ICRH Kenya

INTERNATIONAL CENTRE FOR REPRODUCTIVE HEALTH -KENYA

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  • Prevention of Commercial Sexual Exploitation of Children (CSEC)

  • Linkages Across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES)

  • Bridge to Scale

  • Gender Based Violence and Recovery Centre (GBVRC)

  • 160 Girls

Prevention of Commercial Sexual Exploitation of Children (CSEC)

COMMERCIAL SEXUAL EXPLOITATION OF CHILDREN (CSEC) PROJECT

Project description

With support from Kindernothilfe, ICRH Kenya has been implementing Commercial Sexual Exploitation of Children (CSEC) project since September 2016. The three-year project is ending in July 2019. It covers the larger Changamwe and Kisauni Sub-Counties in Mombasa County. Kenya. Its overall objective is to contribute to the reduction of commercial sexual exploitation and sexual abuse of children as well as improve service delivery to the victims through institutional linkages of both children and caregivers.

Specific objectives of the project

  1. To strengthen the capacity of the community and other stakeholders to prevent and respond to commercial sexual exploitation and sexual abuse of children.
  2. To contribute to behavior change and communication among children who are vulnerable to commercial sexual exploitation and sexual abuse with life skills.
  3. To strengthen services for victims of CSEC and sexual abuse through institutional linkages of both children and caregivers.

Activities

The following interventions are being given; one on one counselling, life skills training sessions and vocational training.  Also being identified and followed up with information are caregivers of the children who are in CSEC, Community Volunteers and different stakeholders including the police, officers from the children department and Ministry of Education officers.

Capacity building sessions on child protection are being carried out on different stakeholders including;  local administrators, religious leaders, paralegals, teachers, school peer educators, community volunteers, out of school peer educators and bar owners. These stakeholders are in turn supposed to reach to children and adults leading to an increased number of CSEC cases being reported.

Poverty being a major contributing factor to CSEC, caregivers are also trained in business skills so as to provide for their children hence reduce the chances of their children getting back to CSEC.

Linkages Across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES)

Population based-surveys conducted over the last 10 years indicate that the Human Immune Virus (HIV) prevalence in Kenya is declining. While prevalence in the general adult population (estimated at 5.6%) is declining, Key populations (KPs), specifically Female Sex Workers (FSW), Men who have Sex with Men (MSM), and Male Sex Workers (MSW) continue to report higher prevalence and incidence of HIV and Sexually Transmitted Infections (STIs). HIV prevalence among FSW is estimated at 29.3% while MSM and MSW report an estimate of (18.2%).  Specific to the coast region, Mombasa County has the fifth highest HIV prevalence nationwide.

Linkages Across the Continuum of HIV services for the Key Populations Affected by HIV (LINKAGES) is a five-year project funded by USAID/PEPFAR through Family Health International and ICRH Kenya is the implementing partner at the  Coast region of Kenya. The overarching objective of the project is to scale-up interventions to increase access to HIV/STI prevention and treatment services, increase demand for HIV prevention and treatment interventions,  and strengthen systems for KP programming in Mombasa, Kilifi and Kwale counties.

The project aims at;

  1. Improving HIV testing and piloting of oral HIV self-testing, expansion of peer educator, peer supervisor and peer navigator activities in order to, i). Scale-up community-based HIV prevention services and linkage to care and treatment, ii). Increase the distribution of condoms and lubricants, and iii). Improve planning and forecasting for condom distribution.
  2. Establishing new Drop-In Centers (DICs) while maintaining support for the all existing DICs, implementing of  “Test and Start” approach for HIV positive KPs, providing  additional psychosocial support for HIV positive MSM and FSWs, scaling up on screening for sexually transmitted infections (STI) and cervical cancer, and championing for anal health for both MSM and FSWs, integrating  pre-exposure prophylaxis to the HIV prevention interventions, and scaling up  comprehensive family planning services to FSWs.
  3. Strengthening systems to prevent and address sexual and gender-based violence, collecting information on the sexual, reproductive and psychosocial health needs for young FSWs and designing interventions to address these, addressing alcohol and drug use among MSM and FSWs, and recruiting anti-drug abuse champions.
  4. Strengthening monitoring and evaluation systems, and introducing a program database and programmatic monitoring system.

Bridge to Scale

Pre-exposure prophylaxis (PrEP) trials of Tenofovir’s efficacy have been done in some studies in South Africa and USA and it has been discovered that when adherence is high, so is the efficacy. PrEP will provide an additional HIV prevention intervention and studies have demonstrated high efficacy for both men and women assuming full adherence to a daily regime. Oral PrEP was endorsed by the WHO in 2015 and Kenya as a country has included it in its revised Anti-Retroviral Therapy (ART) guidelines of July 2016. Modeling shows the potential effectiveness of 99% for Men having Sex with Men (MSM) and 94% for Female Sex Workers (FSWs) assuming full adherence to a daily treatment regime. Time is ripe to move PrEP rapidly from research and small-scale demonstration projects to service delivery at scale worldwide. However, countries need to be convinced that population-level PrEP interventions are feasible and effective.

ICRHK is implementing Bridge to Scale project with a consortium of partners; JHPIEGO, NASCOP, PSI Kenya, and Avenir Health among others. It aims to bridge the gap in HIV prevention among Key Populations (KPs) by the introduction of oral PrEP.

