Introduction
There are many examples where a time lag occurs between the introduction
of new ideas and actual implementation of program activities. The
national, provincial, and district health teams worked together to ensure
that there were no delays in implementation of project activities.
Materials and methods
Preliminary project activities took place between November 2005 and mid-May 2006. Meetings were held between the national-level team, PHMT, DHMTs,
HMTs, and health facilities. These were followed by formative and baseline
surveys in which training, service delivery, and policy-level needs were
identified. Appropriate best practices that had worked elsewhere (e.g., South
Africa where a similar model of integration was piloted) were incorporated.
Modifications in service delivery included revising family planning (FP) registers to
accommodate counseling and testing data. Providers developed action plans
to guide them in the implementation of project activities. NASCOP and DRH
are responsible for the supply of test kits and FP commodities. Supervision
and monitoring were done on a monthly basis.
Results and discussion
Implementation of project activities started in mid-May 2006 immediately
after training of health providers. By August 2006, a total of 8,382 FP
clients had been attended to in nine pilot health facilities in Nyeri District.
Out of these, 5,644 (67 percent) and 1,356 (16.2 percent) were counseled and tested,
respectively. Out of the 1,356 who were tested, 39 (2.9 percent) were HIV-positive.
In Thika District, a total of 11,223 FP clients were attended to in 14 health
facilities. Out of these, 5,629 (50 percent) were referred for testing, and 2,657
(23.7 percent) were tested. Out of the 2,657 who were tested, 437 (16
percent) were HIV-positive. The total number of HIV-positive clients as a proportion of the
number referred for testing was 7.8 percent.
Conclusion and policy implication
The rapid uptake of project activities in the two pilot districts lay in
four prongs: developing and using a problem-based training package; teamwork
between the national level, PHMT, DHMTs, and the pilot facility teams that
facilitated the tackling of service-delivery and policy-level issues;
feasible action plans; and supportive district monitoring and supervision
teams.
