National AIDS Control Council - World Bank Group

Building on our experiences1

National AIDS Control Council

Building on our Experiences:Lessons Learnt and Future Direction

of the Community Programme

Kenya

National AIDS Control CouncilOffice of the President

September 2003

Building on our experiences 2


Technical assistance in compiling and producing this report provided by Apex Communications Ltd.,

P.O Box 12313-00400 Nairobi, Tel: 2716890, Tel/Fax: 2719478 Email: [email protected]

Acknowledgments

The National AIDS Control Council would like to express their sincere gratitude to all

those people whose time and effort went into the production of this report. We particularly

recognise the contribution of the community based, faiths based and non-governmental

organisations for their effort in preparing project reports and ensuring that the projects which form

the basis of this report are implemented.

We also extend our gratitude to the Provincial, District and Constituency AIDs Control

Committees for organising and coordinating the regional experience-sharing meetings both in

Nairobi and Eldoret. Special thanks to the Kenya AIDs NGO’s Consortium (KANCO) for

accepting to assist in facilitation during the first meeting.

Profound appreciation goes to the World Bank and the United Nations Development

Programme (UNDP), without whose financial support the regional-experience sharing meetings as

well as this report would not have been undertaken.



Contents

Acronyms and Abbreviations ..................................................................................................................................................... 4

Foreword ................................................................................................................................................................................................ 5

Summary ................................................................................................................................................................................................ 7

Background .......................................................................................................................................................................................... 9

Accomplishments ........................................................................................................................................................................... 13

Emerging Issues and Challenges ............................................................................................................................................ 25

Emerging Lessons and Future Direction ............................................................................................................................. 31

Appendix

List of Participants ............................................................................................................................................................. 34

Workshop Programme ..................................................................................................................................................... 37



Acronyms and AbbreviationsACUs AIDS Control Units

AIDS Acquired Immune Deficiency Syndrome

AMREF African Medical Research Foundation

ARVs Antiretrovirals

CACC Constituency AIDS Control Committee

CBO Community Based Organisation

CIA Community Initiative Account

COCC Community Orphans Care Committee

DACC District AIDS Control Committee

FBO Faith Based Organisation

FGM Female Genital Mutilation

FMA Financial Management Agency

FONI Friends of Nomads International

HIV Human Immunodeficiency Virus

IEC Information, Education & Communication

IFC International Fellowship Centre

IGAs Income Generating Activities

KANCO Kenya AIDS NGO’s Consortium

KAPC Kenya Association of Professional Counselors

KHADREP Kenya HIV/AIDS Disaster Response Project

MADICAA Makadara Division Campaign Against AIDS

MOCASO Mother/Child with AIDS Support Organisation

NACC National AIDS Control Council

NASCOP National AIDS and STDs Control Programme

NCC Nairobi City Council

NGO Non-Governmental Organization

NOPE The National Organisation of Peer Educators

OIs Opportunistic Infections

OVC Orphans and Vulnerable Children

PACC Provincial AIDS Control Committee

PAIDO Participatory Approaches for Integral Development Organization

PLWD People Living With Disabilities

PLWHA People Living With HIV/AIDS

RICOAN Riruta Community Against AIDS Network

SDA Seventh Day Adventist

SSM Stepping Stones Methodology

STDs Sexually Transmitted Diseases

UCC Ukamba Christian Community

UN United Nations

USAID United States Agency for International Development

VCT Voluntary Counseling and Testing

WEMIHS WEM Integrated Health Services



Foreword

Over the years, HIV/AIDS has emerged as the greatest development challenge facing our

country. By 2001, approximately 2.2 million Kenyans were infected with HIV/AIDS while 1.5

million Kenyans are estimated to have died from AIDS related illnesses.

To meet the challenges posed by the HIV/AIDS pandemic, the Kenya Government declared

HIV/AIDS a national disaster in 1999 and set up the National AIDS Control Council. Declaring

AIDS a national disaster and setting up NACC, marked the beginning of the road to a strong

multisectoral coordination mechanism to tap the full potential of all sectors in the fight against

HIV/AIDS.

The Kenya HIV/AIDS Disaster Response Project (KHADREP), funded to the tune of US$ 50

million by the World Bank provides the framework for involving all government ministries and

departments, civil society, private sector, and faith-based organizations among other stakeholders

in the response towards the epidemic. This project is to run from year 2001 to 2004.

A key component of KHADREP is to support community driven local initiatives through capac-

ity building, financial and human resources through the Community Initiative Account (CIA) with

a budget of US$ 30 million out of the US$ 50 million. The CIA component was operationalized in

June 2002 and by June 2003, over Ksh 816 million from this Account had been approved for dis-

bursement to CBOs, FBOs and NGOs to support community based interventions that they are

spearheading throughout the country.

To tap the “emerging wisdom” over the short period of implementing these interventions,

NACC organized two experience-sharing workshops in May and June 2003 not only to document

the accomplishments and emerging issues but more importantly to draw lessons on the effective-

ness, successes or problems faced in the course of implementing these interventions.

This report is the outcome of those two workshops. It has many inspiring examples of how

communities are organizing themselves to address the challenges posed by HIV/AIDS. These

include the challenges of setting up a community VCT centre, taking care of orphans or increasing

knowledge among specific groups. The report has examples of challenges that need to be ad-

dressed in order for Kenya to face up to the HIV/AIDS challenge with increasing effectiveness.

The report also provides insight on the future direction of the community based interventions

and also points out areas that require action. This report is an important resource for those imple-

menting or planning to implement community based interventions in different parts of the country.

Prof. Miriam Were

Chairman




Summary

As the world enters the third decade of the AIDS epidemic, the evidence of its tragic impact is

undeniable. According to UNAIDS, sub-Saharan Africa is by far the worst affected region. By

2002, the region was home to 29.4 million people living with HIV/AIDS. Approximately 3.5 million

new infections occurred there in 2002.

The epidemic claimed the lives of an estimated 2.4 million Africans in the past year. Ten million

young people aged 15-24 years and almost 3 million children under 15 years are living with HIV.

The situation in Kenya reflects this continental pattern.

The government is however determined to stem the epidemic and reduce the impact on Kenyan

society and economy. The popular version of the Kenya National HIV/AIDS Strategic Plan pro-

vides the roadmap to address priority areas for the control of HIV/AIDS as well as mechanisms for

the mitigation of the social economic impacts at individual, family community, sectoral and na-

tional levels.

This report is the outcome of two workshops held in May and June 2003 that brought together

community based, faiths based and non-governmental organisations funded by NACC. It

documents their experiences, accomplishments, challenges and successes in implementing

community initiatives in response to the HIV/AIDS epidemic and points to the future direction of

these initiatives.

The report is divided into three major parts:

Part one gives an outline of the key accomplishments under three thematic areas namely preven-

tion and advocacy, treatment, continuum of care and support and mitigation of the socio-economic

impact.

Prevention and advocacy activities undertaken by the implementers are focused on increasing

knowledge on HIV/AIDS, modes of transmission and measures that would lead to attitudinal and

behavioural change on sexual matters.

In the area of prevention, creating awareness was the key focus. Several methods have been

used ranging from workshops and seminars to sports forums. The implementers are also working

with priority groups for HIV/AIDS interventions.

Activities carried out under treatment, continuum of care and support include treatment of

opportunistic infections by traditional medical practitioners, counseling, homebased care and

refferals to conventional health facilities.

Under mitigation of social and economic impact, effort is geared towards income generating

activities and care and support of orphans.

Part two of the report documents the emerging issues and the challenges associated with imple-

menting the HIV/AIDS projects at the community level. Key issues and challenges emerged from

discussions that followed presentations and plenary discussions.



Issues that require action range from increasing community participation, easing procedures for

proposal approval and disbursement of funds, to building capacity and developing guidelines on

information and education materials. There were also crosscutting issues that emerged which

includes networks for People Living With HIV/AIDS, lack of capacity and the fate of equipment in

use after the expiry of projects.

Part three discusses the emerging lessons and proposed future direction of the community initia-

tives.

Community participation was found inadequate in some cases and needs to be addressed by the

implementers. Participants also called for the establishment of a central body to coordinate preven-

tive efforts addressing the youth, who form the largest case load of new HIV infection.

Other issues related to capacity building, dissemination of guidelines on home based care and

development of appropriate IEC materials. Action is also required on strengthening the link among

the different structures of NACC on the one hand and the community based implementers to

enhance the supervisory role of these structures.

Another emerging issue relates to monitoring and evaluation. As the project moves on, it will be

important to establish and integrate monitoring and evaluation mechanism for programme activi-

ties in order to capture its successes and challenges more systematically and effectively.



