Kisii County HIV program has made progress in several areas to include HTS uptake and linkage to care, even though a gap exists of over 4000 HIV positive persons yet to be identified. The overall ART enrollment is at 88% while viral suppression is at 91% with gaps in male and children treatment cascades. HIV services are decentralized to lower health facilities and integration of HIV/TB/RH services is done in all service delivery points. The MTCT rate has fluctuated from a high of 17% to currently 9.1% with the problem issues being; low first antenatal clinic visits, non-skilled care births and maintaining mother baby pairs for the HEI’s. Other challenges encountered include social stigma leading to non-disclosure for support, commodity stockouts of pediatric ARV’s formulations and dual test kits, among others. There is a gap in community facility linkage and CHV’s not trained on the HIV module. PrEP uptake in facilities without drop-in-centres is a challenge worsened by inadequate capacity building of health care workers in this and other components of HIV care.
Year one will focus on the HIV positive and HIV-vulnerable populations in South Mugirango sub-county. From year two, the same population will be targeted in tandem with other sub counties within Kisii County. This will be done incrementally until year five when the entire county will have been covered.
Improved capacity of Kisii county government to oversee and manage the implementation of HIV services in South Mugirango, Kisii County then cascaded to the entire county.
Reduced MTCT transmission rates from 9.1% to 6% in three years
Increase adult ART coverage from 75% to 85% in three years.
Increased paediatric ART coverage from 82% to 90% in three years.
Improved management and oversight of HRH, HIV service delivery, and supply chain management in South Mugirango then cascaded to the entire county.
Increased incremental financing of HRH and HIV service delivery by county government
Improved data-driven planning and oversight of HIV programs by county government
Increased Kisii County CHMT leadership in HIV service delivery
Increased county funding allocation to HRH and HIV service delivery
Reduced HIV-related morbidity and mortality among adults, children, mothers, HEI, TB patients, KP and PP in the relevant county
The outcomes will be achieved using eight strategies, key of which will be: To provide direct oversight and management to implement and sustain the HIV service delivery program at county level, through takeover of services by the Kisii County government from PEPFAR IPs.
Monitoring and evaluation will be carried out through-out the program period in accordance with the proposed EPMP.