In March 2016, the Ministry of Health launched a 100-day national HIV Testing and Treatment Rapid Results Initiative (RRI) during a three-day stakeholders planning meeting in Nairobi. The RRI was scheduled to run from April 11 to July 8, 2016, and was targeted at improving countrywide HIV testing and treatment targets, in a bid to speed up Kenya’s progress towards the global 90-90-90 targets.
90-90-90 is an ambitious target launched by UNAIDS in 2013 to accelerate global HIV prevention, care and treatment. By 2020, UNAIDS aims to have 90% of all people living with HIV (PLHIV) knowing their status, 90% of all people diagnosed with HIV infection receiving sustained antiretroviral therapy and 90% of all people on antiretroviral therapy achieving viral suppression.
Existing country data shows that Kenya is below its targets hence the need to fast track this initiative.
The Ministry of Health, development partners and members of county health management teams from all 47 counties converged at the Weston Hotel in Nairobi from March 29 to March 31, 2016 to set county specific goals and strategies, ahead of the 100-day RRI.
Specific Objectives for the RRI
- To identify an additional 32,494 children and 101,351 adults living with HIV
- To increase antiretroviral therapy uptake by 29,369 children and 95,194 adults including pregnant and lactating women and other eligible adults
- To increase viral load uptake among PLHIV on ART from 50% to at least 90%. Specifically, the RRI targeted to conduct 372,789 (27,263 paediatric and 345,526 adult) viral load tests during the RRI period
- To increase Isoniazid Preventive Therapy (IPT) uptake among PLHIV from 50,000 to 500,000 patients initiated on IPT
Speaking at the meeting, Dr Laura Oyiengo, Paediatric HIV Program Manager at NASCOP shared the following factors that will determine the success of the RRI:
- Teamwork between national, county and facility teams
- Support for the frontline team, which includes health care workers
- Involvement of communities and people living with HIV networks
- Involvement of the private sector
- Frequent monitoring and evaluation of progress made, and when progress is sub-optimal, a review of the activities and change tactics is needed
The counties were also urged to focus on their high yielding facilities and departments within these facilities in the pursuit of their targets.
In order to achieve this, CHS coordinated joint strategy and work-planning meetings with respective health management teams from CHS supported counties in Central Kenya, on how to achieve the set county-specific targets, in addition to the recruitment of additional staff to support the RRI. Sensitisation workshops with all stakeholders in these counties were also conducted as the roll out began. As this exercise progressed, CHS engaged the sub-county and county teams in bi-weekly and monthly review meetings for the RRI.
CHS Updates on the National RRI Exercise
During the 100-day RRI period, a total of 135,551 individuals were tested at CHS-supported facilities across five counties in Central Kenya. Out of these, 1,547 were HIV positive.
In addition to the strategies elaborated above, CHS engaged an additional 240 HIV Testing Services (HTS) Counsellors through the county health departments, and engaged in a number of activities in the different counties. These included:
- community activities aimed at reaching more people, including flower farm workers and sex workers
- support for county and sub-county RRI review meetings
- support for commodity supply reporting
Two of the main challenges experienced during this exercise were the shortage of testing kits and lack of adequate infrastructure to accommodate the extra staff. CHS responded to these challenges by, among others, conducting targeted testing at various facility service points, logistical support for rapid testing kits (RTK) redistribution from stations with excess stock, provided screens to make separate rooms for counselling and testing, and re-assigned some HTS providers to community activities.
