Nkatha Njeru, Coordinator of the Africa Christian Health Associations Platform and Program Manager for IMA World Health in Kenya discusses how IMA works with partners and USAID to empower faith groups to increase demand for HIV services in Kenya.

1. Empowering Faith Groups—Increasing Demand
for HIV Services in Nairobi, Kenya
CCIH Annual Conference
July 2017
Nkatha Njeru
Program Manager
IMA World Health - Kenya

2. Presentation Outline
1. Introduction
2. Background
3. Approach & Interventions
4. Results
5. Lessons Learned

3. 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)

4. 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/

5. • 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

6. 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

7. 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
Objectives
Intervention
To contribute to UNAIDS 90-90-90
targets for ending the epidemic by
2030 for pediatrics

8. Faith at the Center… (click to play)

9. 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)

10. 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

11. Launch of the AIDSFree Religious Guides

12. Sheikh using the Khutbah Guide

13. 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

14. 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

15. Results
Aug 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

16. 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
699
23%
1397
47%
902
30%

17. 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

18. 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

19. 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

20. 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)

21. Network Monthly Meetings

22. Thank You!

23. THANK YOU