1. Goals and objectives: The mechanism goal is to develop and reinforce capacities among indigenous sub-grant local organizations (LO) to improve HIV services to individuals in underserved areas of Kenya. The project objectives include increasing capacity of LO to expand quality HIV services including abstinence and be faithful interventions and HIV testing and counseling and to provide people living with HIV access to palliative care, high quality ART services, and support. The mechanism also assists LO provide support to OVCs. The objectives are in line with Kenyas Partnership Framework and GHI.2. Cost-efficiency strategy: The mechanism improves local partners efficiency in program, financial management, and capacity in M&E, through assistance with development of policies, procedures and strategic plans. Trainings are conducted on policy, procedure, strategic planning and sustainability. Site visits are conducted to provide mentorship and guidance in developing these institutional documents.3. Transition to country partners: One of the key outputs of this mechanism is to help the sub-partners be able to apply and access and manage funds on their own for future and continuing programs. CRS works with 16 indigenous partners with an aim of building their capacity to be able to in future carry on with the activities.4. Vehicle information: Five vehicles were purchased with FY1 funds for monthly mentoring and monitoring visits by two technical teams visiting different regions/partners at the same time. During the organization and technical capacity assessments, it came out clearly that a number of partners need vehicles to facilitate their work.

This activity supports GHI/LLC.

Catholic Relief Services-SAIDIA (SAIDIA) has two sub grantees offering adult care and support, Community of St Engidio and Christian Missionary Fellowship, who continue to support comprehensive HIV care and support in 12 health facilities in Nairobi, Rift Valley, and Eastern Provinces. By March 2011, they had cumulatively enrolled 8,321 patients in HIV care and of these, 7,245 were active.SAIDIA 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 10,655 current adult patients in FY12 and 15,888 current patients in FY13. SAIDIA will offer a 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, chlorine for water treatment and educational materials); supplemental and therapeutic nutrition (FBP) to all eligible HIV positive patients; prevention with positives(PwP) except condom and family planning promotion.SAIDIA, in collaboration with MOH, will support targeted capacity building (training and mentorship) for health care workers and offer continuous medical education on care and support, e.g. OI diagnosis and treatment. SAIDIA will identify areas with staff shortages, support recruitment of additional staff, and support good commodities management practices to ensure uninterrupted supply of commodities.SAIDIA 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 and income generating activities; home based care services; gender based violence support programs; vocational training; social and legal protection; and food and nutrition programs. SAIDIA 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 such as supporting male peer educators, mentors and support groups, and supporting women to disclose and bring their male partners for testing and care and treatment.SAIDIA will continue to strengthen data collection and reporting at all levels to improve reporting to National AIDS & STI Control Programme (NASCOP) and PEPFAR. SAIDIA will adopt the new generation indicators and support the development and use of electronic medical records system in accordance with NASCOP guidelines. SAIDIA will continue using the quality of care indicators (CQI) for monitoring the quality of HIV care and support services and integrate them into routinely collected data. Results will be used to evaluate and improve clinical outcomes. SAIDIA will do cohort analysis and report retention rates as required by the NASCOP. SAIDIA will support joint Annual Operation Plan (AOP) development, implementation, monitoring and evaluation, and health system strengthening to facilitate sustainability.

Catholic Relief Society (CRS) SAIDIA Project will support partnerships with local grantees to provide 3,000 OVC in FY12 and 6,000 OVC in FY13 with access to essential services in Nairobi, Central, and Eastern Provinces. CRS will train 200 caregivers and build the capacity of local, community, and/or faith-based organizations to meet the needs of OVC in their communities. CRS will support the partners to provide critical services to OVC which include a comprehensive package for education, shelter, nutritional support, psychosocial care and support, and support to OVC caretakers while linking OVC to other critical services and economic strengthening activities.CRS will target all OVC aged between 0 and 18 years and will provide 6 plus 1 services and report on at least 3 services that they provide to the OVC based on individual need. By March 2011, CRS had achieved the following: 3,840 OVC served; 2,536 of OVC received primary direct support (PDS); 1,304 of OVC were provided with Supplemental Direct Support (SDS); and 100 providers/caretakers trained in caring for OVC.CRS continues to experience challenges in areas of capacity building, partner linkages and networking to the local partners. In the next two years CRS will focus on strengthening HIV prevention education among OVC to equip them with life skills that will reduce their vulnerability to HIV infection. CRS will start to implement OVC interventions that are evidence-based in order to achieve their two year goals.They will also train the local organizations to strengthen the family support system and help them to establish strong linkages between PLWHAs and HIV-infected children with health care services, including ensuring that children and their parents or caregivers and other family members affected access appropriate care and treatment. CRS will work closely to link OVC with care and treatment partners to ensure that HIV-infected children receive appropriate psychosocial support and that they have a consistent caregiver to assure adherence to treatment.CRS will continue to work closely with District Children's Department and will follow guidelines provided by the Ministry of Gender, Children, and Social Development, alongside PEPFAR guidelines. CRS will support the local partners to establish partnerships and networks among other NGOs in order to strengthen their collective voice, build a unified approach, improve coordination, and share knowledge.