Background

The magnitude and impact of HIV/AIDS in Kenya is a major development and public health

challenge that is increasingly creating severe negative socio-economic impact. More than one

million people have developed AIDS and died since 1984. At the end of June 2000, more than two

million Kenyans were living with HIV. In 1998 alone, over 200,000 new infections occurred while 70

per cent of those already infected live in the rural areas. The majority are young people aged

between 15-39 years.

In order to meet the challenges posed by the HIV/AIDS pandemic, the Kenyan government

declared HIV/AIDS a national disaster in 1999, and set the stage for the setting up of the National

AIDS Control Council vide a Gazette Notice No. 170 of 1999. This marked the beginning of a strong

multisectoral coordination mechanism to tap the full potential and participation of all sectors and

stakeholders to deal with the numerous challenges presented by the HIV/AIDS epidemic.

The aim is to mount a successful multisectoral response to the epidemic in accordance with

provisions and objectives of the Sessional Paper No.4 of 1997 on HIV/AIDS in Kenya.

The mandate of the National AIDS Control Council is divided into three broad categories which

include to coordinate and manage the implementation of a national multisectoral HIV/AIDS

programme, provide policy directions for the national multisectoral HIV/AIDS programme and

mobilise resources for the national HIV/AIDS programme.

The setting up of NACC was followed by the development of the Kenya National HIV/AIDS

strategic plan for the year 2002-2005, to guide the national multisectoral approach to HIV/AIDS

control and prevention.

The overarching theme of the plan is social transformation to reduce HIV/AIDS and poverty.

The Plan’s principle objective is to stop the epidemic and reduce its impact on Kenyan society and

economy by:

■ Reducing HIV prevalence in Kenya by 20 to 30 per cent among people aged 15 to 24 years

by 2005;

■ Increasing access to care and support for people infected and affected by HIV/AIDS in

Kenya; and

■ Strengthening response capacity and coordination at all levels.

Priority areas include:

■ Prevention and advocacy;

■ Treatment, continuum of care and support;

■ Mitigation of the socio-economic impact;

■ Monitoring and evaluation and research; and

■ Management and coordination.



Within these agreed priority areas, a variety of interventions are being implemented to achieve

defined objectives for each priority area. In the absence of a cure for HIV/AIDS, the Kenya Na-

tional HIV/AIDS strategic plan for year 2002-2005 weights resources more heavily towards preven-

tive activities within the priority areas and on the communities.

Implementation of the strategic plan capitalises on existing infrastructure and strengths to

increase coverage and quality of service provision through key stakeholders, mainly non-govern-

mental organisations, community based organisations, public and private sectors and religious

organizations. The structural arrangements may be adjusted for greater effectiveness.

For the specific purpose of involving the above stakeholders in the national response to the

HIV/AIDS epidemic and making financial resources available to these organisations, NACC has

established an HIV/AIDS Community Initiative Account (CIA), funded to the tune of US$ 30

million, out of a total of US$ 50 million for the entire Kenya HIV/AIDS Disaster Response Project

(KHADREP).

This component constitutes the largest fund allocation of this project, highlighting the high

priority that is being given to the expansion of community-driven local initiatives. Other compo-

nents are the AIDS Control Units (ACUs) established within government ministries and depart-

ments for US$ 10.3 million and coordination and management of AIDS program by NACC and its

structures for US$ 12.1 million.

The CIA will contribute to the improvement of the welfare of communities by increasing their

access to financial and human resources to assist them to limit further spread of HIV and address

the impact of the epidemic on individuals and households.

It will respond to demands for sub-projects, which aim to address the prevention of HIV infec-

tion or the issues related to the impact of HIV/AIDS on those infected or affected by the disease.

These may include activities aimed at behaviour change, social support to those infected and

affected by HIV/AIDS, training programmes for community volunteers and care-givers, as well as

seed funding to start income generating activities. These sub-projects will be identified, designed,

implemented, managed and maintained by the beneficiary communities.

Disbursement of the funds started in June 2002. As of June 20, 2003, a total of 982 projects had

been appproved for funding to the tune of Ksh 816,661,080 out of which Ksh 487,144,980 has

already been disbursed.

As of June 20, 2003, priority areas which had either been partly or fully funded since the incep-

tion of the programme include prevention and advocacy to the tune of Ksh 522,456,993 and treat-

ment, continuum of care and support to the tune of Ksh 94,242,354 . Others are mitigation of socio-

economic impact to the tune of Ksh 116,339,151 support to orphans to the tune of Ksh 76,122,582

and monitoring, evaluation and research to the tune of Ksh 7.5 million.

The implementation of the KHADREP project of which the Community Initiative Account is a

component is slated to lapse in December 2004. However there are indications that the project will

be extended beyond 2004.

This report is the product of two regional experience sharing workshops which brought together

community based, faith based and non-governmental organisations funded by NACC from the



Community Initiative Account. Organisations made presentations on the activities they had carried

out, the challenges they faced and the lessons they learnt.

The specific objectives of the workshops were to:

■ Identify and discuss what worked and what did not work in project development and

implementation;

■ Identify and discuss the challenges and problems encountered in project development and

implementation; and

■ Identify and document the lessons learnt.



Key Accomplishments UnderThematic Areas

A variety of interventions have been implemented by the community based, faith based and

non-governmental organisations funded by the National AIDS Control Council under the

Community Initiative Account. During the two workshops, a total of 44 implementing organiza-

tions presented their work. A summary of accomplishments as presented by the implementing

organizations are discussed in this section under the following themes: Prevention and Advocacy,

Treatment, Continuum of Care and Support and Mitigation of Social and Economic Impact.

Majority of the activities undertaken were in the thematic area of prevention and advocacy.

Below is a table of implementing organizations that took part in the two workshops and their areas

of activities:

Table 1Implementing organizations that took part in the exercise and their areas of activities

Referrals

TohanchaneCBO

KANCO

RICOAN

MOCASO

Day Aid Care

Communitymobilization

WEMIHS

UkambaChristianCommunity

Beccoh centre

TohanchaneCBO

Incomegeneratingactivities

Day Aid Care

Mother/childwith Aidssupportorganisation(MOCASO)

Sensitization& creatingawareness

Songich S.D.Aevangelistic SHG

Kabras Jua KaliAssociation

MYWO, KeiyoBranch

Olmarei Lang

Beccoh centre

Womankind Kenya

FONI

IhururuInitiative

Riruta CommunityAgainst AidsNetwork (RICOAN)

MIDICAA

Gallamoro Network

Tunu Women Group

Jua Arts

Kuria DistrictDisability Network

Tohanchane CBO

Care andsupport oforphans

NyamiraAdventist CHOP

Makinu YouthAgainst AIDS

WEMIHS

MADICAA

Capacitybuilding

KANCO

LAZERS

Pastoral capacitybuilding anddevelopmentorganisationPAIDO

The NationalOrganisation ofPeer Educators(NOPE)FONI

Treatment

TransmaraHerbalistsAssociation

Resourcecentre

New visionMultimediaHIV/AIDSResource CentreWestern KenyaHIV/AIDS Network

Mt. Elgon

CommunityResource Centre

KANCO

VCT services

Olemila CBO

Condompromotion

Ihururu Initiative

Gallamoro

Tohanchane CBO

Counseling

RICOAN

Day Aid Care

WEMIHS

Western HIV/AIDS Network



Prevention and AdvocacyAccording to the strategic plan, the objectives of efforts in prevention and advocacy is to reduce

HIV/AIDS prevalence by 10 per cent per year through promotion of behaviour change, prevention

of transmission of HIV from mother to child, reducing prevalence of sexually transmitted

infections and ensuring safe blood transfusions and blood products.

The high risk priority groups for interventions are:

■ Adolescents and youth (in and out of school);

■ Women and girls;

■ Security forces;

■ Populations in certain locations such as slums and border towns;

■ Populations who are difficult to reach such as nomads and beach communities; and

■ High-risk groups such as commercial sex workers and long distance drivers.

The following activities have been undertaken under the prevention and advocacy thematic area.

■ Creating awareness on HIV/AIDS;

■ Capacity building;

■ Establishment of resource centres on HIV/AIDS;

■ Condom promotion;

■ Community mobilisation; and

■ Voluntary counseling and testing.

Intended Audiences for Prevention EffortsPresentations by organizations implementing activities under the CIA demonstrated that they are

reaching or working with priority groups for HIV/AIDS interventions. Below is a summary of

groups being reached by different organizations.

