595 KEC Kopanga Dispensary 822 CHAK Ogada Health Centre 605 CHAK Reusse Troyer Health Centre 123 CHAK Sori Lakeside Nursing and Maternity Home 478 CHAK St Barnabas Dispensary 2,591 CHAK St Joseph Mission Hospital 28,462 KEC St Monica Rapogi Health Centre 16,318 KEC Ulanda Dispensary 219 KEC Verna Health Centre 216 KEC MOMBASA Bomu Medical Centre (Likoni) 44,268 Other Bomu Medical Hospital (Changamwe) 59,345 Other Likoni Catholic Dispensary 1,278 KEC Mewa Hospital 7,512 Other Mikindani Catholic Dispensary 5,608 KEC Sayyida Fatimah Hospital 606 Other NAIROBI Babadogo (EDARP) 11,267 KEC Baraka Dispensary (Nairobi) 12,999 KEC Coptic Hospital(Ngong Road) 71,200 CHAK Coptic Medical Clinic 20,072 CHAK Dandora (EDARP) Clinic 16,964 KEC Dreams Center Dispensary (Langata) 2,944 KEC EDARP Donholm Dispensary 20,196 KEC EDARP Komarock Health Centre 35,828 KEC EDARP Njiru Clinic 9,033 KEC Edarp Soweto Health Centre 17,147 KEC Huruma (EDARP) 16,510 KEC Huruma (NCCK) Dispensary 1,983 CHAK Jamaa Mission Hospital 3,913 KEC Kariobangi EDARP 14,433 KEC Kivuli Dispensary 1,494 KEC Lea Toto Kibera 1,544 Other Lea Toto Mukuru 1,344 Other Mathare 3A (EDARP) 10,875 KEC

87 l Emory University, Interfaith Health Program Melchezedek Hospital 258 Other Mukuru MMM Clinic 5,611 KEC Reuben Mukuru Health Centre 2,977 KEC Ruai (EDARP) Clinic 4,792 KEC Shauri Moyo EDARP 9,592 KEC Soweto Kayole PHC Health Centre 17,552 KEC St Alice (EDARP) Dandora Clinic 15,610 KEC St Bridget's Mother & Child 22 KEC St Francis Community Hospital 6,436 KEC St Francis Health Centre 6,436 Other St Joseph Mukasa Dispensary 6,318 Other St Mary's Mission Hospital 41,181 KEC St Vincent Catholic Clinic 16,442 KEC St. Odilia's Dispensary 30 KEC St. Veronica EDARP 5,387 KEC The Mater Hospital Mukuru 13,749 KEC NAKURU Mother Kevin Dispensary(Catholic) 920 KEC Naivasha (AIC)Medical Centre 11,773 CHAK Nakuru West (PCEA) Health Centre 1,297 CHAK St Antony Health Centre 5 KEC NAROK CMF Aitong Health Centre 872 Other Entasekera Health Centre 170 Other Ewaso Ngiro Health Centre 6,078 Other Naikara Dispensary 459 Other Olendeem Dispensary 2 Other St Elizabeth Health Centre 486 Other Talek Health Centre 745 Other NYAMIRA Eronge Health Centre 19 CHAK Gekano Health Centre (Manga) 3 KEC Gietai (AIC) Dispensary 100 CHAK Itibo Mission Health Centre 40 CHAK Kebirigo Mission Health Centre 6 CHAK Kemera Dispensary (Manga) 176 CHAK Magwagwa Health Centre 182 CHAK Matongo Health Centre 702 CHAK Matutu Dispensary 102 CHAK Nyabikomu Dispensary 25 CHAK Nyamakoroto Dispensary 1 CHAK Nyamira Adventist Dispensary 236 CHAK Rangenyo Health Centre 43 CHAK Riakworo Dispensary 489 CHAK St Joseph's Nyansiongo Health Centre 691 KEC NYANDARUA Mukeu (AIC) Dispensary 10 CHAK North Kinangop Catholic Hospital 4,185 KEC NYERI Consolata Mission Hospital (Mathari) 4,379 KEC St Joseph Brothers 195 KEC Tumutumu (PCEA) Hospital 1,559 CHAK

