Hatua Yetu Newsletter August-September 2011

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Hatua Yetu Newsletter August-September 2011
Hatua Yetu
Health Impact Newsletter
Issue No. 1 August-September 2011
Quality health
services and
products
Inside this Issue
Curbing Malaria in Kenya7
HIV Prevention9
Tunza Family Health Network 10
Social Marketing of Health Products13
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
1
About PSI
P
opulation Services International (PSI) was registered in
Kenya as a non-governmental organisation in 1989.
Since inception, PSI/Kenya has been implementing
social marketing programmes to address HIV and AIDS,
reproductive health, malaria and safe water. PSI/Kenya
promotes products, services and healthy behaviour
that enable low-income and vulnerable people to lead
healthier lives. Products and services are sold at subsidised
prices rather than given away in order to motivate
commercial sector involvement.
PSI/Kenya Senior Team
Daun Fest
Veronicah Musembi
Thomas Odiero Alex Njeru
Joyce Wanderi
Dorcas Odondo
Edna Ogada
Allan Ngunze
Sylvia Wamuhu
Lucy Maikweki
Mbogo Bunyi
Lawrence Mbae
Steve Mangeni
Fred Mobegi
- Country Director
- Deputy Country Director
- Finance Director
- Internal Audit Director
- Social Marketing Director
- Supply Chain Director
- Research Director
- HR Director
- Sales Director
- Director HIV & Communication
- Director, Social Franchising
- RH Dep Director Q&A
- Deputy Director – IT
- Deputy Director Finance
Hatua Yetu is a health impact newsletter of
PSI/Kenya. The title ‘Hatua Yetu’ denotes ‘our
action and progress’ as depicted in various
programmes. Hatua Yetu Issue No. 2 will
cover October to December 2011 activities.
PSI/Kenya welcomes contributions and comments on
articles published in this newsletter from partners in the
health sector and individual writers, mainly focusing on
the programme areas implemented by the organisation.
Appropriate acknowledgement will be accorded to all data
published in this newsletter.
Editors
Titus Mung’ou
Jacqueline Nyagah
Editorial Support
Anna Dirksen and Regina Moore
(PSI, Washington DC).
Authors
Daun Fest
Anne Musuva
Joyce Wanderi
Lawrence Mbae
Lucy Maikweki
Sylvia Wamuhu
Susan Karimi
Titus Mung’ou
Wanjiru Mathenge
Key Partners
Acknowledgement
Photography
Titus Mung’ou
Jacqueline Nyagah
James Mwangi
Camerapix
PSI/Kenya must always be acknowledged as the source of
any data, article and photo reproduced from this newsletter.
Address
Jumuia Place | Wing B | Lenana Road
P. O. Box 22591- 00400 | Nairobi
Tel. 2 714 346/54/55, 2715101/3
Fax: 2 714 342/2715096
Email: [email protected]
Website: www.psikenya.org
Karibu PSI/Kenya
This is only a snapshot of our work as much of our work,
specifically in communication and behaviour change
communication (BCC) cannot be measured in DALYs
averted. The PSI/Kenya team works with various Ministry
of Health technical working groups to develop national
communication strategies and interventions to address
the national health strategies.
Some examples of that collaboration and work are:
 Mpango Wa Kando - Concurrent sexual partner BCC,
steered by the National AIDS & STI Control Programme
(NASCOP) and National AIDS Control Council (NACC).
Daun Fest, Country Director
W
ELCOME TO the first edition of the PSI/Kenya
Hatua Yetu newsletter. Through your feedback we
have learned that we need to get better at telling
the PSI/Kenya story and how we bring about our health
impact.
 Nakufeel - Condom self efficacy BCC, steered by
NASCOP and NACC.
 Jitambue - HIV testing & counseling BCC, steered by
NASCOP and NACC.
 Mbu Nje Sisi Ndani - Malaria prevention BCC, steered
by the Division of Malaria Control (DOMC).
Many stakeholders were not aware that PSI/Kenya uses
social marketing to assist the Government of Kenya to
address malaria prevention, increase access to reproductive
health products and services, improve HIV/AIDS prevention
efforts, and decrease the incidence of diarrhoeal disease
through increased availability of safe water products and
communication. We plan to use this newsletter to inform
you and our stakeholders, on the impact PSI/Kenya has had
on improving the health of Kenyans and contributing to
the national health strategies.
 VMMC - Voluntary Male Circumcision BCC, steered by
NASCOP and NACC.
Below are some highlights of our health impact indicators
for the first six months of 2011. PSI/Kenya has:
 Blood Safety - Increasing blood donation BCC, steered
by National Blood Transfusion Services (NBTS).
 Averted 984,791 DALYs which translates to about a
five percent contribution to the reduction of the burden of
disease for health areas we work in.
 SIRI - Four seasons of integrated HIV/RH messaging,
steered by NASCOP and NACC.
 Averted 7,145 cases of HIV through the distribution
of 64,800,261 condoms and 83,527 basic care kits.
 Generated 692,404 couple years of protection
(CYPs), 526 maternal deaths and 145,655 unintended
pregnancies through the distribution of 966,720 cycles of
Femiplan OCs, 248,882 Femiplan Injectibles, 954 implants,
2,417 intrauterine contraceptive devices (IUCDs) inserted
through the Tunza Family Health Network providers.
 C-Word - Youth Contraceptive BCC, steered by the
Department of Reproductive Health (DRH).
 Timing and Spacing - Family planning BCC, steered
by DRH.
 Zuia Kuhara Okoa Maisha – Diarrhoea prevention
BCC – steered by DCAH.
 Chill – Abstinence BCC, steered by NASCOP and NACC.
Cont. pg 5
 Prevented 4,722,694 cases of malaria and 20,192
deaths related to malaria by distributing 2,982,173 LLINs
through antenatal clinics (ANC), mass net distribution and
selling Supanets through rural outlets.
