Detailed Mechanism Funding and Narrative

Years of mechanism: 2011 2012 2013 2014 2015 2016 2017

Details for Mechanism ID: 13546
Country/Region: Kenya
Year: 2011
Main Partner: Henry M. Jackson Foundation for the Advancement of Military Medicine
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USDOD
Total Funding: $1,847,170

Henry Jackson Foundation (HJF Inc.) South Rift Valley has been supporting Kisumu West district (KW) since September 2007 but beginning COP 11, HJF KW will be a new funding mechanism.

The Kisumu-West (KW) district, in Nyanza Province, is situated between Lake Victoria and the Nairobi-Busia Trans-highway, 40km west of the Provincial Capital of Kisumu. The district is comprised of two roughly equally sized rural divisions: Kombewa and Maseno, with a population of about 143,000 (based on 1999 census). The district is predominantly rural with major infrastructure challenges such as little electrical and no water distribution system. Subsistence agricultural activities, petty trading and fishery are the mainstays of the local economy. Rudimentary fishing activities are undertaken by the shores of Lake Victoria; mostly by the male folk who demand sex from the women in exchange for fish. HJF KW plans to target this group to curb further spread of HIV.

The population is composed of 47.7% males and 52.3% females with 52.6% of the total population being <18years (WRP Kisumu Health and Demographic Surveillance System). The HIV prevalence in rural Nyanza Province is at 14.9% (KAIS 2007). It is estimated that the greater Kisumu District has an HIV prevalence of 18.3% (based on PMTCT national program data). Approximately 21% of pregnant women tested in Kisumu-West District in 2008 were found to be HIV-infected (WRP unpublished data). Further, 14% (76/534) of HIV-exposed infants tested in 2008 were found to be HIV-infected.

Factors contributing to high HIV prevalence in the KW district include wife inheritance by the Luo sub-tribe, low levels of education, practice of demanding for sex in change for fish by the male fishermen, and poverty among others.

Up to 80% of women attend ANC at least once during their pregnancy with 19% of these attending at least 4 ANC clinic visits (KW GoK District Health Records and Information System). HJF KW will target 99% HIV counseling for all pregnant mothers who attend ANC clinics.

There are 22 health facilities (including 1 district and 1 sub-district hospital) in the district. KW HIV services are centered at the Kisumu West District Hospital with 7 HIV Care & Treatment sites, 22 PMTCT Sites and 22 HIV Testing and Counseling (HTC) sites. KW uses a network model of HIV service delivery where the main facility is supported to replicate best practices in the smaller facilities.

HJF KW implements its activities through the DHMT and HMT in collaboration with NASCOP to promote local leadership, ownership and sustainability, in line with GHI principles.

HJF KW will promote further decentralization of Comprehensive HIV services towards achieving universal access in line with KNASP 2009/10-2013/14.

In COP 2010 PEPFAR funds were used to support infrastructural renovations, monitoring and evaluation, staff capacity building, laboratory and pharmaceutical commodities, diagnostics, support quality assurance activities and strengthening linkages across PMTCT, Counseling and testing, Care and treatment. KW will continue to support these activities in COP 2011, with increased focus on quality improvement.

All HIV services in KW will be implemented based on Kenyan policies and guidelines.

Specific targets and activities in each program areas are as follows:

PMTCT:

HJF KW will support HIV counseling and testing for 6151 pregnant women, provision of ARV Prophylaxis to (1013) 905 HIV positive women and their infants as per the current guidelines, provision of Cotrimoxazole prophylaxis for both mother and infant, and Early Identification of exposed infants using PCR DNA. Exposed children identified through PMTCT will be enrolled into care at the MCH or HIV clinics. Focus will be honed towards expansion of Couple and Family counseling in PMTCT settings, increasing male involvement to improve uptake of PMTCT services and promoting the integration of ART in the MCH clinics.

HBHC & PDCS:

HJF KW will continue to support HIV Care services for 6000 adults and 1000 children below 15 years. This is aimed at reducing mortality, morbidity and new infections by 50% by 2013.

This program will endeavor to enhance activities that foster early identification and management of Opportunistic Infections, Quality provision of the Basic Care Package, individual and facility based nutritional support, access to cotrimoxazole prophylaxis, as well as enhancing community PwP through Condom provision, referral for FP, Identification and support of discordant couples, provision of /referral to other Prevention with Positive Services, and support implementation of the GoK 's Community Health Strategy. HIV-positive adults and children identified through HTC services including PMTCT, TB/HIV, VCT, PITC, and home-based CT will be linked to care and treatment services.

PDTX & HTXS:

HJF KW will support treatment for 3000 adults and 350 children below 15 years. Specific activities include early initiation of ART in pediatrics and adults as per the current guidelines, Improvement of patient retention and follow up, emphasis on drug adherence, decentralization to attain 80% universal coverage, monitoring of toxicities and treatment failure all in an effort to improve quality of treatment.

HVTB:

The program will support screening of upto 80% of patients in the HIV Clinic for TB , 500 TB patients in the TB setting will be Counselled and tested for HIV while 500 TB/HIV co-infected patients will be put on treatment. The program will scale up the 3Is Intensified Case Finding, Isoniazid Preventive Therapy, Infection Control, promotion of Integrated TB/HIV services in the TB Clinic, and Immediate initiation of ART in those co-infected patients in line with the GoK guidelines.

HVCT:

HJF KW will provide counseling and testing to 30,000 individuals focusing on increasing HTC access to first time testers and couples (couple counseling should account for over 10% of the target population). Efforts will be geared towards scaling up PITC in all health facilities and reaching the most at risk populations among the fisher-folks with mobile services as well as integration of PWP services in HTC settings and continued promotion of Quality Assurance. The program will place emphasis on strengthening the health system capacity to scale up access quality HTC services and referrals. In COP 11, KW plans to roll out a Home Based Counseling and testing program. HIV positive adults and children identified through this activity will be enrolled into care and treatment at the local HIV clinics.

HVSI:

HJF KW SI will support joint coordination through: TWG meetings, supportive supervision, mentorship & leadership, management and coordination, ICT technical support and services, systems capacity development, learning & knowledge management data use etc) through MOH leadership (HIS), covering all program areas. Support in Data Quality Audits and Data reconstruction in health facilities, complete development and support implementation of national EMR upgrades including roll out trainings on EMR. GOK and NACC will be strengthened to carry out Monitoring and Evaluation activities, rollout of national indicators/tools (including NGIs), and printing, TOTS, training of DHMTs, HCWs and their distribution to activity sites. Support to NACC data management including regional stakeholder forums for reviewing of community data and developing action plans, capacity building efforts in data management, data use, demand and analysis, monitoring and evaluation of health programs targeting 30 data management personnel.

Funding for Care: Adult Care and Support (HBHC): $178,691

None

Funding for Treatment: Adult Treatment (HTXS): $738,379

None

Funding for Prevention: HIV Testing and Counseling (HVCT): $250,000

None

Funding for Care: Pediatric Care and Support (PDCS): $39,273

None

Funding for Treatment: Pediatric Treatment (PDTX): $79,909

None

Funding for Strategic Information (HVSI): $257,127

None

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $111,685

None

Funding for Care: TB/HIV (HVTB): $192,106

None

Cross Cutting Budget Categories and Known Amounts Total: $19,732
Construction/Renovation $9,045
Education $955
Food and Nutrition: Commodities $604
Food and Nutrition: Policy, Tools, and Service Delivery $282
Gender: Gender Based Violence (GBV) $3,351
Human Resources for Health $5,495
Key Issues Identified in Mechanism
Child Survival Activities
Safe Motherhood
Tuberculosis