Browse POLICY Project (1995-2006) Materials
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Country and regional assignments reflect those made at the time of production and may not correspond to current USAID designations.
List entries are alphabetical by title and contain the title, abstract, language, and then the filename which is hyperlinked and will open in a new browser window. Many files are PDFs but some of the older ones are Word documents.
KenyaMore recent Kenya publications are available.
AIM projections and impacts.
Over two decades since the first AIDS case was described in Kenya, HIV/AIDS still remains a huge problem for the country in its efforts for social and economic development. Responses to the pandemic have evolved over time as people became aware of this new disease, as they experienced illness and death among family members, and as services have developed to confront this epidemic. Initially many segments of society expressed denial of the disease. Early in the epidemic in Kenya political commitment was limited. While awareness of AIDS has been nearly universal for more than a decade, misconceptions still abound and many still have not dealt with this disease at a personal or community level. The purpose of AIDS in Kenya has been to inform leadership and citizens of the country about the epidemic, make projections about its impact, and describe policy. Emphasis of the publication now shifts; this edition: " describes the level and trends of HIV infection; " assesses the breadth and depth of knowledge of HIV; " identifies behavioural patterns associated with these trends; " provides information on HIV prevalence from VCT clients, STI patients and blood donors; " describes the scale-up in HIV prevention services; " analyses the interaction of the TB and HIV epidemics; " describes the expansion of HIV care and treatment; and " assesses the socio-economic impact and costs of AIDS.
Owing to the high fertility and declining mortality experiences in the past, Kenya is characterized by a youthful population with over 40 per cent being younger than 15 years. This implies that over half of Kenyas population, about 31 million in 2004 is aged below 24 years, with a large peoportion being adolescents. Consequently, Kenya faces the formidible challenge of providing its adolescents with opportunities for a safe, healthy, and economically productive future. In line with the ICPD recommendations, Kenya has put in place an Adolescent Reproductive Health and Development (ARH&D) Policy to enhance the implementation and coordination of programmes that address the reproductive health and development needs of young people in the country. The principles spelt out in the ARH&D Policy provided a conceptual guide to the development of this Plan of Action, which further distinguishes four strategic areas: advocacy; health awareness and behaviour change communication; access to and utilization of sustainable youth friendly services; and management. This Plan of Action also provides an estimation of the total resources required to achieve the goal and objectives outlined in the Adolescent Reproductive Health and Development Policy.
This study was designed to document the extent to which Kenya has managed both its family planning/reproductive health (FP/RH) and HIV/AIDS programs in the context of the high HIV prevalence (14%) the country is experiencing. In order to gain further insights on the dynamics of the FP program (FPP) in the country, interviews were conducted with 16 key informants from relevant government ministries/departments, NGOs, collaborating agencies, and donors. Questions touched on specific issues of FP/RH and HIV/AIDS regarding funding levels, staffing/personnel issues, integration and role of nongovernmental organizations (NGOs) and the private sector in FP/RH and HIV/AIDS programs. The background information for the study was obtained from several policy documents and other related official documents such as strategic plans, relevant survey results/reports, development plans, and statistical abstracts.
A report from a workshop held by the East-Central Division of the Seventh Day Adventist Church, bringing together people from five continents to put forth a united front in the battle against the spread of HIV/AIDS. The workshop sensitized church leaders to the issues of HIV/AIDS, identified priority actions and put forth policy reccomendations to the church Executive Committee.
This manual is designed to help manage the Government of Kenya's Facility Improvement Fund successfully in local health centres. Experience in the health centres has shown that implementation of the policies and procedures described in the manual will improve the collection and use of funds, and enhance patient and staff satisfaction with services.
This report provides a summary analysis of the resources required to achieve the broad objectives outlined in Kenyas National AIDS Strategic Plan (KNASP). The report specifically provides summary information on the key interventions as laid out in the KNASP (2005-2010) and the financial resources required for a credible response to the epidemic. The report also includes the best estimates on the current coverage of those interventions; the current assumptions about HIV/AIDS capacity required to scale up coverage; the best current estimates; and the current and projected HIV/AIDS resources. The data specific to Kenya were obtained using a combination of: 1) key informant interviews with representatives from government, US government agencies, UN institutions, and local universities; 2) a review of six existing HIV/AIDS budgets in Kenya; 3) review of international literature; and 4) various demographic and economic surveys conducted on HIV/AIDS interventions in Kenya.
