GH22-2262: advancing sustainable implementation of high-quality HIV services in select counties in the republic of kenya under the president?s emergency plan for aids relief (pepfar) - despite the…

GH22-2262: advancing sustainable implementation of high-quality HIV services in select counties in the republic of kenya under the president?s emergency plan for aids relief (pepfar) - despite the strides made by the government of kenya towards achieving HIV epidemic control by 2030, the nairobi metropolitan services(NMS) has made significant strides in provision of HIV/TB services. Knowledge of HIV status is at 86%: treatment coverage at 99% and viral suppression at 93%. However IT still faces significant bottlenecks that include high mother to child transmission of HIV, poor service utilization among adolescents, young women, men and children, high TB morbidity and mortality rates, covid 19 impact leading to reduced HIV service delivery, fragmented service delivery and a highly mobile population with resultant poor retention in HIV services. In order to mitigate against this therefore, evidence from countries that have successfully transitioned the HIV services from donor dependance to country owned service delivery models have demonstrated more sustainable epidemic control. Learning from this and the experiences from the unaids fast track cities engagements, the NMS with support from CDC implementing partners has undertaken to have the HIV services systematically transitioned to the NMS towards journey to self reliance. The proposed shine project brings together a team of highly qualified government staff from NMS that will collaborate with CDC and CDC implementing partners in nairobi city to address the gaps and thereby contribute to the achievements of the unaids 95-95-95 targets. The direct engagement of the NMS staff in the day to day management of the project is poised to further improve on quality county led HIV services in nairobi in line with priorities identified during the CO-creation engagement. The NMS has partnered with other health organizations to provide oversight to over 450 facilities in the nairobi county. The direct engagement of health management teams at all levels from county to facility level, structured around specific program areas has ensured delivery of quality integrated health service. This is further reflected at the facility level with percolation to the communities with population specific service delivery models responsive to their needs. The institutionalization of the technical management team further ensures continuity of health service provision irrespective of the political establishment that could hitherto interrupt service delivery. Using a county and subcounty based field expert teams approach, the shine project will build on gains and lessons learnt in previous and ongoing pepfar programs to articulate key service delivery barriers and guide selection of high impact strategies to achieve set goals based on the county's HIV burden, context and pepfar priorities. This will be achieved through provision of evidence based technical assistance and support to the health facilities and communities in nairobi using cost effective, integrated service delivery approaches. Strategic partnerships NMS will forge in service provision include with the MOH entities (kemsa, nascop, nacc) pepfar funded partners, other health partners, csos, institutions of higher learning such as universities(UON, KU), teaching and referral hospitals (KNH, mathare mental hospital, kutrrh), private institutions(AGA khan hospital, nairobi hospital, meds etc.), faith based organizations and professional bodies like KPA, kogs and KAP.