YouthOrganisations like Songich Evangelistic Group of Eldoret, RICOAN of Nairobi, Jua Arts of Kilifi,

Olmarei Lang of Narok, Ihururu Initiative of Nyeri, Gallamoro of Nairobi, Womankind of Garissa,

Tunu Women Group of Lamu, Foni of Isiolo and Tohanchane CBO of Kuria District have activities

directed at both in and out of school youth. Indeed a group such as Jua Arts was set up by the

youth themselves as a vehicle for reaching their peers.

Women GroupsOrganisations like RICOAN of Nairobi, Olmarei Lang of Narok and Tohanchane in Kuria Districts

respectively are examples of women groups which mainstream HIV/AIDS to their agenda.



Local and Religious LeadersIn some areas, activities geared towards awareness creation have been directed at local leaders as

agents of change. In this category, are organisations like FONI, Maendeleo ya Wanawake, Keiyo

Branch, Kuria District Disability Network and Tohanchane CBO. FONI of Isiolo District have

trained councillors and chiefs on HIV/AIDS while Maendeleo ya Wanawake, Keiyo Branch has

trained divisional women leaders and other leaders to create awareness on HIV/AIDS at the

grassroots.

FONI and WomanKind who operate in predominantly Muslim communities involve religious

leaders by conducting workshops for Imams and preachers.

Matatu FraternityThe Ihururu Initiative of Nyeri has organized seminars and workshops for matatu drivers and

touts on HIV/AIDS issues. From their report, the workshops were so successful that they had more

willing participants than they could accommodate. Majority of the participants were out of school

youth.

House helps, out of schoolgirls and single mothersBeccoh Centre of Mombasa is involved in educational programmes for house helps, out of school

girls and single mothers. It has organized educational seminars for the above categories in Mom-

basa.

Nomadic HerdersWomankind has conducted awareness sessions at water points in Garissa District targeting no-

mads. The area is characterised by high illiteracy levels.

The physically challengedThe Kuria District Disability Network which brings together 23 disability self help groups in Kuria

District works to reduce the spread of HIV/AIDS among the physically challenged through

sensitization among other activities.

Creating Awareness and Increasing Knowledge on HIV/AIDSA quarter of the organizations that participated at the two workshops are involved in activities

geared towards creating awareness and increasing knowledge on HIV/AIDS. Their activities focus

on increasing knowledge on HIV/AIDS, modes of transmission and preventive measures that

would lead to attitudinal and behavioural change on sexual matters.

In creating awareness, several methods have been used to pass HIV/AIDS messages as de-

scribed below.



Workshops and seminarsWorkshops and seminars are popular with groups like Olmarei Lang Self Help Group, The Ihururu

Initiative, WomanKind Kenya, Beccoh Centre, Kuria District Disability Network and Tohanchane

CBO. In most of these seminars and workshops, facilitators are hired to educate the people on

issues related to HIV/AIDS.

Video ShowsVideo Shows are also popular with the groups in creating awareness. Organisations like Jua Arts of

Kilifi, MADICAA of Nairobi, the Ihururu Initiative and the Tunu Women Group sensitize people

on the dangers of HIV/AIDS and STDs through video shows. Some of the video tapes used include

the Yellow Card and The Silent Epidemic. Most of the video tapes are donations from organisations

engaged in HIV/AIDS activities like AMREF and Church organisations.

Visits to leisure spotsVisits to leisure spots have been used as an entry point in creating awareness on HIV/AIDS. Such

spots include disco halls, pool and darts clubs. The Ihururu Initiative visits such premises where

they conduct talks with the youth on drug abuse and alcoholism in relation to HIIV/AIDS.

Schools and churchesOrganisations like Olmarei Lang of Narok, Jua Arts of Kilifi, MADICAA, Gallamoro and RICOAN

of Nairobi, Ihururu Initiative of Nyeri, Tunu Women Group in Lamu District and Maendeleo ya

Wanawake in Keiyo District makes visits to schools and churches to talk to the youth. Topics

covered in such sessions include common STDs and their relationship with HIV/AIDS, facts on

HIV/AIDS, modes of transmission and the ABCs of prevention.

Alternative mediaUse of alternative media like drama, theatre, song and dance is another way through which the

organisations create awareness. In this category, we have Jua Arts, MADICAA and the Ihururu

Initiative who are into drama. Gallamoro has been able to enhance and encourage drama groups in

schools. They have organised and registered a drama group with the Ministry of Home Affairs and

Office of the President called the Gallamoro Films and Drama Group.

Gallamoro is also into song and dance where they organise schools to create dances, poems,

plays and music extravaganza on HIV/AIDS. Songich S.D.A Evangelistic self help group of Eldoret

South constituency preach the gospel and sing gospel songs on HIV/AIDS. The group which

operates in Eldoret has visited different places in Eldoret Constituency to sensitize the people

through songs.



Distribution of IEC materialsIn the course of creating awareness, organistaions like RICOAN, Gallamoro and MADICAA of

Nairobi have distributed information, education and communication materials on HIV/AIDS to

their audience. Such

materials are sourced

from Kenya AIDS

NGOs Consortium

(KANCO), Pathfinder,

and National AIDS and

STDs Control Pro-

gramme (NASCOP)

among other organiza-

tions.

Sports ForumsSports is another

method used by the

implementers in

creating awareness.

Gallamoro and

MIDICAA, both of

Nairobi organizes

sports activities like

football matches and

tug of war around

which they create a

platform for dissemi-

nating information on

HIV/AIDS.

Capacity BuildingCapacity building is

another component of

the advocacy and

prevention activities

undertaken by the

implementers. Organi-

sations in this area

include KANCO

branch of Nakuru,

Case Study 1

Reaching the physically challenged in thecampaign against HIV/AIDS

The Kuria District Disability Network ExperienceKuria District Disability Network is an established Community Based Organization (CBO), comprising of the

physically challenged from Kuria District of Nyanza Province. The Network is an umbrella organization of 23

self help groups in the district.

The group is led by Abednego Maroa Mwita, the elected Executive Coordinator of the Network, who

resigned from his teaching job at the district primary school to play an active role in the campaign against HIV/

AIDS among his people.

“The overall goal of the Network is to bring together people who are physically challenged to chart the

way forward in reducing HIV/AIDS among themselves,” says the 35 year old Abednego, who has been physically

challenged since birth.

Contrary to popular belief that the physically challenged are not involved in promiscuous sex, Abednego

says that they are more vulnerable to HIV/AIDS because of the limiting nature of their lifestyles.

“Our mission is to ensure the prevalence of HIV/AIDS among PLWD is reduced by 20 per cent by the year

2005,” says Abednego.

Despite the high HIV/AIDS awareness levels among Kenyans, Abednego says that PLWDs have no access

to such information. Due to various challenges like deafness, blindness, mental problems and those who

have a combination of all the above, PLWDs have completely been left out of the HIV/AIDS campaign in

Kenya, explains the network coordinator.

Abednego, one of the few educated physically challenged people in Kuria, has one motto that drives him:

disability is not inability. He has done what was initially perceived as impossible and organized workshops

and seminars for PLWD to train them on HIV/AIDS related issues.

“Our greatest challenge is the high rate of illiteracy among PLWDs,” explains Abednego, because many

parents do not take their disabled children to school, they lack basic sign language skills, making it very

difficult to communicate with them, he adds.

In response to this challenge, the Kuria Disability Network has discovered that in the process of socialization,

PLWDs have developed their own mode of communication, which suits them. Although it is not the standard

mode of sign language, it is the most effective mode of communication between the Network officials and its

members.

Through this new approach, PLWD in Kuria District have slowly begun to change their sexual behaviour.

However, Abednego says that the best way to reach his fellow brothers and sisters who are physically challenged

has been by way of example.

After several years of campaigning for people to take the HIV test, Abednego, a husband and father of four

daughters, finally decided to take the VCT test, to determine his serostatus. Like anyone else, he was scared,

but resolved to be a role model whatever the outcome. If he were positive, he would become even louder as

an advocate to ensure that HIV/AIDS levels drop among his people and especially among the physically

challenged in Kuria district.



Lazers of Eldama Ravine, Pastoral Capacity Building and Development Organisation of Garissa,

PAIDO of Kitui, The National Organisation of Peer Educators (NOPE) based in Mombasa and

FONI of Isiolo.

Lazers management team trains the various sectoral leaders in every location of Eldama Ravine

Division who in turn train group leaders and representatives. The group leaders and representa-

tives are expected to play a leading role in sensitizing the general public.

