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Intro intro introi intro

get storu used on website

add presence of local leaders

Contact: Joel Rakwar, jrakwar@aphiarift.org

U.S. Ambassador visits rural health centre

August 2013

Supporting counties to give quality health servicesAPHIAplus Nuru ya Bonde project is working in six

counties to support Government of Kenya efforts to devolve management of health services.The project has made joint work plans with Ministry of Health management teams in the counties to strengthen systems to deliver quality services in Baringo, Kajiado, Laikipia, Nakuru, Narok and Nandi counties.In the work plans, health management teams at the county and sub-county levels have identified areas where the project can provide technical support, according to APHIAplus Nuru ya Bonde Project Director Ruth Odhiambo.Planned activities include mentoring of health care workers to provide quality HIV, tuberculosis and malaria services as well as maternal and child health care. Linkages between health facilities and communities are also being strengthened to encourage people to participate in making decisions about their health needs, take action to prevent diseases and seek treatment promptly when they fall ill.In addition, the work plans are guiding interventions to effectively link counties to national supply chains for various medicines and commodities such those required by medical laboratories as well as for family planning.Joint activities also seek to enhance the use of health information for timely decision-making at county and national levels. (Read a story about this on page 4)To ensure conducive working environments for service delivery, the project is renovating key infrastructure

including laboratories and comprehensive care centres.Multi-disciplinary teams have been deployed to the counties and work closely with ministry officials to ensure the planned activities remain on track and respond to emerging challenges. APHIAplus Nuru ya Bonde project is also building the capacity of structures that are required for delivery of quality services in a devolved system. For instance, the project supports district health stakeholders forums to coordinate and mobilize local resources for health. Additionally, sub-committees have been created in sub-counties to lead health promotion. The bahaviour change communication (BCC) sub-committees will guide stakeholders in interventions for disease prevention and to create demand for services. The teams will reinforce quality standards and ensure coordination to maximise use of resources and avoid duplication of efforts. The project is also supporting the establishment of task forces to drive the Kenya Government’s program to eliminate transmission of HIV from mothers to their unborn chidren. The prevention of mother-to-child transmisision (PMTCT) task forces meet monthly to review data and make decisions to improve services to mothers.Community health units are critical to provision of health services at the grassroots. APHIAplus Nuru ya Bonde is strengthening the units, a key avenue for enabling the people participate effectively in planning and managing health services to ensure they respond to their needs.

The U.S. Ambassador to Kenya, Robert F. Godec, recently visited APHIAplus Nuru ya Bonde project sites in Laikipia County. Ambassador Godec praised the efforts of the project in addressing health challenges facing communities in rural Kenya. “It is you all making a commitment to working together with experts and with nurses, to building your own community associations, that you can begin to meet some of the challenges here,” said the Ambassador, while at a community gathering at the Kalulu Dispensary.Ambassador Godec and his team toured the dispensary, one of more than 480 facilities supported by APHIAplus Nuru ya Bonde. The Ambassador was joined by the Kenya Mission Director for the U.S. Agency for International Development (USAID), Karen Freeman.U.S. Ambassador to Kenya Robert F. Godec meets community health workers during a visit to

Kalalu Dispensary in Laikipia County. Photo: George Obanyi/FHI360

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Benard Mulusa is a trained adult education teacher and pastor in Sirwa Yala village of Kapkangani

location, Nandi County. He is also a member of the Sirwa Yala Savings and Internal Lending Community (SILC) group.His passion for improving the lives of fellow community members, especially orphaned and vulnerable children (OVC) and others affected by HIV, prompted him to enroll as a community health volunteer.Mulusa and other community health volunteers (CHVs) are tasked with reaching out to caregivers or guardians of the OVC supported by APHIAplus Nuru ya Bonde through a local community based organization, Mother Francisca Mission Hospital.A common challenge faced by volunteers and program staff who oversee them is how to determine or measure the quality of services they provide.

Resolve challengeEight months ago, APHIAplus Nuru ya Bonde introduced to Mulusa and other volunteers a new concept that promised to resolve the challenge and ensure the quality of services they provide actually improves the lives of children.“When APHIAplus introduced the Quality Improvement concept, it was unique and challenged our mentality,” said Mulusa.Joan Kosgei of Mother Francisca Mission Hospital describes Quality Improvement (QI) as a process that aims to ensure that services that are given to OVC achieve their intended outcomes.“This is a process where we are required to upgrade our services to ensure we achieve our desired outcome,” she said.

Community takes up initiative to improve quality of service

Contact: Simon Makori, smakori@aphiarift.org

The Quality Improvement (QI) process helps local organizations to implement national guidelines on care for orphans and vulnerable children. The guidelines spell out the standards for seven key areas of service that include food and nutrition, education, health and psychosocial support. The other areas are shelter and care, child protection, household economic strengthening and care.

