Cooperative Agreement NU2GGH002450

ACHIEVING AND SUSTAINING EPIDEMIC CONTROL THROUGH COMPREHENSIVE HIV/AIDS PREVENTION, CARE AND TREATMENT SERVICES IN MACHAKOS, MAKUENI AND KITUI COUNTIES IN KENYA UNDER PEPFAR - BACKGROUND: DESPITE A STEADY NATIONAL TRAJECTORY TOWARDS EPIDEMIC CONTROL, KENYA'S LOWER EASTERN COUNTIES OF MACHAKOS, MAKUENI AND KITUI HAVE NOT YET ATTAINED THE 95:95:95 UNAIDS TARGETS. RECENT PROGRESS THROUGH CDC CHAPUZIMA, CDC CHS NAISHI AND OTHER MECHANISMS HAS IMPROVED HTS UPTAKE, LINKAGE TO CARE, ACCESS TO ART AND TREATMENT MONITORING. YET GAPS STILL REMAIN IMPEDING EPIDEMIC CONTROL AND SUSTAINABILITY, SPECIFIC TO THESE COUNTY'S UNIQUE NEEDS AND HEALTH SYSTEMS. THESE INCLUDE SIGNIFICANT GAPS IN PREVENTION INTERVENTIONS AND ART COVERAGE; LIMITED TARGETED HIV TESTING; SUBOPTIMAL LINKAGE, SUPPRESSION, AND RETENTION ON ART, ESPECIALLY AMONG AGYW AND MEN; LOW UPTAKE OF PATIENT CENTERED AND DIFFERENTIATED SERVICE DELIVERY MODELS. THESE ARE WORSENED BY INADEQUATE METRICS AND WEAK HEALTH SYSTEMS FOR A COUNTY OWNED AND COUNTY LED HIV RESPONSE. COUNTY-SPECIFIC RESPONSES THAT BUILD ON PREVIOUS CDC INVESTMENTS ARE NEEDED TO TURN THE TIDE AND ADDRESS STUBBORNLY ENTRENCHED CHALLENGES TO HIV CONTROL. PURPOSE: THE CHAK STAWISHA KAUNTI PROJECT (SWAHILI FOR ENABLE THE WELL BEING OF COUNTIES) PURPOSE IS TO SUPPORT THE LOWER EASTERN COUNTIES TO ACHIEVE, MAINTAIN AND SUSTAIN EPIDEMIC CONTROL THROUGH COMPREHENSIVE, SUSTAINABLE HIGH-QUALITY PREVENTION CARE AND TREATMENT SERVICES. THE POPULATIONS TARGETED WILL INCLUDE ALL PERSONS ELIGIBLE FOR HIV PREVENTION, CARE AND TREATMENT SERVICES IN THE TARGET COUNTIES, WITH EMPHASIS ON ADOLESCENT GIRLS, CHILDREN, MEN, PREGNANT AND BREASTFEEDING WOMEN, KEY POPULATIONS AND HEALTH CARE PROVIDERS. OUTCOMES: FOR THIS PROJECT INCLUDE: REDUCED HIV INCIDENCE; REDUCED INCIDENCE OF STIGMA, DISCRIMINATION AND VIOLENCE EXPERIENCED BY KEY POPULATIONS (KP) AND PRIORITY POPULATIONS (PP); VIRTUAL EMTCT OF HIV; REDUCED HIV-RELATED MORBIDITY AND MORTALITY AMONG TARGETED POPULATIONS; REDUCED INCIDENCE OF TB AMONG PLHIV AND INCREASED INVESTMENT AND ACCOUNTABILITY OF COUNTIES IN HIV/AIDS/TB PROGRAMS. BROAD STRATEGIES: THE PROJECT WILL IMPLEMENT A CONTEXT SPECIFIC AND POPULATION SPECIFIC APPROACH; PROVIDING TECHNICAL ASSISTANCE AND SUPPORT TO COUNTIES AND HEALTH FACILITIES, TARGETED HEALTH SYSTEMS STRENGTHENING, STRENGTHENING COLLABORATIONS, ENHANCING HEALTH INFORMATION SYSTEM MANAGEMENT, INFORMATION USE AND QUALITY IMPROVEMENT; WITH INCREMENTAL TRANSFER OF HIV SERVICE DELIVERY FUNCTIONS FOR A COUNTY-OWNED, COUNTY-LED AND COUNTY-MANAGED RESPONSE WHILE LEVERAGING ON THE GAINS ACHIEVED BY PREVIOUS AND ONGOING PEPFAR HIV PROGRAMMING IN LOWER EASTERN COUNTIES. THESE EVIDENCE-BASED STRATEGIES WILL CONTRIBUTE TO THE ACHIEVEMENT OF SHORT, INTERMEDIATE AND LONG-TERM OUTCOMES. ORGANIZATIONAL CAPACITY: THE CHRISTIAN HEALTH ASSOCIATION OF KENYA, THE PRIME APPLICANT FOR THIS RESPONSE, IS A LOCAL INDIGENOUS UMBRELLA ORGANIZATION OF OVER 500 PROTESTANT HEALTH FACILITIES, SUPPORTING DELIVERY OF QUALITY HEALTH SERVICES THROUGH PARTNERSHIPS WITH THE GOVERNMENT, DONORS, CSOS AND COMMUNITIES. WE ARE AT THE FOREFRONT OF IMPLEMENTING ADAPTIVE, EVIDENCE-BASED HIV/AIDS PREVENTION, CARE, AND TREATMENT PROGRAMMING IN MAKUENI, MACHAKOS, AND KITUI. THE CONSORTIUM OFFERS DIRECT BRIDGES FROM CURRENT PEPFAR PROJECTS-INCLUDING CDC CHAPUZIMA (CHAK, MEDS), AND DREAMS (NOPE)-THAT WILL OFFER SMOOTHER TRANSITION AND A DEEP UNDERSTANDING OF IMPLEMENTATION OPPORTUNITIES. COLLECTIVELY, CHAK'S TEAM WORKS IN ALL PROJECT SUB-COUNTIES AND POSSESSES TRUSTED RELATIONSHIPS WITH GOVERNMENT THAT WILL FACILITATE SEAMLESS TRANSITION. WITH OVER 20 YEARS' EXPERIENCE IMPLEMENTING USG HIV PROGRAMMING, CHAK OFFERS CDC THE REASSURANCE OF HAVING SERVED AS A SUCCESSFUL LOCAL PRIME AND SUB-RECIPIENT ON LARGE-SCALE HIV PROGRAMMING. WE WILL ADDITIONALLY DRAW ON MEDS' EXPERTISE AS THE REGIONAL HUB FOR LABORATORY AND SUPPLY CHAIN MANAGEMENT BEST PRACTICES. NOPE HAS 20 YEARS' EXPERIENCE AND INSTITUTIONAL CAPAC