Kibera, on the southern edge of Nairobi, is one of the largest informal settlements in Africa, with a population of over 170,070 (Kenya Population Health Census - 2009). It is located on government land, 5 kilometers Southwest of Nairobi city on roughly 2 km2. It is regarded as an”illegal settlement” and not included in the city plans and budgets for public services. The community is plagued by high levels of poverty, insecurity, underdevelopment and inadequate access to basic social services. These include basic health care, education, water and sanitation, inaccessibility due to poor roads and inadequate involvement of the government in provision of essential utilities and services.
AMREF has been working in Kibera since 1998 and uses an integrated approach to address issues on comprehensive care for people living with HIV, maternal, newborn and child health and Personal Hygiene and Sanitation Education (PHASE). AMREF reaches a population of between 35,000-45,000 in the four locations (out of 13) where we work in Kibera – Laini Saba, Soweto, Mashimoni and Silanga.
The programme supports a static health facility that provides outpatient services to children and adults and a 24 hour inpatient maternity service. The clinic also runs an ART program that provides care and treatment for HIV/AIDS and TB patients.
AMREF aims to:
- increase the number of HIV- infected adults and children receiving ART and non- ART care in Kibera while increasing the capacity of AMREF, MOH (NASCOP) and communities to provide quality HIV & AIDS services
- increase community engagement, demand for and utilisation of maternal, newborn and child health services while increasing the capacity of the health system to support the delivery of high quality and effective maternal, newborn and child health services
- increase political commitment to provision of health care in informal settlements
- test and document the effects of improving health on pupils’ absenteeism, enrolment and performance in national examinations within the informal settlement while nstitutionalising school health initiatives in schools within the informal settlement by the government and other stakeholders.
So far, the project has:
- enrolled over 6,000 patients for care in the programme with more than 3,000 having started ARVs treatment in the three facilities
- scaled up door to door awareness by community health workers (CHWs) on HIV percentages, reaching to an average of 70% of households
- strengthened laboratory facilities through provision of essential equipment and supplies, support to equipment maintenance, training, supportive supervision, and regular quality assurance monitoring.
- improved quality sssurance and quality control through training and retraining of health workers, ensuring routine supportive supervision and providing equipment and supplies. Over 1,000 health care workers have been trained in different components of comprehensive care and treatment of PLHIV
- reduced HIV infection rate among children born to women living with HIV due to early intervention at the antenatal clinic, ART clinic, increased hospital deliveries and ART prophylaxis for mother and baby
- increased usage of maternity, family planning, ante/postnatal and child health care
- increased community commitment to health care structured units: 1 Health Facility Committee (HFC), 4 community units, 4 Community Health Committees (CHC)
- established Community Based Health Information System
- seen improved class attendance with approximately 85% of pupils in intervention schools reported having not been absent from school between May and September 2010 compared to 57.1% during 2007