KANCO in Nakuru trains organisations in HIV/AIDS activities on technical aspects like pro-

posal writing , programme design and management and resource mobilisation. Examples of

organisations trained by the Nakuru branch of KANCO include Yoseh 2000 Youth Group, Born

Ministries and Love and Hope Centre, all of Nakuru. PAIDO on the other hand trains facilitators

through Stepping Stones Methodology (SSM) workshops in Yatta Division of Kitui District. Such

facilitators are expected to drive the process of behaviour change.

Pastoral Capacity Building and Development Organisation and FONI build capacity in Garissa

and Isiolo Districts respectively. The former has developed a training manual for the youth as well

as training youth groups while the latter has empowered the marginalised pastoralists communi-

ties living in Isiolo District through education and other means in order to influence the attitude

and behaviour change of the residents.

A unique organisation in this category is NOPE of Mombasa, which is a professional body

comprising of peer educators, trainers of peer educators and trainer of trainers in the community

and work places. It was formed to respond to the growing demand for HIV and AIDS prevention

programmes especially in the work places. The group has trained more than 23 organisations on

peer education throughout the country.

Condom PromotionStrengthening condom promotion is another activity carried out by organisations as per the work-

shop proceedings. Organizations in this category include the Ihururu Initiative, Gallamoro Net-

work and Tohanchane CBO. However, what the organisations have done is to distribute the con-

doms and demonstrate their proper use and disposal. There is no feedback to determine the effec-

tiveness of such promotion.

Resource CentresSome of the participating organisations have set up resource centres to provide IEC materials and

information on HIV/AIDS. Such organisations include New Vision Multimedia, HIV/AIDS

Resource Centre in Matayos Division, Busia District, Mt. Elgon Community Resource Centre,

Western Kenya HIV/AIDS Network of Kakamega and KANCO in Nakuru.

Most of the resource centres are situated at central locations and more so at district headquarters

such as Western Kenya Network HQ in Kakamega and KANCO in Nakuru. While some like Mt.

Elgon Community Resource Centre are stand-alone resource centres. A few supplement the re-



source centres through outreach programmes.

The resource centres offer a reading room, audio and videotapes, published materials and

books. KANCO offers information through CD-ROMS and Internet Services. Most of the published

materials are either in English or Kiswahili and therefore of limited use to the users especially in

the rural areas, where majority are less proficient in English and Kiswahili. Because of their central

locations, the resource centres are not readily accessible to all community members.

Community mobilizationOrganisations which have undertaken community mobilisation include WEM Integrated Health

Services (WEMIHS) of Thika, Ukamba Christian Community (UCC), a development arm of the

Anglican Church, Dioceses of Machakos and Kitui Districts, Beccoh Centre of Mombasa and

Tohanchane CBO in Kuria District.

WEMIHS which is guided by a shared vision of empowering communities to effectively re-

spond to the HIV/AIDS has been able to mobilise the community in its area of operation to

strengthen community orphan support interventions which include a day care centre, a school

feeding programme, education support and vocational skills training. Such services are facilitated

by the Community Orphan Care Committees (COCCs), which have been formed by the organisa-

tion in collaboration with the community members.

Community mobilisation activities by the Ukamba Christian Community has led to the forma-

tion of divisional and locational HIV/AIDS committees and the selection of trainers to work as

volunteers to run the HIV/AIDS activities in selected divisions in the three Ukambani districts of

Machakos, Kitui and Makueni.

Beccoh which caters for house helps, out of school girls and single mothers in Mombasa has

facilitated community participation through identification of community based pillars that are

easily acceptable to both employers and house helps.

Tohanchane CBO on the other hand has facilitated formation of Home Based Care committees

per division in Kuria District as a result of involving the office of social services.

Voluntary Counseling and TestingIn voluntary testing and counseling for HIV, a person receives the counseling necessary to make an

informed choice on whether to undergo confidential testing. Such testing and counseling has been

shown to have a role in preventing HIV infection. For people living with HIV, it is a gateway to

care.

Olemila Community Based Organisation offers voluntary counseling and testing in Kapsabet,

Nandi District of the Rift Valley Province to empower the community members to take control of

their lives.

With the assistance from USAID, Olemila counselors have undertaken a one-week training

course in basic counseling conducted by the Kenya Association of Professional Counselors (KAPC).

Six of their members have undergone further VCT specific training with the Liverpool School of

Tropical Medicine VCT project.



Case Study 2:

VCT’s do make a difference – the Olemila ExperienceWhen Michael Otieno came for counseling at the Olemila VCT centre in Kapsabet town, Nandi District, he was scared. Only

25, Michael had led a highly promiscuous life, and was proud of it. Then one day, Michael watched both of his parents’ die one

after the other of a strange incurable disease.

Before he had time to recover from the tragedy, his closest friends began to pass away almost simultaneously including his

most recent girlfriend Anna. The cause? HIV/AIDS. That’s when Michael walked in to the Olemila VCT centre, half trembling,

to prepare for his death. He was certain that he had only a few months to live and wanted to know how he would cope.

The main objective of Olemila is to reduce the HIV/AIDS prevalence by offering Voluntary Counseling and Testing services

for HIV/AIDS in Nandi District. Voluntary HIV counseling and testing is the process by which an individual undergoes counseling

to enable him/her to make an informed choice about being tested for HIV. This decision must be entirely the choice of the

individual and he or she must be assured that the process will be confidential.

The project has eleven members strategically recruited from various socio-economic and professional fields including

health, education, youth and women groups, municipal council, administration and People Living with HIV/AIDS. With this

approach, the Olemila volunteers have been able to reach every aspect of life in the community. The volunteers have also

undergone the Kenya Association of Professional Counselors (KAPC) training course to enable them provide quality services.

At a VCT centre, pre-test counseling is the first step an individual will go through. Pre-test counseling is done to ensure that

the individual understands the basics about HIV/AIDS, the HIV test, and what the results mean. The counselor explains the

risks and benefits of knowing one’s status and discusses the fears, worries and anxieties with each individual client.

When the counselor was sure that Michael was ready to have his test taken, he performed an on-site rapid test which

means results are available within an hour. In all VCT clinics, the protocol is the same; the first screening test is done, if it is

negative, the counselor completes the HIV register and then informs the client his result during post-test counseling. If the

results are positive, a confirmatory test is performed immediately. If the positive result is confirmed, the test results are given

to the client during post-test counseling.

Members of the Olemila VCT centre have established post-test clubs for their clients; for those who are positive and

negative, where they provide support for clients who return to the centre for regular counseling. For those who are positive,

Olemila provides an opportunity to learn about nutrition from their demonstration kitchen garden so that they can learn how to

enhance their bodies’ immunity.

When the test proved Michael negative, it motivated him to stay negative by practicing total abstinence. Michael also

decided that if he had a partner, he would ensure she is counseled in a VCT clinic.

The Olemila project has been successful because of implementing two main strategies which are ensuring that the community

plays a role in establishing the VCT centre and learning best practices from similar centres in the area on the requirements of

establishing a VCT centre.

“After one year of counseling at the VCT centre, we have learned that we still have a long way to go in teaching the

community the truth about HIV/AIDS,” says Godfrey Kutwa, the youth counselor at the Olemila VCT centre.

The stand-alone VCT facility also provides first hand information on HIV/AIDS through videos

and pamphlets, facilitates joining of post-test clubs for the positive and the negative. There is also

counseling as well as education on nutrition from the demonstration garden.



Treatment, Continuum of Care and SupportThe strategic plan defines the objective of the treatment, continuum of care and support for the

infected and affected as to promote quality health life for people infected and affected.

To achieve the above objectives, the following strategies have been identified:

■ Strengthen clinical management and nursing care of opportunistic infections;

■ Prevent spread of infection through infection control guidelines and measures;

■ Reduce social stigma and discrimination;

■ Develop guiding framework on implementation of youth-friendly treatment, care and

support services;

■ Strengthen institutional capacity for providing continuum of care; and

■ Provide social support through NGOs, CBOs and families.

The following activities have been undertaken under the treatment, continuum of care and support

for the infected and affected priority area:

■ Treatment of opportunistic diseases;

■ Counseling; and

■ Referrals.

Treatment of opportunistic infectionsTransmara Herbalists Association in Transmara District of the Rift Valley Province has been treat-

ing Opportunistic Infections (OIs) using herbal medicine since it was established in 2000. Its activi-

ties have not been documented to determine their effectiveness.

With a membership of 35 people, the Association’s goal is to ensure HIV/AIDS patients are free

of opportunistic infections. They have partnered with the Kenya National Museum to analyse and

quantify the chemical ingredients in the herbs they use.

