Effect of Civil Society Organizations on Health, Nutrition and Economic Status of People Living with HIV/ AIDS in Busia County, Kenya

Abstract

 Introduction: Civil Society Organizations (CSOs) play a major role in HIV/AIDS response. Despite their massive effort to promote health care, nutrition and socio-economic empowerment to people living with the disease, documented data on the impact and value of their interventions remain scanty. Globally, people infected with HIV/AIDS by 2018 were estimated to be 37.9 millions recording 1.1 million mortalities in that year. HIV prevalence rate in Kenya was at 4.9% among the general population of ages 15-64 years [2]. In other reports, the national HIV prevalence was at 4.5% while males and females aged 15 to 24 years at 5.2% in 2018. Busia County had HIV prevalence rate of 7.7% in the same year [1].

Aim: The objective of this study was to determine the effect of CSOs interventions on health, nutrition and economic status of people living with HIV/AIDS in Busia County.

Materials And Methodology: A quasi-experimental study design was done with structured and non-structured questionnaires administered to two hundred and twenty (220) participants at baseline and end line by registered CSOs with other facilitators. All permanent male and female residents infected with HIV aged between 15 and 64 years from comprehensive patient attendance lists obtained from the Ministry of Health (MoH) facilities qualified for the study. All respondents signed informed consent forms prior to participation. Qualitative in-depth data was obtained through focus group discussions(FGDs) from key informant interviews.

Results: No statistically significant differences were reported due to gender, household size and education level recorded in both sites at baseline and end line. Access to HIV/AIDS information was higher in CSOs intervention sites (89.5%) than in non - intervention (73.2%) sites at end line. Respondents in the intervention group had a significant improvement in sourcing Antiretroviral (ARVs) drugs especially from private facilities (P<0.05) but no scientific difference in access to health care services between sites after CSOs intervention. Respondents receiving support for Income Generating Activities (IGA) reduced by 2.1% in the intervention sites at end line. Respectively those in non-intervention sites increased by 4.1%. The negative 6.2% Net Effect of Intervention (NEI) reported was nonetheless not statistically significant (OR=0.98 (95% CI=0.42- 1.5), p=0.48). Organizations such as Reproductive Health Initiatives' impact was reported despite others' existence lacked evidence from which to establish their impact of CSOs intervention. Initiation of home based care, Chama support and income generating projects to improve on the source of economic status for PLWHA were programs that supported the government in providing quality services. However, the programs they implement some possibly a duplication of health-related services, were primarily skewed on donor interest because of dependency [10].

Conclusion: CSOs intervention did not have a significant effect on access to HIV/AIDS information, access to health care services, their morbidity patterns, food intake and nutritional status as well as on economic status and income generating activities. This could be due to reports that, some implementing organizations lacked adequate documentation (comprehensive database, reliable and consistent data), eventually, often failing to monitor and evaluate projects they initiated.

Recommendations:CSOs should work in collaboration with the government to develop sustainable interventions aimed at empowering PLWHA in improving their livelihood not only in Busia County but also across the Country. Access to ARVs from the nearest health facility will reduce suffering especially from opportunistic infections.

Keywords: Civil Society Organizations, HIV/AIDS, People Living with HIV/AIDS(PLWHA)