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STRATEGIES TO WIN THE WAR
AGAINST H.I.V./ A.I.D.S.

THROUGH A MULTISECTORAL APPROACH

Kenya Government has issued the following statement on HIV/ AIDS:

COASTWEEK - - KENYA IS FACING a worsening AIDS epidemic with over 2.2 million people infected with HIV representing about sixteen per cent of the adult population.

The government has showed increasing commitment to stop the spread of HIV/ AIDS and mitigate its impact. 

The commitment is demonstrated by the establishment of National AIDS Control Council to provide the beginning of a stronger coordination mechanism to tap the full potential of all sectors to deal with the numerous challenges of the epidemic.

Among the sectors identified are line Ministries, the private sector and civil society.

Information available shows that there are several factors known to be hampering the fight against HIV/AIDS in Kenya. 

Combined and integrated efforts are therefore required to address these factors namely:-

• General moral laxity amongst the people inadequate parental advice
• The tendency of people not to want to reveal their sero status for fear of rejection or losing their jobs
• Poverty
• Enforced idleness amongst the unemployed youth who lack appropriate recreational facility
• Culture of denial of existence of HIV/ AIDS
• Ignorance about the causes of AIDS amongst the general population with some attributing. HIV/ AIDS to witchcraft or curse arising from a break of some criminal taboos and many others.

National AIDS Control Council as a body mandated by the government to coordinate HIV/ AIDS activities in the country and to mobilize resources from within and without has developed priority strategies and interventions identified in the National Strategic Plan 2000-2005 and the Parliament’s 1997 Sessional Paper No. Four.

The Strategic Plan recommends modalities of assisting both private and public sectors in implementing community level interventions that prevent transmission of HIV infection and mitigate the socio-economic impact of the epidemic.

Additionally this plan proposes strengthening institutional capacity to respond to the epidemicarid advocating for greater involvement and commitment of political, religious and other opinion leaders in HIV/AIDS programmes.

THREATS OPPORTUNISTIC AND INTERVENTIONS
AS CONTAINED IN THE STRATEGIC PLAN

Threats to the education Sector:

The HIV/AIDS epidemic in Kenya threatens to undermine achievements in literacy, increase the number of poorly educated children, and increase the number of working children.

Educational attainment is adversely affected because:-

• The supply of experienced teachers is reduced by HIV/AIDS related illness and death
• Children are kept out of school to care for the sick and help support the family
• Children are kept out of school when families cannot afford school fees due to HIV/AIDS illness or death.

Teenage children are especially susceptible to infection, and girls in this age group are more likely to be infected than boys

OPPORTUNITIES

A large percentage of Kenyan children attend and are accessible through school. The infrastructure and human resources in Kenya’s educational system is being used to promote preventive behaviour and create environments that enable and support this behaviour.

PRIORITY INTERVENTIONS

Key actors include the Ministry of Education, non-governmental organisations, religious organizations and other Government of Kenya Ministries.

The recommended interventions and policies focus on prevention and advocacy:

Enhance community care for AIDS patients so that children do not have to stay home from school to care for them

• Increase school bursaries for children who would otherwise drop out due t an AIDS illness or death in the family
• Provide counseling, sensitization and training of working and student teachers
• Develop and teach curricula that include education on family life, reproductive health and prevention of HIV/AIDS
• Use teachers as role models to sensitize students and communities to,’ dangers of infection, and to encourage preventive behaviour

Encourage preventive behaviour through better parenting, counseling by religious leaders and community centered youth activities such as Boys Scouts and Girls Guides

• Increase education and awareness of girls to prevent cases of mother to child transmission
• Improve succession management
• Attract more resources for education through the Medium Term Expenditure Framework (MTEF) budgetary process and development partners.

Threats to the Agriculture Sector:

Agriculture engages eighty per cent of the labour force and accounts for twenty five per cent of gross domestic product (GDP).

Therefore, threats to this sector threaten the country’s food security.

