USAID AFYA PWANI QUARTERLY PROGRESS REPORT JANUARY-MARCH 2020 This publication was produced for review by the United States Agency for International Development. It was prepared by Dr EileenJULY Mokaya,- SEPTEMBER Chief of party, 2018Afya Pwani . This publication was produced for review by the United States Agency for International Development. It was prepared by Dr Eileen Mokaya, Chief of party, Afya Pwani. 1 USAID AFYA PWANI FY20 Q2 PROGRESS REPORT 1st January – 31st March 2020 Award No: Aid-615-C-16-00002 Prepared for Mr. Vincent Ojiambo United States Agency for International Development/Kenya C/O American Embassy United Nations Avenue, Gigiri P.O. Box 629, Village Market 00621 Nairobi, Kenya Prepared by Pathfinder International-Kenya Lavington, James Gichuru Road, Hse # 158 P. O. Box 1996 – 00502 Karen NAIROBI, KENYA Office: +254-20-3883142/3/4 Mobile : +254-733-618359/+254-722-516275 Fax : [+254 20] 2214890 www.pathfinder.org DISCLAIMER The authors’ views expressed in this report do not necessarily reflect the views of the United States Agency for International Development or the United States Government. USAID AFYA PWANI PROGRESS REPORT Q2 JANUARY-MARCH 2020 2 TABLE OF CONTENTS II. KEY ACHIEVEMENTS (QUALITATIVE IMPACT) ....................................................................... 19 SUB-PURPOSE 1: INCREASED ACCESS AND UTILIZATION OF QUALITY HIV SERVICES ............... 19 Output 1.1: Elimination of Mother to Child Transmission (eMTCT): ................................................................. 19 Output 1.2: HIV Care and Support Services ...................................................................................................... 26 Output 1.3 HIV Treatment Services.................................................................................................................. 33 Output 1.4 HIV Prevention and HIV Testing and Counseling ............................................................................. 44 Output 1.5: Tuberculosis/HIV Co-infection Services......................................................................................... 49 Output 1.6: Key Populations ............................................................................................................................ 52 Output 1.7: Determined, Resilient, Empowered, AIDS Free, Mentored and Safe (DREAMS) Initiative ............. 61 SUB-PURPOSE 2: INCREASED ACCESS AND UTILIZATION OF FOCUSED MNCH AND FP, WASH AND NUTRITION ....................................................................................................................... 71 Output 2.1: Maternal, Newborn and Child Health Services .............................................................................. 71 Output 2.3 Family Planning Services and Reproductive Health (FP and RH) ..................................................... 91 Output 2.4 Water, Sanitation and Hygiene (WASH) ....................................................................................... 102 Output 2.5 Nutrition ...................................................................................................................................... 105 SUB-PURPOSE 3: STRENGTHENED AND FUNCTIONAL COUNTY HEALTH SYSTEMS ............................. 110 Output 3.1 Partnerships for Governance and Strategic Planning............................................................... 110 Output 3.2: Human Resources for Health (HRH) ............................................................................................ 111 Output 3.3: Health Products and Technologies (HPT) .................................................................................... 113 Output 3.4: Strategic Information and Monitoring and Evaluation Systems .................................................. 116 IV. CONSTRAINTS AND OPPORTUNITIES ................................................................................. 117 V. PERFORMANCE MONITORING ............................................................................................ 117 VI. PROGRESS ON CROSS CUTTING THEMES: GENDER AND YOUTH ....................................... 121 VII. GRANTS ............................................................................................................................ 122 VIII. PROGRESS ON ENVIRONMENTAL MITIGATION AND MONITORING .................................. 123 IX. PROGRESS ON LINKS TO OTHER USAID PROGRAMS .......................................................... 124 XII. SUSTAINABILITY AND EXIT STRATEGY .............................................................................. 125 XIII. SUBSEQUENT QUARTER’S WORK PLAN ........................................................................... 125 XIV. FINANCIAL INFORMATION ............................................. ERROR! BOOKMARK NOT DEFINED. BUDGET DETAILS ............................................................................. ERROR! BOOKMARK NOT DEFINED. USAID AFYA PWANI PROGRESS REPORT Q2 JANUARY-MARCH 2020 3 OBLIGATIONS VS EXPENDISTURES ................................................... ERROR! BOOKMARK NOT DEFINED. COUNTY ANALYSIS .......................................................................... ERROR! BOOKMARK NOT DEFINED. DISAGGREGATED BY EARMARKS ..................................................... ERROR! BOOKMARK NOT DEFINED. XV. ACTIVITY ADMINISTRATION ............................................ ERROR! BOOKMARK NOT DEFINED. XVI. SUCCESS STORIES ............................................................................................................ 127 LIST OF ANNEXES & ATTACHMENTS ....................................................................................... 132 LIST OF TABLES Table 1:Afya Pwani Performance Q1 and Q2 FY20 ........................................................................ 14 Table 2: Afya Pwani Summary HIV Performance Q2 FY20 ............................................................. 19 Table 3: PMTCT Achievements Jan-Mar 2020 ............................................................................... 19 Table 4: Taveta SC Hospital PMTCT CQI project findings .............................................................. 21 Table 5: PHDP services beneficiaries in support groups Jan-Mar 2020 ......................................... 26 Table 6: OTZ outcomes as at March 2020 ..................................................................................... 29 Table 7: Retention per County Q2 FY20 ........................................................................................ 30 Table 8:Defaulter tracing outcomes Jan-Mar 2020 ....................................................................... 30 Table 9: Linkage by gender Jan-Mar 2020 ..................................................................................... 34 Table 10:Explanations for unlinked clients by County Jan-Mar 2020 ............................................ 35 Table 11: Facility based staff supported by Afya Pwani ................................................................ 37 Table 12: ART optimization as at March 2020 ............................................................................... 38 Table 13: EID tests done in Q2 FY20 .............................................................................................. 38 Table 14:Viral load tests done during Q2 FY20 .............................................................................. 39 Table 15: Viral Load uptake as at March 2020 ............................................................................... 39 Table 16: Viral load uptake April 2019-March 2020 ...................................................................... 40 Table 17: Suppression by gender ................................................................................................... 40 Table 18: HTS performance across counties Jan-Mar 2020 ........................................................... 44 Table 19: Yields by modality Jan-Mar 2020 ................................................................................... 45 Table 20: Yields by age group Jan-Mar 2020 ................................................................................. 45 Table 21: HIV self-testing kits distributed Jan-Mar 2020 ............................................................... 47 Table 22: Coupling testing at maternity of Port Reitz SCH in Mombasa ....................................... 48 Table 23: Gene Xpert tests utilization Jan-Mar 2020 ..................................................................... 50 Table 24: HIV/TB Integration ......................................................................................................... 50 Table 25: IPT uptake Jan-Mar 2020 ............................................................................................... 50 Table 26: DR TB patients in Afya Pwani supported facilities as at Mar 2020 ................................ 51 Table 27:KP served in Jan-Mar 2020 .............................................................................................. 53 Table 28: Summary of KP tested and provided with ARVs by Typology ........................................ 53 Table 29: Uptake of Prevention Interventions among KP Jan-Mar 2020 ...................................... 53 Table 30: Summary of other prevention services .......................................................................... 54 Table 31: PrEP Uptake among KP Jan-Mar 2020 ........................................................................... 54 Table 32: Identification of KP