Empower 300 Children Living with HIV in Kenya

Summary of Progress

AMURT continued implementing comprehensive community- and facility-based intervention to improve treatment adherence and psychosocial wellbeing among Children and Adolescents Living with HIV (CALHIV) with high viral load in Mombasa County, Kenya. The project reached 300 CALHIV across all six sub-counties with generous support from GlobalGiving. Key interventions included home visits, adherence assessments, psychosocial counselling, caregiver mentorship, and close coordination with health facilities and Sub-County AIDS and STI Coordinators (SCASCOs). Transport to Care and nutritional support in terms of Food Baskets were provided to the most vulnerable households. These efforts strengthened caregiver treatment literacy, reduced missed clinic appointments, and enhanced community - facility collaboration - critical factors in supporting sustained viral suppression. 

Activities Implemented  

The project implemented a range of interventions aimed at improving viral load suppression, treatment adherence, psychosocial well-being, and nutritional support for Children and Adolescents Living with HIV (CALHIV) and their caregivers. The activities focused on strengthening continuity of care through counselling, household follow-up, and food assistance. The project achieved its stated targets for beneficiary engagement and food basket distribution, while home visits and counselling sessions were conducted as planned.

The key activities and achievements included:

- Improved Viral Load Suppression: The project targeted 300 CALHIV and supported all 300 beneficiaries, with the objective of improving viral load suppression. Achievement was to be verified through facility viral load reports.

- Enhanced Treatment Adherence and Psychosocial Well-being: The project engaged 300 caregivers against a target of 300, providing support intended to improve treatment adherence and the psychosocial well-being of CALHIV and their families. Counselling records and follow-up tools served as the means of verification.

- Home Visits and Counselling Sessions: Home visits and counselling sessions were conducted for CALHIV households as planned. These activities enabled continued household-level engagement and follow-up, with mentor mother reports used to verify implementation.

- Provision of Nutritional Support: The project distributed food baskets to 300 CALHIV, meeting the target of 300 beneficiaries. This intervention aimed to strengthen nutritional support and promote treatment adherence. Distribution lists signed by caregivers served as the means of verification.

Overall, the project achieved its beneficiary targets for CALHIV support, caregiver engagement, and food basket distribution, while implementing planned home visits and counselling sessions. These complementary interventions were designed to address nutritional and psychosocial challenges, reinforce treatment adherence, and contribute to improved health outcomes among CALHIV.

Results Achieved This Period:

Quantitative results (numbers reached, services delivered)

• 300 Children and Adolescents Living with HIV with high viral load were reached across all six sub-counties of Mombasa County.
• 300 caregivers received adherence counselling and psychosocial support.
• Home visits and counselling sessions were conducted for targeted households.
• Food baskets were distributed to 300 vulnerable CALHIV households to support treatment adherence.

Qualitative results (behavior change, improved wellbeing, skills gained)

• Caregivers demonstrated improved treatment literacy and confidence in supporting consistent medication intake.
• Adolescents reported better understanding of their treatment and increased responsibility for adherence.
• Psychosocial support reduced treatment fatigue, emotional distress, and stigma-related barriers.
• Strengthened collaboration between community mentor mothers and health facilities improved follow-up and continuity of care.

People reached

Target Population:
Children and Adolescents Living with HIV (CALHIV) aged below 18 years with high viral load, and their primary caregivers, in Mombasa County, Kenya 

Number Planned for This Period:
300 Children and Adolescents Living with HIV (CALHIV)

Number Reached This Period:
300 Children and Adolescents Living with HIV (CALHIV)

Total Reached to Date:
300 Children and Adolescents Living with HIV (CALHIV)

Category Of Beneficiaries 

Gender: Boys and Girls

Age: Children and Adolescents (0–18 years)

Disability Status

Not systematically captured during this reporting period 

• Beneficiaries were reached across all six sub-counties of Mombasa County.
• Caregivers of all enrolled CALHIV were engaged through counselling, home visits, and psychosocial support sessions.
• Data was collected through facility records, mentor mother reports, and community follow-up tools. 

Challenges Encountered

The project faced several interconnected challenges affecting adherence among Children and Adolescents Living with HIV (CALHIV). Caregiver fatigue and emotional stress limited consistent supervision of treatment routines, particularly in households caring for multiple dependents or orphaned children. Delayed or poorly managed disclosure processes led to confusion, denial, and resistance to medication among adolescents. Stigma in schools and communities continued to discourage clinic attendance and consistent drug intake, especially for boarding school students. Economic hardship further constrained caregivers’ ability to attend clinic appointments and provide adequate nutrition, while occasional negative staff attitudes at health facilities affected adolescent engagement.

