Eastern Deanery AIDS Relief Program (EDARP) is a local Faith Based Organization (FBO) based in the Eastern slums of Nairobi whose goal is to reduce the incidence of HIV and TB and improve the quality of life through effective care, treatment, and prevention interventions. The program goal & objectives are linked to Kenyas Partnership Framework (PF) and Global Health Initiative (GHI) strategies and are directly aligned to PF pillars 1-3, prevention, care and mitigation, treatment, and systems strengthening. Strategies to reduce maternal and child mortality and eliminate MTCT include supporting family planning integration into HIV clinics. (M&E) plans will align with PEPFAR and country PF. Training on and use of MOH HMIS systems will be supported to eliminate parallel M&E

EDARP will ensure cost efficiency through integration of services, use of existing evidence-based efficient strategies, task shifting, implementing more facility-based training and mentorship as opposed to offsite training, evaluating cost effective strategies for defaulter management, laboratory networking, and mobilization.

EDARP is a local FBO and is partnering with the MOH in various aspects of the HIV program. Capacity-building strategies are aimed at strengthening sustainable local systems for effective transition of technical support from EDARP to MOH. EDARP will continue to build its capacity in monitoring and evaluation of the program by sending its key staff for training and courses in grants management and administration.

EDARP procured 4 vehicles between 2004 and 2008. EDARP requests purchase of 1 vehicle for efficient commodity distribution between their central site and the 14 satellite facilities, as well as during community outreach.This activity supports GHI/LLC.

Eastern Deanery AIDS Relief (EDARP) will support 12 sites in the Eastern slums of Nairobi with an estimated adult HIV prevalence of 7% compared to the national 7.1%. By March 2011, EDARP had cumulatively enrolled 37,722 patients in HIV care of whom 16,226 patients are active.

EDARP will work with the Ministry of Health (MoH) at the provincial, district and health facility level to jointly plan, coordinate, implement and ensure provision of quality HIV care and support to 22,883 current adult patients in FY12 and 27,266 current patients in FY13.

EDARP will offer comprehensive care and support package of services including: HIV testing to partners and family members of index patients and enrolling or referring/linking those that test HIV positive to care and support; provision of Basic Care Kit (safe water vessel, multivitamins, insecticide-treated mosquito nets, condoms, chlorine for water treatment and educational materials); therapeutic nutrition (FBP) to all enrolled HIV positive patients; prevention with positives(PwP), family planning and reproductive health services including cervical cancer screening to all enrolled women.

EDARP in collaboration with MoH will support targeted capacity building (training and mentorship) for health care workers and additionally offer continuous medical education on care and support, e.g. OI diagnosis and treatment. EDARP will identify areas with staff shortages, support recruitment of additional staff, and support good commodities management practices to ensure uninterrupted supply of commodities.

EDARP will also support ongoing community interventions for HIV infected individuals, including: peer education and use of support groups to provide adherence messaging, effective and efficient defaulter tracing and follow up to improve retention in all facilities; referral and linkages to community based psychosocial support groups; water, sanitation and hygiene programs; economic empowerment - income generating activities (IGAs); home based care services; gender based violence support programs; vocational training; social and legal protection; and food and nutrition or/and food security programs. EDARP will adopt strategies to ensure access and provision of friendly services to youth, elderly and disabled populations. Strategies to increase access of care services by men will be employed, including supporting male peer educators, mentors and support groups, and supporting women to disclose and bring their male partners for testing and care and treatment.

EDARP will continue to strengthen data collection and reporting at all levels to improve reporting to NASCOP and PEPFAR. They will do a cohort analysis and report retention rates as required by the NASCOP. EDARP will adopt the new generation indicators and support the development and use of electronic medical records system in accordance with NASCOP guidelines. EDARP will adapt the quality of care indicators (CQI, HIVQUAL) for monitoring the quality of HIV care and support services and integrate them into routinely collected data and use the results to evaluate and improve clinical outcomes. EDARP will to support joint Annual Operation Plan (AOP) planning, implementation, monitoring and evaluation and health system strengthening to facilitate sustainability.

