County government implementation, management and sustainability of high quality HIV services in murang?a county in the republic of kenya under pepfar. - murang'a county is one of the counties…

County government implementation, management and sustainability of high quality HIV services in murang?a county in the republic of kenya under pepfar. - murang'a county is one of the counties created under the kenya constitution 2010. IT is one of the five counties in central region of the republic of kenya and occupies a total area of 2,558.8KM2. IT is bordered to the north by nyeri, to the south by kiambu, to the west by nyandarua and to the east by kirinyaga, embu and machakos counties. The county comprises of seven sub counties namely: kiharu, murang'a south, kigumo, kangema, kandara, gatanga and mathioya; the county headquarters is located in murang'a town. The 2019 population and housing census recorded a population of 1,056,609 persons. The county has 272 health facilities serving a population of 1,056,609. IT has one county referral hospital and six sub-county hospitals, three mission and 3 private hospital. There are 26 public health centers, 114 dispensaries (89 public and 25 mission/NGO) and 137 private clinics. Murang'a county HIV prevalence rate has improved from a high of 5.2% in 2014 to a low of 2.5% in 2020 with an estimated number of people living with HIV as at june 2020 being 20,849 of which 15,947(76%) had been identified, 15,927(99.9%) put on art and 14,840(95%) had achieved viral suppression. There were 192 new HIV infections in 2019 and 288 HIV related deaths, emtct rates for the county has also improved from a high of 20.4% in 2018 to 9% in 2020. Prevalence rate is still high among women at 3.3% compared to 1.7% prevalence rate among men, and sexual transmission still remains as the primary method of infection. Once this application is funded, the project will be implemented in one administrative unit (kandara sub county) which has a population of 175,091(census report 2019). Kandara sub county has been chosen as the initial administrative unit for the project implementation, with potential incremental support to additional sub counties within murang'a county. Kandara sub county is lagging behind compared to the other sub counties towards achieving the 95/95/95 pepfar goals; as at september 2020, paediatric identification was at 74% while adult identification stood at 92%.paediatric suppression rate was at 81% and adult suppression rate at 88%. The HIV exposed infant positivity was at 3.3%. The main focus of the HIV program in murang'a county is to ensure continuous implementation of quality and sustainable comprehensive HIV services with the goal of achieving and maintaining epidemic control, not only in kandara sub county, but also in the entire county. The county government through the chmt/HIV program will ensure implementation of the following key programmatic areas: (I) achieving primary prevention of HIV infection (II) improving the care and treatment of HIV/aids, sexually transmitted infections (STIS), and related opportunistic infections. (III) strengthening the capacity of the sub county to collect and use surveillance data. (IV)developing, validating, and/or evaluating public health programs. The following specific strategies will be fully implemented in the selected administrative unit to ensure the 95/95/95 targets are achieved; provide direct oversight and management to implement and sustain HIV service delivery in kandara sub county. This will be achieved through planning, budgeting and monitoring of HIV services in the sub county, strengthen county financial management system to manage and finance sustainable HIV service delivery including HRH component, identify and enrol plhiv through targeted HIV testing and linkage strategies, provide comprehensive HIV prevention, care and treatment including prevention and treatment of TB, identify HIV infected pregnant and breastfeeding women and initiate HIV treatment, implement HIV prevention services among key and priority populations, strengthen laboratory systems for quality and timely HIV/TB related testing and track, collect and report