Implementing Evidence-based Public Health Programs
CDC-Kenya, in collaboration with local and international partners, evaluates, implements, and scales up proven approaches to achieve large-scale and demonstrable reductions in mortality rates of mothers, children, and families.
Mothers and Newborns
In Kenya, 7,700 women die each year from complications caused by pregnancy and childbirth despite the fact that almost 90 percent of these deaths are preventable. The leading causes of maternal death in Kenya are from obstetric complications such as severe bleeding, obstructed labor, and indirect causes such as HIV/AIDS, malaria and TB, which are aggravated during pregnancy. CDC-Kenya works with healthcare providers and community health workers to help ensure that both mothers and newborns are protected from infections and complications during delivery.
Our strong partnerships with the Kenyan Ministries of Health are critical to achieving maternal and newborn health goals. As a major implementer of the President’s Emergency Program for AIDS Relief (PEPFAR), CDC-Kenya works to prevent mother-to-child transmission of HIV. CDC-Kenya ensures that pregnant women receive routine HIV testing, that HIV-infected mothers and their exposed infants receive anti-retroviral therapy, and that families receive education on safe infant feeding practices.
CDC-Kenya’s longstanding malaria research activities have helped to inform the development and evaluation of the four key malaria prevention and treatment interventions used by global malaria programs today. Since 2008, through the President’s Malaria Initiative (PMI), CDC-Kenya has contributed to efforts that distributed more than 3,500,000 treated bednets and nearly 18,000,000 artemisinin-combination malaria treatments. In 2011, 28 million people were protected through indoor residual spraying. This massive scale-up has helped reduce childhood death rates by as much as 50%.
To contribute to the world's knowledge about how best to protect pregnant women from malaria, CDC-Kenya conducts research on intermittent preventive treatment in pregnancy (IPTp). Within this research context, CDC-Kenya has been able to provide participating mothers health education, free transportation to deliver in a healthcare facility, and waived delivery costs, which has resulted in over 90% of the participants delivering at a health facility compared to an average of 40% in the same communities. CDC-Kenya is partnering with the CDC Foundation to extend free transportation and supplies for safe delivery to pregnant women outside the IPTp study.
Infants and Children
In Kenya, more than 1 in 7 children die before their 5th birthday from causes that are largely preventable: pneumonia, diarrhea, and malaria, with malnutrition often as an underlying cause. One of the best investments we can make to fight preventable diseases and curb child deaths is to improve routine immunization, particularly for pneumonia and diarrhea. Since rotavirus is the most common cause of severe diarrhea in infants and children worldwide, CDC-Kenya, in collaboration with the Kenya Medical Research Institute (KEMRI), was one of several sites for a rotavirus vaccine trial. Results of the trial showed the RotaTeqTM vaccine reduced the number of cases of severe rotavirus diarrhea by 82 percent in the first year of life. As a result, the World Health Organization (WHO) has recommended that rotavirus vaccination be included in all national immunization programs. Since the introduction of a pneumococcal vaccine in the routine immunization schedule in Kenya in February of 2011, KEMRI/CDC has conducted a population-based, post-introduction vaccine safety surveillance study of PCV10 – the first preservative-free multi-dose vaccine being used in the a developing country - that will help inform WHO vaccine policy. Vaccinations against diarrheal diseases and pneumonia are starting to change the trends in under 5 deaths, and at the end of this generation, they shouldn’t be the largest killers of children.
Many children in Kenya are born with neural tube defects - a preventable yet very debilitating and sometimes deadly condition. CDC-Kenya is supporting the Field Epidemiology and Laboratory Training Program residents in conducting an investigation focusing on characterizing cases nationwide, determining the burden of neural tube defects in newborns, and assessing the role of known risk factors such as foliate deficiency and exposure to mycotoxins. CDC- Kenya is also working with the Ministry of Public Health and Sanitation to establish surveillance for neural tube defects, which will provide critical information to guide interventions such as flour fortification, which is being introduced in Kenya.
CDC-Kenya also works with KEMRI and the Ministries of Health and Education under a partnership of the Safe Water and AIDS Project to combine household, clinic, school, and local commercial distribution approaches to increase access to WaterGuard and PuR water disinfectant products, water storage containers, soap, insecticide treated bednets, micronutrient Sprinkles, and de-worming medications. CDC-Kenya recognizes the need to measure the health impact of these combined interventions on a population basis to effect children’s health.
Families and Communities
CDC-Kenya’s diverse portfolio of projects is one way we demonstrate our commitment to families and communities. Cooking and heating with solid fuels indoors, as is common in Kenya, pollutes the air and increases the risk of illness. This type of indoor air pollution is the leading cause of lung cancer and chronic lung disease among nonsmoking women. The risk for cardiovascular diseases, digestive and cervical cancers, and low birth weight newborns may increase when women breathe this unsafe air every day. As a member of the Global Alliance for Clean Cookstoves, CDC is currently implementing field evaluations of several cleaner cookstoves and monitoring the health impact and acceptability of various stove designs in Kenya. By evaluating this project alongside other public health programs like clean water, immunizations, prenatal services, and HIV prevention, the relative public health benefit of each can be compared in ways that assure public health investments and activities produce a maximum benefit.
CDC-Kenya and partners also work in refugee camps in the region to conduct surveillance for infectious diseases and provide support for disease outbreak and emergency response. Each year, up to 25,000 refugees from African countries are resettled in the United States. Before resettlement, most refugees have resided in difficult environments with limited access to medical care and preventive health services, leaving them at a significantly increased risk of illness, death and disability from a variety of health problems. CDC provides testing and treatment before refugees in country and liaises with the Office of Refugee Resettlement and other partners to ensure a continuum of care is provided for refugees as they transition to life in the United States.
CDC-Kenya, together with university, faith-based, and non-governmental partners, have helped over 3 million Kenyans know their HIV status and better manage their health. CDC-Kenya’s Home-Based Testing and Counseling (HBTC) program has reached over 1,700 discordant couples - a stable relationship in which one person is HIV-positive and the other is HIV-negative. Because nearly 60 percent of Kenyans with HIV are in a discordant relationship, during home visits trained counselors offer HIV testing and support to couples. Since late 2010, the HBTC approach has referred 12,000 clients to care and treatment and prevented an estimated 1,200 new infections. Partnering with clinic-based providers approximately 50,000 people since late 2010 have learned they were HIV positive and were enrolled in care and treatment programs because of testing offered by their health care provider. Early treatment not only improves the lives of people living with HIV but transmission to HIV-negative partners can be reduced by 96 percent. In 2003, only 5,000 Kenyans were on treatment. Through the President’s Emergency Plan for AIDS Relief (PEPFAR) funding, in collaboration with CDC, the Government of Kenya, universities, and faith-based and non-governmental organizations have initiated over 450,000 people on antiretroviral therapy - 45,000 of whom are children - who can lead healthier, longer lives.