Eastern Deanery AIDS Relief (EDARP) will support TB/HIV activities in the Eastern Slums of Nairobi. Nairobi province has HIV prevalence of 7% and reported 17,444 cases of TB. The HIV prevalence in TB infected patients is 45.5%. EDARP has been supporting TB/HIV services in 12 sites since 1993 in line with the Ministry of Health Division of Leprosy, Tuberculosis and Lung Disease ( DLTLD) and the National AIDS and STI Control Program (NASCOP).Between October 2010 and March 2011, 1,530TB patients received HIV counseling and testing and all the 893 (100%) TB HIV confected patients identified received cotrimoxazole prophylaxis while 773 received ART.

In FY 2012 and 2013, EDARP will intensify efforts to detect TB cases through clinical exams, laboratory investigations and ensure successful TB treatment through provision of appropriate treatment. EDARP will ensure that each facility providing TB/HIV services has adequate and well trained clinical staff supported by well equipped and staffed laboratory, including sputum specimen transport where laboratory services are unavailable. All TB patients on treatment will be monitored both clinically and through periodic sputum examination.

To reduce the burden of HIV in TB patients, EDARP will ensure that at least 95% of TB patients are screened for HIV and 95%TB-HIV co-infected patients are put on cotrimoxazole and ARVs as early as possible regardless of the CD4 count as per the national guidelines. EDARP will support the one stop model that provides integrated TB and HIV services in all TB clinics. All TB clinics will be stocked with cotrimoxazole and ARVs. 80 HCWs in FY12 and 40 HCWs in FY13 will be trained.

To reduce the burden of TB in HIV infected patients, EDARP will support intensified TB screening for 20,341 in FY12 and 24,238 in FY13 HIV infected persons identified in their HIV care settings. 1,017 co-infected patients identified in FY12 and 1,212 co-infected patients identified in FY13 will be put on TB treatment and those without active TB will be provided with Isoniazid Preventive Therapy (IPT) as per national IPT protocol.

To strengthen TB infection control in HIV settings, EDARP will ensure that the national IC guidelines are available at all sites and training of staff on IC is done. EDARP will support scaling up of at least 2 components of the national TB infection control strategy in HIV care settings, one of which should be fast tracking of patients with cough for expedited diagnostic work up and treatment.

To improve surveillance and management of drug-resistant TB, EDARP will support timely transport of sputum specimens of TB retreatment cases from health facilities to the central reference laboratory for drug susceptibility testing and ensure return of the results to those facilities. EDARP will also support scaling up of drug-resistant treatment sites thus expanding access to MDRTB treatment.

EDARP will also support expansion of prevention with positive (PwP) services in TB clinics, TB/HIV control activities in the prisons, strengthening linkages between facility and community-based services, and improving patient referrals and tracking systems. To strengthen HVTB program monitoring, EDARP will support reporting of selected custom indicators to assist with program management and evaluation and monitoring of new activities.

Eastern Deanery AIDS Relief (EDARP) will continue to support pediatric care services in 12 sites located in Eastern slums of Nairobi province. By March 2011, EDARP had 5,473 children enrolled in care with 2,297 active and on cotrimoxazole prophylaxis. In FY 12, EDARP will provide care and support services to 2,391 children currently on care. The number of children currently on care will increase to 2,901during FY 13.

EDARP will provide comprehensive, integrated quality services, and scale up to ensure 180 HIV infected infants are put on ARV prophylaxis and all HIV exposed children access pediatric care services. The focus of pediatric care services will continue to be provision of comprehensive, integrated quality services including strengthening the use of the Mother-baby booklet, early infant diagnosis, universal provider initiated testing and counseling, and ensure those identified HIV infected are linked to care and ART services.EDARP will ensure children enrolled in care receive quality clinical care services, including clinical history and physical examination, WHO staging, CD4 tests, and other basic tests; opportunistic infection diagnosis, prophylaxis and management, TB screening, pain and symptom relief and management; and psychosocial support. Additional key care services will include nutritional assessment, counseling and support based on the WHO and IYCF guidelines (including provision of therapeutic or supplementary feeding, support to children with growth faltering, provision of vitamin A, zinc, and de-worming); provision of safe water, sanitation and hygiene interventions (WASH) in the community and in health facilities, malaria screening, treatment and provision of long lasting insecticide treated nets in malaria endemic areas.

EDARP will support integration of HIV services into routine child health care and survival services in the maternal child health department, including growth and development monitoring, immunization as per the Kenya Expanded Program on Immunization guidelines, case management of diarrhea, pneumonia, and other childhood illnesses, and community outreach efforts. They will also support the care of the newborn by supporting hospital delivery and ensuring that there is provision for newborn resuscitation and care (thermal care, hygiene cord care), and prophylactic eye care. Exposed children management and follow up will continue to be supported, and will include enrollment, HIV testing (PCR-DNA and antibody testing) as per the national guidelines, provision of Nevirapine throughout the breastfeeding period, follow up and retention, and linkages of those positive to care and ART services.

