THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

1. LIST OF RELATED ACTIVITIES

This activity relates to activities in ARV Services (#7095), TB/HIV (#9057), and PMTCT (#7097).

2. ACTIVITY DESCRIPTION

The University of Nairobi, Department of Pediatrics (UNBO) will work to strengthen the palliative care

services available at the Kenyatta National Referral Hospital (KNH) and two additional sites in order to

provide services to 10,000 people with HIV, including 1000 children. Their activities will emphasize the

provision of treatment to children, management of complicated opportunistic infections among HIV patients,

and participants in US government sponsored research. Palliative care services will include cotrimoxazole

preventive therapy, management of opportunistic infections, management of malnutrition, and end-of-life

care. Activities will strengthen KNH to provide highly skilled and laboratory services, conduct training, infant

diagnostic testing infants, and serve in other diagnostic and management capacities particularly with

respect to care of children. In addition to providing training to 100 health care workers, UNBO will provide

technical assistance to the National AIDS and STD Control Program (NASCOP) in the development of HIV

care policy and guidelines. The University of Nairobi Pediatrics Department has run research clinics for

perinatal cohorts of HIV infected women at KNH for 12 years studying PMTCT, immune responses, and

disease progression in women and children, managing a handful of patients receiving donated ART.

Research doctors have undergone short courses on the topic of HIV management and have now

themselves conducted numerous courses on the topic of HIV care. The KNH Comprehensive Care Center

has been running for more than 6 years providing psychosocial care, and over the past year providing

ambulatory medical care to PLWHA including nutrition, opportunistic infection prophylaxis, and treatment

and ART. The center has dedicated staff providing psychosocial, nutritional, and medical care. By August

2006, more than 4000 patients, including approximately 500 children were receiving care as a result of the

activities of this partner.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA

These activities will contribute to expansion of palliative care for people with HIV, strengthened human

resource capacity to deliver HIV care services, and a strengthened referral network for provision of these

services. These activities will develop the capacity of KNH to serve as a key network center, developing

clinical HIV expertise in the management of both adults and children.

4. LINKS TO OTHER ACTIVITIES

This activity relates to ARV services supported by UNBO at these same sites (#7095), and TB/HIV (#9057),

PMTCT activities being implemented by University of Nairobi, OBGYN (#7097), ARV services coordinated

by and supported through the NASCOP (#7004), and training activities supported by the Kenya Pediatric

Association, a treatment sub-partner of CHF, and to multiple activities in and around Nairobi that refer to

KNH as a network center.

5. POPULATIONS BEING TARGETED

These activities target people (adults, children, infants) living with HIV/AIDS. Treatment services for

diagnosis and care of very young children will be established through a relationship with Kenya Medical

Research Institute (KEMRI), whereby filter paper samples are transported to the KEMRI lab for polymerase

chain reaction (PCR) for infant testing. Public health care providers, including doctors, nurses, pharmacists,

and laboratory workers are targeted for increased HIV care knowledge and skills.

6. KEY LEGISLATIVE ISSUES ADDRESSED

This activity addresses legislative issues related to stigma and discrimination through community

sensitization activities.

7. EMPHASIS AREAS

This activity includes minor emphasis in commodity procurement, development of networks/linkages/referral

systems, human resources, policy and guidelines, quality assurance and supportive supervision, and

training.

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

1.LIST OF RELATED ACTIVITIES

This activity relates to activities in ARV Services (#7095) and Palliative Care (#7096).

2.ACTIVITY DESCRIPTION

The University of Nairobi Department of Pediatrics (UNBO) will support TB/HIV services for patients at the

Kenyatta National Referral Hospital (KNH) and two additional sites in Nairobi. UNBO will offer TB screening

to 5000 HIV infected patients and HIV screening for 1500 TB patients; approximately 750 will be diagnosed

with TB/HIV. Funds will be used to support improved TB screening and diagnosis using sputum smear

microscopy and, if indicated, sputum culture and chest x-rays. Refresher training of laboratory staff will be

initiated and basic laboratory microbiology capacity improved in order to meet the increased needs of TB

testing. 20 health care workers will be trained to provide clinical prophylaxis and/or treatment for TB to HIV-

infected individuals.

3.CONTRIBUTIONS TO OVERALL PROGRAM AREA

These activities will contribute towards the provision of integrated HIV/TB care by reducing TB morbidity

and mortality in HIV-infected individuals and also reducing HIV related morbidity and mortality in TB patients

co-infected with HIV. These activities will strengthen referral systems, improve diagnostics and treatment of

TB among HIV-positive patients, and strengthen capacity of health workers to provide integrated HIV and

TB services.

4.LINKS TO OTHER ACTIVITIES

The overall program activity links closely to Palliative care and ARV services currently supported by UNBO,

and ART services coordinated by and supported through the National AIDS and STD Control Program

(#7004).

5.POPULATIONS BEING TARGETED

These activities target people living with HIV/AIDS and TB suspects. Public health care providers, including

doctors, nurses, pharmacists, laboratory workers will receive training in the diagnosis and management of

TB using government guidelines.

6.KEY LEGISLATIVE ISSUES ADDRESSED

This activity addresses legislative issues related to stigma and discrimination through community

sensitization activities.

7.EMPHASIS AREAS

This activity includes minor emphasis in commodity procurement, development of

networks/linkages/referral systems, local organization capacity development, quality assurance, quality

improvement and supportive supervision, and training.

N/A (exempt)