In July 2011, the Government of Kenya published minimum service standards for quality improvement of programs to support orphans and vulnerable children in Kenya.The guidelines spell out the standards for seven key areas of service that include food and nutrition, education, health and psychosocial support. The others areas are shelter and care, child protection, household economic strengthening and careThrough organizations such as Mother Francisca Mission Hospital, APHIAplus Nuru ya Bonde project is helping to implement the minimimum standards across the Rift Valley counties of Nakuru, Baringo, Nandi, Laikipia, Kajiado and Narok. After the release of the guidelines, the organization’s staff were trained to integrate the concept into their activities to improve efficiency. The process also required them to assess their organization and service delivery sites to identify areas for improvement.The assessment identified gaps in food security and child protection interventions.The organization explained the QI concept to communty health volunteers and asked them to select community members that would form and coordinate the QI team.The volunteers embraced the idea. They, in turn, explained the concept to the community and selected 13 members to form the QI team.The team is composed of religious leaders, chiefs, teachers and other individuals who have a heart to help the community and serve without expecting anything back.Each QI team member is allocated a number of homes to visit each week to check on the welfare of the OVC. During the visits, they pass on the skills that they have learnt and provide mentorship. They meet every Monday to share ideas and the progress reports from their areas.

Joan Kosgey with other staff of the Mother Francisca Mission Hospital, a partners in the APHIAplus Nuru ya Bonde project The team has established Quality Improvement teams in their project areas. Photo: Silas Achar/FHI 360

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Maurice Juma never worries whenever his children come from school with a list of requirements.

He just goes to the garden or ‘shamba’, scans the banana trees, identifies a ripe bunch, cuts it down and heads to school. “Recently, I had a fee balance,” He said, “I just took one bunch to school and the head teacher was impressed, valued it at 800 shillings and I cleared the balance!”Juma is a living example of how with the right information, the lives of individuals, families and communities can be transformed from depending on food aid to being producers of this very basic human need.In a space of 0.2 hectares, he has more than 15 varieties of vegetables and fruits, rabbits, pigs, chicken and very soon, goats. Every space has been utilized and nothing is wasted, even the droppings from the rabbits are used as fertilizer!Juma’s garden is now a demonstration field and he attributes the changes to knowledge and skills he got during training sessions and capacity enhancing forums organized by APHIAplus Nuru ya Bonde. Juma is the chairman of the Tindinyo site community support group in Sirwa Yala sub location in Kapsabet, Nandi County. He is also a community health volunteers (CHVs).The support group has more than 100 members that are care givers of orphaned and vulnerable children (OVC). It is one of the beneficiaries of APHIAplus Nuru ya Bonde’s support in form of school fees, uniforms, linkages and skills empowerment. APHIAplus Nuru ya Bonde project provides technical support and mentorship to their local implementing partner Mother Francesca mission hospital, to enable them to identify, train and work with community health volunteers to provide support to various vulnerable groups in the community, especially the OVC.

John Masinde was devastated when the counsellor informed him that his wife had tested HIV positive. He had just tested negative and could not understand how that was possible. They had been married for 11 years.“We went to a witchdoctor and he confirmed our fears,” said John. “He said that someone had bewitched us and to

set us free, he needed five thousand shillings!” But when her situation worsened, she was admitted to hospital and died. The doctor informed him about his wife’s status and asked whether they had ever been tested as a couple. They hadn’t. So when he tested, he was negative. This confused him. “I was frightened and I didn’t tell anyone. Only the doctor and I knew about the situation,” he said. His two remaining children were tested and one was positive. This confused him more. But he was counselled and it is then that he was referred to the Muitai Care and Support group John said that he joined the group feeling hopeless. But after participating in training sessions organized with support from USAID’s APHIAplus Nuru ya Bonde project, his life has changed.“APHIAplus has given us skills on how to support our colleagues that have been affected by HIV. We have been taught how to come up with self-sustaining income generating projects that are improving our lives,” he said.APHIAplus Nuru ya Bonde has been supporting their group through a local community based organization the Christian Community Services (CCS). Apart from the business skills, APHIAplus Nuru ya Bonde also supplements school fees, uniforms and links the group to other community support services available from government departments.John is hopeful about the future. He says that despite still working in a tea plantation, he has learnt to be independent. He is keen on ensuring that his daughter who is living positively attains the highest level of education. He is also a peer educator and is out to ensure that others like him in their community are empowered through accurate information.