Emory University, Interfaith Health Program l 88 SAMBURU Archers Post Health Centre 177 KEC Catholic Hospital Wamba 4,200 KEC Maralal Catholic Dispensary 8 KEC SIAYA Aluor Mission Health Centre 2,263 KEC Dolphil Nursing & Maternity Home 500 CHAK Future Life Dispensary 2 Other Maliera SDA Dispensary 139 CHAK Mbaga Health Centre 621 KEC Ng'iya Health Centre 16,168 KEC Nyambare Health Centre 3,518 KEC Nyamonye Mission Dispensary 103 KEC Nyang'oma Mission Health Centre 5,398 KEC Rangala Health Centre 2,001 KEC Sega Dispensary 2,770 KEC St Elizabeth Lwak Mission Health Centre 6,751 KEC St Paul Dispensary 4,049 KEC Uradi Health Centre 1,110 KEC TAITA TAVATA Divine Mercy Eldoro (Catholic) Dispensary 332 KEC St Joseph's Shelter Of Hope 2,684 CHAK TANA RIVER Wema Catholic Dispensary 79 KEC Tarasaa Catholic Dispensary 13 KEC Shirikisho Methodist Dispensary 1 CHAK THARAKA NITHI Chogoria (PCEA) Hospital 12,079 CHAK P.C.E.A Karungaru Dispensary 515 CHAK St Orsola Mission Hospital 876 CHAK TURKANA Kakuma Mission Hospital 3,549 KEC Kalokol (AIC) Health Centre 1,054 CHAK Kataboi Dispensary 63 KEC Lokichar (RCEA) Health Centre 1,290 CHAK Lokichogio (AIC) Health Centre 320 CHAK Nakwamoru Health Centre 691 KEC Namoruputh (PAG) Dispensary 182 CHAK Nariokotome Dispensary 421 KEC St Bridgit Kalemunyang Dispensary 206 KEC St Catherine's Napetet Dispensary 854 KEC St Elizabeth Lorugum Health Centre 344 KEC St Mary's Kalokol Primary Health Care Programme 773 KEC St Monica's Nakwamekwi Dispensary 1,362 KEC St Patrick's Kanamkemer Dispensary 1,683 KEC UASIN GISHU Plateau Hospital 1,624 Other St Ladislaus Dispensary 999 Other VIHIGA Coptic Nursing Home 22,822 Other Kaimosi Mission Hospital 6293 Other WEST POKOT Amakuriat Dispensary 132 Other Ortum Hospital 282 KEC 89 l Emory University, Interfaith Health Program Appendix 5

Matrix of Selected PEPFAR Indicators and Rationale for Inclusion in the Analysis

Key Focus PEPAR Indicator Note Area P1.1D: Number of pregnant women with Prevention This indicator connects to prevention in the area of known HIV status Retention in Prevention of Mother-To-Child Transmission care (PMTCT) and to retention in the importance of HIV- positive pregnant women to receiving antenatal care and ARV during their pregnancy and/or during delivery P1.2D: Number and percentage of HIV+ Prevention This indicator connects to prevention in the area of pregnant women who received ARVs to Retention in Prevention of Mother-To-Child Transmission reduce risk of mother-to-child transmission care (PMTCT) and to retention in the importance of HIV- during pregnancy positive pregnant women to receiving antenatal care and ARV during their pregnancy and/or during delivery P5.1D: Number of males circumcised as Prevention MC has been a priority focus for prevention. It part of the minimum package of MC for HIV Treatment as represents an expansion of prevention efforts from prevention services Prevention health education/health behaviors to clinical interventions that could impact likelihood of HIV transmission. Do CHAK facilities or other FBOs do anything to tie MC to cultural practices and beliefs? P7.1D: Number of people living with Prevention Focus on ongoing prevention efforts with those HIV/AIDS reached with a minimum package who are HIV-positive. of Prevention with PLHIV interventions P8.1D: Number of the targeted population Prevention Long-standing approaches to prevention. Are there reached with individual and/or small group any innovations CHAK or other FBOs are using to level interventions that are based on reach hard-to-reach populations with these evidence and/or meet the minimum services? standards required P8.2D: Number of the targeted population AB specific PEPFAR has placed priority on the particular role reached with individual and/or small group prevention of FBOs in AB prevention. level preventive interventions that are primarily focused on abstinence and/or being faithful, and are based on evidence and/or meet the minimum standards required P8.3D: Number of MARP reached with Prevention How effective are FBOs in prevention services to individual and/or small group interventions Key MARP? What is the relationship between these that are based on evidence and/or meet the Populations data and those for indicator P8.2D? minimum standards required P11.1D: Number of individuals receiving Prevention Key focus area of people knowing their status. HIV testing and counseling services for HIV Questions for clarification: What proportion of HIV and received their test results tests are now rapid result? Does Western Blot confirmatory also occur onsite? If not, do we have data on those who get an initial reactive but do not return for confirmatory? C1.1D: Number of eligible adults and Prevention Are FBOs reaching unreached populations? children provided with a minimum of one Treatment core service Support C2.1D: Number of HIV-positive adults and Treatment Scope and quality of clinical treatment children receiving a minimum of one clinical service

