Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 4284
Country/Region: Kenya
Year: 2007
Main Partner: Tenwek Hospital
Main Partner Program: NA
Organizational Type: FBO
Funding Agency: USDOD
Total Funding: $200,000

Funding for Testing: HIV Testing and Counseling (HVCT): $200,000

1. LIST OF RELATED ACTIVITIES This activity relates to activities in HIV/AIDS treatment/ARV services [#6973], Palliative Care: Basic Health Care and Support [#6922] and Palliative Care TB/HIV [#6922]

2. ACTIVITY DESCRIPTION Tenwek Mission Hospital is a 300-bed, faith-based hospital in Bomet District serving an estimated population of 500,000 people. Counseling and testing (CT) activities for the hospital have primarily been conducted through the Tenwek Community Health Department (TCHD) in six districts within the Rift Valley Province through 9 stand alone Voluntary Counseling and Testing (VCT) sites as well as mobile VCT services which attends to the undeserved, hard-to-reach rural areas throughout the six districts. In FY 2006, Tenwek Mission Hospital was able to reach 14,000 individuals through continued support of their existing sites as well as scale up the testing of in-patient and TB patients for HIV. The six districts in Kenya in which TCHD has had a significant presence in the area of CT are characterized by its high rural population and poor infrastructure which severely limits the accessibility of medical services. TMH has been an Emergency Plan partner since 2004 and has successfully provided VCT to approximately 35,000 Kenyans in some of the most- difficult to reach areas in the south Rift Valley. With the assistance of the FY 2007 Emergency Plan funding, TCHD will continue to bring CT services to many of the migrant seasonal workers in the tourism industry in a few Kenyan national parks through mobile VCT. TCHD will also continue to ramp up services at their VCT site in Naikara which serves the migratory population of the traditional Masaai community through both a stand alone site as well as mobile VCT services. TCHD is also targeting at-risk populations through the prisons and outreach VCT services to commercial sex workers in many of the towns along the major Kenyan highways. They have also converted three of their stand alone sites to youth friendly sites, in order to attract and serve both in and out of school youth which contributed greatly to an increase in the number of individuals counseled and tested for HIV at these sites. Through the promotion of CT services to the youth, TCHD/TMH provides an important link to early prevention and subsequent behavior change to youth between the ages of 15-24 who are globally most at risk for transmission of HIV. TCHD will also continue to use mobile VCT as a major strategy in reaching their targets in CT. In FY 2006, TCHD was able to reach over 6,000 individuals through mobile VCT which sought to bring quality VCT services to a population that would not have had access to this service. In order to further expand counseling and testing activities in FY07, 6 health care workers will be trained in Provider Initiated Counseling and Testing (PICT) at TMH as well as other TCHD sites. In addition, funds will be used to train 4 qualified individuals to provide services through the existing stand alone VCT sites and mobile VCT by pursuing trainings for couple counseling and VCT supervision.

3. CONTRIBUTIONS TO OVERALL PROGAM AREA TCHD, in conjunction with TMH, will successfully allow 15,400 more Kenyans to gain a personal knowledge of their HIV status through traditional VCT sites and mobile counseling and testing services. In accordance with the national initiative of increasing HIV testing in clinical sites, TMH will also bring quality PITC in their hospital in Bomet District, which will contribute to the number of individuals learning their HIV status. Furthermore, in accordance with the Emergency Plan's overview for CT, special populations will be targeted in FY 2007 in CT for Tenwek by focusing on bringing quality CT services to identified at-risk populations.

4. LINKS TO OTHER ACTIVITIES TMH CT activity is closely linked with KEMRI-South Rift Valley TB/HIV activities (#6975) and HBHC (#6922) as well as with existing Antiretroviral Therapy (#6973) programs in the south Rift Valley.

5. POPULATIONS BEING TARGETED Many of TCHD VCT stand alone sites are situated along the busy transportation routes of Kenyan highways; the initiative of many of these sites is to target commercial sex workers and other mobile populations such as truck drivers. The transformation of 3 of their existing sites to become youth friendly in FY05 has also captured the youth population. The mobile CT services are bringing CT migrant workers currently working in the seasonal tourism industry in a few of the Kenyan national parks that are part of the geographic area that TMH serves. TMH CT services will also be extended to reach the frequent discordant couple phenomenon found in the church community. PICT will also be targeting the

general population seeking medical services at TMH as well as training private health care workers in the delivery of PICT in the clinical setting.

6. KEY LEGISLATIVE ISSUES ADDRESSED CT activities undertaken by TMH will focus on improving the availability and accessibility of gender sensitive CT services to women and young girls. They will focus on utilizing CT services as a behavior change intervention that empowers young girls to be more pro-active regarding issues surrounding sexuality as well as serving as a tool to counsel men on gender-specific traditional roles and beliefs that have had a direct relationship to the rapid spread of HIV in the area.

7. EMPHASIS AREAS TCHD's budget will be split up into community mobilization, human resources, information, education and communication, and training. A small emphasis of the TMH efforts will also be used to continue the financial support of their dedicated counselors and staff providing quality CT services. TCHD will be mobilizing community resources to disperse educational material to prepare communities for their mobile VCT. Also, the TCHD will need to conduct recruitment and training to meet the needs of their expanding VCT activities.