CONDOM STRATEGY

THE NATIONAL CONDOM STRATEGY 2018–2023 ‘Providing Kenyans with a Choice that Protects’

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

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THE NATIONAL CONDOM STRATEGY 2018–2023 ‘Providing Kenyans with a Choice that Protects’

TABLE OF CONTENTS

Foreward................................................................................................................... i Executive Summary...................................................................................................ii Acknowledgements..................................................................................................iii Abbreviations...........................................................................................................iv 1.0 Background......................................................................................................... 1 1.1 Introduction........................................................................................................ 1 1.2 The Situation Analysis........................................................................................ 2 2.0 The National Condom Strategy.......................................................................... 7 2.1 Overall Goal........................................................................................................ 7 2.2 The Purpose of the Condom Strategy................................................................ 7 2.3 Guiding Principles............................................................................................... 7 2.4 The Conceptual Framework for Comprehensive Condom Programming........... 7 2.5 Implementation................................................................................................ 19 Annex 1: National Forecasting and Quantification Report, March 2018................ 20 Annex 2: List of Drafters and Reviewers................................................................. 24

Foreward It is estimated that there are about 1.5 million People Living with HIV (PLHIV) in Kenya. According to the Kenya HIV Estimates report 2018, the adult HIV prevalence in the general population between the ages of 15 and 49 stands at 4.9 percent.

The sexual mode of HIV transmission accounts for about 80 % of new infections in the country (MOT 2009).The HIV epidemic and a rapidly rising population are key challenges to any developing country and an economy such as Kenya’s. To ensure we protect the social and economic gains the country has achieved since independence, there is need to develop and implement sustainable interventions that embrace meaningful involvement as well as empowerment of the individual and the greater society to reduce their own risk of HIV and STI transmission and unintended pregnancies.

Condoms are an inexpensive and effective tool for prevention when used correctly and consistently. Both the male and female condoms are an effective dual-risk reduction strategy which must be aggressively promoted and provided to all sexually active individuals.

Financing, procurement and distribution of condoms has largely been donor dependent. This has had huge implications on access and sustainability of supply. Quality assurance, and especially of condoms in-market has also been a challenge. Although the country has capacity to locally manufacture its own male condoms; there is total reliance on imports of the commodity to meet demand. These, and gaps in knowledge and skills for appropriate use as well as hygienic and proper disposal of condoms are challenges which need to be addressed.

The Government of Kenya is committed to ensuring a consistent and uninterrupted supply of quality condoms and lubricants, and supporting their appropriate use. Innovative approaches will be identified and implemented to improve reach and effectiveness of this Condom Strategy for better health and social outcomes.

The development of this National Condom Strategic Plan 2018-2023 is aimed at providing a fitting framework for all stakeholders in the condom sector to design and implement effective programmes in the country. All stakeholders in the sector will need to use this Condom Strategy as a road map to ensure we effectively leverage the committed or acquired resources and efforts for maximum impact and efficiency gains.

Ms Susan Mochache, CBS Principal Secretary Ministry of Health

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Executive Summary Globally, condom promotion and distribution has been identified as one of the five pillars for HIV prevention. The“20 by 20” is a UNFPA and partners initiative to increase the access, usage and availability of condoms to the tune of 20 billion condoms in low and middle-income countries by 2020. The initiative brings together all the stakeholders in the condom programming sectors and agencies; and employs a total market approach. In order to increase uptake, robust marketing and advocacy strategies need to be rolled out and scaled up across the countries targeting specific populations.

This can only be achieved by ensuring that commodity security becomes a critical component of sustaining uptake and usage. The security of condoms for HIV prevention, prevention of other STIs and pregnancy will require both the public and private sector players. There is an urgent need for an increase in public procurement of condoms to safeguard against dwindling donor resources. Complementing the public sector resources is the private sector through socially marketed condoms and promotion of local production.

The Kenya National Condom Strategy 2018-2023 is an operational document to facilitate HIV Prevention under Kenya AIDS Strategic Framework. There is therefore a need to develop and implement a comprehensive condom program that includes condom advocacy and promotion, distribution, disposal and M&E strategies that will result in increased uptake and consistent use of condoms.

The purpose of this strategy therefore, is to provide a national framework to guide implementation of a comprehensive condom programme in Kenya. The overall objective is to increase the use of condoms from the current 42% to 80% by 2023. This will be achieved through the following strategic objectives; 1. Establishing an effective mechanism for leadership and coordination of the National and County condom programmes 2. Increasing the annual national demand in Kenya for male and female condoms among sexually active individuals by 2020 3. Having a comprehensive, coordinated and integrated national distribution and logistics management information system that ensures condoms reach those who need to use them in the community 4. Have an effective monitoring and evaluation system that integrates into Health Management Information System (HMIS) and national Monitoring and Evaluation Framework to support evidence-informed implementation of the condom response for better outcomes by the end of plan period Implementation of this strategy will ensure that we are on track to reducing new HIV infections and contributing towards Kenya’s Vision 2030.

Dr. Patrick Amoth, Director General Ministry of Health

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THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

Acknowledgements The development of this National Condom Strategic Plan 2018-2023 would not have been possible without the leadership of the National AIDS Control Council (NACC), National AIDS and STIs Control Programme (NASCOP) and the enormous contribution of the following organisations: Kenya Essential Medicines Supply Agency ( (KEMSA), Kenya Bureau of Standards (KEBS), The Division of Reproductive Health (DRH), Federation of Kenya Employers (FKE), United Nations Population Fund (UNFPA), UNAIDS, AIDS Health Care Foundation-Kenya, Pathfinder International, LVCT Health, WOFAK and Population Services - Kenya (PS Kenya).

