FHI - APHIA II

NOVEMBER 2006 � The U.S. Agency for International Development has selected FHI to lead implementation of the AIDS, Population, and Health Integrated Assistance Program (APHIA II) in Kenya's Rift Valley and Coast Province from 2006-2009. The program will help Kenyans lead healthier lives by easing access to an increased range of quality health services. The U.S. Ambassador to Kenya, Michael E. Ranneberger, officially launched the program in Mombasa, Kenya, on Sept. 26.

Integrated Networks Provide Healthcare "Safety Net"

Building on the success of FHI's IMPACT (Implementing AIDS Prevention and Care) Project, APHIA II will create decentralized and integrated networks for prevention, care and treatment services. These networks will strengthen and link existing programs and resources in the public and private sectors and among faith- and community-based organizations.

According to John McWilliam, FHI/Kenya Country Director, integration of health services extends the Kenyan people a healthcare "safety net." Whether patients enter the system through referral by a community organization, a public health facility, or a private sector program at their workplace, they will receive virtually any health service they need.

While Kenyan communities have offered comprehensive care services for HIV-affected people for some time, these services have not been effectively linked, and people have not known how to access all the care available to them. For example, some private health facility patients may worry that they are unable to pay for expensive lab work, not knowing that these services are free in surrounding government health facilities. With the formal linkages created under the APHIA II network, private practitioners will now refer patients to public facilities for services they may not be able to afford otherwise.

Similarly, in the past patients could not always obtain lab tests that might be useful in their care. One such test is a CD4 test, which indicates how advanced HIV is and predicts risk of complications. Through APHIA II, a patient accessing clinical care at a private health facility will now be referred to a public clinic for a CD4 test if the private clinic lacks appropriate facilities. Other services patients may be referred to include psychosocial support, adherence counseling or micro-financing programs, enabling them to become more productive, economically independent and better able to support their families.

Communication Campaigns Promote Services

Because Kenyans can only benefit from integrated networks if they actually know about and use them, all workplace and community HIV/AIDS awareness campaigns will deliver consistent, appropriate messages about preventing HIV and provide information about where to access care, support and treatment. Communication campaigns will convey the importance of knowing one's HIV status, promote referrals among patients and providers, and reduce stigma and discrimination. FHI expects this to lead to a 60 percent increase in the use of counseling and testing services in Rift Valley Province alone.

Care Providers Focus on Families

Bearing in mind that AIDS affects families and not just individuals, providers under APHIA II will work to meet the prevention, care and treatment needs of patients' entire families. A home-based care provider visiting a person living with HIV/AIDS may ensure that children in the household attend school and receive counseling and healthcare, or encourage the patient's spouse or partner to accept counseling and testing.

FHI already uses this family approach in Nuru Ya Jamii (PDF, 123 KB), a pilot program that provides care and support for children and their HIV-positive parents and caregivers in Nakuru, Kenya. Kenya's Ministry of Health is interested in this "preventing orphaning" innovation, says McWilliam, and may incorporate it more widely into Ministry of Health programming and APHIA II.

APHIA II Builds Local Capacity

In addition to strengthening and scaling up integrated networks of prevention, care and treatment services, FHI and its partners are committed to building the capacity of local communities, the public sector and civil society to sustain APHIA II. Strategic partners working with FHI to meet Kenya's healthcare challenges in the Rift Valley and Coast Province include Catholic Relief Services, Cooperative League of the USA, JHPIEGO (an international health organization affiliated with The Johns Hopkins University in Baltimore, Md.), the National Organization of Peer Educators, Social Impact and World Vision.

The five-year budget for APHIA II in each province is about $40 million. In addition to its lead role in the Rift Valley and Coast Province, FHI is responsible for program monitoring and evaluation in Eastern Province and supports antiretroviral therapy programs in Central and Nairobi provinces.

PHOTO (above): US Ambassador to Kenya, Michael E. Ranneberger, is greeted at the ceremony to launch APHIA II by members of Kenya Girl Guides Association. FHI supports the association's successful peer education program. (FHI/Kenya)

PHOTO (top and home page): A home-based care worker comforts her client. Under APHIA II, home-based care workers and other providers will refer patients and their families to a wide variety of health services and support. (Jim Daniels)

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