 Prevented 172,247 cases of diarrhoea and 213
diarrhoea related deaths through the social marketing
of WaterGuard, PUR and Aquatabs safe water treatment
products.
HIV and malaria campaign posters produced by PSI/Kenya.
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
3
PSI/Kenya Board Members
Chair: Salma Mazrui-Watt
Salma Mazrui-Watt is a management and institutional development specialist with 20 years experience in insurance,
private health care, advertising, finance and advocacy sectors. She brings to the PSI/Kenya Board extensive
experience in administration, sales and marketing management practices, people management, strategic planning,
evolution in private healthcare, project management, resource mobilisation, business development, new product
development, corporate social investment programmes, leading seminars, regulatory reform and improving the
business environment as well as private public partnerships and dialogue. Salma has extensive work experience in
Kenya, Uganda, Tanzania, Cote D'Ivoire, Ghana, South Africa, Zimbabwe, Zambia, Mozambique, Namibia and
Swaziland. Salma holds an MBA degree from the University of Nairobi and BSc in Economics from the George
Mason University, Virginia, USA. As a founding member, she contributed to the formation of Kenya's Private Sector
Development Strategy. Currently, Salma also is a non-executive director of the Kenya Airways and the African Fund
for Endangered Wildlife, a member of the Kenya's National Economic and Social Council, KCA University and the
Centre for Corporate Governance. She was elected as the PSI/Kenya's Chair in March 2011.
Treasurer: Lisa Simutami
Lisa Simutami is currently the PSI’s East Africa Regional Director covering 11 countries. She brings to the PSI/
Kenya Board over 11 years experience in international social marketing, having served as the Senior Director of
Procurement and Contracts, and the Country Director for PSI/Rwanda from 2003-2005. She has served as Treasurer
on the PSI/Kenya Board since March 2010 and currently serves on the boards of PSI/Tanzania, PACE Uganda
and PSI/Malawi.
Secretary: Daun Fest
Daun Fest has over 10 years experience running a private sector business as well as 20 years international
development experience in West Africa, Southern Africa, Central America, the Balkans and East Africa. She has
been with PSI since 1995 serving as the Country Director in Haiti, Guatemala (including Honduras, Nicaragua, El
Salvador, Belize, Panama and Costa Rica), Romania and Kenya. Daun also initiated the Results Initiative, PSI's first
Southern Africa social marketing capacity building project covering 13 countries. She has served as the Secretary
of the PSI/Kenya Board since December 2007.
Member: Dr. Nelson Gitonga
Dr. Nelson Gitonga is the Managing Director of Insight Health Advisors. He brings to the PSI/Kenya Board
extensive experience in health systems management including private and public health insurance programmes. Dr.
Gitonga has evaluated a number of donor-funded service delivery and health systems strengthening programmes
and is currently the private sector advisor to the USAID SHOPS Project. Professional associations that Dr. Gitonga
has been involved in include: member of the Kenya Medical Association, former member of the Association of
Kenya Insurers (AKI), General Insurance Council and Convener AKI medical committee, former member of AKI
HIV/AIDS Life Insurance Product working group, and founding member of the Kenya Healthcare Federation
(KEPSA Health Sector Board). He is also the founder and Chief Executive Officer of the Life Choice Healthcare,
a comprehensive private outpatient medical centre. He has been a member on the PSI/Kenya Board since July
2010.
Member: David Walker
David Walker brings to the PSI/Kenya Board over seven years private sector business experience and over
16 years of international social marketing experience. He served as PSI Programme Manager for West Africa
from 1994-1997, the Country Director for PSI/Malawi from 1997-2001 and PSI/Kenya from 2001-2007.
As the Director of PSI Global Social Marketing Department based in Nairobi, David assists PSI/Kenya develop
innovative social marketing programmes. David also serves as a board member on PSI/Tanzania, PSI Malawi,
and Society for Family Health in South Africa.
4
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
PSI/Kenya Board Members
Member: Milton Lore
Milton Lore is a seasoned enterprise development
executive with academic and professional training
in industrial chemistry and intellectual property
management, coupled with over 14 years of technical
and commercial work experience in East Africa and
Europe within pharmaceutical and chemical industry
operations, technology transfer and venture capital
investment. He holds postgraduate qualifications in
intellectual property law and management from the
Queen Mary, University of London, in addition to a
BSc (Hons) degree in biochemistry and chemistry from
the University of Nairobi.
Member: Dr. Alice Karimi Mutungi
Dr. Alice Mutungi joined the PSI/Kenya Board in
March 2010. She is an Obstetrician/Gynecologist
and is currently a Senior Lecturer at the University of
Nairobi's School of Medicine. Dr. Mutungi has been
a long time supporter of PSI/Kenya. She helped
train health providers and pharmacists throughout the
country when Femiplan contraceptives were launched
in 2004. Dr. Mutungi is an advocate for improving
Kenyans access to and consistent use of reproductive
health products and services. From 2001 to 2006,
she was the Reproductive/Maternal and Neonatal
Health Advisor, and the Point Person for Gender
integration into Health programmes at the Regional
Centre for Quality of Health Care, Kampala, Uganda;
and Honorary Lecturer at Makerere University Medical
School, Uganda.
Member: Dr. Dessmond Chavasse
Dr. Dessmond Chavasse is Head of PSI’s Malaria
Control and Child Survival Departments. He has a
doctoral degree from the Liverpool School of Tropical
Medicine (University of Liverpool) and was a Lecturer
in Medical Entomology at the London School of
Hygiene and Tropical Medicine between 1991
and 1998. He has over 20 years experience in the
control of vector borne diseases with principal focus
on malaria, including the analysis of ITN delivery
models in the field. He has published numerous
papers on mosquito control and written/edited
two books on vector control. Chavasse is based in
Nairobi, Kenya.
