Problem Statement.

In Kilifi County, 90% of the HIV care services are supported through donor funding. This includes support for human resource for health that comprises of clinicians, nurses, pharmaceutical technologists, laboratory technologists and adherence counsellors. Due to the dwindling donor funding, the County has experienced reduction in workforce that supports HIV care services. HIV care services in the County have for a long time been a preserve of the donor supported staff while the County supported staff left to offer the other preventive, curative and promotive services. This has made the donor supported staff to have a wealth of knowledge on HIV care services as opposed to the County supported. In situations that donor staffs are away e.g. on leave, sick, staff reduction due to budget cuts or the recent stop work order(SWO), HIV care and treatment services have suffered leading to patient suffering and even reduction on the gains that had already been made.

Rationale of Addressing the Issue.

This was to ensure that there was continuity of quality HIV care services provision beyond donor funding. This would make sure that the County government takes leadership in all aspects of HIV services provision across all pillars of health systems strengthening (HSS)

Response.

Sensitization of the County leadership(CECM – Health) by the USP COP on budget cuts by the donor(USAID) in USAID Stawisha Pwani year 4 which necessitated staff lay offs. USP technical team was mandated to work with County HIV program officers to come up with HIV services integration road map for the County. The road map was developed, and a County HIV services integration steering committee was formed. The steering committee had meetings and terms of reference developed for the members. A facility assessment tool was also developed to assist in baseline assessment and also subsequent assessments. Priority facilities for integration were then selected in all sub-counties, and SCASCOs sensitized. Capacity building was done to HCWs at KCH through a 5 day sensitization.

Results

Through these efforts, the Kilifi County hospital, Jibana SCH, Malindi SCH, Bamba SCH, Muyeye HC, Marereni dispensary and Mijomboni dispensary, has started service integration and are at different level. The County is taking lead in all integration matters including organizing and chairing the integration committee meetings. The County has now planned to take over some of the support given by donors e.g. sample networking.

Kilifi County HIV Services Integration Road Map.

HIV services Integration Committee meeting

Invitation Letter to a HIV services integration meeting by the County director for health.