We decentralize and scale up the management and delivery of life-long HIV services to make them available at more sites, especially in remote locations. Through training, human resource support, task-shifting, and integration of HIV services where possible, we have grown from serving just two facilities in 2005 to serving 61 health facilities today.

We ensure testing is easy to access throughout the health care system by making testing services available at outpatient, inpatient, nutrition, TB, maternal health, and child welfare centers. We also use partner notification testing and the family testing approach. Partner notification services involves testing the sexual contacts of clients diagnosed with HIV and the family testing approach involves testing the children and partners of patients attending HIV care.

We employ the Community Health Inititiative (CHI), a population-based approach to map, identify, test, and rapidly link individuals to health care services through health campaigns and home-based follow-up in the informal settlement of Obunga in Kisumu. We work closely with community leaders, the Ministry of Health, community- and faith-based organizations and other non-profits supporting Obunga. Together with our partners, we mobilize and deliver multi-disease health services including HIV testing and counseling; linkage to HIV services; screening and referral for tuberculosis, malaria, hypertension, diabetes, fistula, and cervical cancer; and referrals for voluntary medical male circumcision. 

We work to eliminate new HIV infections in children and ensure all pregnant women with HIV start ART and continue it for life through comprehensive and integrated delivery of PMTCT services within Maternal Child Health services.

To increase knowledge and uptake of VMMC, which is proven to reduce HIV transmission, we conduct community outreach and provide VMMC services at both static and mobile clinics. During VMMC, we also offer testing and rapidly link those diagnosed with HIV to care.

To give children, adolescents, and adults living with HIV the best opportunity for long, health lives, we offer a comprehensive package of care, which includes:

• Rapid ART initiation upon HIV diagnosis
• Integrated family planning, including contraception and safer conception counseling;
• TB, STI, and opportunistic infection screening, diagnostics, and management;
• Side effect monitoring at every visit;
• Laboratory investigations, including viral load, to monitor health outcomes;
• Positive Health Dignity and Prevention (PHDP) services, peer support, and adherence counseling to support patients' well-being and boost retention; and
• Pre-Exposure Prophylaxis (PrEP) to prevent HIV transmission in discordant couples and other high-risk individuals.

To reduce the burden of frequent clinic visits for stable patients and ease clinic congestion, we are implementing differentiated care models. This patient-centered approach tailors service delivery based on the preferences of people living with HIV and, in turn, allows clinics to have more time to focus on patients most in need. 

To strengthen HIV and other health related services for this underserved population, we implement a standardized adolescent care package and youth-friendly services. This includes youth-friendly healthcare providers and adolescent centers at eight of our largest facilities which are staffed by peer leaders. The adolescent peer leaders work alongside healthcare providers to empower adolescents to take charge of their health. They are part of Operation Triple Zero (OTZ), an initiative to enhance adolescent health outcomes. OTZ works with adolescents to commit to zero missed appointments, zero skipped drug doses and zero viral load. The peer leaders create a friendly environment for youth, facilitate support groups, and develop strategies like fun days where HIV education is combined with poetry, art, games, and sports. We are also supporting national and county efforts to educate teachers about how to better support youth living with HIV.

By shifting tasks traditionally performed by physicians, such as taking vital signs or providing medication adherence counseling, to capable, well-trained non-physician health workers we optimize the efficient use of local health workforces and meaningfully incorporate people living with HIV into our workforce.

To ensure the long-term sustainability and local ownership of HIV control efforts, we are equipping local governments, health workers, and civil society with the tools, skills, and manpower to manage HIV care systems independently.