Member: Rose Kimotho
Rose Kimotho is the PSI/Kenya’s longest serving
Board member and supporter. In 2001, when PSI/
Kenya initiated an advisory board, Rose was one of
the founding members. She is the Managing Director
and founder of the Regional Reach Limited, a media
company that operates community television and
shows free videos in the rural areas. The company
also owns and operates a radio station, Kameme
101.1FM and a TV station, K24, the first 24-hour
news channel station. She started her career as a
journalist for the Weekly Review and The Nairobi
Times after graduating from the School of Journalism at
the University of Nairobi. Rose also sits in other boards
namely: Stanbic Bank, Rhino Ark Limited and Young &
Rubicum Limited.
Karibu PSI/Kenya
Continued from pg 3
All the interventions would not be possible
without continued financial support from the
British Government through the United Kingdom’s
Department for International Development
(UKAID/DFID) and from the United States
Government through the United States Agency
for International Development (USAID), President’s
Emergency Plan for AIDS Relief (PEPFAR) and
President’s Malaria Initiative (PMI).
This is my first and perhaps the last article for PSI/
Kenya’s Hatua Yetu newsletter. It was a difficult
decision to leave PSI/Kenya team, but I have been
given a new opportunity as the PSI East Africa
Senior Deputy Regional Director, where I shall
share best practices that PSI/Kenya has been so
successful with.
It is also my opportunity to introduce and
welcome Chris Jones who
PSI/Kenya
will be replacing me as PSI/
Kenya Country Director is a flagship
from 1st September 2011. programme in
Chris brings with him over the PSI network .
12 years social marketing
experience in leading and managing the rapid
scale up of social marketing and communications
programmes in reproductive health, malaria, child
survival, HIV and AIDS prevention. He has expertise
in social marketing, social franchising and medical
detailing, research, strategic planning, and
performance improvement initiatives. Chris has
been innovative in introducing aggressive total
market approaches to social marketing; initiatives
in reducing unsafe abortion and increasing the
utilisation of long-term family planning methods;
new prevention and expansion of diagnostics and
treatment programmes in malaria; introduction
of Lawson enterprise resource planning (ERP)
systems; and capacity building initiatives with
teams designed to maximise long-term and
sustainable health impact.
PSI/Kenya is a flagship programme in the PSI
network because of the active partnerships with
you, the stakeholders, and the PSI/Kenya team’s
dedication to delivering impact. I have never
worked with a better, more capable and more
motivated team in my 16 year career with PSI.
Thus, it is with sadness that I leave the PSI/Kenya
team, but with great pride to have been part of it. I
have great confidence that PSI/Kenya will continue
to empower, be efficient, deliver results, have
integrity, innovate and collaborate to improve the
health of Kenyans.
Asante Sana!
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
5
DELTA
PSI marketing planning process
P
SI APPROACH to marketing planning is called DELTA.
The DELTA process is designed to stimulate thought
and ensure thorough analysis of research and past
experience, creating a clear link between past lessons
learned and future strategies. DELTA is meant to detail a
process for marketing planning, rather than a template to
fill in. This is designed to enable flexibility in the style and
type of content included in each programme’s plan.
The cornerstones of
DELTA are audience
insight and brand
positioning.
Decisions made and
insights
gathered
here trickle down
and influence all the
other decisions made
in the marketing
plan. If enough time
and effort is spent
getting these two
things right, then
you have gone a
long way towards
building a high
quality
marketing
plan.
To help structure this
critical
marketing
thinking, the DELTA
process is organised
into steps that are divided into four key questions that a
marketing plan should answer.
1. Where are we now?...Analyses the current situation.
2. Where do we want to go?...Specifies the objectives to
be met.
3. How do we get there?...Identifies strategies to achieve
the objectives.
4. How are we doing?... Outlines research and work plans
with their budgets.
The first step looks at the situation analysis, audience profile
and the positioning strategy.
Every marketing plan begins with a thorough analysis of
all existing and relevant information. This means looking
not only at the research specific to the project, but also at
outside sources of information, and at practical information
gathered while implementing previous marketing
strategies. This helps to better understand the environment
and to identify the strategic priorities
Audience insight: Bringing the target group alive.
PSI is an “audience-centered organisation” and this is done
by bringing the target group alive with a vivid picture of their
lives and what they value. Demographic descriptors, such as
age or sex, provide only the first and broadest descriptors of
who the audience really is.
6
Psychographics refer to people’s personality, values,
attitudes, interests, and lifestyles. Segmentation is the
process of identifying unique groups of people, within
larger populations, which share similar interests and
needs relative to the product, service or behaviour to be
promoted. If the group shares common attributes, then
its members are more likely to respond similarly to a given
marketing strategy.
PSI develops an audience profile for each programme
which is given a name such as Jacinta or Majani.
Brand positioning: Identifying the most compelling
and unique benefit of the product/service or behaviour.
Positioning is the core of brand strategy and the first
marketing decision made. It identifies the most compelling
and unique benefit that a product/service/behaviour
stands for in the mind of the target group. Think of this as
the emotional “hook” upon which the rest of the marketing
hangs.
A brand is not necessarily a product. It can also be a
behaviour or a service. It can be defined as a summation of
everything your target knows and feels about your product
or service.
Combined with the audience profile, the brand’s
positioning will drive all marketing decisions. These two
elements serve as the bedrock upon which the rest of the
marketing plan rest.
Marketing objectives: The fine line between art and
science. Marketing plan objectives specify what you
hope to achieve with the marketing plan. These can
be behavioural objectives, determinants of behaviour
objectives, activity level such as sales, or service client flow
or access objectives.
After the marketing objectives are identified, strategies
are identified to achieve objectives. These fall under place,
promotion, price and product.
