AIDS, Population, and Health Integrated Assistance (APHIA II) Operations Research Project
The APHIA II OR project worked with local partners in Kenya to test innovative interventions to ensure high-quality reproductive health, family planning, and HIV/AIDS and related services to better address Kenya’s health needs.
Meeting the health needs of in- and out-of-school youth, married adolescents, and adolescents living with HIV is one goal of the APHIA II OR Project.
Kenya has made remarkable progress in a number of health areas over the last five years. Improvements in HIV/AIDS treatment and care, family planning, and some key maternal and child health interventions have contributed to an increase in life expectancy. According to the 2008–09 Kenya Demographic and Health Survey, the contraceptive prevalence rate (CPR) among married women has risen from 7 percent in the late 1970s to 46 percent today.
However, significant problems and challenges remain. Despite the improvement in CPR, Kenya's total fertility rate remains high at 4.6, and about 1.5 million adults are living with HIV. An estimated 2.4 million children under the age of 18 are orphans, with 42 percent of them orphaned because of AIDS.
The AIDS, Population, and Health Integrated Assistance (APHIA II) Operations Research (OR) Project in Kenya is a three-year cooperative agreement between USAID/Kenya and the Population Council (Cooperative Agreement No. 623-A-00-09-00001-00), and was completed in early 2012. APHIA II OR Project researchers worked with local partners to test innovative interventions that can ensure high-quality reproductive health, family planning, and HIV/AIDS and related services to better address Kenya’s health needs.
Over the last three years, project researchers worked closely with Kenya's Ministry of Health and other project partners to explore the reasons behind some of Kenya's health problems and to develop new approaches to solving them. Through this collaboration, project staff have continued to identify key health issues that can be addressed through innovative approaches tested through field research and to recommend proven best practices for implementation and expansion.
Banner photo: © Noor Ali/IRIN
APHIA II OR strategy
APHIA II built on the strong research foundation established by the Council's previous USAID-funded OR projects: Horizons and FRONTIERS. APHIA II implemented projects under seven thematic areas:
- Alcohol/substance abuse and HIV risk
- Pediatric HIV and AIDS care
- RH and HIV clinic systems strengthening and integration
- Community services
- Meeting the needs of adolescents
- Gender, reproductive health, and HIV
- Communication, utilization, and capacity building
Impact of project activities
- As a result of the dissemination of findings from the “Positive action for HIV in schools” project, the Kenyan Ministry of Education expressed its readiness to use the information to provide guidelines to schools on how to communicate with students on HIV-related issues through age-appropriate, youth-friendly channels.
- The project "Expanding access to comprehensive RH/FP and HIV/AIDS information and services for married adolescent girls" developed a highly effective media campaign, including a radio soap opera entitled Chakrouk. The show was so popular that the entire series was repeated twice on three different FM stations. Chakruok also won a 2011 "Radio for Peace-building Africa" award in the "Gender" category, and continues to reach tens of thousands of listeners.
- During the activities of "Linking HIV-positive family planning clients to ART treatment and care services,” 93 percent of the HIV-positive FP clients received at comprehensive care centers had been referred from the MCH/FP unit of the same facility. This was a result of two highly effective tools we developed: a detailed referral directory for providers, and the use of triplicate copies of referral forms given to the client by the referring provider.
- As a result of activities during "Strengthening the delivery of comprehensive RH services through the community midwifery model” the number of clients receiving contraceptive implants from certified midwives (CMs) increased by more than 20 times at endline, and the number of clients receiving IUDs from CMs more than doubled.
- Under "Assessing the acceptability of conducting routine screening for intimate partner violence (IPV) in public health care settings in Kenya,” an IPV taskforce was established at Kenyatta National Hospital, which then developed an IPV screening tool that will be implemented and assessed for continual use throughout this year.
- Having participated in research during "Integrating alcohol risk reduction in HIV counseling and testing" and seeing the successful outcomes, Liverpool VCT (a local HIV/AIDS service delivery organization) has continued with the project's model and use of the screening tools and has adopted alcohol-risk reduction counseling into its HCT activities.