Emory University, Interfaith Health Program l 90 C5.1D: Number of eligible clients who Support Scope and quality of support services received food and/or other nutrition services T1.1.D: Number of adults and children with Treatment People knowing their status. ARV availability. advanced HIV infection newly enrolled on Treatment as Referral/retention. ART Prevention Referral/ retention T1.2.D: Number of adults and children with Treatment People knowing their status. ARV availability. advanced HIV infection receiving Treatment as Referral/retention. antiretroviral therapy Prevention Referral/ retention T1.3D: Percentage of adults and children Treatment known to be alive and on treatment 12 Reduction of months after initiation of antiretroviral morbidity therapy Retention H1.1.D: Number of testing facilities with Systems What CHAK testing facilities can perform labs capacity to perform laboratory tests. infrastructure onsite? Which ones: ELISA? Western Blot? CD4? VL? Other? H2.1.D: Number of new health workers who Systems graduated from a pre-service training infrastructure institution Healthcare workforce

91 l Emory University, Interfaith Health Program Appendix 6

Databases Accessed and Keyword Searches Used to Conduct the Literature Review

PubMed

Searches:

Search Search Term number 1 Keyword: (faith based OR faith-based) 2 Keyword: (healthcare OR health care) 3 Keyword: Kenya 4 Keyword: (faith based OR faith-based) AND (healthcare OR health care) AND Kenya 5 Keyword: Quality of care 6 Keyword: (faith based OR faith-based) AND Quality of care AND Kenya 7 MeSh: Quality and included: Health Care Quality, Access, and Evaluation Quality of Health Care Quality Indicators, Health Care Quality Assurance, Health Care 8 Keyword: (faith based OR faith-based) AND Included Quality MeSH results AND Kenya 9 Keyword: (mission OR missionary) AND Included Quality MeSH results AND Kenya 10 (CHAK or Christian Health Association of Kenya) AND Quality MeSH results AND Kenya 11 MeSH: Religion and included: Christianity 12 Keyword: Christianity MeSH AND Quality MeSH AND Kenya 13 Keyword: Christianity MeSH and (HIV OR AIDS) AND Kenya

Relevant Results • Vogel, J. P., Betran, A. P., Widmer, M., Souza, J. P., Gulmezoglu, A. M., Seuc, A., . . . Merialdi, M. (2012). Role of faith-based and nongovernment organizations in the provision of obstetric services in 3 African countries. Am J Obstet Gynecol, 207(6), 495.e491-497. http://dx.doi.org/10.1016/j.ajog.2012.10.003 • Flessa, S., Moeller, M., Ensor, T., & Hornetz, K. (2011). Basing care reforms on evidence: The Kenya health sector costing model. BMC Health Services Research, 11(1),128 • Warren, C., Abuya, T., Obare, F., Sunday, J., Njue, R., Askew, I., & Bellows, B. (2011). Evaluation of the impact of the voucher and accreditation approach on improving reproductive health behaviors and status in Kenya. BMC Public Health, 11(1), 177. • Macharia, W. M., Njeru, E. K., Muli-Musiime, F., & Nantulya, V. (2009). Severe road traffic injuries in Kenya, quality of care and access. Afr Health Sci, 9(2): 118-124 • Amuyunzu-Nyamongo, M., Okeng'o, L., Wagura, A., & Mwenzwa, E. (2007). Putting on a brave face: the experiences of women living with HIV and AIDS in informal settlements of Nairobi, Kenya. AIDS Care, 19 Suppl 1, S25-34. • Gething, P., Noor, A., Goodman, C., Gikandi, P., Hay, S., Sharif, S., . . . Snow, R. (2007). Information for decision making from imperfect national data: tracking major changes in health care use in Kenya using geostatistics. BMC Medicine, 5(1), 37.

