Learning collaborative to support Oral PrEP roll out in Kiambu County, Kenya
The Kiambu County and the OPTIONS Consortium, hosted by LVCT Health and Kiambu County Health Management Team conducted a three-day Learning Collaborative with health policy makers, program implementers and community-based organizations to share experiences and resources on pre-exposure prophylaxis (PrEP) – a daily HIV prevention drug for individuals experiencing ongoing HIV risk. The Learning Collaborative is a forum where participants exchange ideas, share innovations and participate in capacity development through presentations, panels and groups discussions. Attended by 72 participants, this was the third Learning Collaborative held by OPTIONS but the first intra-country Learning Collaborative that focused on engaging stakeholders in Kenya.
The Learning Collaborative brought together members of the Kiambu Health Management Team (County and Sub-County), PrEP implementing partners and community organizations working in the county. The workshop also had health management representatives from Siaya, Kakamega and Nairobi Counties and officials from the National AIDS & STIs Control Programme (NASCOP) and National AIDS Control Council (NACC).
The agenda of the workshop was to provide tools and resources geared towards improving uptake and continued use of PrEP by adolescent girls and young women. The Kiambu County Health Management Team welcomed the initiative which they said would help their population to access their medical needs and spur the County’s health sector towards achieving Universal Health Coverage – one of the big four priorities for Kenyan government.
According to the 2018 HIV estimates, Kiambu County has 59,016 people living with HIV with 36,859 identified. It is also estimated that 2,507 adolescents (10-19yrs) live with HIV and that there are 5,369 youths (15-24yrs) living with the virus.
Currently, a total of 1,665 clients are on PrEP. This is considered a low uptake since Kiambu County contributed to 4.7% (708) of the total number of people living with HIV in Kenya, and is ranked sixth highest nationally, according to the 2018 HIV estimates.
The Learning Collaborative provided an opportunity for rich cross-county learning. The four counties present at the workshop shared their HIV situational analysis, experience in implementing PrEP and challenges faced. This set the stage for discussion towards improving PrEP implementation, developing PrEP demand generation strategies and training community & facility-based health care workers for PrEP service provision.
Participants were introduced to different tools and resources to aid them in PrEP services provision. One of the tools that participants were taken through was the PrEP-IT a tool that aims to support governments, donors, implementers and other stakeholders in addressing programmatic challenges like setting targets, projecting costs and analyzing program efficiency in implementing oral PrEP programs. The tool will be piloted in 4 countries including Kenya and is set to be launched in September 2019.
Another tool shared was the PrEP Communications accelerator a free, interactive, digital resource that guides users in developing communications strategies to create demand for PrEP in different contexts and for different populations. The tool was developed by OPTIONS after 36 consultations with stakeholders from 4 African countries to assess what resources and tools were needed to support the development of communications for PrEP in sub-Saharan Africa.
Participants were also sensitized on a HIV Prevention Ambassador Training Package for adolescent girls and young women and Provider Training Curriculum for health facility staff offering oral PrEP services. These capacity-building resources are at a development stage and will be piloted in 3 sub-counties of Kiambu in collaboration with Kiambu County and other partners working in the 3 sub-counties. Results from the pilot will be used to improve the resources and after finalization they will be shared to all relevant stakeholders in Kenya that are involved in PrEP service provision.
The learning collaborative formed part of the initial work in Kiambu County aimed at improving PrEP uptake and supporting its continued use by adolescent girls and young women. Lessons learnt and experiences from implementation of other planned activities such as piloting of the resources and tools will be shared at the next Learning Collaborative workshop that will be held in Kiambu towards the end of the year. We look forward to success stories and best practices in supporting PrEP services in Kiambu County.
By Alfred Itunga