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28. Equip, mobilize, and support faith leaders, FBOs, people in places of worship, and the wider community to create demand for testing of infants and children.

29. Combat stigma and discrimination among faith leaders and within communities of faith.

30. Further collaborate and coordinate community mobilization, education and outreach to find otherwise hard-to-reach children, adolescents, youth and adults for age appropriate prevention education, testing and linkage to treatment and health and social support services and integrate into the national system.

31. Ensure FBO participation in local and national diagnostic product/supplies forecasting.

32. Support and participate in national efforts to improve the use and impact of pediatric diagnostics and develop national strategies to optimize the use of new technologies and interventions.

33. Work to implement new HIVST modalities (such as oral fluid testing) in communities and homes, where national polices and regulations allow for lay implementation with children.


Commitments 28, 29, and 30:

In February and March 2019, EDARP (located in the Nairobi slums) supported by WCC-EAA and a cooperative agreement with PEPFAR through the CDC provided trainings to 1,300 EDARP Community Health Workers, Young Adult Peer Mentors and to selected male EDARP staff members on the Kenyan National HIV Guidelines including HIV self-testing. They were also trained on new innovations  to improve identification of HIV positive adolescents and interventions to increase retention to care and treatment. The trainings included preparation and orientation of newly identified HIV positive paediatric/adolescent clients, including enrollment in peer support groups (both physical and virtual) and the involvement of their parents and guardians to maximize adherence and retention in care. 


The health care providers training was part of EDARPs effort to increase health care providers (social workers, community mobilizers, and facility team leads [who are nurses and clinical officers] in their knowledge, attitude and practices with regards to gender-based violence and work with key populations. This training aimed at 1) enhancing identification of new positive individuals particularly among key populations, adolescents and young people, 2) Ensuring person centered, targeted care to key populations already enrolled on care at EDARP facilities to improve their outcomes and quality of life and 3) improve the identification of gender based violence survivors, provide immediate post GBV care and provide appropriate referrals.


EDARP operates in 14 sites in the Eastern Slums of Nairobi with 390 staff, and over 1,200 community health educators and peer mentors; 26.000 adults and 1.500 children on ART.

Commitment 30:

Between January and September 2019, EDARP has found 2,034 new HIV positive persons and successfully linked 99.9% to treatment.  This includes 1,971 adults and 63 children under the age of 18 years.  From June through September, EDARP is one of the first FBO’s in Kenya to integrate HIV Self Testing into its programing.  EDARP has distributed 2,058 kits during this time and has confirmed results on 678.  4.5% of the returned results were reactive and confirmed positive.  100% have been linked to treatment.  Between July and September 2019, EDARP integrated more target HIV testing toward individuals most-at-risk.  During this period 4,368 partners of HIV positive persons were elicited and tested, resulting in an HIV positivity yield of 17%.  21% of the HIV negative partners are now receiving PrEP.  EDARP is currently providing HIV treatment services for 25,618 adults and 1,457 children under 18 years of age. 85% of these children have achieved viral load suppression.


38. Support and participate in national efforts to improve and integrate the use and impact of pediatric diagnostics for TB and HIV and develop national strategies to optimize the use of new technologies and interventions. 




71. Equip, mobilize, and support faith leaders, FBOs, people in places of worship, and the wider community to create awareness of the importance of HIV testing of infants and children of people living with HIV. Demand that national school curricula include scientifically appropriate information on HIV prevention, testing and treatment. 


72. Combat stigma and discrimination among faith leaders and within communities of faith around HIV prevention, testing and treatment. Create demand for client-centered and stigma-free care within health facilities as well as access to community-based treatment. 


73. Further collaborate and coordinate community mobilization, education and outreach to find otherwise hard-to-reach children, adolescents, youth and adults for age appropriate prevention education, testing, and linkage to and continuity of treatment, health, psycho-social and spiritual support services and integrate into the national system. 


June 2022

Commodity supply


For the last 6-9 months the program has generally had consistent ART supplies including pediatric DTG minor issues as below:- 

Stock outs

  • Isoniazid syrup –which is now being phased out and facilities are now utilizing isoniazid 100mg tablet which is widely available

  • Nevirapine syrup stock outs but as of 3 months ago stocks have now normalized 

  • AZT/3TC FDC stock outs* (The Kenya MOH seems to be scraping this drug out and replacing it with ABC/3TC as an alternative and we have adequate stocks of this. 



  • EID commodity stock outs were experienced nationwide. As of January 2022 stocks for EID commodities have normalized and EDARP Cardinal Otunga Lab is now able to provide PCR testing  for HEI including those that had not received EID due to the stock outs

  • Viral load commodities- Nationwide stock outs experienced the whole of 2021. Since January VL commodity supplies resumed though not at 100% , necessitating prioritizing different populations  including  Children 0-9years, adolescents (10-19) ,and pregnant women

  • Gene-Xpert cartridges- Frequent stock outs necessitating reverting back to use of sputum ZN fluorescent microscopy occasionally.


