Nairobi, Kenya. Just over half of Kenya’s hospitals and 12 percent of its health centers now provide antiretroviral treatment (ART) for people living with HIV, according to a recently published national survey. While ART services are still not available to everyone, Kenya’s health care system is increasingly providing these life-saving medicines as well as other prevention and treatment services for people facing AIDS.
"Access to ART has increased greatly over the last three years," says Dr. Richard Muga, Chief Executive Officer of the National Coordinating Agency for Population and Development, the agency that implemented the 2004 Kenya Service Provision Assessment (KSPA) survey. "Now almost one in ten health care facilities nationwide offers ART, and 65 percent of facilities provide care and support services for common opportunistic infections and other illnesses affecting people with HIV."
While progress in treating HIV infection is rapid, significant challenges remain. Stock outs of antiretroviral drugs have occurred in one quarter of the facilities providing ART, and many providers are not adequately trained, particularly providers working in private for-profit facilities. Only 18 percent of private facilities offering ART have a staff member recently trained to provide antiretrovirals. In all types of facilities, health care providers are also unlikely to have received recent training for treating opportunistic infections. These findings are particularly worrisome since treatment protocols and guidelines are not widely available.
Over 6 percent of Kenyan adults are infected with HIV, according to the most recent estimates. Access to voluntary counseling and testing is still a problem in some areas of the country and for some populations, however. Less than 20 percent of facilities in Nyanza and North Eastern province offer HIV counseling and testing, for example, compared with the national average of 37 percent. Less than 15 percent offer "youth-friendly" HIV services, that is, services designed to bring in unmarried young women and men who might not otherwise seek care. "This is a national catastrophe," says Dr. Muga, "because HIV infection rates among young unmarried women are a major concern in Kenya."
The 2004 Kenya Service Provisions Assessment (KSPA) is a nationally representative survey of 440 health care facilities in Kenya. The 2004 KSPA was implemented by the National Coordinating Agency for Population and Development (NCAPD) with support from the Ministry of Health, the University of Nairobi, and the Central Bureau of Statistics. Technical assistance was provided by ORC Macro through its MEASURE DHS project. Funding for the survey was provided by the U.S. Agency for International Development (USAID), the British Department for International Development (DFID), and UNICEF.