We have been measurably improving the health of Kenyans since 1989. Our approach harnesses the vitality of the private sector to improve health outcomes for “Sara” — our archetype that focuses our interventions.
We address the most serious health challenges affecting resource-poor and vulnerable communities in Kenya, including HIV/AIDS, reproductive health and family planning, and the greatest threats to children under five including malaria, diarrhea, pneumonia and malnutrition.
Transition to PS Kenya
After 25 years of successful operations in Kenya, we recognize that Kenya-and our organization-has come a long way. The challenges we face today are, while considerable, greatly different than the days when our program was established. In recognition of that evolution, from 2014, PSI’s operations and people will transition to a locally registered, independent, Kenyan entity. By doing so, we ensure that Population Services Kenya, or “PS Kenya” will be well positioned to sustainably improve the health of Sara for years to come.
This transition comes from one of strength. We’ve been led by exceptional Kenyan management teams, supported by strong and mature systems, and guided by a wise and diverse Board. We believe a locally led and governed organization will be well positioned to work with the Government of Kenya (GoK) and donors to deliver local solutions driven by best global practices. PSI will continue to provide technical assistance and support to PS Kenya throughout this transition, and beyond.
PS Kenya estimates that in 2015, its products and services helped avert 2,060,641 DALYs, including, by health area:
- 315,537 Malaria DALYs
- 1,354,485 HIV DALYs
- 386,643 FP DALYs
- 1,365 MNCH DALYs
- 2,524 WASH DALYs
- 87 NCD DALYs
PS Kenya’s family planning programs also provided 1,110,759 couple-years of protection.
The goal of the Kenya National Malaria Strategy (NMS) 2009-2017 is to reduce malaria related illness and death by two-thirds. Key to this is scaling up access to malaria prevention and treatment to all persons living in malaria-risk areas. The Government of Kenya has adopted the vision of a malaria-free Kenya. Some of the strategies towards this are achieving universal net coverage and increasing ITN use to 80 percent.
PS Kenya focuses its ITN distribution program on endemic, epidemic and seasonal risk areas to increase access to and use of long-lasting insecticide-treated nets to prevent malaria. PS Kenya is also involved in malaria diagnosis and treatment programs through the 3T approach i.e test, treat and track.
PS Kenya’s malaria programs support the Ministry of Health through the Malaria Control Unit, in achieving its vision towards a malaria free Kenya.
Water, Sanitation and Hygiene
PS Kenya’s Safe Water Program started in 2003 with the promotion and distribution of WaterGuard, a liquid chlorine solution. In 2006, the program started distribution and promotion of PUR, a dual-action water purifier that acts on turbid water. In 2009, the program introduced Aquatabs into the commercial sector.
Through funding from the U.S. Agency for International Development and United Kingdom’s Department for International Development, PSI/Kenya works closely with key partners to address the Kenya National AIDS Strategic Plan (KNASP) indicators to contribute to the reduction of HIV incidence in Kenya.
PS Kenya’s HIV programs include: promoting delayed sexual debut, condom social marketing, prevention among people in concurrent sexual partnerships, sexual and gender based violence, promotion of HIV services including HIV Counseling and Testing (HTC) and Voluntary Medical Male Circumcision. In addition, PS Kenya supports the GOK with communications for the Blood Safety, Injection Safety and Orphaned and Vulnerable Children (OVC) programs..
In 1993, PS Kenya launched Trust condoms, the first socially marketed condom in Kenya aimed at increasing availability and accessibility targeting high-risk and sexually active groups. PS Kenya also implements various behavior change campaigns to reduce risky sexual practices among at risk and vulnerable populations. Some of this include the campaign targeting multiple concurrent relationships – ‘Wacha Mpango wa Kando, Epuka Ukimwi ‘(Stop ‘spare wheels’ relations – Avoid HIV) and latterly, ‘weka condom mpangoni’ (‘put a condom in that plan’); campaign to promote consistent condom use; campaigns to address barriers to uptake of HIV Testing & Counseling, Voluntary medical Male circumcision among others.PS Kenya has also distributed a Basic Care Package program targeting people living with HIV to reduce their morbidity and mortality to opportunistic infections. An innovative edutainment TV drama series dubbed ‘SIRI’ was also launched to support uptake of family planning and preventative behaviors of Kenyans related to HIV. Awareness is done mainly through mass media and community level small group and one on one sessions. PS Kenya has continued pioneering HIV messaging, for example in 2009.
In Kenya, less than half of married couples use modern family planning methods. The unmet need for family planning is high. PS Kenya helps to bridge this gap by distributing quality short term family planning products at highly subsidized prices. In addition PS Kenya airs communication to address barriers to uptake of FP methods including myths and misconceptions among other barriers. To address the supply side barriers, capacity building of pharmacists and Tunza franchise health providers to counsel clients on all methods is done thus improving their knowledge, skills, attitude and performance in offering quality family planning services. PS Kenya also supports provision of quality reproductive health services through the Tunza Family Network. These services include offering short term and long term family planning methods, cervical cancer screening as well as services to increase safe motherhood.
HSD: PS Kenya manages the Tunza Family Health Network, a social franchise targeted at providing quality health care to low-income and vulnerable populations.
It’s a fractional franchise launched in December 2008 comprising of selected private health clinics providing primary health care services with PS Kenya franchising the key health areas in line with national priorities.. PS Kenya trains and supports providers in– family planning, HIV counseling, testing and comprehensive treatment including elimination of mother to child transmission (eMTCT), , cervical cancer screening and preventative treatment (CCSPT), voluntary medical male circumcision(VMMC),integrated management of childhood illnesses (IMCI),Safe Motherhood (ANC, Skilled delivery and PNC) and Tuberculosis screening and treatment. Integration of non-communicable disease control is underway.
