ST. CAMILLUS MISSION HOSPITAL
ART CLINIC
P.O. BOX 119-40401 KARUNGU
www.karungu.net
KCCB-KENYA AIDS RESPONSE PROGRAM (KARP)
ART PROJECT
stcamillusartkarungu@gmail.com
YEAR 11 ANNUAL REPORT
January – December 2014.
KCCB-KARP
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1. INTRODUCTION
1.1. Background:
St Camillus Mission Hospital-Karungu has been a beneficiary of US-Presidential Emergency
Program for AIDS Relief (PEPFAR) grant since 2004. The core mandate being offering Treatment,
Care and Support to the people living with HIV AIDS in Nyatike, Suba and Ndhiwa Sub-Counties.
The program is locally referred as Kenya AIDS Response Program (KARP). St Camillus Mission
Hospital serves a catchment population of 300,000 spanning a radius of 32 km. Cumulative
patient enrollment by December 2014 stood at 10,965.
A.R.T Project Task Force
Objectives, goals, strategies, achievements, challenges and way forward are the set indicators that
guide our service delivery.
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H.E. The Migori County Governor, Hon. Kobado, presides over 2014 World AIDS Day
Celebration at Muhuru Bay
2. YEAR 10 GOALS & OBJECTIVES.
2.1. Clinical:
1. Achieve >95% Septrin (CTX) Prophylaxis.
2. Enrol 97 new clients each month.
3. Initiate ARVs on 56 clients per month.
4. Provide Post-Pharmacy Counselling (PPC) on a daily basis.
5. Treatment Preparation Sessions on the first 3 Fridays of every month.
6. Retain >85% of the patients.
7. All patients on HAART more than six months are done Viral Load instead of CD4.
8. Intensive Case Finding (ICF) for TB screening to all patients.
9. Prevention of Mother-to-Child Transmission (PMTCT) intervention.
10. Collect PCR sample at 6 months.
11. Quarterly Viral Load testes to qualifying clients.
12. Adhere to Kenya National (NASCOP) Guidelines.
13. Adverse Drug Reaction Reporting(ADR) at 100%.
14. Continuous Quality Improvement (CQI).
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2.2. Community:
1. Health Education every morning at the Clinic.
2. Daily tracking of patients missing appointments through Data Computers.
3. Link newly enrolled/initiated clients to Patient Support Groups (PSGs) and CHVs.
4. Maintain TB-DOT and defaulter tracking.
5. Provide home-based counseling and testing (HBCT).
6. Participate in World AIDS Day St.Camillus, Ndhiwa and Nyatike District
Celebrations.
7. CHV mentorships during monthly co-ordination meetings.
8. Enhanced Youth Friendly Services.
9. Quarterly Adolescent and Peds Psychosocial Days.
2.3. Programme Administration:
1. Facilitate personnel development through external trainings and internal CMEs.
2. Monitoring and Evaluation of Programme activities.
3. Maximize staff motivation and retention.
4. Timely generation of reports to relevant consumers.
5. Networking and Collaborations.
6. Strengthen Capacity at Satellite facilities.
7. Doing more with less resources.
8. Linkages with the County and Sub –County Health Management Teams.
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A young boy plays with a toy at Children’s Day at Mirogi Satellite
3. PERFORMANCE ANALYSIS.
3.1. Clinical:
Accurate adherence to treatment is of immense clinical importance in the delivery of antiretroviral therapy (A.R.T). To achieve this, Early Diagnosis of suspected OIs, Early ARVs
Initiation, Post Pharmacy Counseling, (PPC), clinical follow ups, quality enrollments and
generating defaulter lists daily are some of the vital approaches we have always practiced with
good results in enhancing adherence. We also acknowledge the Government of Kenya’s NASCOP
and our partner KCCB-KARP support in provision of updates on guidelines in relation to
acceptable drugs, PMTCT protocol, TB management etc.
St. Camillus A.R.T. Clinical Team in a Planning Meeting
KCCB-KARP
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 Coming to Clinical Indicators, this is how we realized our goals against the set targets:
Table 1: Clinical Performance.
CLINICAL
INDICATOR
New Enrollments
TARGETS
THE YEAR
1164
Initiation to ARVs.
CD4
at
FOR ACHIEVED
COMMENTS
1063
-Teste kits stockouts.
-Insufficient funds for RRI.
672
915
Surpassed due to increased
initiation baseline from CD4
OF 350 to 500.
>90%
98%
Revised guidelines on viral
load monitoring.
>95%
99.5%
Enhanced monitoring by
clinicians.
The number is high due to
limited home visits to
unadherent clients because of
low funds.
new
enrollment %
CTX uptake %
Started on second All patients failing 150
line treatment
on 1st line.
Patient retention %
>85%
85.1%
DNA-PCR Sample
207
done
Collection & Testing All Exposed Children (100%)
of exposed children
Viral Load Audit
All patients on ART
Detectable=36
TB-ICF.
Treatment
Preparation Sessions.
Only 6 turned HIV positive
& enrolled, an indicator of
strong PMTCT.
Represents strong adherence.
100%
Screening on going
Continuous for all
patients.
9 patients per week.
11 per week All qualifying patients put on
averagely
HAART.
Adverse
Drug OPEN
Reaction (ADR)
76 patients
Low compared to last with a
difference of14.
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Mirogi Health Center receives a Power Generator donated by St. Camillus A.R.T. Project
3.2. Community:
This is the psychosocial, political and economic wellbeing of patient care. It is aimed at linking
the clinic and the patient at the place of the patient’s residence and/or daily life. Personnel with
this responsibility are Social Workers, Community Nurses and Counselors. At the community
level, CHVs complement staff capacity.
A.R.T. Nurse, Joan, mentors children on preparatory Health Education
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 Patient Home Visits/Follow ups:
An average of 2000 home visits were conducted monthly during the year by staff and CHVs
which resulted into zero defaulter rate for a good part of the period. A number of psychosocial
issues were also addressed.
Homa Bay County PMTCT mothers being awarded gifts for HIV infection control
 HIV Testing & Counselling.
We complied to both CDC and National Government requirement in HIV diagnosis through
Provider Initiated Testing and Counseling (PITC) at 50% of OPD turnout, DNA-PCR tests to
exposed children aged <6 months.
Homa Bay County e-MTCT Launch
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PITC/HTC Year 10 Outcome:
PITC (OPD)
IPD SERVICES
MCH
HTC
Service Indicators
Totals During the
Reporting Period
Offered
Tested
Positive
Offered
Tested
Positive
Offered
Tested
Referred
Tested
Positive
Referred
4196
2419
273
1765
1311
72
368
368
33
6103
604
598
 World AIDS Day 2015
This year, the Project actively participated in marking the day in Suba, Nyatike and Ndhiwa. Sub
Counties that we partner with in HIV care. Besides financial and material support, we mobilized
patient groups for informative and educative entertainments. Further, HIV tests and ARV displays
were conducted at the three separate venues by Project staff.
 Decentralization of Activities:
Primary Health Care Facilities that we partner with as affiliate satellites have been key to
cascading our services as well as scaling up the targets. Each satellite has 6 to 8 staff posted and
supported by St. Camillus KARP.
Table 4: Satellite Patient Load as at December 2014.
Satellite
Osani
Mirogi
Kadem
Lwanda Gwassi
Total
Ever Enrolled
828
1,932
973
596
4,329
Current on
ART/ARVs
561
1,115
742
377
2,795
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3.4. Program Administration:
Program management is done by the Project Coordinator. The officer oversees planning,
budgeting, controlling, implementation, monitoring and evaluation activities of the Project.