Treatment is based on assumptions of the ailment since the patients come to them as a last resort

after failing to get well from use of modern medicine. Availability of herbs is however threatened

by the loss of forest cover in the surrounding forests.

CounselingOrganizations that offer counseling include RICOAN of Nairobi, Day Aid Care of Kisumu,

WEMIHS of Thika and Western HIV/AIDS Network of Kakamega.

Day Aid Care is a grouping of People Living with HIV/AIDS. Counseling has played a major

role in encouraging them to live positively with the virus. Western HIV/AIDS Network on the

other hand has two trained counselors who offer the services to their clients.

There is no uniformity on the training of the counselors. While some have undergone a two-

week training conducted by the Kenya Association of Professional Counselors, the duration of the

training differs from one organization to another.



Home Based CareHome Based Care is the care of persons infected and affected by HIV/AIDS that is extended from

the hospital or the health facility to their homes through family participation and community

involvement, with available resources and in collaboration with health workers.

Day Aid Care in Kisumu and MOCASO of Nairobi whose members are People Living with

HIV/AIDS provides Home Based Care for their members. Day Aid Care for instance has trained

40 members with HIV/AIDS on practical and psychological issues in relation to Home Based Care.

These trainees in turn provide immediate care and support to their terminally ill-relatives.

The Nyamira Adventist Community Health and Outreach Programme, based in Nyamira

District trains PLWHAs to develop self-reliance skills to enable them cope depending on their

situation.

MADICAA is taking care of a grandmother who is infected and a girl who deliberately went to

live with a man who was already infected. They are also engaged in the Home Based Care pro-

gramme run by the Nairobi City Council (NCC).

Referral servicesImplementers offering referral services include Tohanchane CBO in Kuria District, Day Aid Care of

Kisumu, KANCO in Nakuru, RICOAN and MOCASO, both of Nairobi.

Most members of Day Aid Care and MOCASO are People Living with HIV/AIDS. Both organi-

zations refer their members to hospitals for treatment for opportunistic infections. KANCO,

RICOAN and Tohanchane on their part refer those who come to them for any assistance to relevant

organizations.

Mitigation of Social and Economic ImpactThe strategic plan defines the objective of the mitigation of social and economic impact as to

reduce the negative social and economic impacts of the HIV/AIDS epidemic.

Consequently, the following activities have been identified in this priority area:

■ Empower NACC to coordinate mobilisation of resources from individuals, communities,

UN agencies, development partners and the private sector;

■ Pass legislation in support of orphans, the infected and the affected;

■ Develop training plans in all sectors, to provide assistance to the infected, and to enable

survivors and the affected to cope with their loss;

■ Develop strategies for resource mobilisation for HIV/AIDS prevention; and

■ Develop and implement a coordinated, multisectoral approach to combat HIV/AIDS and

its impact.

Activities undertaken by implementers under this priority area include:



■ Income generating activities; and

■ Care and support of orphans

Income Generating ActivitiesOrganisations that have engaged in income generating activities include the Day Aid Care of

Kisumu, MOCASO of Nairobi and Olemila in Nandi District. Both Day Aid Care and MOCASO

were formed by People Living With HIV/AIDS. Most of the income generated by the two organisa-

tions is used to support the members.

Day Aid Care is currently engaged in soap and candle making, tailoring and training of other

community based organisa-

tions on soap making. The

income generated is used by

the members for nutritional

support, buying of ARVs and

assisting orphans left behind

by their members, most of

whom are PLWHAs.

The organization has

started a revolving fund

where members borrow

money and return it at a fee.

The organisation is working

with microfinance organiza-

tions like Jamii Bora of

Kisumu to access funds to

facilitate members to start

income generating activities.

Members of MOCASO are

mostly single mothers who

were initially commercial sex

workers in Pumwani area of

Nairobi. Being the sole

breadwinners for their fami-

lies, they lived in low-income

areas of Nairobi and engaged

in petty trades like brewing of

illicit drinks like changaa. A

number of them have died as

a result of HIV/AIDS, living

behind orphans.

To cushion the members,

the organisation has em-

Case Study 3:

The family’s contribution to the fightagainst HIV/AIDSOlmarei Lang self-help group is made up of fifteen closely related members, who have lost their

relatives to HIV/AIDS. The group, which started in 1998, has one major goal; to reduce the

spread of HIV/AIDS in Narok District, Mau Division, by addressing retrogressive cultural practices

that accelerate the spread of the disease.

Simei Ole Sankei, one of the pioneers of the group explains that in the Masaai community, the

family is a very important component, thus the deliberate decision to call their group “Olmarei

Lang,” which simply means family in the Maasai language.

With this approach, Sankei says that they have been able to penetrate core cultures of the

community like Moranism and Female Genital Mutilation, which excerbates the spread of HIV/

AIDS among the Maasai.

In Moranism, for example, young Maasai warriors are encouraged to indulge in casual sex as

a rite of passage. This high-risk kind of behaviour has been condemned severally by many

groups claiming to create awareness on HIV/AIDS in the region. However, due to the wrong

approach, the cultural practice continues every year, raising mortality rates in Narok by significanly

because HIV/AIDS is directly influenced by social behaviour that is part of their local culture.

“Olmarei Lang, focuses on educating the local leaders on the dangers of encouraging sexual

activity during the rites of passage without condemning the culture as a whole,” says Ole Sankei.

The group also recognizes the importance of educating mothers on issues regarding HIV/AIDS

because they believe they are centrally placed to pass on pertinent information that can impact

the community positively.

“Once educated, mothers have great potential to influence the desired behavioural change in

their families,” explains Ole Sankei.

Olmarei Lang has made great progress in creating role models out of respectable families in

the community who have rejected retrogressive aspects of their culture in an effort to reduce the

infection rate of HIV/AIDS in Narok. However, Ole Sankei says that it is a long process that

needs patience.

The Olmarei Lang group has succeeded because they have shifted from project strategies to

people strategies, where partnerships have been formed with the ordinary mwananchi and

ownership of the problem and its solutions created from within at the local level by the community.



barked on income generating activities which include tie and dye, batik, bar and powder soaps

processing and hand weaving.

The most successful has been powder soap processing, resulting in quality soap products which

have been certified by the Kenya Bureau of Standards. The income generated has enabled members

to abstain from commercial sex activities.

Olemila on its part charges a fee to those who visit their VCT centre. They also make beaded red

ribbons for sale.

Care and Support of OrphansOne of the worst consequences of AIDS death is an increase in the number of orphans. There were

an estimated one million orphans as a result of HIV/AIDS deaths in Kenya in 2002.

Organisations that deal with orphans include MOCASO of Nairobi, Day Aid Care of Kisumu,

Olmarei Lang Self Help Group in Narok District, Makinu Youth Against AIDS in Nyando District,

WEMIHS of Thika and Nyamira Adventist Community Health and Outreach Programme in

Nyamira District.

MOCASO whose members have died of AIDS have left behind 400 orphans. Such orphans are

forced to move to the rural areas to stay with their relatives. MOCASO follows them up to ensure

they are coping with life.

Nyamira Adventist Community Health and Outreach Programme is currently supporting 3,100

orphans and empower them on self-reliance through training on how to mobilise and utilise the

available resources. They also contribute to school levies, clothing and medical costs for school

going orphans.

Olemarei Lang works with female members in the organisation to identify the orphans to be

assisted. The group is currently providing books and uniforms to school going orphans.

Makinu Youth Against AIDS is providing 39 orphans with uniforms. The community contrib-

utes food which they distribute to the orphans.

Day Aid Care in partnership with International Fellowship Centre (IFC) of Norway is taking

care of 25 school going orphans whose parents died of AIDS. It has organized mini harambees to

raise money for the orphans upkeep. The organisation provides for all the needs of the orphans

who stay with their relatives.

Lastly WEMIHS provides all the basic needs for orphans and vulnerable children under their

care. They have set up a day care centre for children aged between 3-6 years. Services offered in the

day care centre include informal learning, nutrition and feeding programme, paediatric counseling

and clinical care.

For children between 6-15 years, WEMIHS in partnership with the community offers education

support in terms of uniforms, books, tuition, counseling and a school-feeding programme. Those

between 13-15 years are offered quality life skills training, peer education and better interaction for

behaviour change and vocational training.

The organisation has entered into collaboration with schools, teachers, the government and

church based organisations in assisting the orphans. This has led to the formation of Community

Orphan Care Committees (COCCs) that oversees the orphans programme.



Emerging Issues andChallenges

Participants at the two workshops identified the following emerging issues and the challenges

associated with implementing the HIV/AIDS projects at the community level from the presen-

tations and the plenary discussions. There was consensus on the following issues:

Community ParticipationSome implementers complained of lack of support for their activities on HIV/AIDS by politicians.

