USAID AFYA PWANI QUARTERLY PROGRESS REPORT JULY- SEPTEMBER 2019 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 FY 2019 Q4 PROGRESS REPORT 1st July 2019 – 30th September 2019 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 Q4 JULY- SEPTEMBER 2019 2 TABLE OF CONTENTS II. KEY ACHIEVEMENTS (QUALITATIVE IMPACT) ......................................................................... 16 SUB-PURPOSE 1: INCREASED ACCESS AND UTILIZATION OF QUALITY HIV SERVICES ............... 16 Output 1.1: Elimination of Mother to Child Transmission (eMTCT):....................................................................... 16 Output 1.2: HIV Care and Support Services and Output 1.3: HIV Treatment Services ............................................ 21 Output 1.3 HIV Care and Support Services.............................................................................................................. 30 Output 1.4 HIV Prevention and HIV Testing and Counseling ................................................................................... 41 Output 1.5: Tuberculosis/HIV Co-infection Services ............................................................................................... 48 Output 1.7: Determined, Resilient, Empowered, AIDS Free, Mentored and Safe (DREAMS) Initiative .................. 51 SUB-PURPOSE 2: INCREASED ACCESS AND UTILIZATION OF FOCUSED MNCH AND FP, WASH AND NUTRITION ........................................................................................................................... 59 Output 2.1: Maternal, Newborn and Child Health Services .................................................................................... 59 Output 2.3 Family Planning Services and Reproductive Health (FP and RH) .......................................................... 73 Output 2.4 Water, Sanitation and Hygiene (WASH) ............................................................................................... 80 Output 2.5 Nutrition................................................................................................................................................ 83 SUB-PURPOSE 3: STRENGTHENED AND FUNCTIONAL COUNTY HEALTH SYSTEMS ................................................ 87 Output 3.1 Partnerships for Governance and Strategic Planning ...................................................................... 87 Output 3.2: Human Resources for Health (HRH)..................................................................................................... 88 Output 3.3: Health Products and Technologies (HPT)............................................................................................. 90 Output 3.4: Strategic Information and Monitoring and Evaluation Systems .......................................................... 92 Output 3.5 Quality Improvement ............................................................................................................................ 93 III. ACTIVITY PROGRESS (QUANTITATIVE IMPACT) ..................................................................... 94 IV. CONSTRAINTS AND OPPORTUNITIES ..................................................................................... 94 V. PERFORMANCE MONITORING ................................................................................................. 94 VI. PROGRESS ON CROSS CUTTING THEMES: GENDER AND YOUTH ........................................ 102 VII. GRANTS ................................................................................................................................ 105 VIII. PROGRESS ENVIRONMENTAL MITIGATION AND MONITORING ........................................... 106 IX. PROGRESS ON LINKS TO OTHER USAID PROGRAMS ........................................................... 106 X. PROGRESS ON LINKS WITH GOK AGENCIES .......................................................................... 106 XI. PROGRESS ON USAID FORWARD .......................................................................................... 107 XII. SUSTAINABILITY AND EXIT STRATEGY ................................................................................. 107 USAID AFYA PWANI PROGRESS REPORT Q4 JULY- SEPTEMBER 2019 3 XIII. SUBSEQUENT QUARTER’S WORK PLAN ............................................................................. 107 XIV. FINANCIAL INFORMATION ............................................... ERROR! BOOKMARK NOT DEFINED. BUDGET DETAILS ........................................................................................................ Error! Bookmark not defined. OBLIGATIONS VS EXPENDISTURES .............................................................................. Error! Bookmark not defined. NEW AWARDS ............................................................................................................ 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 ................................................................................................................ 109 LIST OF ANNEXES & ATTACHMENTS .......................................................................................... 112 LIST OF TABLES Table 1:Afya Pwani Performance Summary Table July- September 2019 ..................................... 14 Table 2:Afya Pwani Performance Summary FY19 .......................................................................... 16 Table 3: Quarter 4 PMTCT summary achievements against COP targets ...................................... 17 Table 5:Beneficiaries of support groups in Q4 FY 19 ..................................................................... 22 Table 6:Unsuppressed support group for AYLHIV in 4 sites in Mombasa ..................................... 23 Table 7: Defaulter tracing July-September 2019 ........................................................................... 24 Table 8:Retention and viral load suppression ............................................................................... 26 Table 9:OTZ outcomes as at APR 2019 .......................................................................................... 27 Table 10: Linkage per age group July -Sept 2019 ........................................................................... 31 Table 11:Q4 Linkage per County .................................................................................................... 32 Table 12:Net gain analysis per County Q4 FY19 ............................................................................ 33 Table 13:EID tests done July-Sept 2019 ......................................................................................... 36 Table 14:Viral load tests done during Quarter 4 FY19 ................................................................... 36 Table 15:Viral load tests uptake and suppression by County FY19 ............................................... 37 Table 16:Quarterly HTS performance FY 19 .................................................................................. 41 Table 17: Q4 HTS performance per County ................................................................................... 41 Table 18:Yields per age group Q4 .................................................................................................. 42 Table 19:PNS Cascade Q4 FY19 ...................................................................................................... 44 Table 20:Round 20 Proficiency Testing .......................................................................................... 47 Table 21:Gene Xpert Tests in Q4 FY19 ........................................................................................... 48 Table 22:IPT uptake in Q4 FY ......................................................................................................... 49 Table 23:TB/HIV Integration July-September 2019 ....................................................................... 49 Table 24:MDR patients on treatment in Q4 .................................................................................. 50 Table 25:Condom promotion and education................................................................................. 52 Table 26:AGYW reached with CMM service .................................................................................