The largest integrated health project in East Africa is addressing a spectrum of health needs, from HIV to safe childbirth. In the process, we're transforming health care and empowering communities. Photo: PATH/Eric Becker.
Expanding services to reduce HIV, improve health, and strengthen communities
When Gorretty Akinyi was pregnant with her third child, she got a visit from Pamela Akinyi (no relation), who works as a community health volunteer in their tiny town in rural southwestern Kenya. Gorretty, 23, had little contact with the health system. But at Pamela’s insistence, she went to the local health facility for a prenatal check-up.
That visit changed Gorretty’s life. At the clinic, she tested positive for HIV. With Pamela’s support, she told her husband, and he, too, learned he had HIV and got treatment. Gorretty returned to the clinic for four prenatal visits, just as Pamela recommended. And when she gave birth, the services there helped ensure that she did not pass the virus on to her baby.
“Had it not been for Pamela’s assistance, there is no way I would have had an HIV-free child,” Gorretty said.
On the road to health in Western Kenya
Pamela is one of more than 5,700 volunteers in Western Kenya who have been trained to support their communities on the road to health. The volunteers are just one part of a wide-reaching project called AIDS, Population, and Health Integrated Assistance Zone 1—or APHIAplus Western for short. Led by PATH and funded by the United States Agency for International Development, the initiative works with nearly 800 health facilities in 10 counties that hold more than 10 million people.
Densely populated Western Kenya bears a heavy burden of infectious disease like HIV/AIDS, malaria, and tuberculosis. APHIAplus Western’s community-based programs are increasing the use of services to treat and prevent these diseases, as well as to improve maternal health, family planning, and support for orphans and other vulnerable children. In some areas, use of health services has risen by as much as 40 percent.
By supporting a broad range of services involving all parts of the local health system, APHIAplus Western is helping some of Kenya’s most vulnerable people address a spectrum of needs while strengthening the entire system. The integrated health project is the largest of its kind in East Africa.
One-stop shop for care
The program to prevent mother-to-child transmission of HIV is available at 270 health centers and covers 91 percent of pregnant women in the area. Over the course of four and a half years, 559,000 pregnant women like Gorretty were tested and provided treatment when necessary.
Through the same program, Gorretty also learned about family planning. Now she can delay pregnancy until she and her family are ready for another child. She’s also become an ambassador for family planning and prenatal care in her community.
We’ve seen some other striking improvements in maternal and child health:
- Ninety-five percent of children born to HIV-positive mothers now get treatment to prevent transmission, up from 78 percent when the project began.
- HIV transmission from mother to child dropped 38 percent and now occurs in just 7 percent of children.
- Skilled attendants assist at 60 percent of births, nearly double the proportion in 2011.
- Ninety-nine percent of the area’s 185,000 orphans and other vulnerable children were receiving support services by 2015.
Addressing health from every angle
APHIAplus Western’s programs reach into many corners of society. We use community theater to raise awareness of HIV and provide support groups for orphans, vulnerable children, and people living with HIV/AIDS. A community-based boda boda (motorcycle) ambulance service transports pregnant women in remote areas to health facilities in time to give birth with the help of a skilled attendant. Our work—and our impact—stretch from early childhood education to nutrition to malaria prevention and treatment.
All these programs add up to much more than the sum of their parts. Support for health facilities and training for health care workers help improve and expand care for all diseases. Community engagement programs reduce the stigma around HIV and change behavior that can lead to gender-based violence. Programs that boost literacy and household incomes address economic and social barriers that contribute to poor health.
We link these services to one another and to the larger health system to magnify their impact and make the most of limited resources. Together, our efforts are transforming health care and empowering people and communities in Western Kenya, building the foundation for lasting change.