Empowering Faith Groups—Increasing Demand

for HIV Services in Nairobi, Kenya

CCIH Annual Conference

July 2017

Nkatha Njeru

Program Manager

IMA World Health - Kenya

Presentation Outline

1. Introduction

2. Background

3. Approach & Interventions

4. Results

5. Lessons Learned

Introduction: IMA World Health• US faith-based INGO founded in 1960 by six Protestant churches

• Mission is to build healthier communities by collaborating with

key partners to serve vulnerable populations (MOH, CHAs, NGOs)

Introduction: AIDSFree

Strengthening

the evidence

base of

programs

• Integrate new and emerging research findings

on evidence-based, high-impact HIV and

AIDS-related interventions into country

programs

Capacity

building

• Build the technical competence and

organizational capacity of government and

civil society partners to design and manage

HIV programs

Dissemination

of technical

knowledge

• Research findings, models, and lessons from

implementation of high-impact evidence-

based programs are disseminated widely and

readily available to program implementers

• The Strengthening High Impact

Interventions for an AIDS-free

Generation (AIDSFree)

• Aims to improve the quality and

effectiveness of high-impact,

evidence-based HIV and AIDS

interventions in order to meet

country-specific goals and objectives

• Funded by PEPFAR, managed by

USAID

• Implemented by JSI Research &

Training Institute, Inc. with partners

Abt Associates Inc., EGPAF,

EnCompass LLC, IMA World Health,

the International HIV/AIDS Alliance,

Jhpiego Corporation, and PATH.

• Works globally, mostly in sub-Saharan

Africa

G

o

a

l

s

Learn more: https://aidsfree.usaid.gov/

• Activity goal: to accelerate private-sector provision of quality pediatric

HIV care and treatment (C&T) services in high-burden areas of Nairobi

• IMA World Health works in Korogocho slums of Nairobi with a

population of 150-200K and 50:50 (<24, >24 years); with 14% HIV

infection rate

• IMA’s role: faith-based health systems strengthening, community

engagement, CSO capacity building in partnership with Christian Health

association of Kenya (CHAK) & Redeemed Gospel health Centre (RGHC)

• Religion: 90% of the population practices faith

• Source of HIV/AIDS info:

• Health worker: 90%

• Friends/relatives: 20%

• Community meetings: 16%

• Church/Mosque: 0%

Source: KNBS, 2009; IRIN, 2008; APHRC, 2012

AIDSFree in Kenya

HIV Situation in Kenya: Children & Adolescents

AIDS is a leading cause of morbidity and mortality

1,555,700 PLHIV (5.4%)

9,720 adolescent AIDS related deaths in 2014

39.5% stigma & discrimination rate

Contribute to about 43% of all new HIV infection in

2016

242,300 adolescents & 100,800 children living with

HIV

26,000 new HIV infections in young

people 15-24 & 4,900 children each year 6

40% pop <14 years

Community Approach

CHW

Engagement

Youth

Engagement

Faith

Engagement

1. Increase community knowledge of

pediatric C&T services

2. Increase demand for and access to

pediatric C&T services

3. Engage key community structures

and CSOs in expanding the reach

and uptake of pediatric C&T

services

ObjectivesIntervention

To contribute to UNAIDS 90-90-90

targets for ending the epidemic by

2030 for pediatrics

Faith at the Center… (click to play)

Faith Engagement• Established institutional partnerships (IMA, CHAK -

Redeemed Gospel Health Centre, KENERELA )

• Established a network of 20 religious leaders as “Pediatric

HIV Champions”

• Outreach activities:• Religious gatherings

• Spiritual counseling

• Adherence counseling

• Client referrals

• Peer support groups and youth activities

• Developed Religious Guides on Children and HIV (Christian

& Islamic)

Faith Engagement

Purpose

• To educate religious leaders on pediatric HIV

issues

• To provide sermon starters for religious

leaders

• To provide guidance for incorporating

appropriate health practices in their religious

discourse and spiritual counseling.

Process

• Multi-stakeholder/ inter-faith collaboration in

development of the guides

• KENERELA+, CHAK, IMA, NCCK, SUPKEM

• Theologians, religious leaders, clinicians

• Training of 20 religious leaders on the use of

the guide, pediatric HIV, and the community

approach

AIDSFree Guides on Children and HIV for Religious Leaders

Access the Guides:

https://aidsfree.usaid.gov/resources/khu

tbah-and-sermon-guides-children-and-

hiv-religious-leaders

Launch of the AIDSFree Religious Guides

Sheikh using the Khutbah Guide

Christian Sermon: Key Message: The Truth

Shall Set You Free. Get tested for HIV regularly

so that you know your current status.

Scripture: Hosea 4:6 “my people perish

because of lack of knowledge...”

Islamic Khutbah: Key Message: Seek

Knowledge. Knowledge empowers people

Quran: 39.9 “..are they equal, those who

know and those who do not know.. Only

the people of discernment will reflect (on

the distinction between knowledge and

ignorance, and obedience to God and

disobedience) and be mindful.”

Illustrative Guide Contents

Youth & CHW Engagement

• Established a network of 20 youth

leaders and CHWs as “Pediatric HIV

Champions” working with religious

leaders

• Training on pediatric HIV and the

community approach

• Outreach activities:• Psychosocial support

• Client referrals to Redeemed Gospel

Health Center

• Peer support groups and youth

activities

ResultsAug 2016-May 2017

• 2,998 referrals for HIV testing to date

– 281 referrals for HIV testing in April 2017

– 645 referrals for HIV testing in May 2017

• 26 of 33 new HIV-infected children linked to treatment

• 4,517 support services provided/referred for to date

– 314 support services in April 2017

– 1,619 support services in May 2017

Results: Referrals

0

200

400

600

800

1000

1200

1400

1600

CHWs Religious Leaders Youth Leaders

Referrals by Provider Type Aug 2016-May 2017 (age 0-14yrs) N=2,998

69923%

139747%

902 30%

11%

40%

49%

0

500

1000

1500

2000

2500

Nutritional Support Psychosocial Support Adherence Support

Total Support Services Offered (Aug. 2016 - May 2017) Ages 0-24 Years; N=4,517

Results: Support Services

1203(41%)

1765(59%)

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Total All Sources by Gender

Total Referrals by Gender(Aug. 2016-May 2017) Ages 0-24 Years; N=2,968

Female Male

Results: Referrals by Gender

159 (5%)197 (7%)

324 (11%)

870 (29%)

1161 (39%)

257 (9%)

0

200

400

600

800

1000

1200

1400

�<1 �1-4 �5-9' �10-14 �15-19 �20-24

Total Referrals by Age(Aug 2016-May 2017); N=2,968

Age

Results: Referrals by Age

Lessons Learned and Achievements to Date

• CHWs interact with fewer community members as they conduct

house-to-house visits

– CHWs reach a point of diminishing returns very quickly

• The reality of ‘peak’ outreach seasons for religious leaders (RLs) &

youth leaders (YLs) such as during school holidays

• Communities consider RLs & YLs as trust ‘pillars’ and with

knowledge & skill they can have great impact on stigma, perception

of people

• Religious leaders have a regular captive audience at their weekly

congregation so are able to reach more people at once than CHWs

• Youth leaders also have a captive audience as they interact with their

peers through football tournaments and at school (secondary and

college)

Network Monthly Meetings

Thank You!

THANK YOU