Clinical service provision for children and adolescents


  • Pediatric DTG optimization (Dtg 10 mg) EDARP has managed to optimize over 95% of children below 20 kgs to PDTG 10 mg ART regimens and the 5% on Kaletra formulations are on follow up by the multidisciplinary teams due to single high VL, disengagement from care and travel outside Nairobi ( With support from Maryknoll Fathers) 

  • Improved VL suppression among children under 5years has improved from 67% to 80% and with those optimized to DTG awaiting 3 monthly VL we expect the suppression to go up

  • Ninety five percent suppression rates among adolescents aged 10-14 years



  • VL testing uptake: was the main barrier to patients treatment monitoring but the situation has somewhat normalized with children and adolescents being prioritized. EDARP will utilized schools holidays in June to reach those in boarding schools who are yet to receive a viral load test. 

New innovation with identification

The main strategy for identification of children and adolescents remains CHW referrals and index testing.

For adolescents and young people EDARP is in the process of training providers and peers on social network testing



The program continues to be very successful with elimination and transmission rate is below 1% at 18 months.

Mother and infant pair cohort follow up is still ongoing and those children who had missed EID testing due to commodity stock outs are being contacted we have a few who are upcountry, others have disengaged from care but providers continue with tracing efforts


TB/HIV integration among children

EDARP continues to have a fully integrated TB/HIV service delivery for pediatric and adolescent. TB prevalence among children is low attributed to good viral suppression and TPT uptake at 100% for CALHIV above 1 year old. 

ART uptake among TB/HIV co-infected children and adolescents is at 100% 

No major challenges other than issues with Gen X-pert commodities mentioned above


Linkage with faith communities

EDARP continues to partners with faith communities to optimize community identification of families in need of testing, distribution of HIVST. Community follow up of children, adolescents and their caregivers.

CHW have played a critical role in the support of children with high viral load specifically they are involved in daily observed therapy for ART providing much needed support to children with high Viral loads and their caregivers


Brief Update on the Progress of the EDARP Child Safeguarding

EDARP is actively engaged in Child Safeguarding by ensuring that as we provide services to children we do them no harm, and maintain zero tolerance to child abuse and exploitation. 

Progress made on the same includes;

  • All EDARP Staff and Chws have been sensitized on the policy, and enlightened on issues pertaining to child abuse and need to protect children.

  • All new staffs are also taken through the policy during their orientation process.

  • The social workers who are the Facility Focal Person for Child safeguarding have been spearheading efforts to ensure their respective facilities are safe for children.

  • Child Safeguarding Committees have been created at the facilities. The role of the committee is to conduct investigations on any reported child safeguarding issue. 

  • Local Implementing Partners (LIPs) working under World Vision Tumikia Mtoto program, are also being sensitized on the EDARP Child Safeguarding Policy. Approximately 300 staff and CHWs from the LIPs have been enlightened on the Policy.

Any other significant issues we are dealing with as social workers;

  •  School Drop Out: Due to the current economic hardship since the emergence of Covid-19, a significant number of adolescents have dropped from school due to lack of school fees. Others have not been able to join secondary school after completing their primary education. LIPs offering school fees support are also resource constrained and cannot cater to the large numbers of children needing school fees support.

  • Food Insecurity: Several families with household members on care are facing food insecurity. This has been heighted after several people lost their jobs due to Covid-19 outbreak, while those operating income generating activities report that business is low. This is also affecting adherence among our clients, hence viral suppression and retention.

October 2021

  • During the past 6 months, despite the ongoing COVID-19 epidemic in Nairobi, EDARP has used multiple community-based interventions to reverse the trend of patient loss-to-follow up.  This has been achieved my intensive community case finding through EDARP Community Health Workers and staff dedication to this process.  Since May 2021 EDARP has seen a net increase in adult positive patient of 54 to 28,318 and a net increase of in pediatric positive patients of 19 to 1,302. 

  • However, this has been achieved in the midst of an extremely difficult time of disruptions in supply chain management of basic laboratory and pharmaceutical supplies.  This has impacted the availability of pediatric formulations and the ability to perform EID on children enrolled in our PMTCT program and viral load testing for both adults and pediatrics

  • As of 4 October 2021 the following pediatric commodities are out-of-stock:

    • Isoniazid syrup (out  of stock since March 2021)

    • Isoniazid 100mg (out of stock for more than 6months)

    • Pyridoxine 25mg (out of stock for more than 6 months)

    • Cotrimoxazole syrup (out of stock for the last 1 month)

    • Darunavir 75mg (out of stock as from June1,2021)

    • Pyridoxine 50mg  (out of stock for more than 6 months)

  • Multi month dispensing, which had previously been so successful, is now limited by low stock status and the need for patients to come to clinic monthly, and at times weekly for refills:

    • Isoniazid 300mg (short expiry stocks)

    • Dolutegravir 50mg-for than 3/12

    • TDF/3TC/DTG 90, for the last 1 month

    • Ritonavir 100mg-for than 6/12

    • Lopinavir/ritonavir 40/10mg

    • Fluconazole 200mg.