Product strategies are about what we are offering to fulfill
consumers’ desires / needs. Place strategies are about
making the products and services convenient to locate,
accessible and comfortable to purchases. A good place
strategy optimizes product coverage and ensures access
to product and services.
Price strategies are all about making the exchange easy,
affordable and desirable. The key to successful marketing
is to design an offer in which the benefits of the promoted
behavior outweigh the costs. This includes both monetary
and non monetary costs.
Promotion strategy entails beginning the planning
process for designing messages that will be delivered and
the communication tools that will be used to reach the
consumer. This entails setting objectives, developing key
messages, choosing communication tools and developing
detailed communication plans.
At the end of the day the only way to assess how we are
doing is through monitoring and evaluation and hence the
need for a monitoring and evaluation plan that helps to
identify and address information gaps as well as measure
performance.
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
Malaria
Curbing malaria in Kenya
PSI/Kenya utilises a mix of net distribution
channels to maximise coverage. These
include routine distribution to pregnant
women and children under five years, social
marketing, mass net distribution campaigns
and partnering with private manufacturers.
Net distribution began in 2001 with the
launch of the branded conventional net,
Supanet which was sold in the commercial
sector at a subsidised price. Supanet was
packed with a net treatment kit called
Powertab. From project inception, social
marketing activities employed distinct
demand creation and distribution strategies
for the urban and rural markets.
In 2004, PSI/Kenya expanded its commercial
LLIN distribution networks to include public
health antenatal clinics in 54 endemic and
epidemic priority districts. In April 2005,
Minister for Public Health and Sanitation, Hon Beth Mugo, second right, hands
over mosquito nets to a mother in Koibatek. Looking on, right, Head of Division of LLINs were introduced and distributed
Malaria Control, Dr Elizabeth Juma. Photo/James Mwangi, MCHO, PSI/Kenya
through clinics, replacing nets bundled
with re-treatment.
I
N KENYA, malaria accounts for 30 percent of outpatient
visits and 19 percent of hospital admissions. The
Government of Kenya (GOK) recognises malaria as a
health and socio-economic burden and considers malaria
control a priority investment. The government has adopted
the vision of a malaria-free Kenya, focusing efforts in malaria
endemic provinces, namely Nyanza, Western and parts of
Coast and the government aims to achieve universal net
coverage (one net for every two people) and 80percent
net use.
The mission of PSI/Kenya is to complement the
government’s efforts in addressing public health priorities.
PSI/Kenya’s malaria programme, supports the Division of
Malaria Control (DOMC) in the Ministry of Public Health and
Sanitation in achieving its vision of a malaria free Kenya.
One of the key strategic objectives of the National Malaria
Strategy (NMS) 2009-2017 is to have at least 80 percent of the
people living in malaria risk areas using appropriate malaria
preventive interventions, in
this case universal long lasting We seek to establish
insecticide-treated net (LLIN) a ‘net culture’ in the
coverage for populations at
country.
risk.
The NMS also outlines advocacy, communication and
social mobilisation as a key strategic objective to ensure
that at least 80 percent of people in malaria risk areas have
knowledge on prevention and treatment of malaria. To
support these objectives, PSI/Kenya has interventions in
LLIN distribution as well as communications and social
mobilisation.
In 2008, in order to increase access to the most vulnerable,
PSI/Kenya partnered with the Ministry of Public Health and
Sanitation to give LLINs for free to all pregnant women and
children under the age of one.
PSI/Kenya is implementing one of the largest insecticidetreated net LLIN routine distribution programs in the world.
To date, over 22 million nets have been distributed through
our network of over 3500 public health facilities.
Malaria Treatment
According to the National Malaria Strategy 2009-2017,
the Government of Kenya’s plan is to have 100percent
of all fever cases presented to health facilities receiving
parasitological diagnosis and effective malaria treatment.
The Mobilize Against Malaria Programme funded PSI/Kenya
to support the Division of Malaria Control in developing
communication around early treatment seeking behaviour
for fever in addressing reduction of malaria-related
mortality and morbidity in pregnant women and children
under the age of five years in Nyanza.
An integrated communications approach targeting health
workers and caregivers of children under the age of five
years was adopted for the campaign ‘Haraka Upesi’ which
directly translated means ‘Hurry Fast’.
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
7
LLINs Profile
Attaining universal LLINs
coverage in Kenya
I
N 2000, African leaders committed to reducing malaria
illness by half and eventually eliminating all deaths due
to malaria among all populations at risk of malaria by
2015. In Kenya, insecticide treated net use in children less
than five years old is 39 percent the target is 80 percent,
while insecticide treated net use in pregnant women is
40 percent (the target is 80 percent). The proportion of
households owning more than one insecticide treated net
is about 22.5 percent (the target is 100 percent) with at
least two nets. While the net use and distribution has not
yet reached target levels, public health facilities (including
mission hospitals) are providing the recommended
artemisinin-combination therapies (ACTs) free of charge in
100 percent of facilities. Results from many sentinel facilities
countrywide show that illness due to malaria has been
reduced by between 56 percent and 63 percent in many
parts of Kenya especially in Rift Valley, Central, Eastern,
North Eastern and Coast provinces.
Overall, malaria interventions have helped reduce underfive mortality by 36 percent from 115 deaths per 100 live
births in 2003 to 74 deaths per 1000 live births in 2009. The
infant mortality dropped 31 percent from 75 per 1000 live
births to 52 deaths per 1000 live births in the same period.
Nets distribution
Since 2001, supported by the United Kingdom’s
Department for International Development (DFID), PSI/
Kenya has been distributing long lasting-insecticide nets
(LLINs) to pregnant women and children under 5 years.
These nets are distributed through the Ministry of Public
Health and Sanitation as well faith-based health facilities. To
date, over 22 million LLINs have been distributed. Routine
distribution of nets through this channel is important to
maintain net coverage in between mass net distribution
campaigns particularly among the most vulnerable groups.
