PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2011
University of California at San Francisco (UCSF) Family AIDS Care and Education Services (FACES) supports implementation of comprehensive HIV prevention, care and treatment services in five districts in Nyanza and two sites in Nairobi. Services are targeted at individuals and families of all ages who are at risk of HIV, infected by HIV, or affected by HIV. The program goal and 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. Monitoring and evaluation (M&E) plans align with PEPFAR and country PF. Training on and use of Ministry of Health (MOH) HMIS systems will be supported to eliminate parallel M&E.
Cost efficiency is being addressed through integration of services, reduction of the technical teams by increased capacity building of the MOH staff, 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.Capacity-building strategies are aimed at strengthening sustainable local systems for effective transition of technical support from FACES to KEMRI and HIV care management and implementation from FACES to MOH.
FACES has procured 11 vehicles between FY04 and FY10. In FY12, FACES will procure an additional motor vehicle and four motorcycles for supportive supervision and tracking of defaulters to improve retention.
This activity supports GHI/LLC.
University of California at San Francisco (UCSF)- Family AIDS Care and Education Services (FACES) will continue to support comprehensive HIV care and support in Nyanza and Nairobi Provinces. By SAPR 2011, FACES had a total of 101,617 patients ever enrolled in HIV care of which 85,499 individuals were provided with HIV-related palliative care including 64,431 patients on cotrimoxazole prophylaxis. The overall retention for patients in care stood at 74%.
FACES will continue working 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 63,270 adult patients in FY12 and 76,500 patients in FY13. FACES will offer a package of services that includes HIV testing to partner and other family members of index patient and either enrolling or referring 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); and cervical cancer screening to all enrolled women.
FACES in collaboration with MoH will support targeted capacity building of health care providers through recruitment, deployment, training, and mentorship and additionally offer continuous medical education on HIV care and support. In FY 12, 200 health providers will be targeted for training and another 150 in FY 13. FACES will support good commodity management systems and practices to ensure uninterrupted supply of commodities.
FACES will also support ongoing community interventions for HIV infected individuals through peer education and support groups to provide adherence messaging. Additional activities that will continue to be supported include effective and efficient defaulter tracing system 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.
FACES will adopt strategies to ensure access and provision of friendly services to youth, elderly and disabled populations. Strategies to increase men accessing care services will be employed such as male peer educators, mentors and support groups, disclosure and partners testing and care and treatment.
FACES will continue to strengthen data collection and reporting at all levels to improve reporting to NASCOP and PEPFAR, including adoption of new generation indicators. FACES will support the development and scale up of electronic medical records system in accordance with NASCOP guidelines. Quality of care indicators (CQI, HIVQUAL) will be integrated into routine data collection and results will be used to evaluate and improve clinical outcomes. FACES will also support cohort analysis and report retention rates as required by NASCOP. FACES will support joint Annual Operation Plan (AOP) development, implementation, monitoring and evaluation, and health system strengthening to facilitate sustainability.
University of California at San Francisco Family AIDS Care and Education Services (FACES) program will support five districts in Nyanza and Nairobi Province. Since 2005, FACES has been supporting TB/HIV activities in 5 districts in Nyanza province. As of SAPR 2011, 96,076 HIV clients were screened for TB of which 1,132 were diagnosed and managed for TB.
In FY 12 and 13, FACES will continue supporting TB/HIV activities through collaboration with the Ministry of Health (MoH) in line with TB/HIV collaborative mechanisms. FACES will support intensified efforts to detect TB cases through clinical assessments and physical exams, sputum AFB follow up investigations, and provision of appropriate TB treatments to facilitate good treatment outcomes. FACES will ensure that each facility providing TB/HIV services has adequate and well trained clinical staff and well equipped and staffed laboratory or support sputum specimen transport where laboratory services are unavailable. FACES will ensure that adequate supplies of anti-TB drugs are available and that the national TB treatment guidelines are followed. All TB patients on treatment will be monitored both clinically and through periodic sputum examination.
To reduce the burden of HIV in TB patients, FACES will ensure that all TB patients are screened for HIV and co-infected patients put on cotrimoxazole and ARVs as early as possible regardless of the CD4 count as per the national guidelines. FACES 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 100 HCW will be trained in FY12 and 80 HCW trained in FY13.