How We Responded

The project adapted by strengthening family-centred psychosocial counselling and increasing the frequency of mentor mother home visits to support both adolescents and caregivers. Disclosure processes were approached more carefully, using age-appropriate counselling and close coordination with caregivers and health workers. Transport facilitation and food basket support helped reduce economic barriers, while regular coordination meetings with Sub-County AIDS and STI Coordinators (SCASCOs) and facility staff improved follow-up, referral pathways, and youth-friendly service delivery.

Key Lessons Learned

Sustained viral suppression among CALHIV requires more than access to medication. Continuous psychosocial support, empowered caregivers, and adolescent-friendly services are critical. The project demonstrated that trust-based relationships, consistent follow-up, and flexible community-facility collaboration significantly improve adherence outcomes. Addressing emotional wellbeing alongside clinical care is essential for long-term success.

Use of funds 

The project funds were utilized across five key budget categories to support Children and Adolescents Living with HIV (CALHIV), with a focus on improving treatment adherence, retention in care, nutritional outcomes, psychosocial well-being, and viral load suppression. The allocation prioritized direct support to vulnerable children and their families, while facilitating access to essential health and nutrition services.

The main areas of expenditure were as follows:

- Personnel (18%): Funds supported stipends for one social worker and two mentor mothers to provide comprehensive psychosocial support to CALHIV. Their responsibilities included individual and group counselling, home visits, support group facilitation, and linking beneficiaries to community and government social services. These activities strengthened treatment adherence, retention in care, and viral load suppression.

- Transport to Care (17%): Funds covered essential transportation costs for vulnerable children and caregivers to access health facilities. This enabled attendance at clinic appointments, collection of HIV medication, viral load testing, and access to nutrition services, particularly for households facing financial constraints and long distances to health facilities.

- Food Basket (36%): This was the largest expenditure category, providing food supplies to vulnerable households affected by HIV. The food baskets helped address household food insecurity and improve access to adequate and nutritious meals, supporting the effectiveness of antiretroviral therapy. The assistance also reduced household financial pressure, minimized treatment interruptions, and contributed to better nutritional outcomes and retention in care.

- Psychosocial Support (27%): Funds covered transport and vehicle-related costs for social workers and mentor mothers to conduct home visits, counselling sessions, and follow-up with CALHIV and their caregivers. These activities ensured continuity of psychosocial support, strengthened caregiver engagement, and reinforced treatment adherence and retention in care.

- Transport (2%): Funds provided alternative transport when the project vehicle broke down and supported the safe and timely delivery of food baskets to beneficiary households, ensuring continuity of essential nutritional assistance.

Overall, the expenditure reflects a strong emphasis on nutritional support (36%), psychosocial support (27%), and access to health services (17%), complemented by personnel costs (18%) and contingency transport (2%). Together, these interventions helped address the interconnected nutritional, psychosocial, economic, and healthcare access barriers affecting CALHIV and their families. 

Sustainability and next steps

How the Benefits of the Project Will Continue

The project strengthened caregiver capacity, community mentorship, and linkages with health facilities, ensuring that benefits extend beyond the funding period. Caregivers are now better equipped with treatment literacy and psychosocial skills to support consistent adherence among CALHIV. Mentor mothers and community health workers remain embedded within the communities and will continue to provide follow-up, encouragement, and linkage to Comprehensive Care Clinics (CCCs). Coordination with Sub-County AIDS and STI Coordinators (SCASCOs) and facility teams has institutionalized improved referral, reporting, and adolescent-friendly service delivery.

Planned Activities for the Next Quarter 

In the next phase, AMURT plans to intensify caregiver education sessions with emphasis on disclosure support, treatment literacy, and adolescent mental health. Continued home visits and psychosocial counselling will be prioritized for high-risk households. The project will also engage schools to promote stigma reduction and discreet adherence support for school-going adolescents. Regular case conferencing between community and facility teams will be maintained to monitor adherence and viral load outcomes.

Gaps and Remaining Needs

Despite progress, gaps remain in sustained psychosocial support, economic resilience for vulnerable households, and availability of youth-friendly spaces within health facilities. Continued funding is needed to scale mentorship, expand nutritional support, and strengthen school-based interventions. Addressing these gaps is essential to achieving long-term viral load suppression and improved quality of life for CALHIV.