As part of the Kenyan Government’s goal to reduce
morbidity and mortality caused by malaria and achieve
universal coverage, the Division of Malaria Control in the
Ministry of Public Health and Sanitation is undertaking
a mass net distribution campaign in malaria endemic
Aggrey Okero, left, and Kaiser Mocheche enjoy the
freshness of a new mosquito net issued to their parents in
Nyangoso village, Nyamira District. Photo/Camerapix
districts in the country to ensure that every two people in
a household receive a net. A total 10.482 million LLINs are
being distributed countrywide, with support from various
partners. The United States Agency for International
Development through the President’s Malaria Initiative
(USAID/PMI) is funding the distribution of 2,667,500 LLINs
in mass net distribution campaign.
What we are doing
PSI/Kenya has been tasked to support the government in
the distribution of 2,667,500 LLINs in 27 malaria endemic
districts. These nets are being distributed in two phases.
During the first phase of the mass net distribution, PSI/
Kenya supported distribution of nets to 17 districts namely
Koibatek, Mogotio, Emuhaya, Vihiga Hamisi, Sabatia,
Gucha, Gucha South, Borabu, Kisii Central, Kisii south,
Manga, Marani, Masaba North, Masaba South, Nyamache
and Nyamira.
The following 10 districts are earmarked to receive 1.2
million LLINs during the second phase of mass net
distribution: Mwea East, Mwea West, Eldoret East, Eldoret
West, Wareng, Marigat, Nandi North, Trans Nzoia East, Trans
Nzoia West and Kwanza.
PSI/Kenya worked hand in hand with the Ministry of Health
personnel and the provincial administration in the districts
to ensure the nets get to the household level.
This process also involved building capacity of the
district teams to undertake planning, social mobilisation,
household registration, mapping and distribution
exercises. PSI/Kenya was involved in the warehousing and
distribution of LLINs to all divisions in 17 districts.
Left, Arita Nyacheo, 74, and Joshua Mokua Kimoni, 61, after receiving
their nets at Ting’a Chief’s camp in Nyamira District.
Photos/Titus Mung’ou
8
PSI/Kenya also supported the districts to carry out microplanning and actual nets distribution. This entailed training
and sensitisation of the provincial administration, key
district health stakeholders, data collectors and community
health workers on the campaign. Prior to distribution,
household data was collected to determine the number of
nets each household would receive.
Cont pg 11
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
HIV/AIDS
HIV prevention in Kenya
H
IV PREVALENCE among males and females aged
15-49 years was 7.4 percent in 2007, according to the
Kenya AIDS Indicator Survey (KAIS) and decreased to
6.3 percent in 2008/9, as noted in the Kenya Demographic
and Health Survey (KDHS). Kenya has a generalised
epidemic with the common mode of transmission being
heterosexual sex which contributes 78 percent of new
infections.
However, heterosexual transmission occurs in a variety of
types of sexual encounters: between married couples or
steady sexual partners, concurrent sexual partnerships,
casual sexual partners and a range of transaction-based
sexual practices. Change in the sexual behaviour of
individuals is crucial in the prevention and control of HIV.
The goal of PSI/Kenya’s HIV Programme is to use evidence
to develop interventions that contribute to the reduction
of HIV incidence.
In the early 1990s there was little communication in Kenya
about HIV and AIDS and whatever was there was fearbased communication. HIV was associated with certain
groups of people such as commercial sex workers. There
was low knowledge of HIV prevention methods. It was at
this time that PSI/Kenya carried out a situation analysis to
understand condom availability.
A PSI/Kenya advertisement on Trust condoms.
The study revealed limited availability of and accessibility
to condoms. Condoms were mainly found in pharmacies
in urban areas and were highly priced, making them
inaccessible to most of the population. Free Government
of Kenya (GoK) condoms were only available in health
facilities.
In 1990 PSI/Kenya introduced a social marketing
programme to support the GoK’s efforts to increase access
to and use of condoms. This was done by launching Trust,
an affordable condom, establishing a distribution system
and generating demand through media campaigns.
After a decade of condom social marketing, research
indicates substantial gains in the country. There has been
universal HIV and AIDS awareness, improved knowledge
of HIV prevention methods and universal knowledge of
condoms.
In addition, there is high brand awareness of the Trust
condoms and the condoms are more readily available
in kiosks, dukas and high-risk outlets due to increased
distribution and condom use. This is attributed to
funding from the United States Agency for International
Development (USAID) and United Kingdom’s Department
for International Development (DFID) that has enabled
PSI/Kenya to implement evidence-based targeted
interventions
In addition to condom social marketing, PSI/Kenya has been
working closely with the Ministry of Health to develop and
implement behaviour change communication to address
risk behaviours associated with HIV prevalence. Some of
the recent communication campaigns include:
Cont pg 11
An advert rallying people to know their HIV status.
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
9
Reproductive Health
Access to quality family planning
services
I
N KENYA, less than half of married couples use modern
contraceptive methods which include condoms, pills,
injections, implants and intrauterine contraceptive
devices (IUCD). The unmet need for family planning is
high as one in four married women either do not have
access to family planning services or lack information or
motivation to use services. PSI/Kenya helps bridge this gap
by distributing quality family planning products at highly
subsidised prices, educating communities and distributing
educational materials.
In 2000, PSI/Kenya launched FEMIPLAN, a family planning
brand which comprised of combined oral contraceptives
and progestin-only injectable contraceptives (Depo
Provera). The FEMIPLAN male condom was added to the
range in 2008. FEMIPLAN products are distributed through
a national network of distributors, wholesalers and retailers.
A range of FEMIPLAN products are promoted through mass
media advertising, point-of-sale material in retail outlets as
well as consumer and trade promotions.