For more information on individual project results, outcomes, and impact, please consult this page's "Resources" section to access PDFs of technical reports and OR summaries.
Banner photo: © Noor Ali/IRIN
Effectiveness of a community-based positive prevention intervention for people living with HIV who are not receiving antiretroviral treatment: A prospective cohort study (abstract) (PDF)
Sarna,Avina; Luchters,Stanley; Musenge,Eustasius; Okal,Jerry; Chersich,Matthew F.; Tun,Waimar; Mall,Sabine; King'ola,Nzioki; Kalibala,Sam
Global Health: Science and Practice 1(1): 52-67
Publication date: 2013
Feasibility and effect of integrating tuberculosis screening and detection in postnatal care services: An operations research study (abstract) (PDF) (HTML)
Ndwiga,Charity; Birungi,Harriet; Undie,Chi-Chi; Weyenga,Herman; Sitienei,Joseph
BMC Health Services Research 13: 99-
Publication date: 2013
Expanding access to comprehensive reproductive health and HIV information and services for married adolescent girls in Nyanza Province (PDF)
Undie,Chi-Chi; Birungi,Harriet; Obare,Francis; Ochieng,Ben; Liambila,Wilson; Oweya,Erick; Askew,Ian; Burnet,Rob; Deacon,Bridget; Mohamed,Aisha
APHIA II OR Project in Kenya Technical Brief
Publication date: 2012
Positive action for HIV in schools in Kenya (PDF)
Obare,Francis; Birungi,Harriet; Wanjiru,Monica; Bayley,Sheila; Kiunjuri,John; Omondi,Mary; Burnet,Rob; Deacon,Bridget
APHIA II OR Project in Kenya Technical Report
Publication date: 2012
Routine screening for intimate partner violence in public health care settings in Kenya: An assessment of acceptability (PDF)
Undie,Chi-Chi; Maternowska,Catherine; Mak'anyengo,Margaret; Birungi,Harriet; Keesbury,Jill; Askew,Ian
APHIA II OR Project in Kenya Technical Report
Publication date: 2012
Strengthening the delivery of comprehensive reproductive health services through the community midwifery model in Kenya (PDF)
Liambila,Wilson; Obare,Francis; Undie,Chi-Chi; Birungi,Harriet; Kuria,Shiphrah; Wayua Muia,Ruth; Matekwa,Assumpta
APHIA II OR Project in Kenya Technical Report
Publication date: 2012
Using community health workers can lead to positive sexual behavior outcomes among people living with HIV
(PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 5)
Publication date: 2011
APHIA II Operations Research Project in Kenya Newsletter, April 2011 (PDF)
Publication date: 2011
APHIA II Operations Research Project in Kenya Newsletter, February 2011 (PDF)
Publication date: 2011
APHIA II Operations Research Project in Kenya Newsletter, June 2011 (PDF)
Publication date: 2011
APHIA II Operations Research Project in Kenya Newsletter, March 2011 (PDF)
Publication date: 2011
APHIA II Operations Research Project in Kenya Newsletter, May 2011 (PDF)
Publication date: 2011
Community health workers and the media can be effective in providing health information to married adolescent girls in the community (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 9)
Publication date: 2011
Community health workers can effectively provide information and referrals to people living with HIV in their communities (PDF)
APHIA II Operations Research Project in Kenya Programme Brief (November)
Publication date: 2011
Focus on male youths in addressing alcohol and drug abuse risk in the context of HIV prevention among young people (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 7)
Publication date: 2011
Integrating alcohol risk reduction into HTC services (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 4)
Publication date: 2011
Integrating tuberculosis case finding and treatment into postnatal care (PDF)
Ndwiga,Charity; Birungi,Harriet; Undie,Chi-Chi; Kuria,Shiphrah; Sitenei,Joseph; Ochola,Sam
APHIA II Operations Research Project in Kenya Report
Publication date: 2011
Levels, trends and determinants of contraceptive use among adolescent girls in Kenya (PDF)
Obare,Francis; Birungi,Harriet; Undie,Chi-Chi; Wanjiru,Monica; Liambila,Wilson; Askew,Ian
