OPTIMIZED RETENTION IN CARE MODEL FOR NEWLY DIAGNOSED HIV CLIENTS IN KISUMU COUNTY REFERRAL HOSPITAL

Name: Willis Gasami Kiriago

Registration No.:  W82/89464/2016

Fellowship: Program Management Track

ABSTRACT

Kisumu County is one of the 47 counties in Kenya. The county has a diverse background comprising of urban and rural set-ups as well as a rich ethnic, racial and cultural diversity. There are seven sub counties within Kisumu County where the major economic mainstay of the residents include: Fishing, Farming (rice and sugarcane growing) and Trade. With the prevalence rate of 19.3%, the county ranks third among the 9 counties that account for the highest number of new HIV infections in the country. Having one of the highest HIV incidence and prevalence in Kenya, Kisumu County is working to prioritize and optimize HIV service delivery right from the community to all of its level 2 – level 6 health facilities. In this regard Kisumu county referral hospital is one of the high volume health facility that offers HIV services right at the heart of Kisumu city. Due to its strategic position KCRH has 17600 clients ever enrolled in care with 5400 active registered HIV clients. This number could increase three fold were it not for clients who drop out right after HIV diagnosis. The metropolitan environment with mass transit of people makes it hard to track and retain the newly HIV diagnosed clients in care and treatment within KCRH. This coupled with other operationalchallenges are hindering the achievement of 959595 UNAIDS targets for Kisumu County. There is therefore need to bring on board innovative approaches  especially targeting high volume facilities to help in facilitating and resolving the said challenges. 

Efficient and effective innovations and strategies can therefore play a pivotal role in closing some of these gaps, the project sought to design and implement a retention in care strategy that aimed at retaining newly diagnosed HIV clients in care and treatment hence strengthening the quality of care and achievement of the 959595 targets in KCRH and Kisumu county as a whole.

Upon designing the RIC model, it was piloted in KCRH for 6 months. Over that period cases of HIV positive clients who missed to be enrolled in care and treatment reduced significantly, proving that program data can help to inform designing of innovative interventions that can significantly help to improve RIC among HIV positive clients without much strain on existing health system infrastructure.