After discussions, there was general consensus that political and community support can be

strengthened by ensuring continous involvement of politicians and community leaders in all

aspects of project planning and implemention. There was general agreement that involvement of

community members right from the beginning of the project fosters ownership and ensures

sustainability of the projects.

Proposals and Disbursement of FundsParticipants expressed concern over the delay in approval of proposals, which in turn delays the

commencement of projects. In such cases, by the time funds are disbursed, the situation on the

ground may have changed.

On accountability of the funds, NACC made it clear that disbursements will continue to be

made to ongoing projects only after the project implementers’ account for what they had received.

Participants complained about the complex documentation requirements. They gave an example of

the North Eastern region where a section of the population involved in implementing HIV/AIDS

projects is illiterate, and therefore finds it difficult to meet the documentation requirements.

The FMA officials however clarified that the documentation requirements had been simplified

and promised to make it even simpler, to facilitate the documentation process. Participants were

encouraged to network closely with the NACC structures to hasten the approval proposals and

disbursment of funds.

Participants were informed that NACC regional structures are mandated to forward any infor-

mation on misappropriation of funds by the implementers to the headquarters for action.

Educational Materials, Awareness Creation onPreventive Measures and Community MobilizationSeveral issues emerged during discussions covering information and educational materials, creat-

ing awareness on preventive measures and behaviour change, cultural practices that hinder pre-

ventive efforts and mobilizing different community groups.



One cross-cutting issue emerging from the discussions revolved around lack of guidelines or a

strategy for developing communication approaches to motivate different groups to change their

behaviour.

Other issues are summarized below.

IEC materialsTwo key issues were identified concerning the IEC materials that were available for use in project

areas. The first was the relevance of the message carried by these materials such as Crush AIDS

which participants said was inappropriate and of little relevance. The second issue was the lan-

guage barrier as most materials were in either English or Kiswahili. There was consensus that IEC

materials would have greater impact at the community level if they were translated into local

languages and had messages that were relevant to the intended audience. The messages should

also be personalised to facilitate behaviour change.

NACC undertook to offer technical assistance in the development and production of IEC

materials appropriate for different communities.

Based on experiences shared by participants using educational videos on HIV/AIDS in their

work, there was agreement that these videos serve as a powerful tool to stimulate discussion and

their use should be encouraged. One such video cited is the Yellow Card available free of charge to

project implementers from AMREF.

Resource centersSome implementers such as the New Vision Theatre Group supplements their outreach pro-

grammes with a resource centre, which makes materials on HIV/AIDS accesible to its target

audiences. Resource centres located in centralized locations such as district headquarters were

found to be of limited benefit since they are removed from the community. Further, most of the

materials available are in either English or Kiswahili, languages that grassroots populations are less

proficient in. To address this need, the theatre group plans to shoot educational videos in local

languages.

Materials on HIV/AIDS for schoolsParticipants were informed that NACC and the Ministry of Education, Science and Technology are

developing an HIV/AIDS training manual for teachers. This is to build capacity of the teachers for

the introduction of HIV/AIDS school curriculum.

CondomsParticipants emphasized the importance of promoting condoms as a preventive measure alongside

other control methods in response to concerns that some implementers gave a lot of emphasis to a

single preventive measure such as condoms instead of adopting a wholistic approach in response

to HIV/AIDS.



On the acceptability of condoms by faith based organizations, a secretary from one of the Con-

stituency AIDS Control Committees in Coast Province said that Muslims are not against use of the

condoms as a protective measure against HIV and urged projects implementers to educate people

on its correct use.

Youth Mobilization in the prevention of HIV/AIDSParticipants expressed concern over lack of an umbrella body that brings the youth together to

empower them to address HIV/AIDS, yet they make the largest case load of new HIV infection as

a group.

Participants proposed that a directory on youth programmes or youth networks dealing with

HIV/AIDS be compiled as a step towards forming a National Youth Network. They requested

NACC to provide assistance in identifying youth organizations at the constituency, district and

provincial level and help them mainstream HIV/AIDS issues to their core activities.

A national forum for Kenyan youth took place in July 2003 to jumpstart the process of bringing

the youth together to chart their national agenda that could be supported by NACC for implemen-

tation.

Home Based CareThere were concerns over the technical capacity of individuals and organizations providing Home

Based Care. Projects implementers said that they found it necessary to engage in Home Based Care

to fill the void since those with AIDS require it.

NACC, the meeting recommended should facilitate wide dissemination of the national guide-

lines on Home Based Care to guide the project implementers.

Cultural Practices and TraditionsThe meeting encouraged participants to use African traditions such as those that provide for

counseling of girls by their aunts on sexuality in HIV/AIDS prevention efforts. However there

were other cultural practices such as wife inheritance that perpetuate the spread of HIV that should

be discouraged.

Voluntary Counseling and TestingOne implementer has a programme on Voluntary Counseling and Testing. Results from project

experiences have identified the fear of stigma, rejection and discrimination for those who test

positive for HIV especially in situations where there is no follow up support services or treatment.

Participants considered counseling in VCT a good entry point for tackling stigma.

Other issues:

■ Unqualified service providers offering counseling; and



■ People preferring VCT services located away from where they live due to fear of stigma

and breach of confidentiality.

NACC informed the participants that the Ministry of Health has developed guidelines on VCT and

those engaged in counseling should follow those guidelines.

During discussions, it emerged that clients prefer VCT services that are far from their area of

residence. Mobile VCT clinics were preferred even more because they are considered more confi-

dential. The meeting agreed that implementers should offer VCT services that are acceptable to the

people they serve which may range from integrated services, mobile or stand-alone VCT services.

Cross-cutting IssuesNetworks for PLWHAsExperience from implementers showed that majority of the people who test positive are shy of

publicly declaring their sero-status. One way of overcoming this fear is through facilitating setting

up of networks for people living with HIV/AIDS to create a forum where those who declare their

status publicly can get support.

Capacity of CBOs, FBOs and NGOs to implement activitiesParticipants heard that implementers in some regions lacked the capacity to implement their HIV/

AIDS related programmes due to several reasons, one of them being political interference. The

other reason cited was the lack of capacity to plan and implement programmes. The meeting

agreed that DACC and PACC should spearhead capacity building in such regions.

On KANCO’s role in supporting implementers in capacity building, a representative explained

that their services are provided free of charge to organizations implementing HIV/AIDS activities.

Implementers were encouraged to seek the services of KANCO in building their capacity.

Fate of equipment after lapse of KHADREPParticipants wanted to know the fate of equipment such as generators and television sets bought

with project funds after the lapse of the project. There was consensus that since HIV/AIDS is a

long-term problem, the equipment could be used to generate income to sustain the project after the

Community Initiative Account lapses.

In the event the group disintegrates in the process of implementing the project, the NACC

structures should keep an inventory of the equipment bought at each level and retrieve them for

reissuing to other implementers.

Multiplicity of CBOs/NGOs/FBOsParticipants expressed concern over the mushrooming of organizations claiming to be undertaking

work on HIV/AIDS. NACC structures were asked to vet proposals at every level from such organi-

zations and reject those which in their opinion were not genuine. In addition, the communities



should be in a position to identify and flush out organisations that are not genuine.

Income generating activitiesIn response to a question on whether NACC supports income generating activities (IGAs), partici-

pants were informed that IGAs are considered an important component in mitigating the social

impact of HIV/AIDS. Project implementers can use funds from NACC to start IGAs so long as they

are outlined in their work plans.

Such projects are likely to succeed when the beneficiaries are trained on micro enterprise man-

agement and then linked up with micro enterprise credit organizations that can help them with

initial capital.

Day Aid Care is an example of an implementer supporting IGAs. It is involved in soap making,

tailoring and training to generate income to support its members, most of who are PLWHA’s. The

money generated is shared among the members for nutritional support, buying of ARV’s and

assisting orphans.

The members have also started a revolving fund where money is lent out to members and paid

back with interest. The organization is also working with micro finance institutions like Jamii Bora

to access funds for starting small businesses.

Lack of support by medical personnel in the regionTohanchane CBO told the participants that they lack support from the medical practitioners in the

area since the medical practitioners feel that other people are encroaching into their profession. To

overcome this, a clinical officer has been attached to the group as a resource person to advice the

members on care giving.

VolunteersThe meeting heard of difficulties faced by implementers relying on volunteers. The WEMIHS

representative, whose project is fully run by volunteers, shared how they have overcome this. They

have built shared expectations by outlining what volunteers should expect right at the onset by

signing contracts with the volunteers. However, it was agreed that an implementing organization

should employ adequate staff to handle the technical aspects of the project at a reasonable pay

while volunteers should be given incentives to sustain their morale and meet their basic needs.