EDARP will support hospital and community activities to meet the needs of the HIV infected adolescents: support groups to enhance disclosure and adherence messaging, PwP, substance abuse counseling, support for transitioning into adult services and teaching life skills. Commodity access, infrastructure development, and relevant trainings will continue to be supported.

EDARP will strengthen pediatric data collection and reporting at all levels to increase and improve reporting to NASCOP and PEPFAR.

The Kenya Government/MOH recognized MC as an additional HIV prevention intervention in 2007 and with PEPFAR support developed a MC policy guidance, MC strategy and communication strategy, and adapted/adopted other relevant documents (VMMC clinical Manual, VMMC M&E indicators/tools to guide service delivery and demand creation and tracking. The programs objective is to circumcise men aged 15 49 years by 2013 and reach 80% coverage. Four regions (Nyanza, Western, Turkana and Nairobi) have been identified for priority scale up. Nyanza Province has MC rates of 48% and HIV prevalence of 14.9%. HIV prevalence among the uncircumcised Luo is 17%, and MC rates is estimated to be 22% (KDHS 2008/9). Nairobi Province has MC rates of 83% and HIV prevalence of 8.8%. Since 2008, VMMC services have been provided through PEPFAR implementing partners working at Ministry of Health (MoH) facilities, to over 300,000 males. However, huge gaps still exist, and while coverage is nearly 50% in some Nyanza districts, it is very low in other regions like Nairobi and EDARP will contribute to addressing the existing gapsEDARP will provide VMMC services to 6,977 boys and men aged 15 years and above in Eastlands region of Nairobi County to increase VMMC coverage.EDARP will partner with various church groups in ensuring that Adolescent circumcision camps incorporate safer surgical practices and HIV prevention counseling into the traditional rite of passage in line with the phased approach as outlined in the Kenya National Strategy for Voluntary Medical male Circumcision.EDARP clinical staff and district M&E subcommittee will conduct quarterly support supervision visits to VMMC sites to ensure quality assurance, using the adapted VMMC QA tools and ensure reporting is done through the MOH M&E reporting system.EDARP will ensure requisite demand for VMMC services in generated among males and females in and around the catchment area of each facility where VMMC services are available, and explore other approaches for efficiency including conducting outreaches and mobiles, use of electrocultery, as well as off hour services (Monday to Saturday up to 10 pm in the evening) where applicable.As part of comprehensive prevention package, all VMMC clients will be provided with the minimum package of services at site according to national guidelines, which include opt out HTC for VMMC clients and their partners, age appropriate sexual risk reduction counseling, counseling on abstinence during 6 week healing period.Where necessary, HCW teams to provide VMMC services will be trained to build their capacity, using the MOH VMMC training guidelines.Linkage with other services within facilities and within districts/counties will ensure VMMC is part of comprehensive package of prevention package. Identified men with HIV will be appropriately linked to Care and treatment sites, giving preference of referral to the sites of their choice to reduce Loss to follow up. Active linkages with other programs has been established, with cross referrals to care and treatment for HIV positive men, as well as referral of uncircumcised men from routine HTC sites and discordant couples to VMMC services.Regular EQA from WHO and PEPFAR teams has ensured VMMC activities adhere to international standards. Service provision will be monitored using the standardized VMMC reports and evaluated regularly through the MOH M&E reporting system.

3500 character limit (including spaces)Target population: Eastern Deanery AIDS Relief Program (EDARP) is a local Roman Catholic Faith Based organization that is located in the Eastern slums of Nairobi, covering half a million households and a population of 1.7 million people. EDARP has a community based service delivery model offering integrated HIV/TB care and prevention at 13 sites. EDARP targets the general population with special emphasis on couples, pregnant women, people with TB, and adolescents/youth. In the past 12 months, 93,148 people were tested in the region. The average HIV prevalence for those tested is 9.6%.

HTC Approaches: EDARP provides client and provider initiated HIV testing and counseling. Client initiated testing is offered in the VCTs and during mobile HTC, youth friendly camps at churches and visits to workplaces. Provider initiated testing is offered in home based testing targeting specific geographical areas and households of index clients/patients. EDARPs 13 integrated facilities offer PITC as routine for ANC, TB screening and treatment, voluntary male medical circumcision, cervical cancer screening, and STI screening.