Over the last 20 years, large-scale family planning
communications in Kenya have been lacking. This has
contributed to entrenched myths and misconceptions
especially on the long-term methods of family planning.
In October 2010 PSI/Kenya in collaboration with the Ministry
of Health’s Division of Reproductive Health (DRH) launched
a multi-media behaviour change communication (BCC)
campaign branded C-Word. The aim of the campaign is to
promote the discussion and use of contraceptives among
youth aged between 18 and 24 years. The campaign utilises
a variety of media channels including: mass media, online
and social media, targeted events, a free short message
service, and a toll-free hotline where the youth can call and
receive information on contraceptives and reproductive
health.
Welcome to Tunza
for family health
services
Tunza is a network of private health facilities that are located
throughout the country. At a Tunza clinic, you will receive friendly,
quick and affordable services through qualified health providers.
Tunza clinics also offer quality family planning counseling and
services. A range of family planning methods is available for you
to choose from. Look out for a Tunza clinic near you.
Quality Services for Family Health.
PSI/Kenya is also supporting the Division of Reproductive
Health in the Ministry of Health in the implementation of
family planning communications targeted at women.
Recognising that over 40 percent of family planning
services and 50 percent of IUCDs are supplied through
the private sector, PSI/Kenya partnered with the sector to
support the major role that it plays in providing quality
family planning services, and introduced the Tunza Family
Health Network in 2008.
Tunza programme
Tunza is a Swahili word meaning ‘to nurture.’ Through the
network, women of reproductive age in urban and periurban areas of Kenya are provided with high-quality family
planning products and services. The emphasis is on longterm reversible methods of family planning, which include
IUCDs and implants.
The main objective of the Tunza Family Health Network
programme is to complement the government’s effort
in addressing the unmet needs for family planning and
increasing the contraceptive prevalence rate among
women of reproductive age.
The Tunza Family Health Network is a partnership between
selected private health service providers and PSI/Kenya.
Tunza clinics are privately owned by health providers and
provide a variety of health care services. The providers are
selected by PSI/Kenya using strict quality standards criteria
and invited to join the branded Tunza network. Currently,
PSI/Kenya builds the capacity of Tunza providers to provide
quality family planning counseling and services, and quality
HIV testing and counseling services.
From left, Egetuki Tunza Clinic Proprietor Denice Machuki,
Community Health Worker, Boniface Oyugi and PSI/Kenya’s
Reproductive Health representative in Nyanza Region Joshua
Marwanga, outside the clinic. Photo/Titus Mung’ou
The network has over 250 providers in seven provinces
countrywide composed of nurses, midwives and clinical
officers.
Cont pg 11
Health Programmes
HIV prevention in Kenya
Attaining universal LLINs coverage
Continued from pg 9
Continued from pg 8
What we have achieved
By the end of the first phase of mass net distribution,
PSI/Kenya had distributed 1,510,000 LLINs in 17 districts
across the country. After training and sensitisation of
key stakeholders, data was collected at household level,
followed by quantification of data and allocation of LLINs
to divisions. The nets were then moved from the divisions
to distribution posts and finally to the end recipient. PSI/
Kenya officers provided logistical support throughout the
distribution exercise.
Both the mass media and community mobilisation were
used to remind people to collect their nets from the
nearest posts, as well as to sleep under LLINs consistently.
Most districts harnessed resources across ministries and
departments to make the exercise a success. The ultimate
goal of ensuring universal coverage, one net for every two
people in a household, was largely achieved by the end of
the distribution.
What we learnt
The mass net distribution brought together various
stakeholders and embodied a joint effort to combat
malaria in Kenya. It became evident that there are many
untapped resources at the district and community levels
that provided the campaign invaluable support, especially
from non-health departments such as the provincial
administration, district commissioners and village elders.
An important component of the exercise was the
comprehensive work plan spelt out before commencement
of the work, as it helped to ensure smooth flow of activities
and coordination among diverse stakeholders. The
presence of PSI/Kenya Maternal and Child Health officers
ensured continuous monitoring of the situation and
support to targeted districts. Also significant was the fact
that actual determination of LLINs required per district
became realistic after the quantification exercise; and in
some cases it surpassed the initial projections, hence the
need to have extra stocks to cater for any adjustments.
Where we are going
During second phase of mass net distribution, PSI/Kenya
will distribute 1.2 million LLINs in 10 districts countrywide.
Lessons learnt during the first phase of the exercise will
come in handy and help improve the nets distribution in
the second phase.
Storage and transportation of nets in Nyamira District.
Abstinence campaign named Chill which targets 10-14
year olds with messages on delayed sexual debut; Mpango
wa Kando campaign which is geared towards reducing
the number of sexual partners especially among men and
women in married/cohabiting relationships; a voluntary
medical male circumcision targeting non-circumcising
communities; Nakufeel condom self-efficacy to address
skills in condom use; a sexual and gender based violence
(SGBV) campaign named Sita Kimya, a pilot project in
Kibera, Nairobi geared towards awareness creation on the
link between SGBV and HIV, and demand creation for postrape care services and legal services among others.
In 2008, PSI/Kenya developed ‘SIRI’ an edutainment
programme targeting women of reproductive age (18-49
years), with men of the same age group being a secondary
target. The programme consists of a series of stories and
characters that address essential messages on HIV testing
and counseling, prevention of mother to child transmission,
family planning as well as SGBV.
The edutainment programme contains 46-episode
soap opera that were aired between 2009 and 2011, a
radio drama programme aired between 2010 and 2011,
interpersonal communication drama outreaches in seven
regions done between 2009 and 2010, as well as printed
materials used by volunteer community facilitators to
engage communities in dialogue.
In 2009 PSI/Kenya partnered with the National AIDS & STI
Control Programme (NASCOP) to support the distribution
of SURE, the free government condoms, to at-risk
populations. From 2009 to date, PSI/Kenya has distributed
42.3 million SURE condoms on behalf of NASCOP.