APHIA II Operations Research Project in Kenya Report
Publication date: 2011
Linking HIV-positive family planning clients to treatment and care services in Kenya (PDF)
Liambila,Wilson; Obare,Francis; Birungi,Harriet; Wayua Muia,Ruth; Maina,Joyce Wanderi; Maina,Mary N.; Awuor,Christine; Mohammed,Ibrahim
APHIA II Operations Research Project in Kenya Report
Publication date: 2011
Making HIV services more responsive to young children and infants in Nyanza (PDF)
Wanjiru,Monica
APHIA II Operations Research Project in Kenya Programme Brief
Publication date: 2011
Maternal health care utilization among HIV-positive female adolescents in Kenya (abstract) (PDF)
Birungi,Harriet; Obare,Francis; van der Kwaak,Anke; Namwebya,Jane Harriet
International Perspectives on Sexual and Reproductive Health 37(3): 143-149
Publication date: 2011
Operationalizing and scaling up HIV/RH referrals in Kenya: The way forward (PDF)
APHIA II Operations Research Project in Kenya Policy Brief (no. 1)
Publication date: 2011
Scaling up the integration of tuberculosis screening into reproductive health services (PDF)
APHIA II Operations Research Project in Kenya Policy Brief (no. 2)
Publication date: 2011
Service improvements and community education lead to increase in uptake of HIV services for infants and young children (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 8)
Publication date: 2011
Sexual and reproductive health needs of adolescents living with HIV in Kenya (PDF)
Birungi,Harriet; Obare,Francis; Namwebya,Jane Harriet; Mohammed,Ibrahim; Gitau,Margaret; Makumi,Margaret
APHIA II Operations Research Project in Kenya Report
Publication date: 2011
Strengthening the delivery of comprehensive reproductive health services at the community level in Kenya (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 10)
Publication date: 2011
Ten years of the Kenya Adolescent Reproductive Health Project: What has happened? (PDF)
Evelia,Humphres; Wanjiru,Monica; Obare,Francis; Birungi,Harriet
APHIA II OR Project in Kenya report
Publication date: 2011
Using youth-friendly communication approaches to communicate HIV/AIDS with young people is feasible and acceptable (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 6)
Publication date: 2011
APHIA II Operations Research Project in Kenya Newsletter, December 2010 (PDF)
Publication date: 2010
APHIA II Operations Research Project in Kenya Newsletter, February 2010 (PDF)
Publication date: 2010
APHIA II Operations Research Project in Kenya Newsletter, October 2010 (PDF)
Publication date: 2010
Life-skills education leads to improved effect on adolescents' sexual behavior (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 3)
Publication date: 2010
Referral mechanism improves uptake of ART services for HIV+ FP clients (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 2)
Publication date: 2010
Training service providers increases TB screening in postnatal care (PDF)
APHIA II Operations Research Project in Kenya OR Summary (no. 1)
Publication date: 2010
"APHIA II Operations Research Project in Kenya," brochure (PDF)
Publication date: 2009
Tuko Pamoja: A guide for peer educators (PDF)
Publication date: 2007
Tuko Pamoja: Adolescent reproductive health and life skills curriculum (PDF)
Publication date: 2006
Tuko Pamoja: A guide for talking with young people about their reproductive health (PDF)
Publication date: 2005
Project Stats
Location: Kenya
Program(s):
Reproductive Health
Topic(s):
Behavior change
HIV care, support, and treatment
Integrating health services
PMTCT and pediatric HIV
RTIs/STIs
Duration: 10/2008 - 2/2012
Population Council researchers:
Harriet Birungi
Non-Council collaborators:
APHIA II programs throughout Kenya
Kenya Ministry of Education
Kenya Ministry of Gender, Children and Social Development
Kenya Ministry of Health
Kenya Ministry of Youth Affairs
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