With focus to Lea Toto With focus to Lea Toto Community Based Care - - PowerPoint PPT Presentation

THE CHILDREN OF GOD RELIEF THE CHILDREN OF GOD RELIEF INSTITUTE INSTITUTE (COGRI) (COGRI)

A registered Charity in Kenya, USA A registered Charity in Kenya, USA UK and Italy UK and Italy

With focus to Lea Toto With focus to Lea Toto Community Based Care Community Based Care Program Program

Overall Goal. Overall Goal.

To bring Christian compassion by providing Up To bring Christian compassion by providing Up-

• to

to-

• date Holistic Care and protection for our children.(

date Holistic Care and protection for our children.( both HIV Infected and Affected). Programs being run both HIV Infected and Affected). Programs being run by COGRI are: by COGRI are:

• NYUMBANI CHILDREN’S HOME: Institutional care for

NYUMBANI CHILDREN’S HOME: Institutional care for HIV positive orphaned and abandoned children. HIV positive orphaned and abandoned children.

• LEA TOTO: Community Based Care for HIV infected

LEA TOTO: Community Based Care for HIV infected children within the extended family system. children within the extended family system.

• NYUMBANI VILLAGE: A compound expected to

NYUMBANI VILLAGE: A compound expected to support 1000 people, both orphaned children and elderly support 1000 people, both orphaned children and elderly adults. adults.

LEA TOTO PROGRAM LEA TOTO PROGRAM

Overall GOAL Overall GOAL

• The project goal is to mitigate the

The project goal is to mitigate the impact

• f

HIV/AIDS and impact

• f

HIV/AIDS and decrease the risk of transmission decrease the risk of transmission through the provision

• f

a through the provision

• f

a comprehensive Community comprehensive Community Home Home-

• based Care Package

based Care Package

COMMUNITY BASED CARE COMMUNITY BASED CARE

• Definition

Definition –

–

• This is the care offered to chronically sick

This is the care offered to chronically sick people (As result of AIDS people (As result of AIDS-

• related

related complications) in partnership with their complications) in partnership with their families, local community, health facilities families, local community, health facilities all working together for the well being and all working together for the well being and good health of the sick through a package good health of the sick through a package

• f comprehensive care.
• f comprehensive care.

Comprehensive care package Comprehensive care package (components of community home (components of community home-

• based care)

based care)

• This package usually includes:

This package usually includes: 1. 1. Medical and nursing care including provision of ART Medical and nursing care including provision of ART 2. 2. Psychological support and Spiritual guidance Psychological support and Spiritual guidance 3. 3. Counseling and Testing Services Counseling and Testing Services 4. 4. Provision of food and nutrition supplementations Provision of food and nutrition supplementations 5. 5. Relief for social needs (social support services) Relief for social needs (social support services) 6. 6. Prevention of further spread of HIV Prevention of further spread of HIV 7. 7. Promotion of community empowerment Promotion of community empowerment 8. 8. Self reliance through income generation activities, Self reliance through income generation activities, community ownership and good neighborliness community ownership and good neighborliness.

.

WHY COMMUNITY WHY COMMUNITY-

• BASED

BASED CARE AS A STRATEGY? CARE AS A STRATEGY?

• This strategy provides the most efficient and

This strategy provides the most efficient and effective way of addressing the complexity of effective way of addressing the complexity of needs of persons affected by HIV/AIDS and needs of persons affected by HIV/AIDS and their families, and in this context, Children their families, and in this context, Children Living With HIV and AIDS (CLWHA) Living With HIV and AIDS (CLWHA)

PROGRAM EXPECTATIONS…. PROGRAM EXPECTATIONS….

• To offer an alternative care from the

To offer an alternative care from the Institutional care Institutional care

• Reduction of stigma and discrimination thus

Reduction of stigma and discrimination thus promoting positive living ( through involvement promoting positive living ( through involvement

• f communities in care & support)
• f communities in care & support)
• Increased involvement of community in care,

Increased involvement of community in care, support and prevention efforts support and prevention efforts

• Reduced hospital costs and visits

Reduced hospital costs and visits

• Reduction in child abuse (abandonment and

Reduction in child abuse (abandonment and neglect) neglect)

• Greater involvement of PLWHAs in the care

Greater involvement of PLWHAs in the care and support (encouraging positive living) and support (encouraging positive living)

Program Expectation cont’d Program Expectation cont’d

• Improved care for immune suppressed people.

Improved care for immune suppressed people.

• Reduced morbidity and mortality rate in

Reduced morbidity and mortality rate in CLWHA CLWHA

• improve the quality of life and reduce suffering

improve the quality of life and reduce suffering and pain of the infected children. and pain of the infected children.

• It promotes child development and

It promotes child development and empowerment. empowerment.

• Helps in the coordination of services within the

Helps in the coordination of services within the community. community.

• A community that is empowered to sustain the

A community that is empowered to sustain the care and support of PLWHA care and support of PLWHA

Key Achievement Key Achievement

• 3,080 HIV positive children have been reached

3,080 HIV positive children have been reached (cumulatively) through the program to date, with (cumulatively) through the program to date, with an average of 12,435 household members an average of 12,435 household members

• reached. 1,958 children are actively receiving a
• reached. 1,958 children are actively receiving a

comprehensive care and support services from comprehensive care and support services from the Lea Toto. the Lea Toto.