Emory University, Interfaith Health Program l 92 Web of Knowledge

Searches:

Search Search Term Number 1 Keyword: (faith-based organization* or faith based organization) AND Kenya AND (healthcare OR health care) 2 (CHAK or Christian Health Association of Kenya) AND Kenya AND (healthcare OR health care) 3 (faith-based organization* or faith based organization) AND Kenya AND (HIV OR AIDS) 4 *Christian Health Association of Kenya* OR *CHAK*

Relevant Results • Flessa, S., Moeller, M., Ensor, T., & Hornetz, K. (2011). Basing care reforms on evidence: The Kenya health sector costing model. BMC Health Services Research, 11(1),128 • Macharia, W. M., Njeru, E. K., Muli-Musiime, F., & Nantulya, V. (2009). Severe road traffic injuries in Kenya, quality of care and access. Afr Health Sci, 9(2): 118-124

EBSCO Complete (All Databases)

Searches:

Search Search Term Number 1 Keyword: (faith-based organization or faith based organization) AND Kenya AND (healthcare OR health care)

Relevant Results Oduor, D. N. (2012). The millennium development goals and the role of partners in development: The influence of faith-based organizations on HIV/AIDS prevention in Kenya. Dissertation Abstracts International Section A: Humanities and Social Sciences, 73(2-A), 791. • Vogel, J. P., Betran, A. P., Widmer, M., Souza, J. P., Gulmezoglu, A. M., Seuc, A., . . . Merialdi, M. (2012). Role of faith-based and nongovernment organizations in the provision of obstetric services in 3 African countries. Am J Obstet Gynecol, 207(6), 495.e491-497. • Pearl, E, et al. (2009). Training health workers in Africa: Documenting faith-based organizations' contributions. The Capacity Project: Technical Brief. North Carolina: Capacity Project, 2009; 4.

Pro Quest (All Databases)

Searches:

Search Search Term Number 1 Keyword in abstract – Faith based organization AND Kenya AND (HIV OR AIDS) 2 Search within Bibliography of Prince 3 Search within Shared References of Hofer 4 Search within Bibliography of Hershey

Relevant Results • Hershey, M. (2011). NGOs and community participation in Kenya's fight against HIV/AIDS. Indiana University, ProQuest, UMI Dissertations Publishing, 3488072. • Prince, R., Denis, P., & van Dijk, R. (2009). Introduction to Special Issue: Engaging Christianities: Negotiating HIV/AIDS, Health, and Social Relations in East and Southern Africa. Africa Today, 56(1), 3-3. • Parsitau, D. S. (2009). "Keep Holy Distance and Abstain till He Comes": Interrogating a Pentecostal Church's Engagements with HIV/AIDS and the Youth in Kenya. Africa Today, 56(1), 45-64. • Clarke, G. (2006). Faith matters: faith-based organisations, civil society and international development. Journal of International Development, 18(6), 835-848. • Launch of New Report on Faith-Based Organizations in the Global HIV/ AIDS Fight. (2005, 2005 Apr 07). U.S. Newswire, p. 1.

93 l Emory University, Interfaith Health Program • Hofer, K. (2003). The Role of Evangelical NGOs in International Development: A Comparative Case Study of Kenya and Uganda. Africa Spectrum, 38(3), 375-398. • Liebowitz, J. (2002). The Impact of Faith-Based Organizations on HIV/AIDS Prevention and Mitigation in Africa. Paper prepared for The Health Economics and HIV/AIDS Research Division University of Natal, South Africa • Manji, F., & O’Coill, C. (2002). The missionary position: NGOs and development in Africa. International Affairs, 78(3), 567-583. • Hearn, J. (2002). The 'Invisible' NGO: US Evangelical Missions in Kenya. Journal of Religion in Africa, 32(1), 32- 60.

Key Sources That Informed the Qualitative Evidence Base

Citation Article Type Comments on Religion and Public Health Lipsky, A. B. (2011). Evaluating the Review of To quote the abstract, “This article suggests that the strength of faith: Potential comparative Literature most important comparative advantage that FBOs bring advantages of faith-based to health service delivery in sub-Saharan Africa is organizations providing health moral and ethical standing.” It helps with recruiting services in sub-Saharan Africa. Public volunteer (which cuts costs), develop trust with Administration and Development, communities at the local and national level, and 31(1), 25-36. promotes behavior change. Depending on their standing in the community, the health messaging can be more effective and sustainable. Compared to NGOs, they have may more knowledge of the local area, more flexibility in programming, additional resources, and more motivating energy. They may not be as accountable. Part 2 of the article offers a theoretical framework for understanding the comparative advantages of FBOs.

