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

REFERENCES TO TARGETS AND BUDGETS.

The only changes to the program since approval in the 2007 COP are:

+ Geographic coverage has been expanded to reach married adolescents in Rongo and Nyando Districts.

+ The target population has been expanded to reach 5,000 girls through clubs.

1. LIST OF RELATED ACTIVITIES

This activity relates to activities in Counseling and Testing (#8760), (#6983) and Abstinence and Be Faithful

Activities (#8989).

2. ACTIVITY DESCRIPTION

This project is based on previous research in Kisumu showing that married adolescents are at elevated risk

of HIV infection over and above their sexually active counterparts. With sites in Rachuonyo and Homa Bay

Districts, the project is using media messages through radio spots and drama to raise awareness on the

HIV/RH risks associated with early marriage as well as marital transition of HIV and premarital voluntary

counseling and testing (VCT). Local leaders, including church leaders, are trained as advocates so that they

can pass HIV prevention and reproductive health (RH) messages through their routine activities in the

community. In order to reach girls who are already married or girls at risk of early marriage, a local non-

governmental organization (NGO) is training mentors to mobilize girls into clubs and reach them with HIV

and RH information and referrals. In addition, young people and couples are referred to existing VCT sites,

through a coupon system. In FY 2007, training and media activities will expand with additional radio

messages and additional drama groups trained, while other activities continue to be implemented. Over the

year, 350,000 people will be reached with radio spots raising awareness on early marriage, HIV, marital

transmission and premarital VCT. Additional drama groups will be trained with 30,000 people reached

through this approach. Thirty thousand community members will be reached with prevention messages

through 110 trained church and civic leaders. One thousand couples will be referred for couples VCT and,

of the 30,000 targeted populations reached, 5,000 girls will be reached through clubs. This year will include

small-scale monitoring studies, including a study of the coupon subsidy system, as well as documentation of

the project. In addition, Population Council field staff will be based in the project sites to monitoring ongoing

activities.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA

The project raises awareness of HIV risk that adolescents face within marriage. Abstinence is promoted by

emphasizing that marriage is not a safety zone from HIV-infection, encouraging adolescents and their

families to delay marriage. The project promotes faithfulness within marriage and will contribute to

preventing HIV transmission between discordant couples.

4. LINKS TO OTHER ACTIVITIES

The project will create demand for VCT services being provided by Liverpool VCT and APHIA II Nyanza and

will make links to community activities in AB.

5. POPULATIONS BEING TARGETED

Three hundred and fifty thousand people will be reached with radio spots raising awareness, 30,000

community members will be reached with prevention messages through 110 existing, trained church and

civic leaders. One thousand couples will be referred for couples VCT and 5,000 girls will be reached

through clubs.

6. KEY LEGISLATIVE ISSUES ADDRESSED

Power imbalances in sexual decision-making and the right of women to protect themselves from HIV

infection, even within marriage, is emphasized. This activity will work toward increasing women's legal

protection and addressing male norms and behaviors. Kenya is a signatory to the Rights of the Child that

defines children as below 18 years and considers child marriage a human rights violation.

7. EMPHASIS AREAS

The major emphasis of this activity will be community mobilization/participation in promotion of pre-marital

VCT and VCT for newly married couples. Information, education and communication strategies will be used

to raise awareness of HIV risks associated with early marriage, including messages conveyed through the

radio, through drama, and by community leaders. Community-level married girls clubs will support and

empower newly married adolescent girls in their early stages of marriage.

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 AB (#7022) and OP (#7025)

2. ACTIVITY DESCRIPTION

The Population Council Frontiers in Reproductive Health (FRH) Project will expand activities to integrate

counseling and testing services into existing family planning (FP) service outlets. Integration of CT into FP

offers an opportunity for increasing availability and access to CT services since FP clients will conveniently

be offered opportunities for CT. The Population Council will support the integration of CT into 30 FP Clinics

and train 80 FP providers with a target to provide CT to 8,000 clients. The Population Council will monitor

cost effectiveness of this integration to guide decision regarding further scale up. The Population Council

FRH project has extensive experience in the design, implementation and evaluation of integrated models of

reproductive health globally, including several projects in Kenya. FRH seeks to improve people's lives by

enhancing services in family planning, safe motherhood, and other reproductive health areas. The FRH

program conducts operations research (OR) in collaboration with developing-country organizations to

design innovative interventions for improving services. One of the main goals is to communicate these

research results so they can be utilized for program and policy development. FRH also works to build the

capacity of local organizations to conduct operations research and utilize best practices that emerge from

the studies. The Population Council, Frontiers in Reproductive Health Program in collaboration with the

National Department of Health (DOH) (Maternal Child and Women's Health Directorate) and the Provincial

DOH is currently undertaking a similar program in South Africa and has received support through the South

African Emergency Plan country operational plan (COP). The proposal to integrate CT into FP is based on

feasibility assessment that was conducted by the Kenya government in partnership a number of partners

including JHPIEGO, CDC and FHI. Provision of CT services in FP outlets will be guided by national

standards for CT service delivery and quality assurance. The program has intense social mobilization to

inform potential FP clients about availability and benefits of CT services at FP sites. This integration will be

implemented in Nairobi province, an area with a relatively high FP utilization rate where the benefits or

shortcomings of this integration will be easily monitored and evaluated. Activities will include support for

staff to implement the project, IEC efforts to inform FP clients about CT, training of doctors, nurses, clinical

officers and family planning providers, workers in CT, quality assurance to ensure that high standards are

maintained, and evaluation of this pilot effort.

3. CONTRIBUTIONS TO OVERALL PROGAM AREA

This activity will contribute to the result of increased access to voluntary counseling and testing services.

This activity also supports the National Strategy of the Ministry of Health to expand integrated HIV/FP

services in Kenya. The target groups will be trained in counseling to inform clients about issues of HIV/AIDS

and the need for knowing their status.

4. LINKS TO OTHER ACTIVITIES

The activity creates demand for VCT services and will link to the VCT services at the health facility. More

information will be given to clients and the community during community meetings with the local

administration so that more messages and activities are conveyed through this community channel. The

activity will also be linked to other Frontiers-Population Council activities in AB (#7022) and OP (#7025).

5. POPULATIONS BEING TARGETED

General population will be targeted who will attend the facility for family planning services and also health

facility staff, family planning clients and providers, doctors, clinical officers and nurses. These included men,

women, adolescents and the community at large. Activities will be coordinated with National AIDS control

program staff as well as with community based groups.

6. KEY LEGISLATIVE ISSUES ADDRESSED

This activity will work towards addressing the issue of stigma and discrimination faced by individuals with

HIV/AIDS and their families.

7. EMPHASIS AREAS

Major emphasis will be training and minor emphasis will be information, education and communication

materials which will be used as a part of community mobilization to raise awareness of knowing your HIV

status.