Transcript Stepping up the pace in key population prevention programming in

A-641-0404-04643
Stepping up the pace in Key Population prevention
programming in Kenya by establishing a Technical
Support unit within Ministry of Health Government
of Kenya: Experience from Kenya
John Anthony1, Dr. George Githuka2, Bernard Ogwang3, Shem Kaosa4, Dr Seringo5, Parinita
Bhattacharjee
1: Head Technical Support Unit: University of Manitoba
2: Program Manager: National STD AIDS Control Program, Ministry of health, Kenya
3: Technical Officer KP outreach: Technical Support Unit: University of Manitoba
4: Field Officer Monitoring and Evaluation: Technical Support Unit: University of Manitoba
5: Head: National STD AIDS Control Program, Ministry of health, Kenya
6: Senior Technical Advisor: University of Manitoba
Kenya KP size estimates :Consensus report 2013
• Female sex workers : 133,675 (this covers all the 7
regions in Kenya)
• Men who have sex with men : 21,759 (this covers all
the 7 regions in Kenya)
• Injecting drug users : 18,327 (this covers all the 7
regions in Kenya)
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HIV prevalence among KPs*
Population
HIV Prevalence
MSMs (Men Having Sex With Men)
18.2%
FSWs (Female Sex Workers)
29.3%
IDUs (Injecting Drug Users)
18.7%
*Ministry of Health – NASCOP Consensus Report 2013
National Technical Support UnitKenya: Problem Statement
– Adequate Funding: Inadequate monitoring
Poor
Program Quality
– Interventions generally not led by Program Evidence:
Little to no intervention reporting
– Inadequate staffing:
Existing Government staff
at times prioritize program administration rather than
hands on Tech Support to partners (due to time, skills
constraints)
– Duplications/ Overlaps
– Little to none program standards/ guidelines
Program management: Strategic in-sourcing for quality
assurance
Inputs into guideline
development
Issuing
guidelines, policy
and planning
Funds release,
administration,
implementation
Developing
appropriate
monitoring tools
Managing insourced units
Supportive
supervision and
‘feel on the street’
quality assurance
Usually, the Government tries to do it all!
GoK recognized that it would benefit from taking advantage of
technical capacity available with institutions with appropriate
skills, flexibility & capacity.
Inputs into policy/
guideline development
Issuing guidelines,
policy and
planning
Funds release,
administration,
implementation
Government Programme delivered
Developing
appropriate
monitoring tools
Managing insourced units
In-sourced support
Supportive
supervision and
‘feel on the street’
quality assurance
Role of government
division
Role of TSU
Issuing guidelines/policies
Technical inputs into guideline and
module development
Administration
Developing appropriate tools and
MIS to monitor program
Reviews and ensuring support
structures deliver against mandate
Feet on the street supportive
supervision
Funds flows
Oversight of implementing
partners (NGOs/CBOs)
Handling public inquiries
Strategic planning and ‘problem
solving’ of emerging issues
Quality assurance
Implementation
The role of quality assurance and supportive
supervision units/mechanisms (TSU)
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Technical Support Unit: Kenya
• The unit was established by GoK - MoH in 2012
• Team of 11 hired (technically sound on Key population issues)
• 5 officers were placed regionally to provide hand on support
to the implementing partners
• Since no partner reporting mechanisms were in place, the
same was initiated in early 2013
• Mentoring and supportive supervision was
initiated
for implementing partners
• Field visits were done for 361 days in 29
counties in 80 partner locations coupled
with 56 on site trainings (Jan 2014)
Key Results
•
•
•
•
•
•
Map key populations implementing
partners
Develop a reporting mechanism
keeping the county and federal
sensitivities in place
5 regional trainings done (all 82 IPs)
were trained.
Reporting improved from near 0 to
95 % consistently.
Data analysis done and shared with
Government and IPs on program
performance
To improve data quality, field level
tools were developed to capture
outreach, program and clinic data
applicable to all programs.
Key Results: Services Uptake
• General improvements in
service uptake
• More Key populations are
being met by their peer
educators: MSMs: around 30
% every quarter. Similar
increases in service uptake to
around 20 % every quarter
• PWIDs: NSP has increased
from 0.3 to 11 needles &
syringes per person per month
with general increases in
number of PWIDs being met
every quarter
• This is just a beginning!!!
Key lessons and conclusion
• Key Lessons
– Supportive Government leadership and ownership
– Defined roles and responsibilities (Govt: Administration,
Procurements, Finance TSU: Technical support functions –
Feet on the ground)
– Co-located TSU within the Government Offices
• Conclusion
–
–
–
–
Adds extra hands to a department/ ministry
Improves speed and reduces turnaround times
Improves program efficiency and effectiveness
Provides in house technical and managerial talent
Team
Acknowledgements
• Key populations: FSWs, MSM/ MSW, PWIDs
• Ministry of Health: Government of Kenya
• National AIDS and STI Control Program: Government of
Kenya
• National AIDS Control Council: Government of Kenya
• Bill and Melinda Gates Foundation
• PEPFAR: CDC and USAID
• GFATM
• Dutch Government
• UN Joint Team
• All Key Populations implementing partners in Kenya
• Technical Support Unit - University of Manitoba
Thank you
[email protected]
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