Background

Kenya has made great strides in the fight against COVID-19 since the first case of the disease was reported on 12th March 2020. This progress has been achieved through the collaboration of the Ministry of Health (MoH), County Governments and partners. The intersectoral approach has employed several strategies to contain the spread and manage the disease, including targeted testing, vaccination, and emphasis on cleanliness and hygiene.

Testing as part of the COVID-19 containment strategy has dramatically improved. As at 30th March 2022, Kenya has reported 323,402 confirmed cases of COVID-19 and 5,648 deaths[1]. These figures likely fail to capture the full extent of COVID-19 due to limitations in testing capacity and disease surveillance. Indeed, a 2021 COVID-19 risk perception assessment by Health Poverty Action (HPA) in its African programme countries noted that 37% of the respondents had not taken the test because it wasn’t readily available in their locals.

Nairobi – Kibra, Korokocho, and Kawangware Informal Settlements

The number of informal settlements in Nairobi is currently estimated at 158[2]. It is also estimated that informal settlements absorb 75% of the urban population growth. While informal settlements cover only 5% of the total residential land area of the city, they are inhabited by at least half of the city’s population[3].

Nairobi’s informal settlements are characterized by a lack of basic services, pollution, overcrowding, and poor waste management. This exposes the populace to common health risks. Within these settlements are vulnerable and marginalized groups such as people with disabilities who may face challenges in accessing healthcare and have worse outcomes from Covid-19. The settlements are typically supported by Level 2 (dispensaries), 3 (health centers), and 4 (sub-county hospitals).

[1] https://twitter.com/MOH_Kenya/status/1509179459009720321

[2] Informal Settlements Profiling Report: Nairobi County Draft Report Compiled by Muungano wa Wanavijiji / SDI Kenya

[3] Kenya: Nairobi Urban Profile

To implement the proposed project, HPA has partnered with Youth Alive!, a Youth Serving and Youth-Led Non-Governmental Organization (NGO) that advocates for and supports youth participation in development processes. Youth Alive! has substantial experience working with the Nairobi County government and within informal settlements in Nairobi. For example, through the campaign #InuaMamaZetu the campaign, YouthAlive! held a reflection meeting on the status of the Nairobi City County Health Service Act, 2019. This activity brought together Community Health Volunteers across the county who launched a petition under the hashtag #InuaMamaZetu calling for more resource allocation to public primary health facilities and implementation of the Act. Also, YouthAlive! Have recently collaborated with the Nairobi Metropolitan services to upgrade Gatina and Ngomongo to L2 and Riruta to L3, all facilities within informal settlements. YouthAlive! supports small scale women traders from three informal settlement areas in Nairobi through financial literacy training and capital to revive their businesses

Goals and Objectives

The objective of the project is to rapidly scale-up Community Health Volunteers (CHVs)-led Covid-19 Antigen-detecting Rapid Diagnostic Test (Ag-RDT).

This testing will be linked to health facilities for patient management in Nairobi counties.

How will this be achieved:

• Awareness raising and demand creation; an extensive network of CHVs, community radios, and partners to create awareness, address misconceptions and generate demand for testing and improve testing uptake.
• Capacity building of CHVs; this was already done.
• Build the capacity to scale up testing at level 2 (health dispensaries), and level 3 (health centers) public health facilities.

Intended Outcomes

The outcomes of the project include:

1. Develop the capacity of the local MOH in Covid-19 testing through trained volunteers using Antigen-detecting-Rapid Diagnostic Test (Ag-RDT).
2. Increased community awareness of the benefit of Covid-19 testing, demystify myths about the test and increase uptake of tests.
3. Increased number of Covid-19 cases detected, traced, and provided with treatment in L2 and L3 public health facilities.