    • Lamivudine 150mg

    • Abacavir 300mg


The EDARP Medical Director reports:

  • COTRIMOXAZLE/ SEPTRIN: PEPFAR no longer supports the purchase of Cotrimoxazole (both for adult and pediatric). The MOH/GOK is expected to buy this commodity for PLHIV but there have been challenges since the GOK took this up. EDARP would not be able to utilize PEPFAR funs to procure CTX syrup for HIV exposed infants

  • Isoniazid 300 mg and Pyridoxine 50 mg: This is the adult formulation but important to note that MEDS have indicated they will supply EDARP with this commodity this week. 

  • Pediatric TPT: RH regimen (Rifampicin and Isoniazid) this is currently available and has not been affected by shortages

  • NB: TLD - applies for children and adolescents who weigh 30 kg and above Pediatric DTG- 10 mg dispersible and scored tablets - Health care workers sensitization has commenced. No date has been communicated on when to expect the pediatric DTG



April 2021

EDARP continues to provide fully integrated HIV/TB for children and adolescent.  For Children and adolescent on HIV care and treatment, the viral suppression rate is at 83% and 91% respectively.

The main concerns during the past 6 months have been;

  • Low stocks and eventual stock out of Isoniazid syrup for pediatric TB preventive therapy

  • Stock out of Kaletra syrup and facilities have put all children on Lopinavir/ritonavir on Kaletra pellets

  • Social economic challenges arising from COVID-19 impact negatively affecting care giver support for children and adolescent on ART- EDARP continues to work closely with OVC program (MWENDO implementing partners) to link households to social support. 

  • Stock outs of early infant diagnosis commodities resulting in slowed down testing and missed testing at 6 weeks and follow up testing at 1 years for HIV exposed infants

  • Viral load testing reagent stock outs for the last 2 months resulting in temporary suspension of VL monitoring for PLHIV including children and adolescents. This has a negative impact on the follow up of children with previously High VL that are on MDT follow up who are scheduled for repeat VL.


52. Ensure FBO participation in local and national forecasting of optimal paediatric drug formulations.

53. Collaborate with GAP-f partners to develop, test, and disseminate training tools for treatment initiation with LPV/r and other optimal pediatric formulations.

54. Support and increase family treatment initiation and retention for children, adolescents, and families by:

  • Increasing identification and provision of same-day/same-appointment mother/infant pair treatment through FBO clinics;

  • Promoting male/father engagement in EMTCT programmes; and

  • Increasing stigma reduction interventions through mobilized faith leaders and faith communities

  • Providing social work interventions to assist fathers to support treatment and adherence of their partners and children living with HIV.

55. Foster and more actively participate in coordinated and collaborative advocacy to:

  • Increase funding for research & development, introduction and scale-up of priority pediatric drugs and formulations;

  • Accelerate regulatory processes for rapid adoption and uptake of optimal paediatric drugs and formulations; and

  • Ensure sustainable access to optimal testing and treatment for infants and children.




119. Advocate for and support Ministries of Health to rapidly transition to optimal paediatric formulations as outlined by the latest WHO guidelines, provide coordinated support for the development and implementation of transition plans, inform clinicians and patients of the value of transitioning to new formulations, and ensure communication of reliable information on the availability of new formulations in-country.


120. Support the scale up of access to priority formulations and diagnostics and take steps to facilitate their wider roll-out, including by performing operational research, developing introductory guidance and education, materials, and other tools for health facilities and local community health structures.


121. Promote the revision of national procurement plans to align with WHO recommended regimens and the EML-C, and support the provision of reliable forecasts and the consolidation of orders.


122. Mobilize their networks and work with communities to help build treatment literacy, generate demand, and expand access to TB diagnosis and treatment among children in close collaboration with other stakeholders.


123. Raise awareness in local, national, and global fora about the unmet diagnostic and treatment and prevention needs of children with or at risk for TB.


124. Foster and more actively participate in coordinated and collaborative advocacy to:

  • Increase funding for TB research & development, introduction and scale-up of priority paediatric drugs and formulations; 

  • Accelerate regulatory processes for rapid adoption and uptake of optimal paediatric TB drugs and formulations; and

  • Ensure sustainable access to optimal TB testing and treatment for infants and children.


125. Tackle the TB stigma and discrimination in communities, schools, and healthcare settings that prevent children and adolescents living with TB or at risk of TB from accessing testing and treatment, including promotion of awareness of the difference between infection and disease  and include messages of hope regarding treatment of both HIV and TB.


126. Promote uptake by mobilizing their networks of hospitals and community structures to distribute paediatric medicines in hard to reach places and in situations of conflict and crisis.


127. Support and increase TB treatment initiation and retention for children, adolescents, and families by:

  • Identifying all TB-exposed children and connecting them to treatment and preventive TB treatment through FBO clinics and within communities of faith; 

  • Reducing TB stigma and discrimination through mobilization and evidence-based education and training of faith leaders and faith communities



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