USAID AFYA PWANI QUARTERLY PROGRESS REPORT JANUARY-MARCH 2018 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. USAID AFYA PWANI FY 2018 Q2 PROGRESS REPORT 1st January 2018 – 31st March 2018 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 The Watermark Business Park, Karen, Fountain Court, 1st Floor Ndege Road, off Langata Road 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 JANUARY-MARCH 2018 1 I. AFYA PWANI EXECUTIVE SUMMARY ................................................................................... 10 II. KEY ACHIEVEMENTS (QUALITATIVE IMPACT) ............................................................................. 24 SUB-PURPOSE 1: INCREASED ACCESS AND UTILIZATION OF QUALITY HIV SERVICES ...................... 24 Output 1.1: Elimination of Mother to Child Transmission (eMTCT):....................................................................... 24 Output 1.2: HIV Care and Support Services ............................................................................................................. 31 Output 1.3: HIV Treatment Services ........................................................................................................................ 35 Output 1.4 HIV Prevention and HIV Testing and Counseling ................................................................................... 49 Output 1.5: Tuberculosis/HIV Co-infection Services ............................................................................................... 58 SUB-PURPOSE 2: INCREASED ACCESS AND UTILIZATION OF FOCUSED MNCH and FP, WASH and NUTRITION ..... 63 Output 2.1: Maternal, Newborn and Health services ............................................................................................. 63 Output 2.2: Child Health Services ........................................................................................................................... 73 Output 2.3 Family Planning Services and Reproductive Health (FP and RH) .......................................................... 81 Output 2.4 Water, Sanitation and Hygiene (WASH) ............................................................................................... 87 Output 2.5 Nutrition................................................................................................................................................ 94 SUB-PURPOSE 3: STRENGTHENED AND FUNCTIONAL COUNTY HEALTH SYSTEMS ................................................ 96 Output 3.1 Partnerships for Governance and Strategic Planning ...................................................................... 96 Output 3.2: Human Resources for Health (HRH)..................................................................................................... 98 Output 3.3 a): Health Products and Technologies (HPT)....................................................................................... 100 Output 3.3 b): Health Products and Technologies- Facility Report ....................................................................... 105 Output 3.4: Monitoring and Evaluation Systems .................................................................................................. 109 Output 3.5 Quality Improvement .......................................................................................................................... 116 III. ACTIVITY PROGRESS (QUANTITATIVE IMPACT) ........................................................................ 118 IV. CONSTRAINTS AND OPPORTUNITIES ....................................................................................... 119 VI. PROGRESS ON CROSS CUTTING THEMES: GENDER AND YOUTH ............................................. 139 VII. GRANTS .................................................................................................................................. 155 VIII. PROGRESS ON ENVIRONMENTAL MITIGATION AND MONITORING ....................................... 156 IX. PROGRESS ON LINKS TO OTHER USAID PROGRAMS ................................................................ 156 X. PROGRESS ON LINKS WITH GOK AGENCIES .............................................................................. 157 XI. PROGRESS ON USAID FORWARD ............................................................................................. 158 XII. SUSTAINABILITY AND EXIT STRATEGY ..................................................................................... 158 XIII. SUBSEQUENT QUARTER’S WORK PLAN ................................................................................. 159 USAID AFYA PWANI PROGRESS REPORT JANUARY-MARCH 2018 2 XIV. FINANCIAL INFORMATION .................................................................................................... 159 BUDGET DETAILS ............................................................................................................................................... 159 OBLIGATIONS VS EXPENDISTURES ..................................................................................................................... 160 NEW AWARDS ................................................................................................................................................... 161 COUNTY ANALYSIS ............................................................................................................................................. 162 DISAGGREGATED BY EARMARKS ....................................................................................................................... 162 XV. ACTIVITY ADMINISTRATION ................................................................................................... 162 XVI. SUCCESS STORIES .................................................................................................................. 162 LIST OF ANNEXES & ATTACHMENTS ............................................................................................. 171 Table 1 Afya Pwani Performance Summary Table Jan-March 2018 ............................................ 14 Table 2 PMTCT settings achievement for the reporting period (January to March 2018) against the Country Operational Plan (COP) 2017 Targets. ...................................... 26 Table 3: PMTCT_STAT summary achievements by County, January to March 2018 ................. 26 Table 4 Support group sessions conducted in Q2 .......................................................................... 32 Table 5 Defaulter tracing in Afya Pwani supported counties Jan 18- March 18 ........................... 32 Table 6 Differentiated Care Service Delivery- March 31st 2018 ................................................... 34 Table 7 Reasons for not Clients Not Linked .................................................................................. 36 Table 8 TX_CURR >15 Yrs. Analysis .......................................................................................... 38 Table 9 TX_CURR <15 Yrs. Analysis .......................................................................................... 39 Table 10 Number of CLHIV seen in Pediatric ART Clinics, Jan-March 2018 ............................. 39 Table 11 CME Sessions conducted in Kwale County ................................................................... 40 Table 12 Analysis of Jan-Mar cohort 2017 at 12 months .............................................................. 42 Table 13 Viral Load Uptake in Q2 FY18 ...................................................................................... 43 Table 14 EID tests done during the Quarter .................................................................................. 49 Table 15 Viral load tests done during the Quarter: ........................................................................ 49 Table 16 Yields per testing modalities Jan- Mar 2018 .................................................................. 51 Table 17 Q2 HTS Yields Per County ............................................................................................ 52 Table 18 PNS HIV testing approach (March 1 - 30, 2018) ........................................................... 53 Table 19 GeneXpert utilization Jan-Mar 2018 .............................................................................. 59 Table 20 IPT Uptake Jan- March 2018 .......................................................................................... 59 Table 21 TB/HIV Integration Jan – Mar 2018 ............................................................................... 61 Table 22 Drug Resistant TB Patients as at March 2018 ................................................................ 62 Table 23: No of clients reached during outreaches and maternity open days ................................ 70 Table 24: Number of children below 5 years with fast breathing treated by CHVs- Community Level ......................................................................................................