Health at Home/Kenya

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Winter 2009

Collective Action Initiative Takes Sustainable Health Model to 2 Million

The Coalition Is kicking off its first-ever Impact Initiative in Africa with a breakthrough model that could turn the tide on HIV in Kenya.

The Impact Initiative will reach up to two million people in rural Western Kenya, where the HIV infection rate is about 15 percent-twice the national average. Health at Home/Kenya will take HIV testing door-to-door, leveraging a tested model and proven implementing partner that has already reached 70,000 HIV-positive patients in Kenya. During the program's pilot phase, more than 90 percent of the target population welcomed counselors into their homes.

What will make it work as an Impact Initiative: Pooling financial resources of members, support from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), multiple Coalition members with a mix of core competencies and a superb implementing partner, AMPATH.

A Proven Model for Deep Impact, Long-Term Sustainability

The impact of the pilot model is unmistakable to Betty, an AMPATH client during the pilot phase. Betty found out she was HIV positive in 2004 and has since helped to mobilize her community in support of the door-to-door approach.

"To me as a person living with HIV and AIDS I saw [home-based testing and counseling] as a good program because it could reach people in their homes and maybe those people who have a fear of going to [voluntary counseling and testing] centers because people might see them and maybe talk about them. It was so good for them to come to the homes because it was private-you could talk to the counselor alone."

Betty does not mince her words when she talks about where she would be without the support of the pilot program. "I think right now I'd be dead," she says. Through the Health at Home/Kenya initiative, counselors will provide families with in-home HIV testing and tuberculosis screening, counseling and treatment referrals as needed, anti-malaria bed nets and de-worming medication.

Sustainability is central to the model. Through existing structures, Health at Home/Kenya is connected to programs for long-term sustainability for both personal and community health, including medical care, skills training, microcredit, access to education and agricultural development.

But the model doesn't end with a single home visit. If family members are not at home when the home-based counseling and testing (HCT) team visits, team leaders record the information on PDAs and immediately schedule follow up visits. If members of the household need treatment, an appointment is scheduled on the spot. HCT staff follow-up if appointments are not kept.

The 2007 Kenya AIDS Indicator Survey exposed the seriousness of the HIV/AIDS epidemic in the East African nation: Eighty percent of those who were HIV positive didn't know their status and the fastest growing prevalence rates were in rural areas.

Dr. Nduku Kilonzo, director of Liverpool VCT, Kenya's largest HIV testing organization, says those two findings were a wake-up call.

"That means that if we are going to respond to HIV prevention effectively we need to get people to know their HIV status and that has to be in the rural areas," says Kilonzo.

But there are significant obstacles to getting HIV testing and other health services to rural populations in Kenya. Pervasive HIV/AIDS stigma and the lack of transportation options keep most rural people from ever visiting a VCT clinic.

The Health at Home/Kenya model mitigates these challenges, bringing critical services into the home. The model was perfected throughout the pilot phase and now includes local stakeholder and opinion leader relations as well as community activities, which pave the way for the home visits.

Governments and Multiple Corporate Partners

Health at Home/Kenya is being managed as part of the Coalition's Impact Initiatives program, which creates structured partnerships to focus on high-impact, life-saving opportunities.

A team of businesses with targeted core competencies will support the scaling-up of the program, expanding capacity to make tremendous impact, and establishing a model that will play a critical role in ending HIV/AIDS and significantly improving overall health.

Coalition staff have been collaborating closely with the Kenyan government, which is a critical partner with the private sector in the fight against HIV/AIDS in Kenya.

"We discovered as a government that although we have abilities and infrastructure to reach quite a few people in our population, there are areas where we cannot get to. And we needed different skill sets that are inherent in businesses to be able to reach them," says Professor Alloys Orago, director of the National AIDS Control Council of Kenya.

Orago sees Health at Home/Kenya as a jumping off point for business engagement with his government. "Businesses that come on board now are building a long-lasting relationship with the Kenyan government," says Orago. "And we're looking forward to more coming on board."

Coalition members are joining Health at Home/Kenya in various capacities, such as providing capital, making in-kind contributions and lending core competencies. Selected partners are welcomed at various levels of commitment. The Coalition's Impact Initiatives personnel are continuing their work to
assemble a team of corporate and non-corporate partners with the right mix of competencies to ensure on-the-ground success.

Corporate partners to date include Abbott Fund, BMS Foundation, Deutsche Post/DHL, Pfizer Inc, Premier Medical Corporation, SABMiller, Standard Bank and Standard Chartered Bank.

Coalition staff will convene quarterly meetings with all partners to review progress and make mid-course corrections as needed. The Coalition team will ensure that all partners are well-coordinated, and will develop and oversee the deployment of rigorous measurement and evaluation.

Communications programs, including stakeholder outreach and media relations, are set up for each Impact Initiative.

There are multiple objectives for the communications: To share learnings that others can apply; to ensure awareness among key influencers in the public health arena, government and other critical audiences; to build visibility for partners' contributions to a highly innovative and unusually impactful approach to public health; and to provide tools to support partners' communications with their stakeholders, such as their employees, prospective employees and investors.

Steve Smith, chair of the Kenya Private Sector Association and CEO of Eveready East Africa sees Health at Home/Kenya as an opportunity for businesses to make a difference while also investing in their long-term growth.

"We have to recognize that these are our future consumers and their memories are long and they remember who has helped and who hasn't," says Smith. "So we need to take this opportunity and do our civic part to help communities when they have situations like this, because it is important to the longstanding sustainability of our companies."

TAKE ACTION

Getting Involved with GBC Impact Initiatives

Impact Initiatives are chosen and developed based on priorities identified by Coalition members, coupled with a careful examination of the areas of need and greatest potential impact. The Coalition coordinates each initiative, ensuring that business competencies, products and resources are blended coherently with those of the initiative's non-corporate partners.

We expect to advance models that are replicable- compounding the reach and bringing an end to HIV/AIDS, TB and malaria sooner. Ultimately, Impact Initiatives are about saving more lives. Partners find additional value to their companies on many levels, including:

Employee Engagement Opportunities
Coalition members find that there is a high demand among employees to get involved in on-the-ground lifesaving initiatives. They also find that employees who do this kind of work get an invaluable professional development experience, which often results in greater leadership, better performance and substantial innovation.

Core Competence Applications
Coalition members constantly look for where they fit into the global fight against HIV/AIDS, tuberculosis and malaria-where their specific resources and abilities are most needed and will make the biggest difference. Impact Initiatives define very exacting matches for big challenges and well-honed competencies. Beyond that, Impact Initiatives do so in a way that coordinates many core competencies from many corporate and non-corporate partners into a single, effective team approach.

Cost-Sharing
Particularly in difficult economic times, going it alone on funding is a challenge. Through Impact Initiatives, companies combine their financial resources with funds from other businesses and governments.

Partnerships and Networking
Impact Initiatives are designed as partnerships, and Coalition staff develop structured interactions among participants. Through Impact Initiatives, good relationships are established with host governments, NGOs, funding agencies and many others. The programs are also very visible and important to the population on the ground-the markets of the future.

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