Transport for project activitiesMost implementers complained of difficulties in transporting their resource persons and equip-

ment during project activities and wanted to know if NACC could provide them with efficient

means of transport.

NACC explained that implementors should build in transport costs in their proposed budget

from the beginning.



Disinheritance of OrphansParticipants were informed that orphans are losing property to relatives when their parents die of

HIV/AIDS. In some communities, cultural beliefs dictate that homesteads in which parents have

died be demolished or be burnt to ashes thereby depriving orphans of shelter. Participants wanted

advice on the course of action in such cases since the Taskforce on legal issues related to HIV/AIDS

has not made public its findings.

After discussions, it was agreed that Kenyan laws can competently address the problem of

orphans and participants were advised to channel such grievances through the children’s depart-

ment for guidance.

NACC would soon disseminate an Orphans and Vulnerable Children (OVC) National Action

Plan developed following a recent international HIV/AIDS meeting in Namibia on orphans while

the bill on legal issues related to HIV/AIDS was already in parliament awaiting debate.



Emerging Lessons and FutureDirectionBelow are the emerging lessons and areas that require action based on discussions at the two

workshops:

1. A good number of the implementing organisations were recruited as a result of mobilization

through the NACC structures from the year 2002. The NACC structures are therefore the best

placed to recruit the implementers.

2. Participants acknowledged and valued the existing linkages working with NACC viz PACC and

DACC. There are however problems with the linkage between DACC , CACC on one hand

and organizations implementing activities at the local level which needs to be enhanced.

3. Some of the implementers do not involve the community during the planning and implementa-

tion of the HIV/AIDS projects. It is important for implementers to deliberately involve the

community in the projects right from the planning stage all the way to monitoring and evalu-

ation. This will build ownership and sustainability of the projects.

4. Majority of organizations that participated at the workshops are involved in preventive activi-

ties. Most of the activities revolve around creating awareness and increasing knowledge on

HIV/AIDS. Many of the organizations lack the capacity to go beyond creating awareness to

implementing programmes that can motivate individuals to change their behaviour. Their work

is hampered by lack of skills and capacity to implement preventive activities systematically.

There is need to assist the implementers build capacity to design and implement preventive

programmes using methodologies that are likely to bring about behaviour change.

5. Educational materials used lack uniformity on key messages on HIV/AIDS. Majority of them are

in English or Kiswahili, languages that people at community level are not proficient in. Imple-

menters should develop the materials based on key thematic messages suitable for their

audiences and in a language they can understand.

6. Preventive activities undertaken by implementing organizations are not well integrated within

existing structures. A deliberate effort is necessary to help implementing organizations add on

HIV/AIDS behaviour change communication to the work of such structures to make it sus-

tainable. Working with established structures such as churches or schools will make it easy to

monitor the interventions.



7. The procedures for disbursing funds are lengthy and result in delays of commencement of

projects. There is need to simplify the procedures and the documentation as well as to con-

tinuously educate applicants on the process. Implementers at the local level should familiar-

ize themselves with proposal writing and financial procedures set out by NACC.

8. Mechanisms for supervising implementation of activities at the community level are weak due to

poor linkages with CACCs, some of which are dormant. There is need to strengthen the capac-

ity of CACC, DACC and PACC to supervise and monitor the work of implementing organiza-

tions. Implementers on the other hand should proactively learn from organizations that have

succeeded through networking. This can be strengthened through establishment of regular

networking forums at district and provincial levels coordinated by NACC structures.

9. Some implementers who were successful in obtaining funds had difficulties implementing

activities they had set out to undertake due to lack of skills to plan and deliver programmes.

Implementers should liaise with NACC structures at the provincial and district level to

facilitate capacity building. There is also the need to identify lead NGOs, FBOs or CBOs with

capacity to provide a resource based for district level capacity building activities for both

existing and newly emerging CBOs.

10. There are multiple guidelines from different organizations on an area such as home based care

which at times is confusing to the implementers. The national guidelines need to be dissemi-

nated and implemented to make training and delivery of services easy.

11. The youth present the largest case load of new HIV infection as a group but lack a central body

to coordinate preventive efforts. Structures within NACC, community groups and NGOs

should facilitate developing of a network that can serve as a platform for bringing the

various youth organizations together.



Appendix- List of participants

- List of organizations that participated

- Workshop programmes



List of Participants1. Ezekiel Omanwa Mouko,

Chairman, NACHOP

2. James K. Leitich,

Secretary, CACC Eldoret South

3. Annabel Kihuha,

Field Officer, NACC-FMA

4. Dominic T. Ngechu,

Training/Resource Officer,

NACC-FMA

5. Phillip K. Koitelel,

UNV, South Rift

6. Nelson C. Chepkech,

CACC Chairman, Mt. Elgon

7. Zachariah A. Muyokani,

Project Coordinator,

Western HIV/AIDS Network

8. Kefa Gekonde,

DDO/DACC, Narok

9. Fred I. Amudavi,

CACC Secretary, Kakamega

10. Simeon I. Salach,

Chairman

Mt. Elgon Community Resource

Centre

11. Bathsheba Osoro,

PACC, Western Province

12. Bramwel Amondo,

Coordinator,

Kabras Jua Kali Association

13. Rebecca Koech,

Secretary,

Songich SDA Evangelistic

S.H.G.

14. Lawrence Okudo,

PACC, Nyanza Province

15. Joseph Chacha,

Chairman, Tohanchane C.B.O.

16. Eunice E. Odongi,

PACC Member, Kakamega

17. Mathew M. Mudenyu,

Secretary, CACC

Kitutu Masaba

18. Peter John Akhonya,

DDO, Busia

19. Godfery Kutwa,

Secretary,

Olemila CBO

20. Andrew M. Karanja,

KANCO - Nakuru Branch

21. Timothy J. Ogwang,

DACC, Mt. Elgon

22. Boniface O. Otwani,

CACC Secretary, Nambale

23. Ngota Ephraem,

Coordinator,

New Vision Theatre Group

24. Brigit A. Omondi,

CACC Secretary,

Kwanza

25. Paul Ole Ntaiyin,

Chairman,

Transmara Herbal Association

26. Agnes Nkuyayu,

CACC Secretary,

Narok North

27. Wilfred A. Omari,

DDO, Nandi

28. Oluoch C. Obiero,

CACC Secretary,

Kisumu Town West

29. Tissia John,

Secretary, Lasers

30. M. Maroa Abednego,

Chairman,

Kuria District - Disability

Network

31. Simel Ole Sankei,

Secretary,

Olmarei Lang S.H.G.

32. Joseph L. Ololngojine,

CACC Secretary,

Kilgoris

33. Martin Wekesa,

DDO,

Iten

34. Ruth Sialala,

CACC Secretary,

Eldama Ravine

35. Anne Suter,

Chairperson,

MYWO-Keiyo District

36. Aloyce M. Ratemo,

DDO/DACCO,

Nyamira

37. Joel K.K. Meto,

DDO/DACCO, Koibatek

38. Peter A. Nyakwara

NCPD, Kakamega



39. William C. Kendagor,

CACC Secretary,

Marakwet West

40. Mary Elsie Amolo,

Coordinator, Day Aid Care

S.H.G.

