SIAYA COUNTY HIV AND AIDS STRATEGIC PLAN (2015/16 – 2018/2019) “A healthy and productive population” i SIAYA COUNTY HIV AND AIDS STRATEGIC PLAN (2015/16 – 2018/2019) “A healthy and productive population” Any part of this document may be freely reviewed, quoted, reproduced or translated in full or in part, provided the source is acknowledged. It may not be sold or used for commercial purposes or for profit. iv SIAYA COUNTY HIV & AIDS STRatEGIC PLAN ((2015/16 – 2018/2019) Table of Contents ACRONYMS AND ABBREVIATIONS vi CHAPTER 1: BACKGROUND ON SIAYA COUNTY xii 1.1 Location and size 1 1.2 Population size and composition 1 1.3 Administrative Sub-divisions 2 1.4 Demographic profile 2 1.5 Climatic Conditions 2 1.6 Economic Activities 2 CHAPTER 2: SITuaTION ANALYSIS 3 2.1 HIV Epidemic Analysis 4 2.2 Drivers of new HIV infections in Siaya County 5 2.3 Gaps and challenges Analysis 6 2.4 SWOT Analysis 7 CHAPTER 3: RATIONALE, STRATEGIC PLAN DEVELOPMENT PROCESS AND THE GUIDING PRINCIPLES 8 3.1 Purpose 9 3.2 Process of Developing the SCASP 9 3.3 Alignment with other national and international strategic frameworks 9 3.4 Principles 10 CHAPTER 4: VISION, MISSION, OBJECTIVES & COUNTY STRATEGIC DIRECTIONS 11 4.1 Vision 12 4.2 Mission 12 4.3 Objectives of Siaya County AIDS Strategic Plan 12 4.4 County Strategic Directions 12 CHAPTER 5: MONITORING & EVALuaTION PLAN 38 5.1 Monitoring &Evaluation Systems 39 5.2 Data Quality 39 5.3 Baseline Information 39 5.4 Indicators 39 5.5 SCASP Reviews 39 5.6 Data Flow and Archiving 39 CHAPTER 6: IMPLEMENTATION ARRANGEMENTS 41 6.1 HIV Coordination structure for SCASP Delivery 42 6.2 Roles and responsibilities 43 6.2.1 Governor 43 6.2.2 CEC Health Services 43 6.2.3 County HIV Committee 43 6.2.4 County HIV Coordination Unit (Headed by CDH) 43 6.2.5. Regional HIV Coordination Unit (NACC) 44 6.2.6 County/Sub-county/constituency HIV committees 44 6.2.7 County TWGs 44 CHAPTER 7: RISKS, ASSUMPTIONS AND MITIGATION PLAN 45 CHAPTER 8: FINANCING OF THE SIAYA COUNTY HIV & AIDS PLAN 48 8.1 Projected cost of HIV programming in Siaya County 49 ANNEXES 50 “A healthy and productive population” v Acronyms and abbreviations AGYW Adolescent Girls and Young FBO Faith Based Organization Women FMS Financial Management System AIDS Acquired Immuno Deficiency FSW Female Sex Worker Syndrome GBV Gender Based Violence ANC Antenatal Clinic HBC Home Based Care APHIA AIDS Population and Health HBTC Home Based Testing and Integrated Assistance Counselling ART Antiretroviral Treatment/Therapy HCBC Home and Community Based ARV Anti-Retroviral Drugs Care BCC Behaviour Change HCW Health Care Worker Communication HEI HIV Exposed Infants CASCO County AIDS and STI HIV Human Immunodeficiency Virus Coordinator HMIS Health Management CASP County AIDS Strategic Plan Information System CBO Community Based Organization HPV Human Papilloma virus CCC Comprehensive Care Centre HR Human Resources CCM Country Coordination HTC HIV Testing and counselling Mechanism HTS HIV Testing Services CDH County Director of Health ICC Inter-agency Coordination CEC - H County Executive Committee Committee Member of Health IDU Injecting Drug Users CG County Government IEC Information, Education, and CHEWs Community Health Extension Communication Workers IGAD Intergovernmental Authority on CHMT County Health Management Development Team ILO International Labour CHV Community Health Volunteer Organization CIDP County Integrated Development IPC Infection Prevention and Control Plan KAIS Kenya AIDS Indicator Survey COG Council of Governors KASF Kenya AIDS Strategic COH Chief Officer of Health Framework CHC County HIV Committee KDHS Kenya Demographic and Health CRA Commission for Revenue Survey Allocation KEMSA Kenya Medical Supplies DHIS District Health Information Authority System KEPH Kenya Essential Package for EBI Evidence Based Intervention Health EMR Electronic Medical Reporting KHSSP Kenya Health Sector Strategic eMTCT Elimination of Mother to Child Plan Transmission KNASP Kenya National AIDS Strategic ETR End Term Review Plan vi SIAYA COUNTY HIV & AIDS STRatEGIC PLAN ((2015/16 – 2018/2019) Acronyms and abbreviations KP Key Populations STI Sexually Transmitted Infection LGBT Lesbian, Gay, Bisexual and SW Sex Workers Transgender TB Tuberculosis M&E Monitoring and Evaluation TBD To Be Determined SCASP Siaya County AIDS Strategic TOWA Total War against HIV and AIDS Plan TTI Transfusion Transmissible MDAs Ministries, Departments and Infection Agencies TWG Technical Working Group MoH Ministry of Health UN United Nations MOT Modes of Transmission UNAIDS Joint United Nations MSM Men who have Sex with Men Programme on HIV & AIDS MSW Male Sex Worker UNDP United Nations Development MTR Mid-Term Review Programme NACC National AIDS Control Council UNFPA United Nations Population Fund NASCOP National AIDS & STI Control UNICEF United Nations Children’s Fund Programme UNODC United Nations Office on Drugs NCDs Non-Communicable Diseases and Crime NEPHAK Network for Empowerment of USAID United States Agency for People Living with HIV in Kenya International Development NGO Non-Governmental VCT Voluntary Counselling