deliveries with a skilled birth attendant in U.S. Government – assisted programs (122.33% of our target)
individuals are receiving antiretroviral therapy
‘Health in the City’
Health care in Nairobi faces several chronic challenges: a fluctuating population, numerous informal settlements, a high rate of HIV prevalence and an overburdened health system. Plus, the recent devolution of the country means counties are now overseeing their own planning, budgeting, supply chain and other administrative tasks related to the provision of health care instead of the national government. While this change allows for more tailored health care services, naturally there has been a learning curve.
This year, IMA World Health began implementing our first, full-scale USAID-funded project in Kenya. IMA’s presence aims to support the country’s most-populated county in delivering health services and helping local civil society organizations respond to the burden of HIV.
From Swahili meaning “health in the city,” the Afya Jijini program helps Nairobi City County deliver health services. The approach is altogether unique. Instead of implementing traditional individual public health activities, IMA has shifted the focus to implementing a set of well-defined activity models. While each of these efforts can stand alone, the power is in scaling them up as one integrated package.
IMA and our partners in Afya Jijini began gaining momentum toward project goals early. One example: to improve maternal and child health outcomes, one of our first steps was to encourage and empower health facilities to see patients on weekends. In our first year, the project has 35 facilities open seven days a week in targeted neighborhoods in Nairobi, and they have seen an additional 10,000 patients—a remarkable accomplishment for all involved.
At the same time, we are reaching key populations that are vulnerable to HIV infection through highly-engaged, community-level organizations. These local groups engage communities of faith, commercial sex workers and men who have sex with men in order to reduce stigma, promote safety and prevent mother-to-child transmission.
While navigating all these changes and new ideas is challenging, one great aspect of a learning curve is the learning itself. As data from Afya Jijini’s first year roll in, and our work under the AIDSFree partnership continues, the IMA Kenya team are excited to dig in and learn what’s working best and how the health system in Nairobi City County can continue to grow and shift to better serve its people.
individuals were tested for HIV, and received the results of the test and counseling. During the first 9 months, the project exceeded program targets by almost 100%.
(Funding varies by program year)
Under the global AIDSFree Project, IMA is implementing the community-level component of the Public Private Alliance for Pediatric HIV, designed to improve delivery and access to quality health services through improved health systems. Through IMA’s leadership and partnership with the Christian Health Association of Kenya, IMA is piloting a novel approach: engaging religious leaders in the urban informal settlements of Korogocho of Nairobi.
Recognizing their potential to influence behavior change and social norms, the approach equips Christian and Muslim leaders to become Pediatric HIV Champions. As such, religious leaders engage their congregations to increase community knowledge of HIV pediatric care and treatment services as well as demand for and access to these services. To equip religious leaders with the adequate tools and knowledge to make an impact, IMA and CHAK have developed sermon and khutba guides on pediatric HIV and trained religious leaders how to use them. Both the National Council of Churches Kenya and the Supreme Council of Kenya Muslims have praised these religious guides, and faith leaders will be encouraged to use them in their congregations beginning in September 2016 through 2017.
adults and children receiving antiretroviral therapy
$34.9 million | USAID | 2015-2018
Afya Jijini, which translates to “health in the city,” is a three-year contract USAID contract (with two option years) designed to strengthen Nairobi City County’s institutional and management capacity to deliver quality health care services. With IMA leadership and a strong consortium of local partners, the project’s strategic goal is to improve county-level institutional capacity and management of health service delivery through three primary objectives:
- Increase access to and use of quality HIV services;
- Improve access to and use of maternal, neonatal and child health services; family planning and reproductive health services; water, sanitation and hygiene; and nutrition services;
- Strengthen county and sub-county health systems.
Already the program is making an impact. In its first year, the USAID-funded Afya Jijini project supported Nairobi City County to scale up and make maternal and child health services available seven days a week at 35 of the County’s high-volume sites. More than 3,000 mothers were reached with focused antenatal care and other maternal, neonatal and child health services as a result of the availability of weekend services. An additional 7,000 children benefited from weekend child health interventions. Additionally, following the launch of the project’s “We Men Care” initiative in April 2016, the project reached more than 2,500 male partners of pregnant or lactating mothers with messaging focused on antenatal care, pregnancy, newborn and child health-related complications, birth planning and family planning.
IMA partners with NOPE to engage communities most at risk to HIV, such as this education session in Nairobi.
Photo by Craig Thompson
Kenya’s National Organization of Peer Educators works with at-risk communities
Kenya’s National Organization of Peer Educators supports service delivery and initiates community engagement activities for targeted population groups. NOPE focuses on youth engagement strategies for at-risk youth and the provision of youth-friendly services at facilities; gender engagement and mainstreaming activities, including addressing gender-based violence; guidance to health providers on attitudes and approaches to best reach key populations; and activities under the Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe Women, or DREAMS, component of the project.