CRS will embrace community and family centered approaches (such as the cash transfer program) that are preferred to institutional approaches and they will explore livelihoods OVC programming approaches. There is limited information regarding current OVC programming by CRS supported partners. CRS will undertake an OVC situation and gap analysis for its CBOs to document best practices and lessons learned for OVC to help the CBOs to explore new program approaches. CRS will also develop an OVC advocacy curriculum and provide training to CBOs and other OVC stakeholders. CRS will work with the local organizations to engage and advocate for OVC issues with key stakeholders in the Kenyan HIV/AIDS response, including donors.CRS will work with the local partners to improve M&E systems based on rapid capacity and gaps analysis of the OVC activities they support. The program will also capture age specific services that are offered to OVC aged between 0 and 18 years.

Catholic Relief Services (CRS) SAIDIA project is a consortium of two members: CRS (lead) and JHPIEGO sub-partner. SAIDIA has three partners providing HVTB services: Community of St Engidio, Christian Missionary Fellowship, and African Inland Church Ministries. SAIDIA will support the sub-grantees in capacity building to provide quality HIV/TB services in 7 health facilities in Nairobi, Narok, and Eastern. SAIDIA has been supporting TB/HIV services in the 7 sites since October 2010 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, 184 TB patients received HIV testing and 47 TB HIV co-infected patients were identified. A total of 184 HIV positive patients were screened for TB. In FY 2012 and 2013, SAIDIA will intensify efforts to detect TB cases through clinical exams and laboratory investigations and ensure successful TB treatment through provision of appropriate treatment.To reduce the burden of HIV in TB patients, SAIDIA will ensure that at least 95% of TB patients are screened for HIV and 80%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. SAIDIA 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 and be staffed with 60 HCW trained as needed.To reduce the burden of TB in HIV infected patients, SAIDIA will support intensified TB screening for 9,471 in FY12 and 14,122 in FY13 HIV infected persons identified in their HIV care setting. 474 co-infected patients identified in FY12 and 706 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, SAIDIA will ensure that the national IC guidelines are available at all sites and training of staff on IC is done. SAIDIA 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, SAIDIA 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. SAIDIA will also support scaling up of drug-resistant treatment sites thus expanding access to MDRTB treatment.SAIDIA will support expansion of prevention with positive (PwP) except condom and family planning promotion 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, SAIDIA will support reporting of selected custom indicators to assist with program management and evaluation and monitoring of new activities.

Catholic Relief Services (CRS) SAIDIA project is in year 3 of funding as a CDC partner. CRS-SAIDIA has two sub grantees doing pediatric care and support: Community of St. Engidio and Christian Medical Fellowship. SAIDIA builds capacity of sub-grantees to provide quality pediatric care services.By March 2011, SAIDIA had 12 sites offering pediatric care and support, 1,012 children enrolled in care with 986 receiving HIV care, and 323 on cotrimoxazole prophylaxis.In FY12 and 13, SAIDIA will provide care and support services to 1,113 and 1,690 children currently on care respectively. SAIDIA will provide comprehensive, integrated quality services and scale up to ensure 109 HIV infected infants are put on ARV prophylaxis and all HIV exposed children access pediatric care services.SAIDIA will improve access to cryptococcal antigen testing; TB screening and management; pain and symptom relief and management; psychosocial support (including disclosure counseling and support) provided through education; and counseling and linkages to facility or community based support groups. SAIDIA will strengthen the 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 health facilities to prevent diarrhea and other illnesses among the HIV infected, exposed and other children in the community; and malaria screening, treatment and provision of long lasting insecticide treated nets in malaria endemic areas. Emphasis will be on enhanced follow up and retention of all identified HIV infected and exposed children.SAIDIA will support the 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.

