A Clinician checks the blood pressure of a client at a wellness booth at Bondo County Hospital. This innovative approach has encouraged more men to test for HIV as part of the wellness package offered to address poor health seeking behaviour
Steve* has been lingering around the hospital gates for a while now. His black leather shoes, which clearly reflected the bright blue skies when he stepped out of his hostel room, have now collected a fair amount of opaque red-soil dust from the constant pacing. His mind keeps racing back to a party at the university a month ago and his steamy escapade with his long-time crush Atieno*. Since that encounter, he has been worried about his HIV status following all the gossip he has heard about her. He is here at the Bondo County Hospital for an HIV test that will hopefully ease his anxiety once and for all.
Waves of courage led his pacing feet towards the hospital gates but quickly deflected his movements when he got close, worried that one of his friends would spot him inside the hospital. Finally, he mustered all the courage he could find within him and quickly walked through the gate and ducked into a small room a few metres from the gate…hoping that no one had spotted him!
About half an hour later, Allan* briskly walks through the same gates, his wife’s bag in one hand, and the other gently guiding his ailing wife towards the hospital reception. He takes his wife to the outpatient department, ensures she is received and served, then briefly excuses himself from her side, retracing his steps to the booth he had spotted close to the gate. He has been meaning to visit the hospital for some time now but found it difficult to take time off work.
Steve’s and Allan’s experiences are not unique. They represent the challenges of many men in Siaya and beyond as relates to health-seeking behaviour.
Despite their many social and economic advantages, recent research and studies show that men are less likely to seek out health care, to take an HIV test, or to initiate and adhere to HIV treatment as compared to women (UNAIDS, Blind Spot, 2017). The 2016 Kenya Tuberculosis Prevalence Survey revealed that men contributed to 65% of the study population who had symptoms of TB and did not seek care.
The CHS program team in Siaya informally studied the barriers that prevent men from accessing HIV testing services over time, and the following were identified:
- Most hospital departments operate between 8 AM and 5 PM on weekdays, limiting access to routine services for many men who may be working during these hours
- Many men are wary of being spotted walking into an HIV testing point for fear of stigma and discrimination from their friends or community
- Men are discouraged by long queues at service delivery points
To address some of these barriers and provide innovative health service options for men, CHS constructed a booth offering a wellness check-up package close to the entrance of the Bondo County Hospital. This clinic, which began operating in December 2017, is not branded and offers a safe space where men like Steve and Allan can access quick and confidential services away from the main hospital block. They can access the facility with reduced risks of being spotted by people who know them. Without this booth, the two men may have had to endure more anxiety filled sleepless nights unaware of their HIV status.
HIV Testing and Voluntary Medical Male Circumcision screening services are offered here as part of the package increasing the uptake of these services among men uncomfortable with visiting the more public Comprehensive Care Centres (CCCs) and well-known HIV testing booths. Any other complication that the clients may present with are referred directly to the relevant departments within the hospital, eliminating the need for the men to visit the hospital’s outpatient department.
Scaling up the Innovation
With funding from PEPFAR through CDC, CHS is in the process of constructing 115 such booths across various health facilities in Siaya County. These clinics offer an array of services including: HIV testing, TB screening, male circumcision screening, GBV screening, diabetes testing, weight and blood pressure testing among others. In Bondo, the clinic attracts a large number of young men and couples from the nearby Jaramogi Oginga Odinga University of Science and Technology for HIV testing and condom distribution services.
*Not their real names
