Kenya
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Country situational analysis [1]
In 2007, Kenya carried out the Kenya AIDS Indicator Survey (KAIS) whose aim was to track progress towards national goals and targets. KAIS was the first national, population-based survey with measurement of HIV prevalence since the Kenya 2003 Demographic and Health Survey, and provided comprehensive and up-to-date information on HIV and other sexually transmitted infections.
According to KAIS, the total number of people living with HIV in Kenya at the end of 2007 was 1.4 million. Women are disproportionately affected: 3 out of 5 people living with HIV are women. HIV prevalence among adults aged 15-49 years in Kenya was 7.4% [7.1% - 8.5%] in 2007 as compared to 6.7% in 2003. This data shows that HIV no longer appears to be declining. HIV prevalence in urban areas was slightly lower in 2007 compared to 2003 [10.0% to 9.2%].
HIV prevalence among urban women dropped from 12.3% to 11.1% and among urban men from 7.5% to 6.4% between 2003 and 200. HIV prevalence in rural areas was slightly higher in 2007 compared to 2003 [5.6% to 7.4%].
HIV prevalence among rural women increased from 7.5% to 8.7% and among rural men from 3.6% to 5.7% Most behavioural indicators improved between 2003 and 2007.
The percentage of boys and girls (15-19) who had sex by age 15 has dropped. Condom use during last higher risk has increased among men (46.5% to 51.8%) and women (23.9% to 35.0%) between 2003 and 200. Access to antiretroviral treatment increased five fold in Kenya. An estimated 138,000 people were accessing antiretroviral treatment in mid-2007.
Treatment access was up from 6% in 2004 to 35% in 2007. Based on service coverage at present more than 212,000 individuals are accessing ART services The estimated number of AIDS related deaths has fallen from 100,000- 160 000 in 2001 to 85 000 - 130 000 in 2007 [UNAIDS 2008 Global report on AIDS data - not KAIS data].
The Kenya AIDS Indicator Survey results demonstrate that Kenya's AIDS response is showing results in terms of increase in uptake of HIV testing, and people on treatment. However, HIV prevention efforts have to be scaled up: Increase in HIV prevalence among men in rural areas points to the urgent need to scale up prevention interventions across the country; HIV among circumcised men is lower than among those not circumcised; Nearly 50% of women with HIV have unmet need for family planning, even though access to family planning is widespread.
According to the 2010 UNAIDS Report on the AIDS epidemic, adult HIV prevalence in Kenya was 6.3% at the end of 2009. The number of adults and children living with HIV in the same time period was 1.5 milllion. According to the same report, there were 250,576 people on antiretroviral treatment at the end of 2009, equivalent to 48% coverage.
key elements of the national response
Overall coordination of the National Response is the responsibility of the National AIDS Control Council assisted by its decentralised structures – District Technical Committees and Constituency AIDS Control Committees and in collaboration with sectoral coordination bodies for civil society and private sector and AIDS Coordinating Units in Government Ministries and Departments.
NACC is mandated to ensure a multi-sectoral coordination and implementation of the National Response. The Kenya National HIV and AIDS Strategic Plan for 2009/10-2012/13 (KNASP III) provides guidance in implementation of the national response. KNASP III is organised along four pillars: (1) Health Sector HIV Service Delivery, (2) Sectoral Mainstreaming of HIV, (3) Community-based HIV Programmes, and (4) Governance and Strategic Information.
Important milestones in the government's response to the HIV epidemic in the past years include:
- Comprehensive Kenya National AIDS Spending Assessment (KNASA) undertaken to track actual HIV and AIDS spending from public, international – bilateral and multilateral and private sources.
- Key populations at higher risk of HIV infection were prioritized in 2007. The Modes of Transmission (MOT) study was completed in 2008 to increase understanding of the interventions needed to address HIV in these groups. Key populations identified by the MOT are individuals who have casual heterosexual sex and their parners, men who have sex with men and injecting drug users who make up almost half of the annual HIV incidence in Kenya.
