Evurore, Kenya—When community health worker Cecily Wanyaga promotes healthy behaviors and HIV prevention and treatment services among her neighbors, she speaks from her heart—and experience. As an HIV-positive woman, Cecily is leading a healthy lifestyle and she and her husband are raising their HIV-negative son.
Cecily’s personal journey has inspired others. Tragically, she learned of her HIV status when her second child died soon after birth in 2006. The baby’s death prompted Cecily to get tested for HIV. Cecily, her husband and their older daughter all tested positive. The entire family received counseling services at Ishiara Sub-District Hospital in Embu County, and immediately began antiretroviral therapy, which they have continued to this day. “Since we learned about our status, good health has been our priority,” said Cecily, who owns a fruit stand just outside the hospital where she received her diagnosis. Her daughter is now 14 years old.
Cecily is one of 50 community health workers from the Evurore community who learned about prevention of mother-to-child transmission (PMTCT) of HIV, drug adherence and the importance of breastfeeding through a course sponsored by the Jhpiego-led APHIAplus KaMili project. Funded by the U.S. Agency for International Development (USAID), APHIAplus KAMILI is a five-year, $100 million integrated health service delivery project in Kenya’s Eastern and Central Provinces (APHIA stands for AIDS, Population and Health Integrated Assistance). Seven partners are collaborating in this Ministry of Health–supported effort: PATH; International Center for AIDS Care and Treatment Programs; African Medical and Research Foundation; Liverpool VCT, Care and Treatment; Christian Health Association of Kenya; Land O’Lakes International Development; and the Kenya Red Cross.
Through the APHIAplus KAMILI project, more than 400 health facilities are offering PMTCT services, where all pregnant women coming to the prenatal care clinic are offered counseling and testing for HIV. HIV-positive pregnant women are identified and given antiretroviral (ARV) prophylaxis, according to the national guidelines. They are followed up with and encouraged to deliver in the health facility. When the women come for postnatal checkup six weeks after delivery, their infants are immunized and HIV-exposed infants are identified for treatment and follow-up testing.
As of June 2013, more than 62,000 women had been tested for HIV through the APHIAplus KAMILI project, said Dr. Mildred Mudany, the Chief of Party of USAID APHIAplus KAMILI. “The project identified 1,428 HIV-infected women and provided ARV prophylaxis to virtually all of them and their exposed babies. Because of the interventions KaMili has put in place, giving antiviral prophylaxis to HIV-positive mothers and exposed infants as per guidelines, we have reduced mother-to-child transmission to 8 percent, and are aiming at a transmission of less than 5 percent by 2015. Had there been no intervention, 35–40 percent of infants born of HIV-positive mothers would be HIV-positive. We are focused on achieving virtual elimination of pediatric HIV.”
Community health workers like Cecily learned about access to HIV prevention and treatment services through the work of APHIA partner PATH. This training has allowed Cecily to educate her own community about the importance of adhering to HIV drug regimens and maintaining good nutrition.
Now, Cecily goes from house to house, visiting close to 100 people every month. She provides health education on home-based care for HIV, as well as referrals to health facilities. Cecily also spreads awareness about HIV treatment at public gatherings, churches and youth groups.
“People living with HIV can identify with me—that helps to convince them to return to care and treatment,” said Cecily, adding that she has so far convinced three HIV-positive women to give birth at the hospital instead of at home. All three women delivered HIV-free children.
Cecily credits APHIAplus KAMILI with allowing her to feel comfortable disclosing her own HIV status. “The ability to disclose my status has helped our community a lot,” said Cecily, “we formed a support group and the numbers keep increasing each time we meet.” The group, which is affiliated with the Ishiara Hospital, meets once a month.
When Cecily and her husband, Duncan Nyaga, decided that they wanted to have another child, they used their new knowledge about PMTCT in the hopes she would give birth to an HIV-free baby. Throughout her pregnancy, Cecily followed good nutrition guidelines and faithfully attended all of her prenatal appointments. She gave birth at Ishiara Hospital.
Their son, Ian, is now 2 years old. He has gone for three HIV tests: at 6 weeks, 9 months and 19 months. All of Ian’s tests were negative.
“I don’t know where I would be right now if it wasn’t for my commitment,” said Cecily. “But look at me now, I have a young boy who looks up to us and this gives me hope.”