Amirkhanyan, A. A., Kim, H. J., & Quantitative The article seeks to add rigor to the debate over the Lambright, K. T. (2009). Faith-Based Study effectiveness of FBOs compared to NGOs by Assumptions About Performance: comparing faith-based and non-faith-based nursing Does Church Affiliation Matter for homes. They looked at 11,877 nursing homes in the Service Quality and Access? Nonprofit US and found no empirical difference between the two and Voluntary Sector Quarterly. categories. However, their results are focused on the 38: 490-521. particularities of nursing homes. Tabatabai, P., Prytherch, H., Mixed Methods Looking at the staffing patterns of health facilities in Baumgarten, I., Kisanga, O. M. E., Study Tanzania, the authors found that the general trend in Schmidt-Ehry, B., & Marx, M. (2013). staffing was for people to move from FBOs to The internal migration between public government-run facilities. The traditional explanation and faith-based health providers: a for this move is pay differential. However, in interviews, cross-sectional, retrospective and they found that it also related to “career development multicentre study from southern and training, management support, employee Tanzania. Tropical Medicine & engagement and workload.” Basically, the FBO International Health, 18(7), 887-897. workers felt over worked and improperly managed. Since the FBOs are the primary health providers in rural catchment areas, the authors see the potential for a severe impact on these areas that could “erode cooperation potential between the public and private health sector.” Green, A., Shaw, J., Dimmock, F., & Survey of Religious organizations have/will continue to play a key Conn, C. (2002). A shared mission? Christian Health role in health service provision in Sub-Saharan Africa. Changing relationships between Associations They have a more robust funding system than simply government and church health relying on the government, as well as a strong service services in Africa. Int J Health Plan ethos, concern for quality, and good relationships with Manage, 17(4), 333-353. staff and patients. However, there is potential for conflict between the churches and the government health services given the “changing and uncertain external environment.” This could lead to them following separate agendas, but the authors advise against that. Emory University, Interfaith Health Program l 94 Chand, S., & Patterson, J. (2007). USAID Report FBOs have networks that reach even the most remote Faith-based models for improving areas. They offer services that are culturally sensitive maternal and newborn health. US and influence the attitudes and behaviors of their Agency for International Development: constituents. “FBOs offer compassionate care through Washington, DC. well-organized programs and facilities that are better equipped and managed than the public facilities.” They have access to supplemental funds beyond what the government provides/has access to. However, they are having issues with recruitment and retention of skilled providers because of remote locations. There is also a potential issue with accountability/transparency. UNFPA (United Nations Population UN Report FBOs have influence on behaviors, attitudes, and Fund). (2008). Culture Matters: perceptions. They also “manage the oldest, most far- Lessons from a Legacy of Engaging reaching and diverse array of social service delivery Faith-based Organizations. UNFPA: mechanisms.” Partnering with religious organizations New York. can be key to gaining wider acceptance and ownership of programs, promoting behavior change, and mobilizing communities. Green E C. (2003). Faith-based USAID Report FBOs are uniquely positioned to spread prevention Organizations: Contributions to HIV messages as they have an extensive network that Prevention. US Agency for reaches even the most remote places. “The Church International Development: can be viewed as the largest, most stable and most Washington, DC. extensively dispersed non-governmental organization in any country. Churches are respected within communities and most have existing resources, structures and systems upon which to build. They possess the human, physical, technical and financial resources needed to support and implement small and large-scale initiatives. They can undertake these actions in a very cost-effective manner, due to their ability to leverage volunteer and other resources with minimal effort.” They have a good understanding of the social and cultural patterns and can have extensive infrastructure. Part of this ability to mobilize stems from their emphasis on faith, idealism and compassion, which are powerful motivators for staff and volunteers who work in difficult situations. They can be influential on moral issues – especially around sexuality. The article also includes a breakdown of the type of work being done by FBOs in relation to HIV/AIDS. FBOs are structured in a way that can encourage behavior change – especially around abstinence and monogamy. They also provide hope to people living with HIV/AIDS, which can have a positive effect on treatment. Steinitz, L. Y. (2006). Meeting the Programmatic Challenge with God on our Side. report/ International Review of Mission, Theological 95(376-377), 92-103. reflection

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Emory University, Interfaith Health Program l 96