To reduce the burden of TB in HIV infected patients, FACES will support intensified TB screening for 56,240 in FY12 and 68,000 in FY13 at each clinical encounter using the national screening tool. 2,812 co-infected patients identified in FY12 and 3,400 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, FACES will ensure that the national IC guidelines are available at all sites and training of staff on IC is done. FACES 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, FACES 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. FACES will also support scaling up of drug-resistant treatment sites thus expanding access to MDRTB treatment.
FACES 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, FACES will support reporting of selected custom indicators to assist with program management and evaluation and monitoring of new activities in all levels.
University of California at San Francisco Family AIDS Care and Education Services (FACES) program is a family-focused, comprehensive HIV prevention, care, and treatment program working collaboratively with the Government of Kenya in Nyanza and Nairobi Provinces since 2005. FACES will continue supporting HIV services including pediatric services in Nyanza and Nairobi Provinces.By SAPR 2011, FACES had 16,127 children enrolled in care with 4,107 on ART, 10,739 on cotrimoxazole prophylaxis, and 3,100 HIV exposed children on ARV prophylaxis. In FY12, FACES will provide care and support services to 6,611 children on care. The number of children currently on care will increase to 8,138 during FY13. FACES will provide comprehensive, integrated quality services and scale up to ensure 6,231 HIV infected infants are enrolled and followed up for care and support.
FACES will improve access to TB and cryptococcal screening and management, pain/symptom relief and management, psychosocial support (including disclosure counseling and support) provided through education, counseling, and linkages to facility or community based support groups.FACES will strengthen growth and development monitoring including nutritional (provision of vitamin A, zinc, and de-worming); support linkages for safe water, sanitation and hygiene interventions (WASH) in the community to prevent communicable disease among children; 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.
FACES will support the integration of HIV services into routine child health care and survival services in the MCH department and through wrap around of non-HIV services such as strengthening routine growth and development monitoring; immunization coverage; and management of diarrhea including oral rehydration therapy, pneumonia, and other childhood illnesses. The support will also include community outreach efforts. FACES will expand support to include care of the newborn by supporting hospital delivery and ensuring that there is provision for newborn resuscitation and care (thermal care, appropriate feeding options and hygiene including cord care and prophylactic eye care).
FACES will support the needs of HIV infected adolescents such as clinical and psychosocial support disclosure, PwP, substance abuse counseling, support for transitioning into adult services, and teaching life skills. FACES will also ensure optimized linkages of children to various programs including TB/HIV, education, OVC support, legal and social services, and other community based programs.
FACES will also support improved health care provider knowledge and skills through in-service and on-job trainings as well as continuous medical education. In FY 12, 200 health care providers will be targeted for training and 150 in 2013.
FACES will strengthen pediatric data collection and reporting at all levels to improve reporting to NASCOP and PEPFAR. With guidance from the national PEPFAR office, the new generation indicators will be adopted. To improve the quality of care and strengthen pediatric services, FACES will support supervision and mentorship activities and integrate the quality of care indicators (CQI and HIVQuaL) into routinely collected data to monitor the quality of pediatric HIV services.
GoK/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 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, Turkana and Teso. In 2012, FACES will contribute to addressing the VMMC gaps existing in Nyanza, and other pockets with significant populations of uncircumcised men in Kenya as advised by National Taskforce on VMMC.FACES will provide VMMC services to 7,000 boys and men aged 15 years and above in all these areas (Kisumu county, Homabay County, Migori County,and in other identified areas by MOH)Current coverage of VMMC services in Counties ranges between 5% in some, and reaching 50% in others, and FACES will contribute to covering these gaps.FACES (clinical & M&E) staff and the 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.FACES 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 moonlight services 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, and promotion of correct and consistent condom useWhere necessary, HCW teams to provide VMMC services will be trained to build their capacity, using the MOH VMMC training guidelinesLinkage 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 LossTo 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 servicesRegular 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.