Quality family planning services
Continued from pg 10
The Tunza brand promise is friendly, quick and affordable,
while ensuring quality services by qualified providers.
Priority is placed on maintaining quality in compliance with
the network’s core principles of technical competence,
client safety, informed choice, client privacy and
confidentiality, continuity of care, quality and consistency
of data.
A double-pronged approach has been adopted to
manage the Tunza Network. On the supply side, private
health providers are selected through a rigorous selection
process; they are then taken through a contraceptive
training update and continuous support supervision to
equip them with the knowledge and skills to provide
quality family planning services.
On the service demand side, community level demand
creation activities are carried out by a team of BCC team
referred to as Tunza mobilisers. Tunza mobilisers are
recruited from the communities where they are expected
to carry out demand creation activities.
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
11
Safe Water
Promoting safe water at the
household level
I
N KENYA, diarrhoea remains one of the major causes of child
sickness and death. In 2010 the World Health Organisation (WHO)
indicated that diarrhoeal disease was the highest preventable
cause of child sickness and death. Current estimates indicate that
one in every 14 babies born in Kenya will die before first birthday, of
completely preventable causes.
The main objective of PSI/Kenya Safe Water Programme is to increase
the number of caregivers who consistently use a governmentapproved method to treat their drinking water.
PSI/Kenya‘s Safe Water Programme started in 2003 with the promotion
and distribution of WaterGuard, a liquid chlorine solution. In 2006,
through private public partnership (PPP) with Proctor and Gamble
(P&G), the programme started the distribution and promotion of
PUR, a dual-action water purifier that acts on turbid water, flocculates
the dirt and disinfects water, making it safe to drink and use.
In 2009, the Safe Water Programme engaged MediPharm East Africa
in a mutually beneficial partnership to introduce Aquatabs into the
commercial sector and to give technical assistance in developing
and implementing demand creation activities.
With low perception of diarrhoeal disease coupled with low
adaptation of preventive practices, PSI/Kenya with the Division of
Child and Adolescent Health in the Ministry of Public Health and
Sanitation developed the diarrhoea communications slogan ‘Zuia
Kuhara Okoa Maisha’ (Prevent Diarrhoea, Save Lives).
The campaign was developed to:
 Raise awareness about the severity of diarrhoea by communicating the risks to children under five years.
 Promote preventative practices to prevent diarrhoea in households, with particular emphasis on household water treatment and safe storage of drinking water with a government- approved method.
Zuia Kuhara Okoa Maisha communications campaign has been
undertaken in priority districts. The Safe Water Programme works
with implementing partners including the Government of Kenya
(GoK) to implement small group discussions centered on diarrhoea
prevention and to promote GoK’s approved household treatment
methods.
In 2008, the Safe Water Programme developed the ‘Linda Kila Tone’
(Guard Every Drop) campaign for the WaterGuard product.
The campaign was developed to address the perception held that
clear water is safe; it pointed out that there may be invisible germs
that may cause a child to be sick.
In 2009, the ‘Koroga Koroga’ (Mix or Stir) campaign was developed
for the PUR product. The campaign was developed to create
awareness on PUR, with a focus on mechanics of using the product
and differentiating it from the other point-of-use water treatment
products.
12
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
Distribution Profile
Distributing health products through
social marketing
P
SI/KENYA uses private-sector expertise to make
health products available and accessible to the
vulnerable populations in Kenya. In order to fully
maximise on social marketing techniques, PSI/Kenya
established a Sales and Distribution Department when it
started its operations in Kenya in 1990, mainly to improve
the distribution and availability of health products. Today,
PSI/Kenya distributes over 10 products in four different
health areas.
Private sector: PSI/Kenya’s commercial partners range
from commercial distributors (50), wholesalers (700), retail
outlets including kiosks, dukas, lodges, pharmacies, bars
and lodges (30,000), Tunza clinics (257) and community
based organisations (110) that sell the health products for
income generation.
Public sector: PSI/Kenya partners with the Ministry of
Health in the distribution of free Government of Kenya
condoms and long-lasting insecticide-treated nets (LLINs).
The condoms are mainly distributed to community
based organisations (CBOs) and clinics while the nets are
distributed to clinics recommended by GOK. In addition,
PSI/Kenya distributes basic care package kits for free
through the clinics, mainly targeting people living with HIV.
Institutions: NGOs and private institutions are key partners
in the distribution of the health products. In most cases
the private companies buy products for corporate social
responsibility activities while the NGOs buy depending on
the health needs in their areas of operation.
Some PSI/Kenya products in a retail shop.
Product flow
PSI/Kenya procures products through Crown Agents,
the PSI headquarters in Washington and the PSI/Kenya
Supply Chain Department. The products are delivered to
PSI/Kenya’s Nairobi warehouse where they are dispatched
directly to appointed distributors. The products then move
through the normal trade levels from the wholesalers
to retailers, and finally to the retail outlets where the
consumers can access them.
What we have achieved
Distribution growth: Over the years, the sales have had
positive health impact on vulnerable populations. For
example, PSI surveys called Tracking Results Continuously
(TRaC ) show that there has been a significant increase in
condom use, meaning that there has been a decrease in
risky behaviour.
Increased availability: The availability of condoms has
increased from less than 10 percent in 1990 when PSI/
Kenya started to an average of 30 percent in both urban
and rural areas.
‘Crowding in’ the private sector: Introduction and
marketing of PSI/Kenya health products has attracted
the private sector to introduce other brands in the same
category and this may eventually lead to sustainability.
Free condom distribution: Collaboration with the
Government of Kenya in the distribution of free condoms
in rural areas has helped PSI/Kenya to distribute 9.7 million
condoms in 2009 and 2010 mainly to the rural communities
through CBOs.
