THE KAREN HOSPITALCONTRIBUTION OF THE KAREN

HOSPITAL AS A PRIVATE SECTOR TOWARDS HIV & AIDS

05/02/23 1

“Setting Benchmarks in patient Care in Kenya and beyond”

THE KAREN HOSPITAL

05/02/23 2

Presented By Florence Riaga

OBJECTIVES

05/02/23 3

Support of HIV Prevention initiatives and programmesSupport for people living with the HIV virusSupport to Universal access to treatmentPrevention of Mother-to-child TransmissionSupport for Private Public partnerships

History• Kenya’s largest multi-super specialty hospitals

in Karen, Nairobi• Aim: bringing to Kenya the highest standards

of medical care along with clinical research education and training

• Capacity: 102 beds with 3 operating theatres caring for over 26 specialties

• Satellites: Nairobi, Meru, Nakuru, Nyeri, Karatina Ngong and Kitengela

05/02/23 4

Collaborations

• Gold Star Network has for the past three years initiated the Comprehensive Care Clinic to facilitate Healthcare services for HIV/AIDS prevention and Management.

• Ensures consistent supply of HIV commodities and staff support when and where necessary

• Other collaborators: MOH, and USAID/APHIA–Plus.

05/02/23 5

The Care, Treatment & Management

Interventions are initiated at three levels: – patient level; – at the medication/treatment level; – at the healthcare delivery level and;– interventions at the community level

05/02/23 6

Care at Patient’s LevelEngaging the patient: rapport, education on disease and

course, assess client’s readiness for medication, goals of therapy, adherence, and treatment plan.

Assessments necessary: behavioral skills (goal-setting, time-tabling; Assertiveness/communication, problem-solving, among others); asses behavioral determinants of adherence (daily routine, such as. eating, sleeping and working patterns, recreational activities, familial/social relationships and responsibilities, travel plans, etc.) and;

Impact of resistance on future options and what to do if doses are missed, delayed, or vomited, Walsh et al. (2002)

Emphasis is to assist clients based on their level of awareness in order to facilitate them

05/02/23 7

Prevention Initiatives • Support of HIV Prevention initiatives and

programmes at Karen Hospital are entrenched in the treatment

• Outreach programmes to corporate, companies the universities around Karen area

• Target: those who have not been tested for HIV/AIDS to carry out tests and know their statuses in order to take control of their lives

• Success: More enquiries and actual use of the contraceptives both duo method and dual protection.

05/02/23 8

Interventions at the medication/treatment level:

• Focus is on achieving the international standards

• Implement a tailor made regimen for each patient after thoughtful consideration of the simplicity or complexity of the regimen; use the best of medications locally available

05/02/23 9

Interventions at the medication/treatment level…:

Things to Consider: – the cost factor( whenever and wherever applicable); – be aware of the job constraints, especially for a regimen requiring

doses to be taken twice aday.eg PI based regimen.– keep the dose frequency and number of pills to the minimum; – convey the common and probable side effects of ART before

starting therapy as awareness improves the patient’s confidence in the physician and hence the adherence;

– anticipate side effects and treat them as soon as possible; – modify the dietary pattern to suit the antiretroviral agents; – avoid adverse drug interactions amongst ART drugs and drugs used

for controlling other symptoms as well as opportunistic – infections and detect and treat any intervening illness and

opportunistic infections at the earliest Mitty, et al., 2002; Kagay, et al., (2004).

05/02/23 10

Support for people living with the HIV Virus at Karen Hospital

• The Comprehensive Care Clinic has facilitated people’s access to the clinic with ease and without discrimination.

• It is not labeled to give patients leverage and ability to feel secure. This has facilitated people from all backgrounds of life to access and use the CCC services

• Integrated Approach to services - counselling, nutrition, psychological and social support initiatives through support group(THE ARK CLUB)which is helping its members to journey on through sustainable projects.

• Gold Star Network, constant supply and staff development support has been realized

05/02/23 11

Prevention of Mother-to-child Transmission:

• Close attention is given to the parents: during pre-natal, delivery and postnatal care.

• Couples are encouraged to come together during the visits, delivery and Maternal Child Health clinics

• General Effect: improved situation of relationships amongst couples as a result.

• Timely ART introduction for sero+ mothers• Information giving: exclusive breastfeeding and

replacement feeding. • Observation: most of the parents opt for the exclusive

breastfeeding for six months with notably good results. 05/02/23 12

CONCLUSION

05/02/23 13

Observably, Karen Hospital has set the pace for HIV/AIDS prevention and Management as well as care. This is supported also by the fact that it is a referral hospital and therefore clients are happy to get all services at the same point. Despite common place claims that private hospitals are expensive, we remain relevant in the management of HIV/AIDS irrespective of socio-economic status of the clients leading into the achievement of the key motto of leadership in Healthcare and realization the MDG 6 by 2015 and beyond.

RECOMMENDATIONS

Continued private-public partnershipHTC at every entry point and systematic

referrals to specific clinics for further management

Frequent updates on current National/WHO guidelines to private practitioners on the management of HIV infection

05/02/23 14

THANK YOU

05/02/23 15

THANK YOU