Target population: FACES supports HIV testing and counseling services in all health facilities in five districts in three counties in Nyanza Province. The counties are Migori, Homabay and Kisumu. The districts of support in include Migori, Rongo, Nyatike, Kisumu East (from 15th August 2011) and Suba (from October 1st 2011). Target population includes all patients, their families and caretakers who access out and in patient services at all the health facilities in the 5 districts.HTC Approaches: The program utilizes provider initiated opt out approach and the services are offered within all out patient departments, TB clinics, VMMC clinics, FP, ANCs, special clinics, HIV clinics (targeting family members) and in patient departments. The counseling and /or testing is either done within the consultation rooms by trained clinicians, counseling rooms by lay counselors within the outpatient if space is available or the in laboratories. Occasionally testing is offered during community action days, world Aids days and when the facilities conduct camps then community and home based counseling and testing is conducted.Targets and achievements: HTC targets for FACES from July 2010 to June 2011 were 59,140 out of which it achieved 80,411 (139%). 15% of the total tested was HIV positive. In COP 2012, FACES will target to provide HTC services to a total of 115,000 persons of which 20% will be tested as couples and 10% will be children below the age of 15.Testing algorithm: National algorithm is being used.Referrals and linkages: In order to strengthen referrals, FACES continues to sensitize counselors on need for proper referral. Counselors continue to educate clients on importance of being enrolled into HIV care and treatment programs if positive. Counselors also capture locator details for patients counseled and tested who turn positive; use of MOH referral tools and use of escorts/peer educators in different departments has also been strengthened. In order to monitor linkages from HTC to appropriate services FACES uses tracking tools/registers for the positive patients to verify whether they have reached the referral points.Quality management: In order to improve and maintain high quality HTC services, FACES will put in place the following strategies: formation of District and facility HTC quality committees; recruitment of qualified and certified counselors; strict adherence to the standard operating procedures outlined in the national HTC guidelines; proper handling of HIV rapid kits as per the guidelines; putting in place a functional QA systems as provided for in the national HTC guidelines; participation in EQA- proficiency testing and finally conducting support supervisory visits.Monitoring and evaluation: FACES will use 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 will be introduced at all HIV testing points except PMTCT.Promotional activities for HTC: All patients attending the supported facilities will be given health talks including the need for HIV counseling and testing and the importance of couple testing. Couples are given priority services. Sexual partners of HIV positive clients will be given individualized invitations though the index clients and available avenues for testing including individualized home testing.
UCSF implements comprehensive prevention, care and treatment programs in Nyanza province. In FY 2012/13, UCSF 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 EBIs 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.
UCSF 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. Nyanza province has the highest HIV Prevalence (14.9). UCSF will reach 35639 (60%) PLHIV in FY2012 and 30360 (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.
UCSF 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 UCSF 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).
University of California at San Francisco Family AIDS Care and Education Services (FACES) has been implementing PMTCT services in 127 sites in 5 Districts in Nyanza region since 2005. The region has about 244,416 expected pregnancies annually and HIV prevalence of 15.1%.As of 2010 APR, FACES had counseled and tested 18,349 women in ANC at 117 sites, 19 of which are fully integrated with Antenatal Care (ANC)/ART. Among 2,614 HIV positive women in ANC and Maternity (MAT), 2,352 women (90%) and 2,399 of their exposed infants (92%) received ARV prophylaxis. 309 out of 2,399 women who received ARV prophylaxis were initiated on HAART. Post natally, 371 HIV positive women were identified and received ARV prophylaxis (17 received HAART). A total of 1,125 partners across ANC, MAT, and postpartum were tested for HIV.In FY12, FACES will offer HIV counseling and testing to 40,108 pregnant women at ANC and give ARV prophylaxis to 5,964 infected pregnant women. HIV infected women will receive a CD4 test after undergoing a WHO clinical staging. FACES will give HAART to all eligible pregnant women in line with the revised PMTCT national guidelines. In FY13, FACES will increase the number of pregnant women counseled to 42,113 and offer ARV prophylaxis to 7,243 pregnant women and 6,321 infants, and do EID for 6,321 infants.FACES 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. FACES will incorporate TB screening into routine antenatal care.FACES will support integration of ART in MCH clinics, access to FP/RH services, and establish or strengthen infection control and waste management activities. FACES will support hospital delivery through provision of delivery beds and sterile delivery packs, training, working with CHWs and TBAs to promote community-facility referral mechanisms, health education, and community services providing skilled birth attendance.FACES will support safe infant feeding practices as per national guidelines and support enrollment and follow up of 6,321 of babies born to HIV infected mothers to access CTX, ARV prophylaxis, and EID services using the HIV exposed infant register till 18 months. FACES will facilitate ART initiation for those who test positive before 2 years.FACES 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, 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.Program quality and proficiency testing will be emphasized to validate PMTCT results. FACES will train 90 HCWs in FY12 and equal number in FY13 on PMTCT and provide orientation on the revised PMTCT and infant feeding guidelines. FACES will also engage in community activities for demand creation for health services such as male involvement with couple CT services.