• The Program has cumulatively enrolled 621

The Program has cumulatively enrolled 621 children on Anti Retroviral Therapy, with 552 children on Anti Retroviral Therapy, with 552 being active in the treatment. being active in the treatment.

• Clinical Visits per month averages approximately

Clinical Visits per month averages approximately 1,800 1,800

Key Achievement Cont’d Key Achievement Cont’d

• Voluntary Counseling & Testing Averages to

Voluntary Counseling & Testing Averages to approximately 600 persons approximately 600 persons

• Highly reduced stigma and discrimination within

Highly reduced stigma and discrimination within the community, where the program operates. the community, where the program operates.

• Greater participation of community members in

Greater participation of community members in care and support of those infected and affected, care and support of those infected and affected, i.e. 72% of households receive some form of i.e. 72% of households receive some form of support from their local communities. support from their local communities.

• The program provides food assistance to 940

The program provides food assistance to 940 households out of the 1,700 households, households out of the 1,700 households, reaching out to over 5,000 poor family reaching out to over 5,000 poor family members. members.

Where are We Today? … Where are We Today? …

• We have a remarkable reduction of both child mortality

We have a remarkable reduction of both child mortality and morbidity rates, i.e. our morbidity rate stands at and morbidity rates, i.e. our morbidity rate stands at 62.2% while our deaths dropped from 8 to 1 child per 62.2% while our deaths dropped from 8 to 1 child per month month

• Greater involvement, ownership and spirit of

Greater involvement, ownership and spirit of compassion from the local community compassion from the local community

• Expansion of our outreach clinics covering now most

Expansion of our outreach clinics covering now most

• f the Nairobi’s slums
• f the Nairobi’s slums
• Inadequate Knowledge on the Management of HIV

Inadequate Knowledge on the Management of HIV and related opportunistic infections especially in new and related opportunistic infections especially in new areas the program is now penetrating slums. areas the program is now penetrating slums.

CHALLENGES CHALLENGES

• Overwhelming needs and expectations among the

Overwhelming needs and expectations among the beneficiaries. beneficiaries.

• Extreme Poverty among families in Nairobi’s poorest

Extreme Poverty among families in Nairobi’s poorest slums slums

• Able to provide food assistance to only 940

Able to provide food assistance to only 940 households, over 840 household accounting to 4,200 households, over 840 household accounting to 4,200 family members are in need of urgent food assistance, family members are in need of urgent food assistance, these are families headed by elderly grandparent, these are families headed by elderly grandparent, bedridden sick parents, by elders siblings, and poor sick bedridden sick parents, by elders siblings, and poor sick single mothers. single mothers.

• Inadequate Knowledge on the Management of HIV

Inadequate Knowledge on the Management of HIV and related opportunistic infections especially in new and related opportunistic infections especially in new areas the program is now penetrating. areas the program is now penetrating.

CHALLENGES Cont’d CHALLENGES Cont’d

• Pill Burden as these drugs are for a lifetime (no

Pill Burden as these drugs are for a lifetime (no single one tablet dose is currently available) single one tablet dose is currently available) Extreme Poverty among families in Nairobi’s Extreme Poverty among families in Nairobi’s poorest slums poorest slums

• Inadequate office equipment such as computers,

Inadequate office equipment such as computers, telephones among others telephones among others

• Negative cultural practices and religious beliefs

Negative cultural practices and religious beliefs

• Illiteracy and ignorance on HIV Testing or

Treatment.

• The need to address extreme poverty and

rampant unemployment

• Spousal violence especially among discordant

Spousal violence especially among discordant l

LESSONS LEARNT LESSONS LEARNT

• The Key players should be involved right from the beginning.

The Key players should be involved right from the beginning.

• A comprehensive and continuous training of staff is very

A comprehensive and continuous training of staff is very important to any successful program. important to any successful program.

• Multidisciplinary team is vital for an effective and efficient H

Multidisciplinary team is vital for an effective and efficient HIV IV and AIDS Community and AIDS Community-

• based care programs

based care programs

• Decentralization of planning and implementation to the lowest

Decentralization of planning and implementation to the lowest level possible. (involve local communities in decision making) level possible. (involve local communities in decision making)

• A Holistic care and support services should be provided.

A Holistic care and support services should be provided.

• Anti Retroviral Therapy and good Nutrition contributes

Anti Retroviral Therapy and good Nutrition contributes Significantly to the Quality of life of the infected children. Significantly to the Quality of life of the infected children.

• A Nurse Dispensing

A Nurse Dispensing ARVs ARVs at a Client’s Home at a Client’s Home

Social Workers and a Nurse coming from a Home Social Workers and a Nurse coming from a Home Visit Visit

• Children on Life Skills Training

Children on Life Skills Training

Community Awareness on Community Awareness on HIV/AIDS in Kibera, the largest HIV/AIDS in Kibera, the largest Slum in Kenya Slum in Kenya

Gunny Bag Farming demonstration to caregivers to Gunny Bag Farming demonstration to caregivers to produce highly nutritious vegetables. produce highly nutritious vegetables.

Delivery of food for the children at one of Delivery of food for the children at one of the Lea Toto Outreach Clinics in Nairobi the Lea Toto Outreach Clinics in Nairobi

Community Volunteers off Community Volunteers off-

• loading the

loading the food food