hiv prevention in migrant population_irc's experience_ias2012_peter mutanda
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HIV Prevention in Migrant
Population IRC’s Experience
AIDS2012 IAS ConferenceWashington DC, July 2012
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Life in Turkana
Life in Turkana
Kenya’s HIV prevalence at 6.4% (KDHS, 2008/9)
Turkana hosting refugees from Somalia, S/Sudan, Ethiopia and ALL Great Lakes countriesRefugee camps in existence since 1992Estimated Turkana population: >850,000 (KNBS, 2009)
Refugee population > 85,000 (UNHCR PHHIV Report, 2011)
Community reliant on food aid, mostly by external donorsCommunity in denial – “HIV problem of the urban” (2005)
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HIV Prevalence: Sentinel Surveillance – Turkana (Nascop, 2011). IRC started program in 2005
2006 2007 2008 2009 20100
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4
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12 11.3
7.4
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5.14.8
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IRC in Kenya
Started work in refugee programs in 1997Host population programs started in 2005 – HIV Prevention, WASHRefugee programs – direct implementationInevitable interactions, assimilation over time among refugees and their hosts at KakumaHost Population Programs- mainly with partners through enhancing capacity of Community Based Organization
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Through the Path…
2004/5 – HIV Program limited to small part of Turkana, no public disclosure in the region, denial of HIV at community, first HIV sentinel surveillance – 18% (Nascop)2006 – HTC services through mobile programs, mass awareness in the community/schools, HIV Care and Treatment at three facilities2007 – Decentralization of HIV care, treatment more facilities, trainings of health care workers and community health workers, first public disclosure
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…the Path
2008/9 – Rapid results campaigns, support CBOs on MIPA initiatives, complimentary programs2010 – Emphasis on Evidence Based Intervention,, decentralized supply commodity mechanism, target new HIV testing2011 – Severe drought slows down community activities, focusing on EBI – relevance, efficiency and sustainability
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Targeted HIV Prevention Approaches
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Families Matter! Program: Targets 9-12 year-olds through parent/child communication. Healthy Choices: Targets 13-17 year oldsCommunity HIV Testing: Home or family-based HIV testing Community Prevention with Positives: From clinical settings to the community
Hard Lessons
Program priority not community priority!
Very key: Program linkages, active community participation
Agreement on what constitutes evidence since many factors influence its acceptance 9
Taking services to the community
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Participation
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Anticipation, Emergency Preparedness
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Leadership
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Standards, Standards
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Acknowledgements
Centers for Disease Control and Prevention (CDC)Kenya Government through the Ministry of Public Health and SanitationTurkana Community and their leadershipOther donors for supporting other health programs
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16Thank You