Contact: Joseph Ochieng, jochieng@aphiarift.org

APHIAplus Nuru ya Bonde covers Nakuru, Baringo, Nandi, Narok, Kajiado and Laikipia counties. On these two pages we feature stories of our work in Nandi County. For more information on our work in Nandi and Baringo visit our office in Kabarnet or contact: Kennedy Yogo, kyogo@aphiarift.org

Juma uses his small farm well: Food and fees are no problem

Maurice Juma shows off his rabbits to visitors at his farm in Sirwa Yala village, Nandi county. Photo: Silas Owiti Achar/FHI 360

Father’s big dreams for his HIV-positive daughter

She elaborates that through community health volunteers like Juma, they are able to identify and link people living with HIV and OVC to other community support services. The capacity of these CHVs has to be enhanced to ensure that they reach to these groups.“We have sponsored Juma and some fellow group members to participate in forums where they are taught new skills and share ideas from other regions,” she said.

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Thanks to APHIAplus Nuru ya Bonde staff and partners as well as community members who shared their stories for this issue.

Stories by George Nyairo Obanyi and Silas Owiti Achar.

Contacts: Ruth Odhiambo, Director, APHIAplus Nuru ya Bonde, rodhiambo@aphiarift.org or George N. Obanyi, Information Officer, P.O. Box 13208-20100 Nakuru; kenya-aphianews@aphiarift.org

The USAID-funded AIDS, Population and Health Integrated Assistance (APHIAplus) program aims to empower people lead healthier lives by increasing access to high quality HIV and AIDS, reproductive health, family planning, maternal and child health services.

Participants during a workshop on data use for decision-making for Ministry of Health managers and staff from Nakuru County organized by APHIAplus Nuru ya Bonde. Photo: George Obanyi/FHI 360

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Family Health International (FHI 360) is responsible for overall program management, technical leadership, strengthening HIV counselling and testing, PMTCT, reproductive health and family planning, MNCH in facilities, capacity building of local implementing partners and coordination of M&E activities.AMREF is the lead partner in supporting roll-out of the community strategy.

Catholic Relief Services (CRS) is the lead partner in home-based and community care for families affected by HIV, and support for orphans and vulnerable children (OVC). Gold Star Kenya provides technical assistance to the private sector to provide quality HIV clinical care and other services, and implements HIV prevention with selected most-at-risk populations (MARPS).

LVCT Care and Treatment provides technical assistance to address sexual and gender-based violence, including services prevention among MARPs, specifically discordant couples. National Organization of Peer Educators (NOPE) promotes healthy behaviours among marginalized youths and links them to services offered at health facilities.

APHIAplus Nuru ya Bonde Strategic Partners

APHIAplus Nuru ya Bonde has its head office in Nakuru and regional offices in Narok, Kabarnet, Naivasha, Nanyuki and Ngong.

Workshop promotes data use for decision-making to improve services

More than 30 health information systems managers and staff from the Ministry of Health in Nakuru County recently attended a workshop on data use for

decision-making to improve services.The workshop, organized by APHIAplus Nuru ya Bonde project, built the capacity of MOH staff in data analysis, presentation, interpretation.Using real-time data from the national Demographic and Health Information System (DHIS), participants discussed ways to standardize the types of analysis county and district teams can do with their routine data from dispensaries, health centres, hospitals and other service delivery points. The participants also identified areas of service delivery for further analysis to help improve services for HIV, TB and other patients.The workshop was facilitated by Linda Muyumbu of APHIAplus Nuru ya Bonde project, Mike Merrigan of Family Health International (FHI 360) and Boniface Isindu of National AIDS and STI Control Program (NASCOP). FHI 360 is the lead agency in the consortium that implements the project.Similar workshops are planned for staff from other counties.

PROJECT BRIEFSMentor mothers start work:APHIAplus Nuru ya Bonde is recruiting 35 mentor mothers to join 12 already in the project. The mothers are living with HIV but safely delivered babies free of the virus after benefitting from prevention of mother-to-child transmission (PMTCT) services. The mentors will use their experiences to support new mothers enrolled for PMTCT.

Contact: Linda Muyumbu, lmuyumbu@aphiarift.org

Community-led Total Sanitation:The USAID-funded WASHplus program is collaborating with APHIAplus Nuru ya Bonde project and the Ministry of Health to implement a comprehensive water, sanitation and hygiene intervention in two divisions of Naivasha District. The aim is to empower the local community to promote sanitation.

Keeping girls in school: One of the key objectives of the APHIAplus Nuru ya Bonde project is supporting vulnerable children, especially girls stay in school and transition to college and careers. In Loitoktok District, Kajiado County, the project is piloting the innovative Four Pillars approach that involves teachers, the community and mentors to support girls’ education.New publications:The Health Communication team has published several new publications including: Fact Sheets for Community health Workers, Guidelines for Conducting Community Dialogue Sessions for Community Health Extension Workers. Two curricula, for pastoralists and transport sector workers have also been developed. Facebook: APHIAplus Nuru ya Bonde or Follow us on Twitter @aphiaplusnuru