Strengthening PMTCT Services in Kwale County – A Journey of Integration, Innovation, and Impact

Through the USAID-funded Stawisha Pwani project implemented by Ciheb-Kenya, Kwale County is making remarkable progress in eliminating mother-to-child transmission of HIV (PMTCT). Working closely with the County Department of Health, Ciheb-Kenya has supported the integration of PMTCT services into six health facilities now fully run by Ministry of Health nurses. These include Msambweni County Referral Hospital, Kwale Subcounty Hospital, Tiwi Rural Model Health Centre, Lunga Lunga Subcounty Hospital, Kinango Subcounty Hospital, and Samburu Subcounty Hospital.

The project’s impact is visible not only in systems strengthening but also in the lives it has touched. In FY22–23, the county celebrated a significant milestone—431 HIV-exposed infants (HEIs) tested negative. This was marked during an HEI graduation ceremony, graced by the Deputy Governor of Kwale County. It served as a powerful moment of recognition for mothers and health care workers committed to eliminating vertical transmission.

Capacity building remains central to this journey. In FY23–24, 35 healthcare workers were trained on pap smear collection, while seven clinicians—including doctors and gynecologists—were trained in the LEEP procedure for treating advanced cervical lesions. The county also received a LEEP machine from the National Cancer Control Program, reducing the need for patient referrals to Mombasa and allowing women to access care closer to home.

Recognizing the power of community engagement, the project trained 125 Community Health Assistants (CHAs) and Public Health Officers on community PMTCT. These officers then sensitized over 600 Community Health Promoters (CHPs), contributing to an impressive 21,468 first antenatal care visits—a critical entry point for HIV prevention.

In remote areas without lab services, Ciheb-Kenya supported the rollout of a roving HTS/Lab model. This innovation has bridged access gaps, ensuring pregnant and breastfeeding women are tested and linked to care on time.

Mentorship and supportive supervision have been key in ensuring quality. In FY23–24, nearly 300 health workers across 86 facilities received mentorship. In addition, nurse mentors from all five sub-counties were trained to lead peer-to-peer learning at the facility level.

To address the challenge of delayed early infant diagnosis, Ciheb-Kenya provided technical guidance to the County Health Management Team (CHMT). This led to the successful integration of HEI screening with PENTA 1 immunization, better use of the MOH 510 register, and a shift in responsibility to lab staff for post-ANC1 testing when HTS providers are unavailable.

With a focus on sustainability, equity, and localized solutions, Ciheb-Kenya continues to walk alongside Kwale County in its bold journey to end mother-to-child transmission of HIV - clinic by clinic, community by community, and milestone by milestone.