CARE International in Kenya is the Principal Recipient (PR) for a 5 year Global Fund Round 7 Program on HIV/AIDS in Kenya and the lead agency for Civil Society sector in a three agency partner consortium, namely Ministry of Finance, Ministry of Public Health and Sanitation and Ministry of Medical Services. The program overarching goal is improvement of quality of life for people living with HIV and AIDS in Kenya and reduction of HIV infections. Efforts to achieve this goal are geared towards increasing uptake of HIV prevention and treatment services, specifically increasing access to HIV testing and counseling services and provision of behaviour change communication and outreach services while also strengthening implementers' institutional capacity to effectively implement and monitor the program.
Through this grant CARE International in Kenya has gained extensive experience of managing perfomance based programs and posted oustanding results over the past 2 years - April 2009 to June 2011 (phase 1) of implementation of the program which was achieved through partnership with 54 Civil Society Organizations. The CSOs included international, national and local NGOs and CBOs spread across Kenya. The CSOs employed different cultural and context specific strategies and innovations to deliver the program incorporating new ideas based on learning from other partners implementing similar programs in their regions, new information regularly shared by CARE and; National AIDS Control Council (NACC) and National AIDS AND STI Control Program (NASCOP) - the technical arms of the line ministries. Organizational and Insitutional strenghening of the participating CSOs was a key obejctive as mentioned above, which CARE realized through organization of quarterly program review meetings with implementors, breakfast meetings with their directors and routine field techncial support. This was achieved by a team of about 28 staff comprising Program. Grants and M&E Officers supported by an able mangement team.
Courtesy of the collective efforts and contributions by the Sub Recipient, the program has been able to achieve an A1 rating (93%), a first on any Global Fund implemented program in the country. This is a remarkable achievement considering this is the first non-government funded program under Global Fund. In terms of aggregate contribution to this score, over 85% of the Sub-Reciepients posted A2 average score going by the Global Fund rating performance rating .
This success was realized through the tireless efforts of Sub Recipients notable emaples among others being GCI and CHAT who despite being small local NGOs and the initial challenges of program implementation, were able to achieve remarkable results as highlighted in their indivudal program summaries below and the separate human interest story by Patrick Kimanzi of CHAT.
Global Communications Institute
Global Communications Institute (GCI) is a local NGO that implements the Global Fund (GF) Programme in Siaya District of Nyanza Province, Kenya named Initiative to Increase Uptake of HIV/AIDS Prevention and Treatment Services in Siaya District. Nationally, HIV prevalence remains the highest in Nyanza at 13.9%, more than double the national prevalence estimate of 6.3% for ages 15-49 (KDHS 2008-09) with Siaya at 24%. GCI's role in the GF Program is thus critical because of the high HIV prevalence context. The organization targets PLWHIV and youth with information on increasing the up take of ART and VCT uptake. During Phase One of the Program, the organization demonstrated institutional capacity building responsiveness, impressive funds absorption, cost effectiveness, accountability in program delivery, commendable program performance and broad and diverse (gender balanced) stakeholder participation. GCI undertook organizational governance reforms suggested by CARE and presented staff for training and learning from other GF partner organizations. Community participation in program reduced the costs substantially, allowing for more activities to be done and ultimately outstanding program results. The organization's performance in Phase One was rated at 114% (A1) according to GF rating.
Community Health Africa Trust
Community Health Africa Trust (CHAT) is a local NGO implementing the Global Fund Program in Laikipia and Samburu counties in the Norther Rift- Valley region and parts of Isiolio County in the Eastern Province lying north and North East of Mt. Kenya respectively.
The Kenya country HIV prevalence rate is at 6.3% while in Rift Valley where CHAT works is at 4.7%, Laikipia county is estimated at 5.7% and Samburu county at 6.8% according to (KDHS, 2008-09). KDHS report further shows that the use of HIV prevention methods is lower among women and men age 15-49 than among people age 20. Level of formal education was seen as a factor of HIV knowledge with town dwellers having higher knowledge than rural areas. This translates to low level of knowledge in both Sanburu and Likipia regions where CHAT is implementing HIV program due to high level of illiteracy, low uptake of girl child education among other traditional practices that promotes high rates of HIV transmission.
CHAT uses integrated household health care service provision as an entry point for all HIV and health related services in the target areas.The integrated health strategies and interventions are delivered through mobile delivery platform and approaches such as: mobile motor vehicle outreaches, camel , bicycles and foot based outreahces. With the GF funding over the past two year period (2009 - 2011), CHAT has intensively scaled up HIV Testing and counseling and Behavior change prevention activities implemented through the forementioned approaches and delivery service points. The target groups of the program are largely nomadic and often polygamous with significant age differences. Through provision of basic curative and immunization services, and using community based health care workers (CBHCWs) from these communities, CHAT has earned credibility from within the households to address sensitive issues such as Family Planning (FP), HIVAIDS- partner testing & disclosure and condom education. CHAT keeps the CBHW supplied with condoms, some FP commodities, and HIVAIDS test-kit supplies for easy access by the target users.
Strengthening of community structures has played a vital role in the, move and campaign against HIVAIDS. CHAT has built the capacity of 30registered CBOs who also operate as PLWHIV Support Groups across Laikpia and Samburu. CHAT works closely with these support groups and has instituted mechanisms of networking and collaborating to enhance linkages and referrals among other service providers such as GoK's Ministry of Health; NGOs and Faith Based Organizations (FBOs). These stakeholders are envisioned to play a lead role in the continuum of care and sustainability.
Through this integrated program, CHAT has cost effectively delivered the GF program despite a very difficult terrain and a myriad cultural barriers - emerging as one of the leading SRs with an overall score of A1.
CARE International in Kenya would like to take this opportunity to thank all Global Fund partners for making this program a success.