The Impact of Community Centered Approach on HIV indicators in Samburu County, Kenya

BACKGROUND: Samburu County supported through Afya Nyota ya Bonde project is one of the ASAL regions, not performing well and subjected to internal performance improvement to improve uptake of HIV Preventionsub optimal indicators. ANYB and Ministry of health initiated a Community centered approach as a component of rapid results interventions to improve on 4 indicators to allow increased access and ease availability of prevention, care and treatment services to the rural population at risk.
DESCRIPTION: The Community Centered Approach (CCAH) entailed CHVs supported by NEPHAK in Samburu mobilized through CHV Led pre-SURGE for sensitization and training on four indicators; HTS-INDEX targeting household members with children below 18yrs, 2) HTS-SELF targeting all community members involved in high-risk behavior, 3) PREP-NEW and 4) CX-CA SCRN targeting HIV Positive women 15-49 years. CHVs were allocated households for both family index testing and CA-CX Screening and an integrated outreach mobilization template was shared with the CHVs to support holistic mobilization for services in a household visit addressing fatigue and duplication of work.
LESSONS LEARNED: Comparing a ten-week periodpre-surge as the baseline and during surge for four sub-optimal performing indicators, there was a significant improvement in the % achievement against weekly targets for HTS INDEX testing growing from 21% to 87%, HTS SELF with a growth from 3% to above 100%, PREP NEW increasing 2.5 times to 249% of the expected target and CA-CX screening improving from 2% to 215% by March 2021.
CONCLUSIONS: CCAH towards improving/upscaling of HIV Prevention and Care services in ASAL region using local HIV positive CHVs not only to upscale the uptake of services but provide solutions to long withstanding household and self-stigma. Good coverage on CA-CX Screening, PREP New, HTS Self Testing and Index Testing with sustained performance across the surge period.