Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 4271
Country/Region: Kenya
Year: 2007
Main Partner: Pathfinder International
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $850,000

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $850,000

1. LIST OF RELATED ACTIVITIES This activity relates to activities in HIV/AIDS Treatment: ARV services (#7095), (#6836), (#6880), (#7094), (#6869), (#6866), (#6867), (#7100), and Palliative Care: TB/HIV (#6879).

2. ACTIVITY DESCRIPTION Pathfinder International (PFI) has been supporting the implementation of PMCT services in 220 facilities located in 18 districts in the four provinces of Nairobi (all districts), Eastern (Meru South, Meru North, Meru East and Tharaka Districts) Rift Valley (Nandi North, Nandi South, Uasin Gishu Districts, Keiyo, Marakwet and Trans Nzoia District). In FY05, PFI achieved 72% of the set targets. PFI supports facilities to provide a comprehensive antenatal package for all pregnant women. PFI has facilitated the establishment of over 100 support groups of PLWHAs, formed around PMTCT sites by mothers who have benefited from the program services. Referral linkages have been established to centers providing antiretroviral therapy for continuum of care for the mother, male partner and, infant.

In FY 2007, there will be significant change in geographic focus where PFI will consolidate its activities in Nairobi (8 districts), Eastern (5 districts), and Central (1 district) provinces. PFI will implement integrated comprehensive PMTCT service in accordance with the National Comprehensive PMTCT guidelines. Comprehensive integrated PMTCT services include, but are not limited to counseling and testing of pregnant women and their partners in antenatal clinics, delivery units and postnatal clinics using the opt-out approach, clinical staging of all HIV-positive women using WHO guidelines and use of appropriate antiretroviral regimens. Early Infant Diagnosis (EID) at six weeks via PCR on Dry Blood Spots (DBS) from all exposed infants and successful referral of HIV-positive mothers, their male partners and infected infants to antiretroviral treatment centers. PFI targets counseling and testing to 118,774 pregnant women and provide antiretroviral prophylaxis for 10,000 (1,000 on HAART, 4,500 on AZT+sdNVP and 4,500 sdNVP) HIV-positive women. The target for EID using DBS at six weeks and cotrimoxazole prophylaxis to exposed infants is 6,000. The number of sites will increase from 220 to over 300. Innovative approaches will be used to increase male partner participation such as using peer approaches, work place awareness creating as well as targeting men in social settings. 600 counselors will be trained for enhanced adherence support to HIV-positive women and their families. 300 community health workers will be trained to provide community and facility referral linkages. 150 health supervisors will be trained in program management skills, including utilization of data for decision making for program improvement. Pathfinder will train and update skills of 630 service providers in comprehensive HIV management for HIV-positive pregnant mothers, their infants and their families.

In FY 2007 PFI will conduct targeted evaluation to determine characteristics of women coming to delivery and postnatal units with unknown HIV status. This will inform specific approaches to reach majority of the women in the population and develop effective strategies for enhanced Maternity and postnatal testing.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA This activity will contribute to 12% of the overall 2007 Emergency Plan PMTCT targets for Kenya. Community participation and male involvement will significantly contribute to PEPFAR goals for primary prevention, access to care and treatment, and support of those affected and infected. Technical assistance to the Ministry of health facilities will contribute to improvement of the quality of services. PFI will facilitate capacity building of DHMTs for improved management of health services and set up of referral networks and linkages for a continuum of care from facilities to Home-based care within the community and among various programs within the district. This activity contribute to increased awareness, demand creation and stigma reduction leading to increased utilization of services towards the goal of universal access to prevention, care and treatment services.

4. LINKS TO OTHER ACTIVITES Linkages to HIV care and treatment services will be strengthened, to ensure immediate appropriate care for the woman and exposed infants, and family members as well and thus optimize utilization of complementary services created through Emergency Plan funding. This activity will relate to the ARV services of University of Nairobi, Department

of Pediatrics (#7095), AMREF (#6836), EDARP (#6880), University of Manitoba (#7094), CHF (#6869), University of Columbia (#6866 and #6867) and University of Washington (#7100), and TB/HIV (#6879).

5. POPULATIONS BEING TARGETED This activity targets adults, pregnant women, HIV-positive pregnant women, HIV affected families, and HIV+ infants. Health care providers including doctors, nurses and other health care workers will be targeted for training on PMTCT using the national NASCOP PMTCT CDC/WHO based curriculum.

6. KEY LEGISLATIVE ISSUES ADDRESSED This activity will address gender equity in HIV/AIDS programs through improved PMTCT service delivery at ante-natal clinics and maternity units. Community health workers will conduct community mobilization activities that will help increase service uptake as well as address issues of stigma and discrimination at community level.

7. EMPHASIS AREAS This activity includes major emphasis on development of Network/Linkages/Referral systems with minor emphasis on Quality Assurance and Supportive Supervision; Community Mobilization/Participation and targeted evaluation.

Subpartners Total: $889,531
Kenyatta University: $15,515
Kenyatta National Hospital: $295,834
Kenya Network of Women with AIDS: $68,182
Federation of Kenya Employers: $70,000
Kenya Association of Professional Counselors: $70,000
Malteser International: $370,000