As donor funding for HIV programs continues to decline, counties like Kilifi are facing the urgent need to take greater ownership of HIV service delivery. Recognizing this challenge, Ciheb-Kenya, through the USAID Stawisha Pwani program, has played a central role in supporting Kilifi County to transition toward a more sustainable, integrated approach to HIV care.

For years, up to 90% of Kilifi’s HIV services - including clinicians, laboratory personnel, pharmaceutical technologists, and adherence counselors - have been supported by donors. County-employed staff, on the other hand, primarily handled general health services. This separation created a knowledge and skills gap that became evident whenever donor-funded staff were unavailable due to leave, illness, or recent staffing cuts.

In response, Ciheb-Kenya provided technical leadership and strategic guidance, beginning with sensitization of Kilifi County leadership on the implications of reduced donor funding. Following high-level engagements led by the Chief of Party for USAID Stawisha Pwani, the County Executive Committee Member (CECM) for Health committed to supporting a structured integration process.

Together with the County Health Management Team, Ciheb-Kenya facilitated the development of a County HIV Services Integration Roadmap and supported the formation of a County HIV Integration Steering Committee. This committee developed clear terms of reference, carried out baseline facility assessments, and prioritized integration in key sub-county facilities.

Capacity building followed—with Ciheb-Kenya conducting a five-day training for healthcare workers at Kilifi County Hospital to equip them with skills to deliver integrated HIV services. SCASCOs were also engaged to support and oversee rollout at the facility level.

Thanks to these coordinated efforts, facilities including Kilifi County Hospital, Jibana SCH, Malindi SCH, Bamba SCH, Muyeye HC, Marereni Dispensary, and Mijomboni Dispensary have all begun integrating HIV services into their broader care models—each at different levels of maturity.

Crucially, Kilifi County is now taking the lead—chairing integration meetings, coordinating partners, and even planning to absorb responsibilities previously funded by donors, such as sample networking.

This success underscores Ciheb-Kenya’s pivotal role in strengthening health systems and empowering counties to lead. By bridging technical gaps and working alongside government structures, Ciheb-Kenya is helping ensure that HIV care remains accessible, uninterrupted, and sustainable—long after external funding phases out.