Some PSI/Kenya products on display at the Safe Water and AIDS
Project (SWAP) head office in Kisumu, Nyanza Region.
Cont pg 14
Hatua Yetu Newsletter, Issue No. 1 August-September 2011
13
Distribution Profile
HIV Products Distribution Since Inception to 2011
Distributing health products through social
marketing
Continued from pg 13
324,214,405
Lessons learnt
 Private sector involvement: Utilise the existing private-sector networks to promote efficiency and sustainability.
Units
Units
re
al
ba
Ti
BCP Kits
et
tR
BCP Water
Resupply
So
cia
Ne
lM
484,768
m
en
at
MOH
Condoms
ar
sN
as
M
m
g
tin
Trust
Studded
et
Trust Base
AN
t
IN
st
Di
BCP Water
LL
r.
IN
LL
BCP Kits
ee
MOH
Fr
Trust
C
Trust Base
Studded
Condoms
Health products
distributed
by Resupply
PSI/Kenya
473,402
14,061,096
ke
Units
Units
 Good product availability increases product 63,389,149
uptake: As availability of PSI/Kenya products improved, 473,402
484,768
14,061,096
the products became more accessible to consumers and Where we are going
the sales improved.
Trust Base
Trust
MOH
BCP Kits
BCP Water
Condoms
 From PUSH toStudded
PULL distribution
system: Resupply
The main
objective
of
this
strategy
is
to
ride
on
the
existing  Good visibility: Good visibility of products acts as a commercial-sector networks to pull the products from reminder to consumers.
the distributors
wholesalers,
and finallySince
to the Malariato
Products
Distribution
HIV Products Distribution Since Inception to 2011
retail level, based
on
end-user
demand
without
PSI/Kenya’s
 Advertisement of product use and behaviour Inception to June 2011
direct
involvement.
promotes sales: High product awareness increases
HIV Products Distribution Since Inception to 2011
7,715,629
consumer324,214,405
pull.
 Total market approach (TMA): Work together with the 324,214,405
private and
public sector to take products where they  Partnering with other stakeholders on the ground: 2,951,776 to ensure a
are
needed
as determined by affordability
Collaboration with other partners involved in similar 1,560,275
1,512,017
sustainable market and create health impact in an
projects such as the government,
NGOs and CBOs, 90,240 63,389,149
484,768
equitable manner.
14,061,096
increases health impact
and efficiency. 473,402
63,389,149
MalariaDistribution
Products Distribution
Sinceto 2011
HIV Products
Since Inception
Inception to June 2011
Malaria Products Distribution Since
Inception to June 2011
Child Survival Products Distribution Since
7,715,629
Inception to June 2011
en
m
LL
re
at
tin
g
Ne
tR
et
ke
ar
ia
So
c
Ti
ba
m
al
t
IN
r.
Di
st
M
lM
Ti
re
tR
et
Waterguard
Ne
lM
90,240
Aquatabs
PUR
So
cia
662,225
et
C
ba
Fr
m
ee
al
t
en
at
tin
g
ar
ke
sN
as
M
BCP Water
Resupply
m
st
Di
et
ee
Fr
C
AN
BCP Kits
LL
r.
MOH
Condoms
AN
IN
LL
IN
Trust
Studded
20,701,909
9,328,938
as
sN
473,402
14,061,096
Trust Base
90,240
484,768
LL
IN
1,560,275
63,389,149
1,560,275
1,512,017
Units
2,951,776
1,512,017
2,951,776
Units
Units
Units
7,715,629
324,214,405
Malaria Products Distribution Since
Inception to June 2011
Child Survival Products Distribution Since
RH Products
InceptionDistribution
to June 2011Since
Inception to 2011
Units
Units
9,328,938
662,225
2,249,542
2,205,432
Waterguard
Ti
ba
m
al
t
en
m
at
20,701,909
Aquatabs
26,678
PUR
11,220
Re
tre
g
tin
ke
lM
ar
cia
So
662,225
Ne
t
r.
st
Di
sN
et
as
M
Waterguard
90,240
20,701,909
LL
IN
9,328,938
LL
IN
Fr
C
AN
14,135,811
2,951,776
1,560,275
1,512,017
ee
Units
Units
Child7,715,629
Survival Products Distribution Since
Inception to June 2011
Aquatabs
PUR
Femiplan
Condom
Femiplan
Pills Ocs
Femiplan
Injection
Copper T
380 A IUD
Jadelle
Implant
RH Products Distribution Since
Inception to 2011
Child Survival Products Distribution Since
RH Products Distribution Since
to
June
2011
14 Hatua YetuInception
Newsletter,
Issue
No.
1 August-September 2011
Inception
to 2011
s
14,135,811
News Pictorial
A banner announces the launch of the mass net
distribution in Koibatek District, Rift Valley Province.
Minister for Public Health and Sanitation Hon Beth Mugo,
left, at the PSI/Kenya stand during the launch of the mass
net distribution exercise in Koibatek District.
Photos/James Mwangi, MCHO PSI/Kenya
Nurses demonstrate how a mosquito net is pitched inside
a house, during a public sensitisation meeting at Ting’a
Chief’s camp, Nyamira District.
Trusted product: Peter Odero, an attendant at Kelly’s Bar
in Kisumu City, where he sells Trust condoms to patrons
and residents from nearby estates.
Some elders from the Turkana community hold pieces of
condoms distributed in Lodwar town by the Government of
Kenya and PSI/Kenya in April 2011.
Photos/Titus Mung’ou
Left, Jane Anyango of Polycom computer centre in Kibera
talks with PSI/Kenya’s APHIA II Project Manager, Michael
Owigar, near a gender based violence Sita Kimya
campaign wall mural along a road in Kibera, Nairobi.
Photos/Titus Mung’ou
16
Hatua Yetu Newsletter, Issue No. 1 August-September 2011

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