SAIDIA will support hospital and community activities to meet the needs of HIV infected adolescents such as support groups to enhance disclosure and adherence messaging, PwP except condom and family planning promotion, substance abuse counseling, support for transitioning into adult services, and teaching life skills. SAIDIA will ensure optimized linkages of children to various programs including TB/HIV, PMTCT and OVC services, and other community based programs such as education, protection, and legal and social services.SAIDIA will also support relevant class-based, on-the-job trainings, and continuous medical education. SAIDIA will strengthen pediatric data collection and reporting at all levels to increase and improve reporting to NASCOP and PEPFAR. To improve the quality of care and strengthen pediatric services, SAIDIA will support supervision and mentorship activities and use quality of care indicators (CQI and HIVQuaL) for monitoring the quality of pediatric HIV services and integrate them into routinely collected data.

SAIDIAs activities focus on strengthening institutional capacity building for indigenous organizations to improve HIV treatment, care and support services to marginalized people in underserved areas of Kenya. Participatory Development Consultancy was commissioned to provide technical support to the fifteen indigenous organizations supported by the SAIDIA Agencies project to develop and/or review governance systems, financial guidelines, programs management, human resource policies and strategic plans in order to not only facilitate the implementation of the SAIDIA project but also enhance their capacity to independently bid for funds.The process entails the following tasks: Review of capacity assessment reports for the fifteen indigenous organizations contracted by CRS in the SAIDIA project, training of board members from the fifteen indigenous organizations, workshops to train management team members on institutional guidelines/policies development, mentorship visits to the fifteen indigenous partner organizations to support them in developing individual institutional guideline and policies to ensure organizational growth, several trainings on proposal writing and presentations will be delivered.PDC is also developing a guidance manual for good practice. This manual is part of a wider CDC/CRS indigenous organizations systems strengthening strategy which included capacity assessment of various organizations in Eastern, Central, Rift Valley and Nairobi provinces of Kenya.Monitoring and evaluation are conducted through site visits which are conducted one to three times per quarter with every sub-grantee. Partners are contacted and dates are sent for the visit and objectives and activities of the visit are shared. Before the site visit starts previous trip reports to the partner are reviewed. During the trip there is a meeting with the partner staff to review the objectives and activities and any other issues that may need to be addressed are discussed. The site visit is conducted with the technical team from CRS occaisonally accompanied by CDC technical team, observing program activities and agency capacity. After the visit is complete a meeting is held with concerned project staff and management to review the visit, any issues that need immediate attention and any other recommendations that needs to be discussed. After the meeting a trip report is completed and shared with the partner.

CRS works in the following provinces and counties: Nairobi, Eastern (Machakos, Embu, Kituia and Makueni), and Central (Nyeri, Kirinyaga, Nyandarua, Maranga, and Kiambu) to implement HIV-prevention, abstinence and being faithful evidence-informed behavioral interventions (EBIs) among the following priority populations (targets): 10-14-year-olds (20,000), 15-19-year-olds (20,001), and parents of youth 9-12 years of age (9,654).CRS and its partners will serve youth aged 10-14 with two EBIsHealthy Choices I (HC1) and Families Matter! Program (FMP).FMP is an EBI for parents of preadolescents and promotes positive parenting practices, positive reinforcement, parental monitoring, and effective parent-child communication on sexual topics and sexual risk reduction. FMP seeks to delay onset of sexual debut by training parents to deliver primary prevention messages to their children. HC1 targets in-school youth and aims to delay sexual debut by providing knowledge and skills to negotiate abstinence, avoid negative peer pressure, avoid or handle risky situations, and to improve communication with a trusted adult.For quality assurance, CRS has put in place for all sites the following: use of approved national curricula; emphasis of importance of fidelity to the respective curricula; use of trained and certified pair of gender balanced facilitators; trainings on EBIs are conducted by certified national trainers; observed practice of implementation is done soon after training; use of standardized, national data tools at every stage of EBI implementation; and regular field visits by trained program staff to check on delivery of EBIs and offer support supervision.The proposed activities and EBIs are guided by the goal and objectives of the project. Targets for each of the interventions are laid out at the start of the project year which is tracked on a monthly basis through respective field reports. Results are analyzed on a quarterly basis. The targets are in line with the PEPFAR Next Generation Indicators (NGIs). Monitoring and evaluation will be conducted with EBI approved data capture / monitoring tools. Field staff will send reports on a monthly basis; these reports will be compiled into an overall report quarterly which will be submitted to CDC.

