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You are here: Home Modules Module Examples Module 2 Examples Example 11 - Identifying intervention options: HIV/AIDS in Kenya
Example 11 - Identifying intervention options: HIV/AIDS in Kenya Print E-mail
Module 2 Examples

Kenya identified a range of interventions aimed at different system levels and adopted an integrated framework.

Ontario Public Health Practioners

Multiple HIV/AIDS interventions: Comprehensive and holistic approach

HIV/AIDS interventions in Kenya are guided by a national framework for 2005-2010 (MOH, 2005) and are aimed at national, provincial, district, community, household and individual levels. They involve people from the public and private sectors, civil organizations and community-based organizations. Most of those involved focus on specific interventions at different levels. The interventions focus on holistic approaches aimed at prevention, care and social support (MOH, 2005).

Prevention

Intensifying HIV prevention and enhancing access to treatment has been a major focus in addressing HIV/AIDS (Seckinlgin, 2007). Prevention interventions allow for the inherent differences among groups. People who are particularly vulnerable include commercial sex workers and their clients, intravenous drug users, discordant couples, women and young girls, migrant workers, prisoners and police and military personnel.

Early preventive interventions focus on changing behaviour to avoid risky sexual practices and reduce infection. They include:

  • information, education and communication;
  • peer education programs for youth;
  • condom promotion;
  • voluntary counselling and testing;
  • the ABC formula for preventing HIV: Abstain from sex, Be faithful to one another and use Condoms;
  • safer blood transfusions;
  • preventing mother-to-child transmission; and
  • integrating life-skills education into primary school.

Interventions for people living with HIV/AIDS to reduce morbidity and mortality include:

  • clotrimoxazole prophylaxis;
  • isoniazid prophylaxis;
  • promoting safe drinking water to prevent diarrhea;
  • providing micronutrients and vitamin A;
  • promoting condom use;
  • counselling and support for family members;
  • promoting insecticide-treated bed nets to prevent malaria (Mermin et al., 2005).

Evidence of successful preventive interventions includes:

  • A peer-education program among vulnerable Kenyan men achieved 60 per cent adherence to at least one of the ABC strategies (Fergurson, Pere, Morris, Ngugi, & Moses, 2004).
  • A randomized controlled trial to study the impact of improved sexually-transmitted disease management and behavioural interventions on HIV incidence in rural Uganda showed the interventions were adequately implemented.

The specific interventions included

  • Information-Education-Communication (IEC) Programs and care for sexually transmitted disease;
  • Social marketing of condoms; and
  • Offering voluntary testing and counselling .

Care

Care in health facilities focuses on medical management of complex AIDS signs and symptoms, opportunistic infections and other sexually transmitted diseases, as well as nursing and psychological care (World Bank, 1997; UNAIDS, 2001).

  • Need for home-based care: Patients with AIDS spend a lot of time in hospital but Kenya has limited resources, so a home-based care strategy was introduced to allow stable patients to be cared for at home by family, supported by community health workers. Various organizations train and support health-care providers and community-based health workers to implement home-based care in areas hard hit by HIV/AIDS.
  • Comprehensive model for home-based care: Home-based care provides services near to patients and responsive to community needs. Kenya adopted comprehensive home-based care that offers prevention, basic care and support at home. It involves public-health professionals, families and other organizations working with HIV/AIDS. An evaluation of the homecare program in Nyanza province showed how professionals co-ordinate the delivery of HIV/AIDS services at district and community level and try to challenge stigma at individual and community levels (Waterman et al., 2007)
  • Social support: The Kenyan approach includes organizational, community, society and policy-level interventions.

Organizational and systems interventions

Strengthening organizational and institutional capacity to fight HIV/AIDS has required building the capacity for care and research, training personnel and increasing the availability of drugs and supplies to manage opportunistic infections.

Co-ordinating committees

There are co-ordinating committees at all levels of the health-care system to link HIV/AIDS activities in various sectors and levels and ensure horizontal and vertical integration of interventions (MOH 2005)

Policy interventions

Political support for change and policy development was initially low in Kenya, but has improved. Kenya has developed policy documents and plans to guide implementation of interventions including:

  • A national policy to mitigate the socio-economic impact of HIV/AIDS
  • Policies on condom use, antiretroviral management, prevention of mother-to-child transmission and nutrition
  • Making gender a mainstream issue in the national HIV/AIDS strategic plan.

These policy documents can be accessed through http://www.usaid.gov/our_work/global_health/aids/Countries/africa/kenya.html

Enabling legislation

Enabling legislation (the HIV Bill) was needed to put HIV into the Emergency Recovery Strategy, the Medium-Term Expenditure Framework and the public sector by the end of 2007 (USAID 2008).

Workplace policies

The government has introduced a workplace HIV/AIDS policy (eg. provide HIV/AIDS information to employees, guidelines for managing infected employees, ending discrimination, protect jobs and increase access to medication) but what it does and whether it is effective has not been well documented. In the private sector, 50 per cent of medium- and large-scale companies have HIV/AIDS workplace policies.

Last Updated on Monday, 01 June 2009 07:46