University of California at San Francisco Family AIDS Care and Education Services (FACES) will continue supporting treatment in Nyanza and Nairobi regions. Nyanza has a population of about 5.4 million with an estimated adult HIV prevalence of 14.9% compared to the national 7.1% and about 500,000 people are living with HIV (PLHIV). As of 2011 SAPR, 30,923 adults were on ART in 67 health facilities supported by FACES. 60 health care workers (HCWs) were trained on adult ART through both in-service training and continuous medical education at the facilities. Translation of knowledge to practice was enhanced through mentorship and Uliza clinician consultation hotline services contributing to improved quality of care. Cohort analysis revealed that 86% of adults were still on ART 12 months after initiation. Patient support groups, peer educators, and community health workers were engaged in supporting patient retention. Clinical Quality assessments and clinical mentorship activities were ongoing in most of the sites.
In FY12, FACES 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 46,117 patients currently receiving ART and 12,832 new adults resulting to a total of 55,341. In FY13, a total of 55,753 will be receiving ART while 12,982 new adults will be initiated resulting to 68,323 cumulative number on ART.
FACES will support in-service training of 200 and 150 HCWs in FY 12 and FY 13 respectively and continuous mentorship of trained HCWs on advanced HIV management including management of patients with ARV treatment failure and complicated drug adverse reactions. FACES will identify and support human resource and infrastructure gaps as well as support good commodity management systems to ensure uninterrupted availability of commodities.FACES will support provision of a 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; adherence and psychosocial counseling; referral to support groups; 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 support groups to provide adherence messaging and defaulter tracing and follow up will continue to be supported to improve retention in all sites.FACES 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. FACES will also support short term activities to improve impact and patient outcomes.FACES will continue to strengthen data collection and reporting at all levels to improve reporting to NASCOP and PEPFAR. FACES will also do cohort analysis and report retention as required by MoH and support program data review and evaluation in all facilities to inform programming and decision making. Use of an electronic medical records system will be supported and strengthened. FACES will strengthen local capacity as part of the transition plan to MoH for sustainable long-term HIV patient management in Kenya.
University of California at San Francisco Family AIDS Care and Education Services (FACES) has been supporting and will continue to support pediatric treatment services in five districts in Nyanza and Nairobi Provinces. Nyanza has an HIV prevalence of 14.9% and approximately 12,440 paediatrics ever initiated on ART as of May 2011. FACES has been supporting pediatric HIV treatment since 2005 and as of SAPR 2011, 3,360 paediatrics were active on ART and 120 health care workers (HCWs) were trained on pediatric ART and another 51 as Mentors, which contributed to improved quality of care. Strategies like engagement of peer educators and community health workers are ongoing to improve quality of services and retention. Clinical Quality Assessments and mentorships were implemented in all the sites.
In FY12, FACES will work with the Ministry of Health (MoH) at all levels to continue supporting expansion and provision of quality pediatric HIV treatment services as per MoH guidelines to 5,120 pediatrics currently on ART and 1,024 new pediatrics resulting to cumulative 6,144 pediatrics ever initiated on ART. In FY 13, this number will increase to 5,639 pediatrics on ART and 922 new resulting to 7,066 ever initiated on ART.
FACES will support comprehensive pediatric ART services including growth and development monitoring, immunization schedules as per the Kenya Expanded Program on Immunization, management of childhood illnesses, clinical and laboratory assessments including WHO staging and CD4 (through strengthening of lab networks), OI screening and management, ART eligibility assessment and initiation as per MoH guidelines, Adherence (ART), psychosocial counseling, ART toxicity and treatment failure monitoring. FACES will promote strengthened follow up and retention strategies, EID as per MoH guidelines and PITC to all children and their care givers attending Child welfare clinics, family focused approaches, community outreach efforts, and integration of HIV services in other MNCH services.
FACES will support hospital and community activities to meet the needs of the HIV infected adolescents such as 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.
FACES will support in-service training of 200 and 150 HCWs in FY 12 and 13 respectively as well as continuous mentorship and capacity building of trained HCWs on specialized pediatric treatment including management of ARV treatment failure and complicated drug adverse reactions. FACES will identify human resources and infrastructure gaps, 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.
FACES will continue to strengthen data collection and reporting at all levels to increase and improve reporting to NASCOP and PEPFAR. Additionally, FACES will support facility program data review and evaluation to inform programming and decision making. Use of an electronic medical records system will be supported and strengthened. FACES will strengthen local capacity as part of the transition plan to MOH for sustainable long-term HIV patient management in Kenya.