The right to own and inherit property is a crosscutting right that traverses the realm of civil, political, economic, social and cultural rights. This right is central to the true empowerment of everyone in society (men, women, boys and girls) and is a key developmental right. It is the common right to all societies and cultures. It is central to securing the dignity of all members of the society. Emerging legal and social trends, as they relate to the ownership and inheritance of property, indicate a practice that has largely worked out to the detriment of women in virtually all communities and social classes in Kenya. They include the laws relating to property, to marriage and dissolution of marriage, land registration systems, and the social and cultural attitudes that determine the actual enjoyment of these rights. Compounding the problem is the HIV/AIDS pandemic, which has caused massive destitution, displacements, blame-passing and mistrust in nearly all communities in Kenya. The high stigma associated with it has increased the vulnerability of women in this regard. In no other community in Kenya is the twin problem of societal and cultural practices - which discriminate against women and thereby translate into widespread of HIV/AIDS - more stark than within Luo Nyanza. It is against the backdrop of the realisation of this continuing trend of violation of womens (especially, but by no means limited to widows) right to property ownership and inheritance rights and the urgency of the problem in the face of HIV/AIDS pandemic that the POLICY Project Kenya ( funded by the Futures Group) and Kenya National Commission on Human Rights (KNCHR) (funded by the Governance Justice Law and Order Sector reform program) came together inspired by the same need to work on enhancing the enjoyment of this right by women in Kenya.
This manual provides a comlete set of guidelines for operations of the Health Boards and Committees.
The National AIDS Control Council has realized the need to mainstream gender issues in programmes/projects since mainstreaming gender issues in the planning, implementation and evaluation of programmes strengthens the effectiveness of the response to HIV and AIDS. The overall goal of this toolkit is to sensitise policy and senior level decision makers on key HIV, AIDS, and Gender issues. It offers guidelines to use when planning and formulating gender responsive policies and programmes relating to HIV and AIDS.
A quarterly newsletter on population issues in Kenya, produced by the National Council for Population and Development (NCPD) and the POLICY Project. Theme: Kenya Demographic and Health Survey 2003
A quarterly newsletter on population issues in Kenya, produced by the National Council for Population and Development (NCPD) and the POLICY Project. Theme: Improving the Quality of our Population: ICPD+10: Lessons Learnt
The POLICY Project implemented a core package of research and technical assistance to assist the government of Kenya in understanding the costs associated with the provision of family planning (FP) services over the period from 2003-2005. In implementing the financing part of the package, special attention was paid to addressing the needs of the poor, with free or highly subsidized services being delivered to such groups. This subsidy aspect of the package was introduced at the stage of developing guidelines for the implementation of user fees, waivers, and exemptions. Implementation of user fees was designed to generate revenue to maintain availability of FP services and strengthen the quality of those services while expanding access to the poor and underserved. Activities included analysis of current fee charging practices; analysis of operational policies affecting FP fees, waivers, and exemptions; market segmentation analysis; review of willingness and ability to pay; and development of draft pricing guidelines for FP services. POLICY core package activities led to a critical change of position on the merits of cost sharing by the Ministry of Health. The draft pricing guidelines will enable the government to enact an effective, evidence-based approach to implementing user fees, waivers, and exemptions for FP services. These results will ultimately lead to improved access to high-quality FP services for all social groups, including the the poor and currently underserved populations. This report documents the POLICY Project's core package in Kenya, taking into consideration the family planning and economic context in which the FP services are provided; key stakeholders; activities and products; key research findings; and lessons learned. The FP financing experience in Kenya has potential for replication in other countries.
