Putting the client at the centre
“The need to have continuous engagement with women and girls of childbearing potential to enable them to have information on all FP options and to support them in making informed choices cannot be emphasized enough.”
Dr Lazarus Momanyi is a medical doctor and public health specialist with over 10 years’ experience designing and implementing HIV programmes in Kenya. As Technical Advisor for HIV DSD at the National AIDS and STI Control Programme (NASCOP), a division of Kenya Ministry of Health, he is currently involved in coordinating the design, implementation and scale up of client-centred DSD models.
What does NASCOP do?
NASCOP leads Kenya’s health sector response to HIV and AIDS, sexually transmitted infections (STIs) and viral hepatitis through policy and guidelines formulation, procurement and supply chain management coordination, capacity building and monitoring and evaluation.
What is the biggest current challenge for NASCOP in DSD and family planning?
Despite making great progress in scaling up DSD in Kenya, we are yet to implement to scale “one-stop” shops where women are able to access comprehensive services, including family planning (FP), through various facility and community models.
Proudest achievement to date?
One of our successes has been the progressive scale up of the integration of FP services within HIV clinics over the years. We have achieved this through routine pregnancy intention screening of women of childbearing potential, capacity building of healthcare workers, and infrastructural support.
As you scale up DSD models, what opportunities are there for FP within community DSD models?
As we make efforts to implement community models at scale, we need to continually rethink innovative ways to integrate FP within the models. Some of the practical opportunities include alignment of FP for the women during six-monthly facility clinic visits and dispensing of oral FP in community ART groups (CAGs), as well as delivery of injectable FP in the community with healthcare worker-led CAGs.
Lessons learned: How can the sexual and reproductive health (SRH) and antiretroviral therapy (ART) programmes work better together to ensure that women and girls living with HIV have their family planning (FP) needs met?
As scale up of rights-based FP for women of childbearing potential is an integral ingredient for elimination of mother-to-child transmission of HIV, we need to ensure alignment of the HIV and SRH/FP policies as much as possible and strengthen technical coordination between the two programmes nationally. In addition, there is a need to strengthen joint monitoring and evaluation of both programmes as opposed to working in silos.
Why did you decide to become engaged in the HIV response?
In my early years as doctor, I had the opportunity to join the Kenya Medical Research Institute (KEMRI)/Walter Reed Project as an investigator, and I was involved in several vaccine and therapeutic trials. Later, I transitioned to HIV public health programmes as I felt I wanted to be involved and be part of the Kenyan HIV response success story. I derive great fulfilment from knowing that I am part of a programme that has successfully started more than 1.2 million people on antiretroviral treatment and is responsible for averting thousands of new infections and AIDS-related deaths through our direct actions.
Describe your typical working week.
My week typically starts by checking my emails and responding to any outstanding inbox tasks, followed by phone calls with various teams, including county, colleagues in the national programme and implementing partners. As the week progresses, I will have a section meeting with my colleagues to review the previous week’s activities, examining the data, as well as updating on the status of the work plan. Part of the week will be spent reviewing documents, preparing a technical presentation and conducting virtual engagement meetings with various stakeholders. Occasionally, I will join a planning or technical workshop or visit a facility to offer technical assistance for care and treatment and DSD.
Your advice for readers looking to implement similar models?
The need to have continuous engagement with girls and women of childbearing potential to enable them to have information on all FP options available to them and support them in making informed choice cannot be emphasized enough. Task shifting among health and lay workers is also critical for successful scale up of FP within DSD models.
Finally, describe DSD in three words.
Client at centre
Thank you, Dr Lazarus Momanyi.
LinkedIn: Dr Lazarus Momanyi │Twitter @lazmomanyi
About NASCOP: The National AIDS and STI Control Programme (NASCOP) is a division in the Kenya Ministry of Health that has the overall role of technical coordination of HIV and AIDS, sexually transmitted infection and viral hepatitis programmes in the country.
www.nascop.or.ke Twitter: @NASCOP
