What we do
To reach our goal of reducing MTCT in the region, we implemented a number of initiatives through CHAPP, many coordinated with SOTENI’s AIDS Barefoot Doctors (ABDS).
These ABDs are not physicians; they are community health workers providing home-based care and education. The word ‘Barefoot’ shows the close connection between the health workers and their respective communities. They are members of the community who understand the culture and issues at play, and who also have the benefit of having received local health service training from SOTENI. This unique model fosters mutual understanding and trust – two important things when dealing with sensitive issues like sexual and reproductive health and HIV/AIDS prevention.
“Then SOTENI has its own cadre of what is an equivalent of home-based caregivers, but in our own language in SOTENI as AIDS Barefoot doctors. Now I mean I need to clarify what I mean by AIDS Barefoot Doctors because AIDS Barefoot Doctors does not mean doctors, they are a cadre of paramedics, we have people who have gone to 12th grade and we train them in provision of health services within their own community and the word bare foot means, ‘I come to you the way I am.’ So these guys have grown up in these areas, they know the culture they know the issues affecting these people and then they have some specialist training for supporting people who are HIV+ and we send them all to go and work in their own areas.”
- Edward Wanyonyi, SOTENI
These ABDs reached out to the local community in a number of ways. The most powerful platform was through local barazas. At barazas we educated crowds of young men and women on HIV prevention services and safe sex practices - often simple, but uncomfortable topics such as condoms. Statistics show that men and women aren’t using them as much as they should so we wanted to explain their importance; we even had our ABDs hold sessions about how to properly put on a condom. The crowd may be shy and laugh but ultimately learn a valuable lesson about something that can have serious consequences and is otherwise never discussed. Through these barazas we were without a doubt making progress on breaking some of those cultural norms that contribute to HIV transmission.
To combat MTCT in the area we also established a framework between the ABDs and the local health facilities with the aim of increasing referrals to ANC, VCT and PMTCT services. This referral framework encouraged women to move away from home births with TBAs, consistent with the new Kenyan government health guidelines. Despite their cultural significance, home births increase the risk of MTCT. The framework ensured women were fully informed and taking advantage of the best available services for HIV care and prevention.
Other activities included:
- Over 150 presentations by our ABDs to support groups, specifically for people living with HIV on subjects including PMTCT, breastfeeding, emotional support, VCT and infant nutrition.
- Production and display of an informative billboard outside a local health facility to raise awareness about available PMTCT and ANC services.
- Strengthening networks with other community-based organisations, government agents, self-help groups, women’s groups and a faith-based organisation to anchor socio-cultural support for PMTCT.