The emphasis is on continuous quality improvement– monthly support supervision, mentorship and bi-annual quality assessments are conducted through a dedicated quality assurance team.
PS Kenya conducts Provider Behavior change Communication (PBCC) through medical Detailing. This intervention equips pharmacy providers with the skills and tools required to improve on management of different health conditions, counseling of clients, and creating referral systems with clinicians for health conditions or undesired events that cannot be managed within a retail pharmacy.
Medical Detailing PBCC is on below health areas:
- Family planning
- Diarrhea management.
- Use of malaria Rapid diagnostic test kits –Pilot
The program works with 2400 pharmacies countrywide.
PS Kenya uses IPC interventions to:
- Support various health areas addressing behavioral factors that require one-on-one discussions and small group interactions. Such factors include demonstrations, skills building and social support.
- Create demand for socially marketed products and services offered through PS Kenya or its partners.
- IPC interventions are implemented either through partnership with local civil society organizations, or by engaging community health workers.
- PS Kenya mainly uses a community dialogue approach derived from motivational interviewing known as Education through Listening (ETL).
- Ministry of Health
- Malaria Control Unit
- Family Planning Unit
- Maternal and Child Health Unit
- National AIDS and STDs Control Programme
- National AIDS Control Council
- Division of Leprosy, TB and Lung Disease
- Kenya Medical Research Institute
- Marie Stopes Kenya
- FHI 360
- Safe Water and AIDS Project
- Towards Subsidized Malaria Rapid Diagnostic Tests. Lessons Learned from Programmes to Subsidise Artemisinin-Based Combination Therapies in the Private Sector: a Review
Private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. A subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries.
- What Happened to the Malaria Market in Kenya after the AMFm?
The AMFm continuation under the private sector copayment mechanism has maintained strong QA ACT availability in the private sector, where nearly 90% of antimalarials are distributed. However, QA ACTs accounted for only half of antimalarial distribution, and 1 in 5 antimalarials distributed were non-QA ACTs. Furthermore, QA ACT price increased following the AMFm pilot to more than double that of SP. Availability of confirmatory testing has improved in the public and private sectors, however availability remains low in the private sector and only 1 in 4 antimalarial-stocking outlets were equipped to test. This result suggests that presumptive treatment remains common.
- Expanding Access to HIV Self-Testing: A Market Development Approach
PSI envisions a healthy market for HIVST to be one that is supported by multiple buyers and suppliers and that delivers on the 5As (Availability, Assured Quality, Appropriate Design, Awareness, and Affordability) to achieve public health goals. Realizing this vision for the HIVST market will require consideration of two key markets- public and private sectors. While HIV testing has traditionally been driven by the public sector, HIVST opens up the possibility of utilizing private sector pharmacies to expand and extend the reach of testing.
- Fever Case Management Supervisor Job Aid
Supervisor job-aids assure that quality of fever case management (FCM) is preserved even many months after trainings. These supervisor job-aids are part of a larger Quality Assurance Manual and Toolkit developed through the UNITAID Private Sector RDT project to provide guidance on quality assurance for FCM in the private sector.
- Fever Case Management Client Register
Client registers aim to capture the universe of Fever Case Management (FCM) from a qualitative and quantitative point of view. This FCM Client Register is part of a larger Quality Assurance Manual and Toolkit developed through the UNITAID Private Sector RDT project to provide guidance on quality assurance for FCM in the private sector.
- Fever Case Management Provider Job Aid
The aim of these provider job-aids developed for Tanzania, Madagascar and Kenya is to visually support providers during their day-to-day activities and guide them through the steps they must undertake to perform, read and dispose of malaria Rapid Diagnostic Tests (RDTs).
- Ensure Key Population Get Access to Condoms and Lubricant
To avoid new infections and reduce HIV risk, PSK provides technical assistance to socially market HIV prevention products, aiming to increase visibility and availability of condoms and lubricant among KPs in high-risk venues. A “peer-to-peer sale approach strategy” has been employed by PEPFAR/USAID-funded Flagship program to implement on-site peer marketing of condoms and lubricants. The success of this innovation was recognized, and it has been replicated as a core activity in the National HIV/AIDS strategic plan for 2014-2020 under the prevention package. Additionally, it has been replicated under the Global Fund’s New Funding Model.
- Evaluating the Impact of Social Franchising on Family Planning Use in Kenya
This study seeks to understand whether access to the Tunza social franchise network increases the overall use of FP or provides another alternative for women who would have found FP services in the public sector.
- Evaluating the Impact of Social Franchising on Family Planning Use in Kenya
At the iHEA conference, PSI presented the results of a study that aimed to determine whether the Tunza Family Health network increases access to family planning for women of reproductive age in Kenya.
- Market Trends for Malaria Blood Testing in Sub-Saharan Africa, 2009-2014
In 2012, the World Health Organization (WHO) launched the Test, Treat, Track initiative recommending confirmatory testing prior to antimalarial treatment. National malaria control programs (NMCP) across subSaharan Africa (SSA) subsequently aligned national guidelines with this recommendation. Strategies to scale up testing using malaria rapid diagnostic tests (mRDT) were introduced by NMCPs. We examine malaria testing availability, price and market share using national market survey data collected by the ACTwatch project.