This occurs when:

• Productivity drops and costs rise due to illness and death in the labour force
• Fertile land may remain idle due to labour shortages
• Families may be forced to sell off farm assets in order to survive
• Agricultural workers may die before they can pass on their skills andexperience to their children or other trainees.

OPPORTUNITIES

The economic participation of most Kenyans in this sector makes it a priority area for targeting education; information and resources promote behaviour change.

PRIORITY INTERVENTIONS

ln the agriculture sector Key actors include the Ministry of Agriculture and Rural Development NGOs and CBOs.

Priority interventions are;

• Community mobilization and sensitization
• HIV/ AIDS education for farming communities
• Capacity building and training of extension workers and local constituents AIDS committees.

Threats to the Health Sector

The HIV/ AIDS epidemic increases the number and percentage of people seeking health services, and increases the costs of health care.

Whether money is spent on treatment or prevention, the effect is to reduce the amount of money available for prevention and treatment of other illnesses.

It also reduces the money available for providing other public services.

Both the number of people who can be helped and the quality of that help may decline.

OPPORTUNITIES

This sector is central to a successful response to the H1V/AIDS epidemics.

Expanding early diagnosis and including counseling on behaviour change may reduce the spread of the disease.

Help with treatment and care reduces the burden on already poor families.

Research, monitoring and evaluation of interventions for prevention and cure in Kenya contribute to worldwide efforts to stem or stop HIV/ AIDS.

Threats to Kenyan Society:

The HIV/AIDS epidemic strains the social fabric, overwhelms traditional support and care systems, and traumatizes families.

Increased needs for social services include:

• One million AIDS orphans, including some who have AIDS themselves
• Children affected by AIDS who are swelling the population of "street children"
• Growing numbers of elderly people who have lost the adult children who supported them
• Voluntary counselling and testing (VCT)
• Counselling for bereaved relatives and friends
• Information, education and advocacy to mitigate discrimination and bias against the infected from families, friends, employers and others

OPPORTUNITIES

Social services can support and strengthen traditional family and community support systems.

Lessons learned from testing and counselling sites, situated mainly in urban areas, can be extended to other parts of Kenya.

Women, who bear the brunt of discrimination and gender bias, as well as caring for the sick and dying, are a priority for social services interventions.

PRIORITY INTERVENTIONS

Key players include the Office of the Vice President, the ministry of Home Affairs, Heritage and Sports, NGOs, CBOs, and religious organizations.

Priority interventions are:

• Training community workers to provide social support to the infected and affected
• Establishing voluntary counselling and testing centers and patient support services in all districts
• Easing adoption laws to meet parenting needs of AIDS orphans
• Sensitization to discourage harmful cultural practices

Threats to the Industrial Sector

The HIV/ AIDS epidemic lowers the productivity of labour in the industrial sector and increases labour costs.

Resultant price increases, combined with declining household incomes, may result in lower demand for industrial goods.

OPPORTUNITIES

There are about 4,000 firms in Kenya, cutting across manufacturing, trade, transport and tourism.

Stakeholders such as the Kenya Association of Manufacturers, the Kenya Chamber of Commerce and Industry, the Federation of Kenya Employers, the Kenya Association of Tour Operators and the GOK could collaborate on a representative study of the economic impact of HIV/AIDS on this sector.

PRIORITY INTERVENTIONS

Key players include private firms, umbrella groups, trade unions, religious organizations, NGOs and CBOs.

Threats in the National Security Sector

This sector includes both the military and police forces, which are among the most susceptible populations to HI V/AIDS. Ministries of Defence in Sub-saharan Africa report prevalence levels of twenty to forty per cent within their armed forces.

This population is youthful, sexually active, susceptible to peer pressure and likely to take risks.

Furthermore they are often away from home and surrounded by opportunities for casual sex.

Attrition from HIV infection and AIDS deaths causes:

• Lack of continuity in ranks and leadership
• Increased recruitment and training costs
• Reduced military and emergency preparedness
• Threats to internal stability and external security

OPPORTUNITIES

This sector is highly structured and characterized by clear chains of command.