Target population: CRS Umbrella mechanism is mandated to build the capacity of local indigenous organizations to be able to implement high quality and cost effective HIV programs. The target population for these local organizations is mainly the general population in the three provinces of Kenya (Nairobi, Eastern and Central). These regions have a generalized epidemic and the coverage of HIV testing and counseling (HTC) programs are below 50% except in Nairobi Province.HTC Approaches: CRS sub-partners utilize both client-initiated (CITC) and provider initiated (PITC) approaches. Sub-partners that have health facilities focus mainly on PITC in the OPD, TB clinics, Wards and ANC settings. Sub- partners that do not operate within health facilities utilizes mainly static, mobile and Home based counseling and testing.Targets and achievements: In the past 12 months, CRS had a target of 100, 000 persons and surpassed its target. A total of 52 providers were trained in HTC using the national training curriculum. For COP 2012, CRS will target 77,000 with HTC services of which 20% will be tested as couples, and 10% will be children below the age of 15.Testing algorithm: National algorithmReferrals and linkages: In order to achieve effective referrals and linkages, CRS has established a referral directory at all the testing points to facilitate easy referrals by the providers. It has also made actual contacts to referring facility for discussions on complete referrals. Further to this, each partner keeps a referral log to track referrals. Phone calls and in the case of CHBCT, actual home visits done to confirm that client visited. And in the cases of community units, CHWs are utilized for follow up purposes. In order to monitor successful referrals, CRS came up with data collection tools for monitoring linkages, these indicators are reported on a monthly basis, to ensure that they are performed and tracked.Promotional activities for HTC: CRS utilizes a number of strategies to promote HTC uptake. They include use of health talks at the facility level targeting inpatient and outpatient clients; community awareness and demand creation activities facilitated by Community Health Workers/Promoters; use of media campaigns (HTC video screening, IEC materials) targeting the general population, etc.Quality management: Training and continuing education of HTC providers; HTC is conducted in accordance with the procedures outlined in the national HTC guidelines; HIV rapid kits are managed as per the guidelines; Functional HTC QA systems are in place as provided for in the national HTC guidelines; IQA- In-house lot testing of kits; participation in EQA- proficiency testing and finally conducting support supervisory visits.Monitoring and evaluation: CRS Sub-partners uses all ministry of health tools to capture HTC data, both for couples and individual patients. These include HTC lab Register and Monthly summary tool (MOH 711). MOH approved HTC lab registers have been introduced at all HIV testing points except PMTCT.

CRS SAIDIA implements comprehensive prevention, care and treatment programs in Nairobi, Eastern, and Central. In FY 2012/13, CRS SAIDIA will expand HIV prevention services to include evidence based behavioral interventions (EBIs) 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 implemented will be Positive Health and Dignity Prevention (PHDP) targeting adult male and female and adolescents living with HIV (PLHIV).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; sexual risk reduction counseling including reduction of sexual partners, alcohol counseling; 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.CRS 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. HIV Prevalence in Central is (3.6%), Nairobi is (8.8%) and (4.6%) in Eastern province. CRS will reach 6,002 (60%) PLHIV in FY2012 and 10,459 (70%) in FY 2013 with a minimum package of PHDP.Quality assurance for PHDP will be promoted through appropriate training and certification of peer educators using approved national curricula, standard job-aids and guidelines and regular supervision.CRS 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 services, as necessary, through patient escorts.Monitoring of PHDP will be done through the review/input of CRS 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)

Catholic Relief Services CRS SAIDIA Project will support implementation of PMTCT services through its sub-grantees in Eastern and Nairobi Provinces and Narok District. SAIDIA has three partners doing MTCT: Community of St Engidio, Christian Medical Fellowship, and MMAAK. These funds are used to promote male involvement in PMTCT using innovative methodologies including mobilizing men to come with their spouses to the MCH clinic, giving the woman an invitation to come with the spouse to clinic, and making the MCH clinic male friendly.By end of March 2011, SAIDIA had counseled and tested 1,568 pregnant women; given ARV prophylaxis to 55 HIV positive pregnant women and xx infants. SAIDIA trained 11 HCW in PMTCT and did not give food supplements to pregnant women. SAIDIA tested 17 HIV exposed infants for HIV and tested 11% of couples.In FY12, SAIDIA will offer HIV counseling and testing to 3,333 pregnant women at the ANC and give ARV prophylaxis to 105 HIV infected pregnant women. The HIV infected women will receive a CD4 test after undergoing a WHO clinical staging. SAIDIA will give HAART to all eligible HIV positive pregnant women in line with the revised PMTCT national guidelines. In FY13, SAIDIA will increase the number of pregnant women counseled to 3,500, offer ARV prophylaxis to 127 pregnant women and 109 infants, and do EID for 109 infants.SAIDIA will focus on 3 prongs of PMTCT: primary prevention; 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 except condom and family planning promotion, follow up, retention, and referral and linkages. SAIDIA will incorporate TB screening into routine antenatal care.