All Monthly reports were submitted to respective destinations at 90% within deadline
of 5th of every month.

Due to exemplary performance, a Laptop Computer was donated to the Project by
USAID Nutritional Program.

The Project was recognized by various implementation agencies including County
Governments for participation a number of forums including planning and hosting of
Kenya’s First Lady H.E. Mrs. Margaret Kenyatta in Homabay.

We are partnering with RCTP-SEARCH program in as study dubbed; TEST &
TREAT for early initiation to ARVs at a CD4 of 500c.

Satellite facility refitting went on for a better part of Quarter one where Mirogi, Kadem
TB and Lwanda Gwasii satellites had space improved structurally in Shelving and
Partitioning.

Numerous Ministry of Health, NASCOP and donor Supportive Supervisions were
hosted and benefitted facility staff.

Though consistent in remittance, funds were never adequate to support all the planned
activities towards the last quarter.
In regard to human resources, we can report that:
I.
An average of 27 staff members were trained in various internal and external programs
arranged under our personnel capacity building plan.
II.
Six staff left the Program for other avenues of their choice and replacement done in
time.
III.
Three College students benefited from industrial attachments during the year.
IV.
Leaves were broken as desired with minimal off duties towards the end of the year.
KCCB-KARP
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ART Paediatric Day at a St.Camillus Satellite Clinic.
.
4. SUMMARY
Critical Analysis of Year 10 under Key Indicators
4.1. Achievements:
 Provided staff training and development at 75.8%.
 Achieved patient retention at 86%.
 Less than 1% children turning PCR positive at two years.
 Online reporting to Kenya Pharma for drugs.
 Alternative power supply at Mirogi Satellite.
 Enhanced MoH linkages.
 Supporting Mirogi and Kadem satellites with Pharmacy and Data Staff.
 A Laptop donated by USAID-Nutritional HIV Program (NHP) for reporting purposes.
A Community Health Volunteer follows events at a
World AIDS Day function Nyatike Sub-County.
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4.2. Challenges:
Compared to the last reporting year, we have improved on most of the challenges we faced and
achieved more.
 Turnaround for Infant Diagnosis (PCR) done is 3 months against recommended 5 days.
 Working with a flat line budget.
 Inconsistent Power Supply at Kadem TB satellite responsible for delayed reports.
 Administrative gaps at Osani satellite out of Facility Sponsorship.
 High patient transfers to other facilities due to reduced number of Opportunistic Infection
drugs at St. Camillus.
Kadem TB & Leprosy Clinic Innovative Directional Plan.
Conclusion:
The program’s success is embedded to the honest and dedicated relations that exist between St.
Camillus Mission Hospital and KCCB-KARP, as we put more efforts in serving those affected
and infected by HIV-AIDS. Without this kind of vital intervention, numerous lives could have
been lost within Karungu and its environs. Our prayers will remain focused on more strength and
spirit, so that we can be able to continue delivering efficiently and effectively.
Report Compiled by Obillo Meshack.
Coordinator
KCCB-KARP
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