These attributes could be exploited to maximize the speed and effectiveness of interventions.

PRIORITY INTERVENTIONS

Key players include the Offices of the President and Vice President, the Ministry of Home Affairs, Heritage and Sports, the Ministry of Health, NGOs and CBOs, and the private sector.

Priority interventions are:

• Continue awareness creation and promotion by training peer educators and counsellors
• Develop and disseminate condom messages in military and police establishments
• Promote and socially market condoms Promote safe condom disposal
• Offer voluntary HI V/AIDS counselling and testing (VCT) during recruitment Treat and control sexually transmitted diseases through syndromic management.

MANAGEMENT AND CO-ORDINATION

NATIONAL AIDS CONTROL COUNCIL 

Successful implementation of the Strategic Plan depends on comprehensive, effective management and coordination.

To meet this need, Presidential Order in Legal Notice No.170 of 26/11/99 established the NACC in 1997.

NACC has the following responsibilities relate to the control and prevention of HIV/AIDS.

• Coordination and supervise HIV/AIDS Activities.
• Mobilise resources
• Develop policy, strategy and guidelines.
• Develop sector specific programmes
• Develop national management information systems
• Collaborate with local and international agencies
• Develop mechanisms and guidance for implementing agencies on selection of activities and monitoring and evaluation of activities.
• Play a leadership role in advocacy and public relations.

AIDS CONTROL UNITS 

The ACUs in each Ministry will coordinate implementation of the Strategic Plan in every sector.

Their leadership and advocacy role will extend beyond Government to all authorities, bodies and organizations.

Their responsibilities include:

• Ensure that HIV prevention is considered in all projects and services
• Adapt infrastructure and human resource planning.
• Introduce new or scale up old modes of service delivery.
• Advocate for legislation to protect the infected and affected from discrimination.
• Recommend ways to enhance NACC policies.
• Coordinate inter-sector commitments in respective sectors
• Ensure implementation of HIV/AIDS policies, create awareness and undertake advocacy in respective sectors.
• Compile databases and conduct statistical analyses.
• Develop and implement operational objectives and action plans.
• Promote cultural and behavioural change
• Develop Ministry specific guidelines for the use of resources allocated to HIV/ AIDS.
• Liaise with ACUs in other Ministries.

Provincial HIV/ AIDS Control Committees 

The PACCs are the coordinating bodies of the Strategic Plan at the Provincial level.

The Committee membership will include people from the GOK’s departments, civil society and the private sector. Persons living with or affected by AIDS will be included as members.

District HIV/ AIDS Control Committees  

The DACCs will coordinate implementation at the District and community level.

Their membership will be drawn from the same broad spectrum as the PACCs. Their functions will be:-

• Communicate and interpret policies to district level institutions
• Monitor the implementation of policies
• Collate information on activities in different sectors,
• Calculate cost of District level interventions
• Prioritise potential interventions according to resource constraints
• Communicate a proposed set of multi-sector Prioritised and costed activities to ACUs and the NACC

Constituency AIDS Control Committees

The CACCs will facilitate implementation of resolutions passed at the 1999 HIV/AIDS symposium for Members of Parliament; develop people-centered activities and Responses and coordinate all HIV/AIDS activities in constituencies.

Specifically they will:

• Mobilise communities to play an active role.
• Operate as agents of change
• Ensure that committees of elders discuss local cultural influence on the spread of HIV/AIDS.
• Promote positive health seeking behaviour.
• Facilitate participation of youth in activities aimed at behavior change.
• Develop sustainable community owned care and care and support systems for the affected and infected, including widows, widowers and orphans.
• Mobilise and ensure proper utilization of local level resources.
• Promote and strengthen income generating activities among vulnerable groups.
• Network, collaborate and coordinate with other AIDS service organizations.
• Establish and implement monitoring and evaluation systems and submit quarterly and annual reports to NACC.

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