SAIDIA will support integration of ART in MCH clinics, and establish or strengthen infection control and waste management activities.SAIDIA will support hospital delivery through provision of delivery beds and sterile delivery packs, training, working with CHWs and TBAs to promote a community-facility referral mechanism, health education, and community services providing skilled birth attendance.SAIDIA will support safe infant feeding practices as per national guidelines and support enrollment and follow up of 109 HIV exposed infants to access CTX, ARV prophylaxis, and EID services using the HIV exposed infant register till 18 months. SAIDIA will facilitate ART initiation for those who test positive before 2 years.SAIDIA 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 utilizing data at facility level for program improvement and quarterly progress reports to CDC.SAIDIA will train 30 HCWs in FY 12 and equal number in FY13 on PMTCT and provide orientation on 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 and reaching non clinic attendants.

Catholic Relief Services SAIDIA will support HIV treatment activities in 12 sites through two sub-grantees: Community of St Egidio in Nairobi and Eastern and Christian Medical Fellowship in Narok. As per 2011 SAPR, a cumulative 4,448 adults had ever been started on ART and 3,236 were active; SAIDA reported 7 service outlets providing ART and 28 HCWs trained on ART.

In FY12, SAIDIA will work with the Ministry of Health (MoH) to continue supporting expansion and provision of quality adult HIV treatment services as per MoH guidelines to 5,019 patients currently receiving ART and 397 new adults resulting to cumulative 6,023 adults who have ever been initiated on ART. In FY13, this number will increase to 5,317 currently receiving ART and 401 new adults resulting to 6,424 adults who have ever been initiated on ART.SAIDIA will support in-service training of 80 and 70 HCWs, continuous mentorship of trained health care workers on specialized treatment, including management of patients with ARV treatment failure and complicated drug adverse reactions. SAIDIA will identify human resources and infrastructure gaps and support in line with MoH guidelines as well as support good commodities management practices to ensure uninterrupted availability of commodities.SAIDIA will support provision of comprehensive package of services to all PLHIV including ART initiation for those eligible; laboratory monitoring including biannual CD4 testing and 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), except condom and family planning promotion; and improved OI diagnosis and treatment including TB screening, diagnosis, and treatment.Ongoing community interventions for PLHIV including peer education and support groups to provide adherence messaging, defaulter tracing, and follow up will continue to be supported to improve retention in all sites. SAIDIA 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.SAIDIA 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.SAIDIA will continue to strengthen data collection and reporting at all levels to increase and improve reporting to NASCOP and PEPFAR. SAIDI will also do a cohort analysis and report retention as required by MoH. Additionally, SAIDIA will review data and evaluate programs to inform programming and decision making. Use of an electronic medical records system will be supported and strengthened. SAIDIA will strengthen local capacity as part of the transition plan to MOH for sustainable long-term HIV patient management in Kenya.

Catholic Relief Services - SAIDIA through two sub-grantees (Community of St Engidio and Christian Medical Fellowship) has been supporting HIV pediatric treatment services in 10 sites in Nairobi, Eastern, and Rift Valley Provinces.In FY12, SAIDIA 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 1,121 pediatrics currently receiving ART and 224 new pediatrics resulting to cumulative 1,345 pediatrics ever initiated on ART. In FY 13, this number will increase to 1,454 pediatrics currently receiving ART and new 202 resulting to cumulative 1,547 pediatrics ever initiated on ART.SAIDIA 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; 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.SAIDIA will support hospital and community activities to support the needs of the HIV infected adolescents: support groups to enhance disclosure and adherence messaging, PwP except condom and family planning promotion, substance abuse counseling, teaching life skills, and supporting their transition into adult services.SAIDIA will support in-service training of 80 and 70 HCWs in FY 12 and 13 respectively and 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. SAIDIA will also 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.

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