The prevalence of HIV/AIDS in the district is still very high estimated at 3.6%. There are pockets in the district where prevalence is high like in fishing communities, taxi brokers and boda-boda men around the district. The lifestyle of these communities exposes them to more infections. The prevalence of HIV/AIDS from sentinel ANC sites is high especially the sub counties that have Hospitals (DHO office). The prevalence of the epidemic has reduced from 4-3.6% for the Last 10 years. The reduction has been as a result Home Based Counseling and Testing (HBCT) programme that moved from door to door providing VCT services to the communities and increase in percentage of Health units offering PMTCT and ART. In the fishing communities and IEC awareness, there are reports of fishers saying that after all it takes long to kill. The communities believe that there is no solution to it. Wrong and boring messages could be responsible for the high prevalence or may be a large section of the communities in the district are well sensitized about the epidemic but they have just decided to pay a deaf ear to it.
The HIV prevalence among men tested is lower than that of women i.e. (301 males positive and 397 females positive. Fewer men attend VCT sessions, as their health-seeking behaviour is low
|
Indicator |
Coverage |
|
· No and % of Health units up to HC11 that have integrated HCT · Stock out of HIV test kits · Average no HCT outreaches per month · % age of people who demand for HCT services and are counseled for HIV · %age that received HCT results · %age of PHAs receiving nutritional counseling |
· 81 % (HMIS). · 33%HMIS · The annual format does not show the outreach-HMIS · 93%-HMIS · Format does not capture the nutritional aspect. |
Source: Health Management Information System (HMIS)
Prevention of Mother to Child Transmission of HIV/ADS
PMTCT services are being provided in Kumi at 22 different sites which include: Atutur District Hospital, Kumi Hospital, Ngora District Maternity Unit, Ngora HCIII, Kobuin HCIII, Mukura HCIII, Kapir HCIII, Kumi HCII, Nyero HCIII, Kanyum HCIII, Mukongoro HCIII, Ongino HCIII, Ajeluk HCIII, Agu HCII, Atoot HCII, Omiito HCII, Omatenga HCII, Kamacha HCIII, Aguurut HCII, Akide HCII, Agaria HCII and Olimai HCII. From the above only 10 sub counties have PMTCT services leaving 1 sub county that is not receiving services. Hence, mothers have to walk Short distances to access the service. The sources of funding for PMTCT included UNICEF , EGPAF, and a small portion from PHC.
HIV/AIDS and the Education Sector
The Universal Primary education scheme, planned to improve literacy levels has enabled over 6 million children country wide to get primary education. In the district the total enrolment in both private and Government primary schools stand at 105,000 while for secondary schools, it is about 1964. However a large proportion of children drop out of school due to a number of reasons; like early marriages especially the girl child, early pregnancies, lack of basic needs like uniform and scholastic materials. This is because majority of the households are very poor to provide for all the basic needs of the children. The children being drown out of school to attend to the sick at home and boys to provide the much-needed labour as the old ones die due to HIV/AIDS.
According to the education department 70% of the pupils that enroll in primary one do not reach primary seven. Secondly, 20% of the total enrolment in both government and private primary schools are orphans some of whose parents died of HIV/AIDS while for secondary schools 10% of the students enrolled are orphans. Though the HIV prevalence among young people is lower than in adults, still young people remain vulnerable due to;
· Engaging in risky behaviors that expose them to HIV infection like drug abuse, alcoholism, and commercial sex.
· Economic insecurity such that they are easily lured into sex for economic gain.
· Social insecurity resulting into defilement, rape and sexual abuse by adults.
· Inadequate life planning skills
· Peer pressure.
Rape and defilement increase the susceptibility to HIV infection among the vulnerable groups especially the girl-child. The rape and defilement victims are usually stigmatized hence so many cases remain unreported despite several reports of defilement in the media but in most cases rape cases are difficult to confirm as cases come after having destroyed the evidence (A girl or A woman is supposed to come in the state of being raped but instead they bath before reporting to the respective officer killing of the evidence). Even those cases that are reported take long to be disposed off by the courts of law due to shortage of manpower in the judiciary and police.
Mitigation of the social-economic and health effects of HIV/AIDS
Health Effects
The first objective will be to increase and expand access to comprehensive health care and support for people living with HIV/AIDS up to HCII in a number of ways;
- Expanding and sustaining the human resource capacities at different levels of care to provide comprehensive care and support, including ART, for both children and adults, Increase equitable access to ART to at least 80% and provide of those requiring treatment
- Support communities (particularly PHA organisations) to provide care programs to ensure adherence to ARV drugs.
- Promote and expand specialised pediatric and adolescent HIV/AIDS care services
- Support and expand provision of home-based care (HBC)
- Support and expand provision of palliative care and incorporate it in provision of Health Services
- Ensure a functional continuum of care between health facilities, home, community and other HIV related services
- Integrate HCT in health facilities from Hospitals-HCIV-HCIII up to HCII/provide guidelines
- Home Based HIV Counseling and testing (HBHCT)
- Equip laboratories with testing equipment and reagents including kits
- Promote improved care-seeking behavior through BCC/IEC
- Promote positive living among PHAs