41. Maureen A. Omollo,

Secretary, Makinu Youth

Against AIDS

42. Joshua L. Silingi,

DACC, Marakwet

43. Boniface M. Kariuki,

DACC, Kilgoris

44. George O. Ayoma,

DDO, Kuria

45. Grace Chebii,

MYWO, Keiyo Branch

46. Simon Korir,

DDO, Kisumu

47. Margaret Janet Kariuki,

CACC Treasurer, LARI

48. Rukiya Lali,

Chairperson, Tunu Women

Group

49. Mahmoud Ahmed Abdulalkadir

CACC Chairman, Lamu West

50. Joseph J. Olita,

Programme Director,

Gallamoro Network Nairobi

51. Hassan Mohamud M.,

Field Coordinator, Handicap

International,

Garissa

52. Micah K. Kisoo,

Programme Officer,


53. John Ochako,

DACC Member, Garissa

54. Amos Ndenge,

CACC Secretary,

Bahari CACC-Kilifi

55. Abdikadir Dokata Guyo,

Project Officer, FONI, Isiolo

56. Nicholas Wambua Kitua,

DDO/DACC, Lamu

57. Michael Kyalo,

DACC/DDO, Kitui

58. James Mwanzia,

PACC, Eastern Province

59. Japhet Shadrack,

Secretary, Jua-Arts Kilifi

60. Dr. Esther Getambu,

PACC, Mombasa

61. Agisu Adangah,

Programme Officer,

NACC, Nairobi

62. Abdullah Hersi,

Project Officer,

Nomadic Heritage Aid, Garissa

63. Job Akuno,

Youth Programme & Special

Events Coordinator,

National Organization of Peer

Educators (NOPE),

Mombasa

64. Mohamed A. Hirey,

Volunteer, HAMADOWR, Garissa

65. Philip Osoro,

CACC Secretary, Nairobi

66. Hassan Osman Shurie

PACC Member, North Eastern

Province

67. Abdi Dagane,

Vice Chairman, IYAP Youth

Group,

Isiolo

68. Abdullahi Adon Diis,

CACC Secretary, Dujis, Garissa

69. Agnes Muthanje,

CACC Secretary,

Maragua, Makuyu

70. Dr. Mtana Lewa,

Chairman,

Coast HIV/AIDS Consortium,

Kilifi

71. Joyce Kamondo,

Coordinator,

Mother/Child with AIDS Support

Organisation,

Nairobi

72. Diriye Ibrahim Maalim,

Coordinator,

Pastrol Capacity Building and

Development Organisation,

Garissa

73. Anthony Maina

Program Manager,

Womankind Kenya,

Garissa

74. Sirat Kithye Abdi

Chairman, Ramagab Wildlife

Conservation Group,

Ijara District



75. Suleiman Mohamed Laag,

CACC Secretary Fafi, Garissa

76. Mustafa K. Wachu

CACC Secretary,

Isiolo North

77. Chege W. Jenipher

Programme Manager,

RICOAN, Nairobi

78. Mureithi Oscar Kingori,

Chairman, The Ihururu Initiative,

Nyeri

79. Rev. Wamathai Bildad,

Church Minister,

Presbyterian Church, Nyeri

80. William K. Mahinda

PACC, Central Province

81. Mutie Lawrence

CACC Secretary Kasarani,

Nairobi

82. Gertrude Openda

Chairperson, MADICAA,

Nairobi

83. Rev. Amos Mumu Mbithi

Pastor Coordinator,

Thome Baptist Dev Group,

Nairobi

84. Kasaya Edward Kisaka,

PACC, Nairobi

85. Lawrence Nyamwaya

DDO/DACCO, Isiolo

86. Mailu Gideon Makundi

PACC member,

Nyeri

87. Mutava Johnrick

Chairman, Beccoh Centre,

Mombasa

88. John Kimanthi Mainga

Team Leader, PAIDO,

Kitui

89. Esther Musili

Director, UCCS/ACK,

Machakos

90. Benson Kimani

DDO/DACCO,

Maua

91. Mboroki Jackson Kiogora

CACC Secretary, Igembe,

Maua

92. Mutinda Kithuku

Member, DACC,

Garissa

93. Shakuntala Haraksinsh Thilsted

Consultant, The World Bank,

Nairobi

94. Loise Muriuki

Support Programme Officer,

WEMIHS,

Thika.

95. Beatrice Manyonge

DACC, Kiambu

96. Michael Oyalo

DACC, Nairobi

97. Patrick M. Wambua

UNV/NACC,

Nairobi

98. Wairimu Mungai

Program Director,

WEMIHS, Thika

99. Michael Musili

Project Volunteer,

Beccoh Centre,

Mombasa

100. Daniel M. Kairu

Aids Control Coordinator

Maragwa DACC, Makuyu

101. Nyambura Githagui

World Bank, Nairobi

102. Wacuka Ikua

Operations Officer, World Bank

103. Yusuf Mbuno,

DACC,

Kilifi

104. Mohamud M. Asan

Field Coordinator

Handicap International,

Garissa

105. Dr. Bert Voetberg

World Bank, Nairobi

106. Diriye I. Maalim

Coordinator

Pastrol Capacity Building &

Department Organisation

107. Abdikadir Dokata,

Project Officer

Friends of Nomads

International (FONI)

Isiolo

108. Dr. Magaret Makumi

Field Co-ordinator/Facilitator

National Aids Control Council,

Nairobi

109. Esther Gatua

Facilitator,

KANCO, Nairobi



Regional Experience Sharing Meeting forNGOs/CBOs/FBOs from Selected Districts27th - 28th May 2003, Silver Springs Hotel - Nairobi

Programme

DATE

26th May 2003

27th May 2003

28th May 2003

TIME

5.00pm - 6.00pm

8.30am - 9.00am

9.00am - 10.00am

10.00am - 10.30am

10.30am - 11.00am

11.00am - 12.00pm

1.00pm - 2.00pm

2.00pm - 4.30pm

4.30pm - 5.00pm

8.30am - 9.00am

9.00am - 10.30am

10.30am - 11.00am

11.00am - 12.00pm

12.00pm - 1.00pm

1.00pm - 2.00pm

2.00pm

ACTIVITY

Arrival

Registration

■ Climate Setting

- Introduction

- Participants Expectations

- Workshops Objectives

- Administrative Issues

Official Opening

Tea Break

■ KHADREP, Overview of Community

Initiative Account

■ Roles and Responsibilities of Civil

Societies, FBOs, Private Sector and

Development Partners

■ Accountability

Lunch Break

Experience Sharing in Plenary

■ Central Province

■ Eastern Province

■ Coast Province

Tea Break

Re-cap previous day


■ North Eastern Province

Tea Break

Nairobi Province

Discussion of Emerging Issues and Way

Forward

Lunch Break

Departure

FACILITATOR

NACC

KANCO

Dr. Margaret Makumi

Director NACC

Dr. Margaret Makumi

KANCO

FMA

PACC

Nairobi

Participant

PACC

Eastern/KANCO

PACC

CENTRAL

Deputy Director (T)/

Deputy Director (F&A)

Workshop Programme



Regional Experience Sharing Meeting forNGOs/CBOs/FBOs from Selected Districts23rd - 24th May 2003, Wagon Hotel - Eldoret

Programme

DATE

22nd June 2003

23rd June 2003

24th June 2003

TIME

5.00pm - 6.00pm

8.30am - 9.00am

9.00am - 10.00am

10.00am - 10.30am

10.30am - 11.00am

11.00am - 12.00pm

1.00pm - 2.00pm

2.00pm - 4.30pm

4.30pm - 5.00pm

8.30am - 9.00am

9.00am - 10.30am

10.30am - 11.00am

11.00am - 12.00pm

12.00pm - 1.00pm

1.00pm - 2.00pm

2.00pm

ACTIVITY

Arrival

Registration

■ Climate Setting

- Introduction

- Participants Expectations

- Workshops Objectives

- Administrative Issues

Official Opening

Tea Break

■ KHADREP, Overview of Community

Initiative Account

■ Roles and Responsibilities of Civil

Societies, FBOs, Private Sector and

Development Partners

■ Accountability

Lunch Break


■ Western Province

■ North Rift Province

Tea Break

Re-cap previous day


■ South Rift Province

Tea Break

Nyanza Province

Discussion of Emerging Issues and Way

Forward

Lunch Break

Departure

FACILITATOR

NACC

Dr. Margaret Makumi

Dr. Margaret Makumi

Dr. Margaret Makumi

Dr. Margaret Makumi

Micah Kisoo

FMA

PACC

Nyanza

Participant

PACC

Western

PACC

S/Rift

Dr. Margaret Makumi



Notes



Dear Reader,

BUILDING ON OUR EXPERIENCES: Lessons learnt and Future Direction of the Community Programme.

The National AIDS Control Council would like to know if this publication is of interest to you, and whetheryou will use its information in your work. Please take a moment to complete this questionnaire by tickingthat which applies to each question. It will guide future publication decisions. Thank you!

Is this publication relevant to your work?

Very relevant

Somewhat relevant

Not relevant but of personal interest

Neither relevant nor of personal interest

How would you use this publication in your work?

Programme planning

Reference purposes

Share with colleagues

Library

Other

Is the way the information is presented in this publication useful to you?

Yes

No - I would prefer to see this information .......................................................................................................................................................

Who else would you recommend this publication to and why?

..................................................................................................................................................................................................................................................................................................

Other comments

..................................................................................................................................................................................................................................................................................................

Please mail the completed questionnaire directly to:

The Field CoordinatorThe National AIDS Control CouncilP.O. Box 61307Nairobi

Or your respective PACC or DACC.

National AIDS Control Council - World Bank Group

Documents

Transcript of National AIDS Control Council - World Bank Group