PEPFAR Technical Guidance in Context of COVID-19 Pandemic
In January 2020, a novel coronavirus, SARS-CoV-2, was identified as the causative agent of an outbreak of viral pneumonia centered in Wuhan, Hubei, China. The disease caused by this virus is called COVID-19. The disease is now widespread, and nearly every country in the world has reported cases.,
Widespread disturbances of international travel and shortages of medical supplies have led to challenges in the provision of medical care. In the areas hardest hit, medical facilities have been overwhelmed bylarge numbers of COVID-19 patients, and stay-at-home orders and staff illness provide additional challenges. During the COVID-19 pandemic, PEPFAR remains committed to continuing essential HIV prevention and treatment services, while maintaining a safe healthcare environment for clients and staff. In order to meet our commitment to uninterrupted care and treatment for PLHIV and the prevention of deaths among PLHIV due to HIV associated co-morbidities, PEPFAR is committed to adapting HIV services,so that PLHIV have the best possible outcomes within the context of stretched healthcare systems.
The evidence on the impact of COVID-19 amongst PLHIV is still scarce. There is currently no direct evidence that people with HIV are at higher risk of COVID-19, or of severe disease if affected. As more data becomes available from regions of high prevalence, we will continue to update the field on the effect of COVID-19 on PLHIV. HIV virological suppression is a critical intervention that improves the health of all PLHIV, and PEPFAR is committed to ensuring that PLHIV have uninterrupted care. Currently, there is no known effective treatment for COVID-19. We discourage the use of experimental therapies outside of registered clinical trials, as they may be dangerous. Drug-drug interactions with ART and other HIV related therapies may pose risks for our PLHIV clients. Download
Unlocking the Potential of Communities in Responding to Gender-Based Violence during COVID-19
Following the declaration by the World Health Organisation of COVID-19 as a pandemic on 21 Mar 2020, the world came to the realization that its existence was threatened by a virus more serious than imagined. Since then the disease has swept swiftly across all the continents causing untold suffering and the shutdown of the entire globe. Kenya is one of the first Countries in Africa that declared shut down of institutions, ban on travels both inbound and out bound and later local movement within the Country except for cargo. Many businesses have been shut down except for food, medical and agricultural enterprises. Kenya, like most of developing Countries, has 80% of the people working informal jobs that live on daily wages from hand to mouth. Around the world, this situation is worse for women as an estimated 70% of the women work in informal jobs with few protections against dismissal or for paid sick leave and limited access to social protection and yet women bear the biggest burden of global challenges. Experiences have shown that where women are primarily responsible for procuring and cooking food for the family, increasing food insecurity as a result of the crises may place them at heightened risk, for example, intimate partner violence (IPV) and other forms of domestic violence due to heightened tensions in the household.
Women and girls are experiencing distinct challenges and risks associated with the lockdown due to the COVID-19 pandemic, and as such the outbreak has exacerbated already existing risks of GBV. Confinement has increased risks of intimate partner violence for women and girls, while worsening their socio-economic situation. This then exposes the already vulnerable women and girls especially in rural areas who are facing increased risks of sexual exploitation by community members as well as partners to greater risk. In parallel, access to regular GBV services has become challenging for survivors. For countries like Kenya that is hosting refugees, the challenges are doubled as it has to respond to the needs of refugees and its citizens.
There is already worrying amount of information on GBV occurring against the backdrop of the COVID-19 outbreak. It is also becoming increasingly clear that many of the measures deemed necessary to control the spread of the disease are not only increasing GBV-related risks and violence against women and girls, but also limiting survivors’ ability to distance themselves from their abusers as well as reducing their ability to access external support. In addition, it is clear from previous epidemics that during health crises, women typically take on additional physical, psychological and time socio economic burdens as caregivers as seen in West Africa and DR Congo during the Ebola outbreaks. As such, it is critical that all actors involved in efforts to respond to COVID-19 across all sectors take GBV into account within their programme planning and implementation. This kind of response including actively working with men (perpetrators) at community level in advocating for GBV free communities. In a cross global call, the UNFPA’s core message is “the pandemic will compound existing gender inequalities and increase risks of gender-based violence. The protection and promotion of the rights of women and girls should be prioritized.
Community TB Situation
Taita Taveta County has four (4) administrative sub-counties, which are also the Tuberculosis control zones, with each having a sub-county tuberculosis and leprosy coordinator (SCTLC). A total of 25 HCWs were trained in Taita Taveta County in 2017 by NTLD-P in a bid to strengthen tuberculosis control activities at community level as a commitment by the program to end TB in Kenya. According to NTLD-P, Taita Taveta County has 48 AFB sites, 52 TB treatment sites and 2 GeneXpert sites with GeneXpert utilization rate of 31% in 2017. In the same year, the county’s case notification rate was at 145 per 100,000 persons while the proportion of Childhood TB was at 8%.4 The 2 GeneXpert machines are at Moi County Referral Hospital in Voi TB control zone and the other at Taveta Sub-County Hospital in Taveta TB control zone. Due to the terrain of the county, the GeneXpert machine at Taveta Hospital serves mostly Taveta TB control zone while the one at Moi CRH serving the remaining TB control zones..
While the set target for the proportion of deaths among TB patients in Kenya in 2018 was greater than 5%,Taita Taveta County reported 11% deaths of all forms of TB cases, thereby becoming the 3rd highest nationally after Siaya and Vihiga Counties.5 This is even after reporting 8% deaths in the previous year 2017.
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