Kenya CP final report.doc
This brochure describes the KENEPOTE program. KENEPOTE is a network of HIV-positive teachers, founded in 2003 by two HIV-positive teachers. KENEPOTE aspires to create an environment where teachers with HIV and AIDS will be free from fear, shame, denial, stigma, and discrimination. The KENEPOTE mission is to build the capacity of it's members in advocacy for the reduction of stigma and discrimination, protection of rights of HIV-positive teachers, orphans and vulnerable children; increase access to psychosocial support services and skills to teachers; prevent further spread of HIV and AIDS in collaboration with other stakeholders by bringing positive change in attitude and behavior of communities to HIV and AIDS.
This is a report of the first wrokshop held in Kenya for HIV-positive teachers in December 2004. It was organised by KENEPOTE and the POLICY Project. The goal of the workshop was to sensitise HIV-positive teachers and important education-sector stakeholders on KENPOTE goals, vision, mission, and objectives. The workshop further hoped to get HIV-positive teachers to share their workplace and life experiences and to explore ways in which they could unite to address the challenges facing them, given their great potential as Kenyan agents of change.
During the process of formulating the Kenya National HIV/AIDS Strategic Plan, some of the gender dimensions of the epidemic had been recognised. It was noted that a striking feature of the epidemic was its impact on women as compared to men; the incidence of HIV/AIDS among women was rising at a shocking rate and women were being infected at an earlier age than men were. However, explicit strategies that focused specifically on gender issues were not included in the development of policies or programmes under the five priority areas. In 2001, as the gender aspects of the epidemic became clearer and it was recognised that gender was playing a crucial role in the dynamics of the HIV/AIDS pandemic, the National AIDS Control Council established a Technical Sub-Committee on Gender and HIV/AIDS Task Force. It was agreed that the best approach would be to engender the existing Kenya National HIV/AIDS Strategic Plan because it is the key document that guides and co-ordinates all responses to HIV/AIDS in Kenya. The Technical Sub-Committee’s mandate was to formulate guidelines and create a strategic framework through which gender concerns could be integrated into the analyses, formulation and monitoring of policies and programmes relating to the five priority areas of the Kenya National HIV/AIDS Strategic Plan so as to ensure that the beneficial outcomes are shared equitably by all – women, men, boys and girls. The gender analysis and mainstreaming strategies contained in this document are centrally informed by two National AIDS Control Council commissioned field studies carried out in October 2001 and May 2002. The findings of the field studies illustrate how different attributes and roles societies assign to males and females profoundly affect their ability to protect themselves against HIV/AIDS and cope with its impact. Examples range from the gender issues that render both men and women vulnerable to HIV infection to the ways in which gender influences men and women’s responsibility for, and access to, treatment, care and support. The findings from the field studies and the resulting gender analyses illustrate that gender roles and relations powerfully influence the course and impact of the HIV/AIDS epidemic. Gender-related factors shape the extent to which men, women, boys and girls are vulnerable to HIV infection, the ways in which AIDS affects them, and the kinds of responses that are feasible in different communities and societies. The control of the spread of HIV/AIDS is dependent on the recognition of women’s rights in all spheres of life and therefore, women’s empowerment is an important tool in the fight against HIV/AIDS. Because the HIV/AIDS pandemic is fuelled by gender inequalities, a proactive engendered response is required to minimise its impact. It is through this document that the Technical Sub- Committee on Gender hopes to ensure that the gender dimension of the HIV/AIDS epidemic does not remain just an intellectual idea, but through the identified strategies becomes a practical tool for guiding policy decisions and programming for all activities under the umbrella of the Kenya National HIV/AIDS Strategic Plan for 2000 - 2005.
Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
Home-based care is an approach to care provision that combines clinical services, nursing care, counseling and psycho-spiritual care, and social support. It represents a continuum of care, from the health facility to the community to the family to the individual infected with HIV/AIDS, and back again. The Government of Kenya regards home-based care as a viable mechanism for delivering services because it has important benefits for everyone on that continuum. This guide summarizes the existing policy framework defining and supporting home-based care in Kenya. It then presents the preferred approach to programme design and service delivery.
These guidelines spell out the basic component of home care services, the programmatic standards, and the requirements for service delivery.