The four-year project demonstrates and documents an affordable, effective and sustainable model on how oral PrEP can be scaled up as an HIV prevention intervention under low-resource, real-market conditions in order to generate the enthusiasm needed to catalyze global scale-up of oral PrEP amongst populations at high risk. The project areas are; Mombasa, Kilifi, Taita Taveta and Kwale Counties.

Gender Based Violence and Recovery Centre (GBVRC)

The GBVRC is a public-private partnership between the Ministry of Health and ICRH. It was set up in May 2007 to complement and strengthen services available at the CPGH and provide comprehensive, quality care for survivors of rape, sexual violence and sexual exploitation. Coast Province General Hospital (CPGH) is one of the largest public hospitals in Kenya based in Mombasa and serves as a referral and training centre for the Coast region. The GBVRC is situated next to the casualty/emergency unit of the hospital to ensure ease of access to services by survivors of Sexual and Gender-Based Violence (SGBV).

Services provided at the centre include:
• Medical: management of injuries, provision of Post Exposure Prophylaxis (PEP) to prevent HIV transmission, Emergency Contraceptive Pills (ECP), prevention and treatment of Sexually Transmitted Infections (STIs), forensic collection and management (collection of physical evidence and samples, filling in of Post Rape Care (PRC) and P3 forms etc
• Psycho-social care: trauma counselling of survivor and family/relatives, HIV counselling and Testing (HCT) and  adherence counselling
• Legal counselling and support: referral to police, court preparation and watching brief in court
• Referral for specialized services (medical, psycho-social and legal)

The Centre has developed initiatives to:
• provide comprehensive, quality and continuous care for survivors of sexual and gender-based violence as outlined in the national guidelines on the management of sexual violence in Kenya;
• offer improved physical and psychological services in a confidential and supportive environment;
• assist with legal and social counselling to Survivors who have experienced violence and their families;
• monitor and evaluate the follow-up care of survivors;
• create evidence-based outcomes promoting public health care alongside legal advocacy;
• raise awareness around the physical, social, and legal implications of sexual and gender-based violence at the individual, community, hospital, national and regional levels.

160 Girls

The practice of rape and girls’ defilement in Kenya is so common it can be described as an epidemic. Every 30 minutes a girl/woman is raped in the country. Studies have revealed that as many as 68% of school‐aged children have experienced sex under coercive conditions, that roughly 165 children are ‘defiled’ every month, and that defilement incidents continue to be on the rise. The perpetrators include family members and community members, some of whom are guided by the misconception that having sex with a virgin is a cure for HIV/AIDS. In reality, the epidemic of girl child rape leaves these young girls at increased risk of contracting HIV/AIDS themselves. Despite the stiff criminal law penalties against defilement (the term used in the Kenyan Sexual Offences Act to refer to the rape of girls under 18), the law is not adequately being enforced. As a general pattern, police fail to conduct adequate criminal investigations into these crimes, resulting in a culture of impunity which only serves to perpetuate this violence.

The equality effect commenced the 160 Girls – Kenya project in 2011 working with the Kenyan‐based children’s rights organization, Ripples International. Ripples operates the Brenda Boone Tumaini Girls’ Rescue Centre, a shelter in Meru, Kenya that provides care and support for defilement victims. At the time this project was launched, the Centre had sheltered over 160 defilement victims, between the ages of 3‐17 years of age, who needed access to justice. That figure continues to rise by the week. The aim of the “160 Girls” project is to hold the police and the Kenyan state accountable for the enforcement of defilement laws and thereby meet their duty to protect girls in Kenya from this most appalling form of violence. The equality effect’s 160 Girls project team, includes lawyers, academics, and activists from Canada, Ghana, Kenya and Malawi, considered various options for addressing the widespread police failure in the handling of defilement cases. A team of legal volunteers from around the world assisted in the legal research in support of the case (all of the lawyers working to support the “160 Girls” case volunteer their time). Ultimately it was decided that a constitutional petition would be brought against the State, arguing that its failure to enforce the laws meant to protect girls from rape amounted to a violation of their constitutional human rights. This avenue was seen as the strategy with the most potential for widespread, systemic impact.

The overall objective is to monitor police treatment of defilement cases reported at the Gender-Based Violence Recovery Center (GBVRC) based at Coast Provincial General Hospital (CPGH) –Mombasa, through a standard `intake and monitoring’ form. The activities for the project are: Recruiting, monitoring and documenting police treatment of defilement claims of survivors attended to at the CPGH-GBVRC, divide the intake forms into the specific police stations under which every defilement claim had been reported and make interactive phone calls to the guardians of the survivors to get updates on the progress of each claim documented in the intake form at the GBVRC. ICRHK implemented 160 Girls project which conducted public legal education in primary schools and the community in sub-counties of Mombasa County with support from equality effect.  With an aim to raise community awareness that, pursuant to the Order of the High Court of Kenya in the “160 Girls” case, police must conduct “prompt, effective, proper and professional” (PEPP) investigations into defilement cases and bring all perpetrators of defilement to justice. The community education program focus was legal educational empowerment and establishing a partnership between community members and police and civil society.  The school workshops have been conducted  using the “Girls for Justice” training program used to promote children’s awareness of the“160 Girls” decision, their equality rights, and duties owed to them by police and their community—empowering them to help girls stand up against defilement, report defilement and be agents of change in their communities. The focus is to equip girls with increased knowledge and voice to bring greater community attention to defilement, provide a stronger check on police and community actions that are harmful to girls, and ultimately serve to make girls safer in their communities.