This document provides information on HIV/AIDS statistics in Kenya and Africa, the disproportionate impact of HIV/AIDS on women and girls, challenges in accessing healthcare in Kenya including shortages of healthcare workers and facilities, and prior mHealth trials in Kenya that faced challenges with scale and sustainability. It discusses the potential for mHealth solutions in Kenya that utilize international partnerships and collaboration across industries and sectors to develop culturally appropriate, autonomous solutions for increasing access to care, education and social support through mobile technologies and services.
6. CURRENT GLOBAL HIV/AIDS STRATEGY IN AFRICA
WHO – MDG- TARGET GOALS TO BE ACHIEVED BY 2015.
Goal 6. Combat HIV/AIDS
6a. Have Halted by 2015 and begun to reverse the spread of HIV/AIDS
6b. Achieve by 2010 universal access to treatment for HIV/AIDS for all those who need it.
Progress 2011- reduction in % of newly infected- but increase of 2.5M
Treatment = In 2011 more than 8 M people living with HIV receiving antiretroviral therapy
(ART) in low and middle income countries. Another 7 M need 2 be enrolled in treatment to
meet the target MDG of providing ART to 15 M people by 2015.
Treatment suppresses symptoms – does not cure or prevent contagion of others
Non-adherence to antiretroviral therapy – side effects, adverse events including death
Testing = test reveals the presence or absence of antibodies to HIV in the blood. HIV may
not b detectable for 3-6 weeks after contacting the virus. Is infectious immediately.
Global burden of Disease www.who.int
WHO Millennium Development goals (MDGs) Fact Sheet www.who.int
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7. UNIQUE SELF-MANAGEMENT AND CHRONIC CARE
CHALLENGES FOR HIV/AIDS
US MODEL PROPOSED BY HEALTH RESOURCES AND SERVICES
ADMINISTRATION (HRSA) HIV/AIDS BUREAU 2006 ACKNOWLEDGES
UNIQUE CHALLENGES*
A. LOW ADHERENCE TO ART TREATMENT DUE TO RIGIDITY OF
MEDICATION, DIET, RESTRICTIONS, AND SEVERITY OF SIDE EFFECTS
B. DAILY SELF-MONITORING TESTS NOT AVAILABLE
C. STIGMA AND GUILT AND SENSE OF RESPONSIBILITY FOR ACQUIRING THE
DISEASE
SELF MANAGEMENT MAY INCLUDE EMPLOYING MEASURES TO
PREVENT INFECTION IN OTHERS
SOCIO-CULTURAL PERCEPTIONS OF SELF-MANAGEMENT
*Providing HIV/AIDS Care in a changing environment. (2006)HRSA http://hab.hrsa.gov/publications/march2006/
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9. SOCIO-CULTURAL ENVIRONMENT
Population = 39,002,772
Size = 582646 K (approximately the size of Texas)
Language: English and Swahili
Religion: Christian majority; Muslim (Sunni) minority; Animism
Currency – Kenyan Shilling (KSH) 1$=70KSH
Capital: Nairobi, Population 3-4 M, Main airport
7 major ethnic groups (tribes) -can be placed above the nation
Transportation = 8,933km paved roads, 54,332km unpaved, 2,778km railways
CHALLENGES:
URBAN/RURAL, TRIBAL, RELIGIOUS DIFFERENCES
Communicaid Group 2010 Doing Business in Kenya
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11. ECONOMIC OPPORTUNITY THROUGH
MOBILE PAY TECHNOLOGY
M-Pesa mobile based money-transfer
Powered by Safaricom- leading Kenyan Operator
2/3 of Kenya’s financial transactions
by phone- $8.6b in first half of 2013
10/27/2013
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15. CONTEXTUAL HEALTHCARE SYSTEMS
HEALTHCARE = COMPLEX ADAPTIVE OPEN SYSTEM
Comprised of people and activities that mutually influence one another in complex
ways with often unpredictable outcomes. The system evolves as it interacts over time.
World Bank report 2012 sees m-health ecosystems as complex with multiple interests
of government, health care systems, technology, and finance.
Kenyan fragmentation and system complexity exacerbated by multiple multi-national
players with private interests, including NGO’s, donors, and Kenyan government
operating in silos. No universal healthcare delivery or funding system, minimal
interaction of players
M-Health business models developed in isolation aimed at solving specific problems in
narrow areas of the health system. Lack of coordination between donors, NGO’s
multi-national companies and government lacks system wide solution development.
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