Targets and achievements: For last 12 months up to July 2011, EDARP tested 55,460 people in VCT versus a target of 40,000. In PITC, 21,099 people tested against a target of 30,000.The HBCT target is 70,000, and 19,865 people have been tested. EDARP also trained 114 staff on the following areas; Couples HTC - 15, HBTC- 78, and HIV testing and counseling -21. For COP 2012, EDARP will target to reach 117,000 persons of which 20% will be tested as couples and 10% will be children below the age of 15.

Testing algorithm: National algorithm

Referrals and linkages: Strengthening of linkages and successful referrals is aided by an integrated model where HTC is linked to all services offered ensuring that clients who have positive tests are smoothly transitioned into care in the same setting. In outreach settings, involvement of community health workers for community mobilization and as a link for those tested to ensure successful referrals.

Promotional activities for HTC: Promotional activities around HTC for demand creation includes community mobilization. EDARP also uses of IEC materials and media campaigns. EDARP also leverage on other integrated services like TB screening and treatment, VMMC and Cervical cancer screening.

Quality management: Activities for Quality Assurance for both testing and counseling include support supervision to all HTC staff, continuous skill building by regular HTC updates and trainings, participation in Proficiency testing (PT) and Human Quality Assessment Services (HUQAS) in every quarter. For home based testing, HTC counselors submit a DBS for every 20th client per counselor which is sent to the National Reference laboratory. All HTC counselors undergo Observed Practice every quarter.

Monitoring and evaluation: This will involve collection of data using routine HTC indicators as defined in the revised MOH HIV/AIDS HMIS guidelines and PEPFAR NGI. EDARP will apply appropriate technology in Health Information Management including Electronic medical records system. EDARP submits monthly reports using the national system. The facilities review the HTC indicators monthly

EDARP implements comprehensive prevention, care and treatment programs in Nairobi province. In FY 2012/13, EDARP will expand HIV prevention services to include evidence based behavioral interventions (EBI) for specific target populations in clinical settings at comprehensive care center (CCC), TB and Maternal Child Health (MCH) clinics as part of HIV combination prevention programs. The EBI will include Positive Health and Dignity Prevention (PHDP) targeting adult male and female and adolescents living with HIV (PLHIV); and Sister to Sister EBI (S2S) targeting sexually active HIV negative women attending the MCH clinics.

PHDP is an ongoing 5-10min group and individual level intervention that targets PLHIV in clinical and community settings. This mechanism will support this intervention which constitutes of ART adherence counseling and support; partner and family testing; provision of PEP to the discordant spouse; treatment for prevention once approved; safer pregnancy counseling and provision of modern contraception; sexual risk reduction counseling including reduction of sexual partners, alcohol counseling, promoting of consistent and correct condom use; Sexually Transmitted Infections (STI) screening and treatment and using meaningful involvement of people living with HIV/AIDS ( MIPA ). The efficacy of PHDP has been shown to be 68% in preventing transmission of HIV, and 96% in treatment for prevention.

S2S is a 20 minute individual level intervention that targets women of reproductive age that focuses on self efficacy, safer sex negotiation skills and condom use. Condoms are 80% effective in heterosexual relationships when used correctly and consistently.

EDARP will use HVOP funding to recruit and support appropriate peer educators/counselors to reinforce prevention messages delivered by health providers as a feasible model for task-shifting in the provision of PHDP in clinical settings, and specifically promote MIPA. It will support placement of 5 Peer Educators at the MCH, TB and CCC Clinics in hospitals, and 2 Peer educators at health centres and provide appropriate counseling space. One of the peer educators will do regular client home follow up to strengthen ART adherence.

Approximately 1.6 million Kenyans are PLHIV. The Kenya AIDS Indicator Survey 2007 showed 6% of couples to be in discordant relationships. Nairobi province HIV Prevalence is high (8.8%). EDARP will reach 12890 (60%) PLHIV in FY2012 and 17949 (70%) in FY 2013 with a minimum package of PHDP. It will implement S2S EBI on a pilot basis.

Quality assurance for EBIs will be promoted through appropriate training and certification of peer educators using approved national curricula, standard job-aids and guidelines and regular supervision.

