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Back ground

UNIVERSITY OF NAIROBI, CENTRE FOR HIV PREVENTION AND RESEARCH ( CHIVPR) MARPS Project Topic Effectiveness of the peer led system in retention of the key populations in HIV and AIDs comprehensive and care services in Central and Eastern Provinces.

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Back ground

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  1. UNIVERSITY OF NAIROBI,CENTRE FOR HIV PREVENTION AND RESEARCH ( CHIVPR) MARPS ProjectTopicEffectiveness of the peer led system in retention of the key populations in HIV and AIDs comprehensive and care services in Central and Eastern Provinces By Kageni L, Ngugi E, Nderitu M, Pere W, Gisore A, Agwanda C, Achote E, Muigai J, Mohammed H, Muguna A, Mutegi A, Nyang’au R, Kiraithe P

  2. Back ground • Implemented in both Central and Eastern Provinces. • Commenced in October 2010. • Targets Most at Risk Populations; Female sex workers (FSW), Male sex workers (MSW), Men who have sex with Men (MSM), Truckers • Adolescents (10-17 years old). • The interventions are guided by the GoK (Ministries of Health) Guidelines.

  3. Figure 1:UoN MARPs Project-Coverage Oct. 2010-Mar. 2013

  4. Criteria for election and training of peer leaders • Typology specific Popular opinion leaders who are acceptable by their peers • Consultative mechanism is applied to ensure equitable representation • The peer leaders must be available and willing to serve • Trained in accordance with NASCOP’s standard curriculum • NASCOP provides certificates

  5. Supplies and Materials provided to peer leaders • HIV and AIDS and reproductive health IEC materials • Penile and vaginal models • Male and female condoms and lubricants • Carrier bags • Branded Tshirts • Branded caps • Identification badges • Data collection tools • Airtime support

  6. Retention of peer leaders • Recognition for their service is provided by giving them a monthly stipend, identification badge, branded Tshirt and caps. • Use of human relations and persuasive skills • Transport reimbursement when involved in mobilization during outreaches • Monthly targets are given so that all peer leaders are clear of what is expected of them. • They are involved in decision making for planning, mobilization and outreach activities. • Linkages are made with microfinance institutions mainly equity, family and Barclays bank. • Linkage with Government development funds i.e Uwezo • Succession and replacement mechanisms are managed by the peers with assistance of the staff

  7. Figure 1:How the peer leader system works Community engagement and Mapping Coordinator Assistant Community E and M officer Direct supervision 18 Community mobilizers Direct supervision ,monthly meeting, Monthly reports for their payment, updates 186 peer leaders Condom distribution and health education on condom, mobilization and referral of their peers. 6000 peers .

  8. Roles of the peer leaders • Health promotion and education on safer sex practices, FP, STI screening and treatment,HTC alcohol and drug use • Promotion, education, demonstration and distribution of male & female condoms and Lubes • Risk reduction counselling • Report on GBV • Refer to the DICE for biomedical services • Maintain cohesion and team spirit • Refer for social networks • Used in community mobilization to reach old and new KPs

  9. How peer leaders help in Retention • Individual home visits • Defaulter tracing • Phone calls • Escort to the DICE • Linkage and follow up • Weekly meetings with records

  10. Peer leader demonstrating condom use

  11. Truckers mounting condom dispensers

  12. Monitoring and Evaluation • Standard data collection tools used are -PE First contact form -PE Monthly calendar • Data Flow – peer leaders report on a monthly basis to the community mobilizer who compiles the data and transmits to the central office • Data is analysed for reporting and decision making • Feedback is given back to the DICEs for decision making at their level • Supportive supervision done bi-weekly

  13. Achievements • Determined in terms of the number of peer leaders selected and trained • coverage, • KPs reached, • KPs tested including quarterly retesting • KP enrolled in the DICE • KPs in peer led and support groups • IGA activities in various groups

  14. Peer leaders elected and trained • 186 active peer leaders • Each with a specific mapped and zoned area and sensitization on roles and responsibility

  15. Eastern-Coverage per DICE • Lower Eastern • Makindu- Kibwezi, Mtito Andei, Emali, Salama, sultan, mbui nzau ,manyanga, kinyambu, kisayani, kambu, machinary, masimba, kiboko, miangeni, ikutha, kibarani, kiundwani, Mutomo. (18) • Mwingi- Matuu, migwani, Nguni, ukasi, kyuso, tseikulu,ngomei, tharaka, mui, kithyoko,katse (11) • Machakos- Mjini, Eastligh, Mumbuni, Kariobangi, Miwani, Masii, Mumandu, Wamunyu, Mutituni, katoloni, Makutano, Kenya-israel, Kitanga, kitanga, Malili (15) • Total-44 Sites • Upper Eastern • Meru- Nkubu, timau, makutano, kiirua, githongo, gakoromone, kithirune, ngishishi (11) • Chuka- polepole, ciakariga, chogoria, mitheru, kibugua, marimanti, kirege, kanwa, Moi girls, Chera, Itugururu, Mugui, Kaanwa, Ikuu, Kibumbu (15) • Embu-Muthatari ,Mutunduri, Kithimu, Kangaru, Dallas, Kiritiri, Karurina, Manyatta, Runyenjes, PI Ishiara, Kibugu, Majengo, Njukiri, Kirigi, Embu Town. (14) • Total- 40 All are 84 (both moonlights and outreach sites)

  16. Central Province • Nyeri- nyahururu, nanyuki, karatina, Othaya, naromoro, chaka, endarasha, mukurweini, kiriaini. 3 in Nyandarua, (12) • Mwea- Kerugoya, makutano,kambiti, sagana, kagio, kianyaga, kagumo, kimbimbi, mururi, ithale, Mahigaini, Kiangai, Kimunye, Kiriko (14) • Thika- kiganjo, makongeni, athena, witeithie, juja, murang’a, kabati, limuru, gatundu, kilimambogo, kiganjo, Kiirwara, Kenol, Murang’a (11) • Total-37

  17. KPs Reached From Mar’ 2011

  18. Enrollment per year from Mar 2011 to Sept 2013

  19. Retention per year • .

  20. Table 9:PEER LED GROUPS (social economic growth) 2010 to date

  21. Table 10:PLHIV SUPPORT GROUPS ( social economic growth) Yr3’2013

  22. Figure 2: Kitchen demonstration garden in Nyeri

  23. Figure 3: Mwingi kitchen demonstration garden • .

  24. Structural empowerment

  25. Community engagement activity

  26. Sex workers prepare Aloe bathing soap to supplement their income

  27. Some of the products made by the Peer Led Groups

  28. Lessons Learnt • Retaining KPs in the DICEs is best achieved through peer led system because they are a support system • Upgrading training of peer leaders at least once a year enables them to produce quantity and quality work • Helping Market their products motivates them to embrace expanded choices to sex work • Appreciating KP as partners facilitates the process of developing self esteem

  29. .

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