KEMRI – UCSF FACES Program

March 2014

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Launched in September 2004 in Nairobi, Kenya and March 2005 in Kisumu, Nyanza Province, Kenya◦ PEPFAR funded through CDC

Goal◦ Strengthen local healthcare systems to increase high-quality,

comprehensive HIV prevention, care, and treatment services Technical Support in partnership

with Ministry of Health (MoH) Service Provision by the MOH Program areas

PMTCT, PITC, VMMC, CCSP Care & Treatment, TB/HIV

Program Overview

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Nyanza Providing HIV services in remote, hard-to-reach locations

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HIV Care & TreatmentCare & ART Sites

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Sep '04

Dec '05

Dec '06

Dec '07

Dec '08

Dec '09

Dec '10

Dec '11

Dec '12

Dec '13

Mar '14

0

20

40

60

80

100

120

140 126125

HIV Care Supported Sites ART Sites

HIV Care & TreatmentEnrollment

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Cumulative in care: 138,501Active in care: 76,846

Cumulative on ART: 63,669Active on ART: 50,187

Dec '05

Dec '06

Dec '07

Dec '08

Dec '09

Dec '10

Dec '11

Dec '12

Dec '13

Mar '14

0

20000

40000

60000

80000

100000

120000

140000

160000142754

66225

Cumulative HIV Care Enrollment Cumulative Antiretroviral Treatment

PMTCT Prevention of Mother-to-Child Transmission

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133 PMTCT Sites Supported

-8,790 women tested for HIV in ANC in the last quarter -949 HIV exposed infants tested in the last quarter (PCR) for HIV

Sep

'07

Sep-

08

Sep-

09

Sep

'10

Sep'

11

Sep

'12

Sep

'13

Dec '1

3

Mar-1

40

50000

100000

150000

200000

250000 224105

Counseled, Tested, Received Results

Counseled, Tested, Received Results

Sep '07

Sep '09

Sep '10

Sep '11

Sep '12

Sep '13

Dec-13

Mar-140

2000400060008000

100001200014000160001800020000 18141

EID - Tested via PCR (6 wks & >3 mo)

EID - Tested via PCR (6 wks & >3 mo)

48% of active enrolled adult females in HIV care are on FP

96% of health facilities have integrated FP services within HIV care services

100% of active patients in care assessed for pregnancy status and intentions during their clinic visit

Ongoing FP health talk s and services for women and men

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FPFamily Planning

FP Health Talk

HIV Exposed (HEI) Graduation Celebration

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"The doctors really supported me. They told me to adhere to my medications and clinic dates. I followed everything they told me and today I am here with my baby graduating and my baby is HIV negative. I don’t know what to tell all the doctors here the only thing I can say is that God bless you” Mother of a graduating HEI

HIV Counseling and Testing

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HTCHIV Testing and Counseling

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137 Testing Sites Supported

0

100000

200000

300000

400000

500000

600000

700000

800000

741548Individuals Tested

VMMCVoluntary Medical Male Circumcision

11Community MobilizationGroup Education

Clinical Team

22 supported sites

Oct '08 Dec '08 Dec '09 Dec '10 Dec '11 Dec '12 Dec '13 Mar-14

0

10000

20000

30000

40000

50000

6000049486

Cumulative VMMC Surgeries

75 facilities in Nyanza supported 21,843 HIV positive women screened and

managed for since 2007◦ 2,947 HIV positive women screened in the past

among quarter, among which 160 screened positive were referred accordingly

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CCSPCervical Cancer Screening and Prevention

Cryotherapy at Mbita District Hospital

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Community EngagementWorld AIDS Day – Getting to Zero

Participated in the large procession from the Kondele ground to the Jomo Kenyatta Sports Ground

Dr. Oyaro, FACES Country Director singing his Pata Pata song, which has an eliminating MTCT theme

Kisumu Marathon – 300 participants including 30 program members.

Rongo hosted its first World AIDS Day Run as well

Mobilization IEC materials Blood donations Testing Testimonials Display Stand Procession Entertainment Marathon

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Community EngagementWorld AIDS Day – Getting to Zero

Mobilization IEC materials Blood donations Testing Testimonials Display Stand Entertainment Grandma Obama in attendance

Family Model of Care Decentralization Integration of Services

◦ FP, HAART, TB services Task Shifting

◦ Lay workers◦ Nurses

Hiring through the Ministry of Health Electronic Medical Records System Mentorship for the MoH staff ULIZA HIV Clinicians Hotline Defaulter Management

Best Practices

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Greater Involvement of PLWAs- Support Groups Community Strategy Support More GoK Involvement and Healthcare System

Strengthening Platform for PHEs/studies

◦ Cervical cancer screening and prevention◦ TB prevention in children◦ Shamba Maisha (Agriculture-microfinance intervention)◦ SHAIP (Study of HIV and Antenatal care Integration into HIV clinic)◦ FP integration study◦ MaMas (Maternity in Migori and Aids Stigma Study)◦ The HIV Neurology Study

Best Practices- cont’d

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CDC Ministry of Health City council of Kisumu FACES (KEMRI-UCSF) staff Other stakeholders (AED, Concern, UNICEF) Patients and their families

Acknowledgements

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