EDARP will work with appropriate national Technical Working Groups (TWG) to support integration of HIV prevention into care and treatment programs in clinical settings. These programs will also be linked to other HIV community programs. PLHIV will be specifically linked to STI and FP services, as necessary, through patient escorts.

Monitoring of PHDP and S2S will be done through the review/input of EDARP implementation plan, analysis of KePMS data, quarterly reviews, semiannual and annual reports. Evaluation will be conducted through operation research of combination HIV prevention and periodic surveys (Kenya Demographic and health survey, Kenya Indicator AIDS Survey, Kenya Service Provision Assessment)

Eastern Deanery AIDS Relief Program (EDARP) will support implementation of PMTCT in the Eastland slums in Nairobi. Since 2004, EDARP has been implementing a PMTCT program in 12 health facilities in these informal settlements with a HIV prevalence of 11%. By end of March 2011, EDARP had counseled and tested 1,495 pregnant women and given ARV prophylaxis to 955 HIV positive pregnant women.

In FY12, EDARP will offer HIV counseling and testing to 1,952 pregnant women at the ANC and give ARV prophylaxis to 172 HIV infected pregnant women. The HIV infected women will receive a CD4 test after undergoing a WHO clinical staging. EDARP will give HAART to all eligible HIV positive pregnant women in line with the revised PMTCT national guidelines. In FY13, EDARP will increase the number of pregnant women counseled to 2,050, offer ARV prophylaxis to 209 pregnant women and 180 infants, and do EID for 180 infants.

EDARP will focus on 4 prongs of PMTCT: primary prevention; family planning, ARV prophylaxis to all HIV positive pregnant mothers and exposed infants, and care and treatment to eligible HIV positive mothers, partners and children. The Minimum care package will include health and HIV education, individual/ family HIVCT, clinical/laboratory monitoring and assessment, OI screening and treatment, ARV prophylaxis and treatment for both mother and baby, nutritional support, psychosocial support, PWP, follow up, retention, referral and linkages. EDARP will incorporate TB screening into routine antenatal care.

EDARP will reach 615 couples with couple CT to identify discordant and concordant couples to improve primary prevention and facilitate linkage to HIV care and treatment for the eligible.EDARP will support integration of ART in MCH clinics, access to FP/RH services, establish or strengthen infection control and waste management activities. EDARP will support hospital delivery through provision of delivery beds and sterile delivery packs, training, working with CHWs and TBAs to promote community- facility referral mechanism, health education and community services providing skilled birth attendance.

EDARP will support safe infant feeding practices as per national guidelines and support enrollment and follow up of 180 HIV exposed infants to access CTX, ARV prophylaxis and EID services using the HIV exposed infant register till 18 months. EDARP will facilitate ART initiation for those who test positive before 2 years.EDARP will adopt efficient retention strategies for mothers and babies by supporting use of diaries and registers for tracking defaulters, having a structured mentorship and supervision plan, enhancing data quality and streamlining M&E gaps including orientation of new MOH ANC/maternity registers and utility of data at facility level for program improvement and quarterly progress reports to CDC.

Program quality and proficiency testing will be emphasized to validate PMTCT results.EDARP will train 30 HCWs in FY12 and 30 in FY13 on PMTCT and provide orientation to the revised PMTCT and infant feeding guidelines and engage in community activities for demand creation for health services such as male involvement with couple CT services, referral and linkages and reach non clinic attendants.

Eastern Deanery AIDS Relief (EDARP) will support treatment in Eastern slums of Nairobi province which has a population of about half a million people and an estimated adult HIV prevalence of 9% compared to the national 7.1%. Since 2003, EDARP has been supporting HIV treatment activities in 12 sites within the informal settlements in Eastern Nairobi. As of March 2011, EDARP had enrolled 21,497 adults on ART with 14,560 active on treatment. As per the 2009 treatment cohort, 80% of patients were still on ART at 1 year, 14% lost to follow up, and the rest reported dead.

In FY12, EDARP will jointly work with the Ministry of Health (MoH) to continue supporting expansion and provision of quality adult HIV treatment services as per MoH guidelines to 14,593 patients currently receiving ART and 3,377 new adults resulting to cumulative 17,512 adults who have ever been initiated on ART. In FY13, this number will increase to 17,129 currently receiving ART and 3,417 new adults resulting to 20,546 adults who have ever been initiated on ART.

