complete statement from Mugo Ndung’u
The Ministry of Health in Isiolo County…
has a long-term goal of enhancing healthy lives for all of its citizenry. This is critical, especially when addressing communicable and non-communicable diseases in light of the devolved health services in the Republic of Kenya. Chronic health conditions warrant collaborative inputs along the care continuum, especially for people living with HIV, who need comprehensive care and treatment.
The health department works closely with local and international civil society organizations (CSO), including Kiunga, in health development. However, there has been diminished support to the different components of the health programs due to global and municipal changes, and even more so, due to the negative impact of the COVID-19 pandemic. One of the areas that has been adversely affected is mental health and psychosocial support for people living with HIV due to the reprioritisation of resources by partners.
Since the introduction of antiretroviral therapy (ART), there has been a major movement from thinking of HIV as an infectious deadly disease to a manageable chronic health condition. And for many years, the health department has depended, to a great extent, on support from external partners for mental health and psychosocial support services, as opposed to local government funding as they do for the procuring of antiretroviral drugs.
Nevertheless, in Isiolo County, which lies in the northern part of Kenya, communities are constrained by resource-poor settings with perennial droughts and pronounced poverty levels, which hinders people from attending facility-based psychosocial support group meetings.
This is addressed by the community-based model/strategy employed by Kiunga, which is currently the only CSO supporting psychosocial support group services to people living with HIV in Central Division, Isiolo Sub-County. Their model is worth borrowing a leaf from and replicating in the County AIDS Implementation Plan (CAIP) for the next 5 years. The plan is waiting to be published by the county level ministry in collaboration with the National AIDS Control Council during this third quarter of the government’s fiscal year.
Most of the individual, social and health systems barriers associated with ART adherence and retention in care affecting the general population also apply to persons coinfected with tuberculosis and/or non-communicable diseases like diabetes or hypertension. At different levels, young people living with HIV, children and adults face psychosocial risk factors, such as anxiety and depressive disorders emanating from the chronicity of HIV infection, being orphaned, changes of guardianship, and the nature of parental or partner support.
Most government facilities have constrained spaces to hold psychosocial support meetings due to the coming up of new structures and expanded service delivery points for other equally important health services. At the community level, holding psychosocial support meetings seems more sustainable since clients don’t have to travel so far away to meet with their peers for support.
Kiunga enables people living with HIV to cope with anxiety, isolation, suicidal ideation and HIV-associated stigma, which is a serious problem in Isiolo County. They also offer appropriate referrals to health facilities.
Jointly, the medical social workers and other health workers, in cooperation with Kiunga, offer advance psychosocial support interventions spanning interpersonal, informational activities and strategies that focus on biological, behavioural, cognitive, emotional, social and environmental factors, with the purpose of improving individuals’ health functioning and mental well-being.
Mugo Ndung’u
Senior Medical Social Worker
Ministry of Health, Isiolo County