- Success with scale up in HIV testing, PMTCT and treatment has continued to exceed almost all expectations.
- Kenya has held two testing campaigns in 2007 and 2008 which have proved that there is demand for HIV testing.
- A strengthened national AIDS coordinating agency with an adequate staff complement to lead the national AIDS response
- Increased focus on the national HIV prevention agenda, with particular emphasis on improving the cost-effectiveness of the prevention response
Prevention
Although KNASP III focuses on populations most at risk, challenges remain in how to operationalise the plan.
There is an overall lack of comprehensive data on populations most at risk of HIV infection that hinders effective targeting. For example, it is known that sex workers, with relatively high HIV prevalence, are widespread in urban centres and along major transport routes. However, attempts to quantify accurately the population size have so far been unsuccessful. KNASP III uses the latest model default estimates to arrive at 80,000 sex workers for planning purposes. Men who have sex with men are a significant population but their size is difficult to estimate. Injecting drug use is increasing in Kenya, but again real numbers and their distribution remain unknown.
Monitoring and Evaluation
Compared to the status highlighted in the previous UNGASS report, the M&E systems has greatly improved especially in terms of coordination and alignment of stakeholders to the national reporting system.
However, capacity remains a challenge, particularly among Civil Society Organisations (CSOs), including NGOs and community-based organisations, that need continuous training.
While one M&E system is in place, it is not fully operationalised and parallel systems, also related to donor programmes, are still in place.
The Health Management Information System needs to be strengthened.
Financing of KNASP III
The global economic crisis is likely to pose a real threat to financing of HIV and AIDS Programmes globally and Kenya will equally be affected. In the wave of the economic crisis, donor funding is expected to decrease, and grants can no longer be taken for granted. Such effects could erode the gains already made in addressing HIV and AIDS. However, Kenya's improved capacity, information base, results-based programming, cost effectiveness and accountability and a new national AIDS plan, all ensure that the country has an opportunity to maximize the use of the substantial amount of HIV funding available.
- NACA - National AIDS Control Council
- National Strategic Plan
- National Male Circumcision
- Policy HIV and AIDS Worplace Policy
- PMTCT and Paediatric Care and Treatment Fact Sheet
- Modes of transmission (MOT) study
- 2010 UNGASS Report
UNAIDS Country Office
Maya Harper (UNAIDS County Coordinator)
Block Q
UN Complex
Gigiri
PO Box 30218-00100
Nairobi
Tel: +254-20-762-4391
Fax: +254-20-762-4390
National AIDS Control Council
Prof. Miriam K. Were
Chairman
Ministry of Health
Landmark Plaza
9th Floor
Argwings Kodhek Road
Nairobi
P.O BOX 61307- 00200
Nairobi
Tel: Tel:+2542715144/+2542715109/+2542711261/+2542250529/+2542316109
Email: communication@nacc.or.ke
Networks of Organisations working on HIV
Kenya AIDS NGOs Consortium (KANCO)
Chaka Road, Off Argwings Kodhek Road
P.O. Box 69866 -00400
Tel: +254-20-2717664 , +254-20-2715008
Email: kanco@kanco.org
Website: www.kanco.org
Kenya Consortium to Fight AIDS, TB and Malaria (KECOFATUMA)
Main Office: Woodlands Road (opposite DoD) Hurlingham, Nairobi
P.O. Box 10013 - 00100
Nairobi, Kenya
Tel: +254 20 2726083
Email: kecofatuma@wananchi.com
Website: www.kecofatuma.org
Networks of people living with HIV
National Empowerment Network of People Living With HIV/AIDS in Kenya (NEPHAK)
Inviolata Mwali Mmbwavi, National Coordinator
P.O. Box 75654-00200
Nairobi, Kenya
Tel: +254 20 2736415
Email: nfoplha@nephak.org
Website: www.nephak.org
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1. All epidemiological data comes fromt the country's 2010 UNGASS report, unless otherwise stated
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