EDARP will support in-service training of 80 and 60 HCWs in FY 12 and FY 13 respectively, continuous mentorship of trained health care workers on specialized treatment, including management of patients with ARV treatment failure and complicated drug adverse reactions; identify human resources and infrastructure gaps and support in line with MoH guidelines; and support good commodities management practices to ensure uninterrupted availability of commodities.EDARP will support provision of comprehensive package of services to all PLHIV including ART initiation for those eligible; laboratory monitoring including biannual CD4 testing, viral load testing for suspected treatment failure (through strengthened laboratory network); cotrimoxazole prophylaxis; psychosocial counseling; referral to support groups; adherence counseling; nutritional assessment and supplementation; prevention with positives (PwP); FP/RH; and improved OI diagnosis and treatment including TB screening, diagnosis and treatment.Ongoing community interventions for PLHIV including peer education and use of support groups to provide adherence messaging, defaulter tracing and follow up will continue to be supported to improve retention in all sites.EDARP will do cohort analysis and report retention as required by MoH. EDARP will adapt the quality of care indicators (CQI, HIVQUAL) for monitoring the quality of HIV treatment services integrate them into routinely collected data and use the results to evaluate and improve clinical outcomes. EDARP will also support strategies to ensure access and provision of friendly HIV treatment services to all, including supporting peer educators, mentors, support groups, and supporting patients to disclose and bring their partners for testing and care and treatment.EDARP will continue to strengthen data collection and reporting at all levels to increase and improve reporting to NASCOP and PEPFAR. Additionally, EDARP will review data and evaluate programs to inform programming and decision making. Use of an electronic medical records system will be supported and strengthened. EDARP will strengthen local capacity as part of the transition plan to MOH for sustainable long-term HIV patient management in Kenya.

Eastern Deanery AIDS Relief (EDARP) will support Nairobi province which has a population of about 3.1 million people and an estimated adult HIV prevalence of 9% compared to the national 7.1%. Since 2003, EDARP has been supporting HIV treatment activities in 12 sites within the informal settlements in Eastern Nairobi. As of March 2011, EDARP had enrolled 1,337 children on ART with 945 active on treatment. As per the 2009 treatment cohort, 85% of patients were still on ART at 1 year, and 15% lost to follow up or dead.

In FY12, EDARP will jointly work with the Ministry of Health (MoH) at all levels to continue supporting, expanding and ensuring provision of quality pediatric HIV treatment services as per MoH guidelines to 1,451 pediatrics currently receiving ART and 290 new pediatrics resulting to cumulative 1,741 pediatrics ever initiated on ART. In FY 13, this number will increase to 1,546 pediatrics currently receiving ART and new 261 resulting to cumulative 2002 pediatrics ever initiated on ART.EDARP will support comprehensive pediatric ART services including growth and development monitoring, immunization as per the Kenya Expanded Program on Immunization, management of childhood illnesses OI screening and diagnosis; WHO staging; ART eligibility assessment; laboratory monitoring including 6 monthly CD4, hematology and chemistry (through strengthening of lab networks); Pre-ART adherence and psychosocial counseling; initiation of ART as per MoH guidelines; Toxicity monitoring, treatment failure assessment through targeted viral load testing; Adherence strengthening; enhanced follow up and retention; support EID as per MoH guidelines and PITC to all children and their care givers attending Child welfare clinics; support family focused approach; community outreach efforts and integration of HIV services in other MNCH services.

EDARP will support hospital and community activities to support the needs of the HIV infected adolescents: support groups to enhance disclosure and adherence messaging, PwP, substance abuse counseling, teaching life skills, providing sexual and reproductive health services and support their transition into adult services

EDARP will support in-service training of 80 and 60 HCWs in FY 12 and 13 respectively, continuous mentorship and capacity building of trained health care workers on specialized pediatric treatment including management of ARV treatment failure and complicated drug adverse reactions; identify human resources and infrastructure gaps and support in line with MoH guidelines; and support good commodities management practices to ensure uninterrupted availability of commodities. Linkage of ART services to pediatric care services, PMTCT, TB/HIV, community programs, and other related pediatric services will additionally be optimized.

EDARP will continue to strengthen data collection and reporting at all levels to increase and improve reporting to NASCOP and PEPFAR. Additionally, EDARP will review data and evaluate programs to inform programming and decision making. Use of an electronic medical records system will be supported and strengthened. EDARP will strengthen local capacity as part of the transition plan to MOH for sustainable long-term HIV patient management in Kenya.