and Organizations Testing OIs Opportunistic Infections VMMC Voluntary Medical Male OVC Orphans and Vulnerable Circumcision Children WHO World Health Organization PEP Post-Exposure Prophylaxis PHDP Positive Health, Dignity and Prevention PITC Provider-initiated Testing and Counselling PLHIV People Living with HIV PWD People/Persons with Disabilities PMS Post Marketing Surveillance PMTCT Prevention of Mother to Child Transmission PrEP Pre-Exposure Prophylaxis RBM Results Based Management RH Reproductive Health SCACC Sub-County AIDS Control Coordinators SCASCO Sub-County AIDS and STI Coordinator SRH Sexual and Reproductive Health “A healthy and productive population” vii Foreword Siaya County HIV and AIDS Strategic Plan is the blueprint that offers a roadmap for the implementation of HIV response for the next 5 years. It is premised on evidence based interventions to address drivers of HIV and AIDS in the county while ensuring an all-inclusive approach for improved health outcomes. This County HIV and AIDS Strategic Plan is aligned to the Constitution of Kenya, the Vision 2030, the African Union goals on HIV control, the Kenya AIDS Strategic Framework (KASF), County Integrated Development Plan (CIDP) and the County Health Strategic Plan (CHSP). It recognizes the centrality of a multi-sectoral response to HIV and outlines roles and expected actions from different sectors and actors and the need for strengthened stakeholder accountability for results. It sets out a clear coordination and governance structure through the county implementation and oversight committees. This strategic plan outlines approaches that my government will use to leverage funding and set up Siaya County HIV kitty to ensure sustainable implementation of the HIV response. Therefore, my government is committed to facilitating achievement of the results outlined in this strategic plan and to build on the progress made so far towards improving the health outcomes of persons living with HIV and AIDS, reducing new HIV infections and addressing HIV related stigma. H.E CORNEL AMOTH RASANGA Governor, Siaya County viii SIAYA COUNTY HIV & AIDS STRatEGIC PLAN ((2015/16 – 2018/2019) Preface The Siaya County HIV and AIDS Strategic Plan (2015/16 – 2018/2019) is an important document that marks a major turning point in the county’s HIV response since health services were devolved more than three years ago. In developing this strategic framework for the county’s HIV response, the health managers and stakeholders have shifted the core focus of our HIV response towards provision of high quality sustainable models of health that are acceptable by the local community. This document is a culmination of tireless efforts of our health team in consultation with our local and regional collaborators and agencies. Over the last several years, we have been able to register some marked progress in a number of critical areas in our HIV response. During this period, new infections have reduced, we have been able to put more persons living with HIV on life saving ARVs and have ensured that those on treatment are virally suppressed in line with the UNAIDS 90-90-90 approach. This strategic plan requires that all actors pay particular attention to vulnerable and marginalized groups. To make real progress in HIV prevention, treatment and impact mitigation, we need a paradigm shift. This approach will require the use of social, behavioural, cultural, biomedical, scientific, technological and implementation science innovative interventions as outlined in this document. Our key strategic objectives in the next five years will be: 1. Reduce new HIV infections by 75%. 2. Reduce AIDS related mortality by 25 %. 3. Reduce HIV related stigma and discrimination by 50%. 4. Increase domestic financing of HIV response to 50%. Let us all join hands as we deepen and strengthen our response while seeking innovative ways to sustain our response. If we pull together our vision of ‘a county free of HIV infections, stigma and AIDS related deaths’will be a reality. DR. OLANG’o ONUDI CEC Health “A healthy and productive population” ix Acknowledgements This Siaya County AIDS Strategic Plan (SCASP) is the first guiding document for addressing the HIV and AIDS epidemic in alignment with the Kenya AIDS Strategic Framework 2014/2015 – 2018/2019. It will provide guidance to all stakeholders who are involved in the HIV response in the County.This document was developed and validated through a participatory and consultative process involving health leadership, implementing partners and ‘Wananchi’ at the county and sub county levels. In particular we thank HE the Governor of Siaya County for his exemplary leadership and patronage of this plan. We also thank the CEC member - Health Services for his visionary leadership and guidance during the development of this strategic plan. We also thank the Siaya County HIV TWG members who successfully spearheaded this process. Our appreciations also go to National AIDS Control Council, NASCOP and HIV Implementing partners for providing the technical and financial support towards the development of this plan.