User fees are gaining widespread use in government health programs as a means of alleviating pressure on constrained budgets as demand for services increases. Concerns that fees reduce access to services among the poor have led to the promotion of fee exemption mechanisms in order to protect those unable to pay for services. The exemptions, however, may not effectively ensure access among the poor because (1) informal fees and other costs associated with seeking and receiving services are not alleviated by most exemption mechanisms and (2) exemption mechanisms are poorly implemented. The low proportion of formal fees to total costs to the consumer and the unpredictable nature of informal fees and other costs of access may actually work against formal fee exemption mechanisms. Even though little is known about how well fee and waiver mechanisms function for maternal health services, it is important to understand whether exemption mechanisms alone hold promise for protecting access for the poor or whether the mechanisms need to be supplemented with other strategies. This study was conducted simultaneously in five countries: Egypt, India (Uttaranchal), Kenya, Peru, and Vietnam. The objectives were to survey actual costs to consumers for antenatal and delivery care; survey current fee and waiver mechanisms; assess the degree to which these mechanisms function; assess the degree to which informal costs to consumers constitute a barrier to service; and review current policies and practices regarding the setting of fees and the collection, retention, and use of revenue.
The POLICY Project prepared this paper as part of a study of the status of family planning in four countries hit hard by HIV/AIDS: Ethiopia, Kenya, Zambia, and Cambodia.
Working Paper 17- FP HIV Integration Synthesis.doc
Despite some attempts to integrate family planning with sexually transmitted infection (STI) and HIV/AIDS services, policies and programs continue to treat them as unrelated areas of intervention. Furthermore, international attention to the HIV/AIDS pandemic has overshadowed attention to family planning, particularly in Africa where the HIV/AIDS epidemic is most acute. Yet family planning is closely related to two components of HIV/AIDS services: prevention of mother-to-child transmission (PMTCT) and voluntary counseling and testing (VCT). Is there a role for family planning in the context of HIV/AIDS programs? This paper analyzes how international guidelines, national HIV/AIDS policies and PMTCT and VCT policies have addressed family planning in 16 high-HIV prevalence countries. It also describes major gaps in the various countries’ policy environment.
Kenya’s family planning (FP) success has been overshadowed by the HIV/AIDS epidemic, which was declared a national crisis in 1999. Data from the 2003 Demographic and Health Survey in Kenya (KDHS) provide a cautionary tale of the unintended outcomes associated with the shift in attention of programs and resources from family planning primarily to HIV/AIDS. From a steady rise in contraceptive prevalence from 27 percent in 1989 to 39 percent in 1998, contraceptive prevalence stalled and remained at 39 percent in 2003. Yet, the surveys have consistently shown that many women report wanting to delay or limit future births but are not using any FP method. In the context of the HIV/AIDS pandemic, is there still a need for family planning? As government and donor resources in Africa shift increasingly to support of AIDS programs, the answer to this question is crucial. The purpose of this study was to explore how family planning is being implemented in Kenya in the context of high HIV prevalence. A similar study was conducted in Zambia.
The 1994 International Conference on Population and Development (ICPD) in Cairo stressed the importance of gender and noted that reproductive health programs should be implemented from a gender perspective. However, little has been written about how reproductive health programs that focus on improving quality of care and access to care can integrate gender. This paper describes the experiences of three types of programs (government, reproductive health NGO, and women’s health NGO) in Kenya, India, and Guatemala that integrate gender in their work and examines how they integrate gender into programs that improve quality of care and access to care. It should be emphasized that this report does not document whether gender integration results in higher quality and access, but rather documents how gender integration can take place. This report is based on data that were collected in the three countries, through interviews with a total of 27 program staff and 34 providers and through focus groups with 136 clients. These three types of programs engage clients in the clinic and community setting in a manner closely related to their mandates and perspectives on gender. In the government and reproductive health (RH) NGOs, the emphasis is on quality and access, with gender included as a means to reach those goals. The women’s NGOs have the mandate to first promote gender equity (primarily through women’s empowerment), and also to use it as a means to promote reproductive health care. The organizations with the strongest internal gender policies, namely the women’s and RH NGOs, are also the most committed to integrating gender into their programs for clients. The RH NGOs are most committed to gender equity or equal participation of women and men in the organization.