We also wish to thank all stakeholders in the public and private sector as well as civil society organisations who provided technical input during development of the initial draft, and who will be counted upon during implementation of this strategy. We acknowledge the technical leads who provided oversight and worked tirelessly to make this strategy a reality: Dr. Emmy J. Chesire (NACC), Dr. Celestine Mugambi (NACC), Joab Khasewa (NACC) and Helgar Musyoki (NASCOP). We also acknowledge the technical support, additional review and input from Lilian Langat (UNFPA), Gloria Bille (UNAIDS), Andrew Juma (PS Kenya) and Joel Karanja (AVEP Kenya).

We also wish to acknowledge UNFPA for both their financial and technical support. The UNFPA provided funds which was used for the development of the draft document, printing and launching of the final Condom Strategy.

The effective implementation of the national condom response, informed by this strategy will no doubt help many Kenyans reduce their risk of infection and transmission of HIV and other sexually transmitted infections and unintended pregnancies.

Dr. Nduku Kilonzo, EBS Chief Executive Officer National AIDS Control Council

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Abbreviations AIDS ANC AOP BCC CAPR CCCs CCP CSO CTWG DRH FP HIV HMIS KAIS KDHS KEBS KEMSA KNASP M & E MSM NACC NASCOP OIs PLHIV PPP PPOA PwP PSI RH STDs STIs ToRs WHO UNAIDS UNFPA USAID VCT

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- Acquired Immunodeficiency Syndrome - Antenatal Clinics - Annual Operational Plan - Behaviour Change Communication - Community AIDS Programme Report - Comprehensive Care Centres - Comprehensive Condom Programme - Civil Society Organisation - Condom Technical Working Group - Division of Reproductive Health - Family Planning - Human Immunodeficiency Virus - Health Management Information System - Kenya AIDS Indicator Survey - Kenya Demographic Health Survey - Kenya Bureau of Standards - Kenya Essential Medical Supplies Agency - Kenya National AIDS Strategic Plan - Monitoring and Evaluation - Men having Sex with Men - National AIDS Control Council - National AIDS and STIs Control Programme - Opportunistic Infections - People Living with HIV - Public-Private Partnership - Public Procurement Oversight Agency - Prevention with Positives - Population Services International - Reproductive Health - Sexually Transmitted Diseases - Sexually Transmitted Infections - Terms of Reference - World Health Organisation - Joint United Nations Programme on HIV/AIDS - United Nations Population Fund - United States Agency for International Development - Voluntary Counselling and Testing

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Background

1.1

Introduction

The current national HIV prevalence is estimated to be at 4.9 percent (Kenya HIV Estimates, 2018) and there are about 1.5 million people living with HIV in Kenya.

In 2016, United Nations (UN) Member States committed to reducing the number of new adult HIV infections to fewer than 500 000 globally by 2020. Similarly, one of the objectives of the Kenya AIDS Strategic Framework 2014/15-2018/19 is to reduce new HIV infections by 75% which translates to less than 20,000 new infections by 2020. There were 44,000 new adult HIV infections in 2017 and approximately 40% of those occurred in adolescents and young people aged 15-24 years (Kenya HIV Estimates, 2018).

About 62 percent of all PLHIV in the country are women (Kenya HIV Estimates, 2018). Furthermore, women between 15 to 24 age brackets are four times more likely to be HIV infected than their male counterparts (KAIS, 2012).

The main mode of HIV transmission in Kenya is through sexual contact a nd this accounts for about 80% of all new HIV infections. The main drivers of the HIV epidemic in the country include; Multiple Concurrent Partners (MCP), inconsistent and incorrect condom use with partners of unknown status, inter-generational sex, income inequality (poverty), high mobility, injection drug use, sex work, gender inequalities, sexual and gender basedq violence, low levels of male circumcision in certain parts of the country as well as alcohol and drug abuse (KAIS 2012; KDHS 2014). It is important to note that these are risk factors and, therefore the possibility of HIV infection through sexual contact varies by age, region of residence, presence or absence of genital ulcers, number of sexual partners and prevalence of male circumcision in the community.

The risk of HIV infection is 3.7 times higher among women who are below 30 years and those having genital herpes. The risk of HIV infection among their male counterparts is 2.8 fold higher for those under 30 years; 3.5 fold higher for those with multiple sexual partners; 3.0 fold higher for individuals who are not circumcised and; 6.6 fold higher for those with genital herpes (KAIS, 2012).

A higher proportion of Kenyans between the age of 30 and 34 are infected with HIV. This is more than any other segment of the population. In addition, about two thirds of the PLHIV in Kenya who are in the age bracket between 15 and 64 years are in a union (married or cohabiting) and living with a partner who is uninfected. It is important that discordant couples be encouraged to embrace abstinence or safe sex practices including correct and consistent use of condoms.

They should also receive and adhere with HIV treatment to significantly reduce their own risk of transmitting the virus.

Globally, condom promotion and distribution has been identified as one of the five HIV prevention pillars. There is therefore, a need to develop and implement a comprehensive condom program that includes condom advocacy and promotion, distribution and M&E strategies that will result in an increased uptake and use of condoms among all population groups across the divide.

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1.2

The Situation Analysis

Condoms are at the center of the combination HIV prevention approach; they are also costeffective tools for preventing other sexually transmitted infections and unintended pregnancies.

Condoms have been at the forefront of HIV prevention for more than 30 years, given their effectiveness , availability and comparative cost. Since 1990, it is estimated that over 45 million HIV infections have been averted using condoms. The cost per infection averted would be approximately be Kshs. 45, 000 well below the lifetime cost of providing antiretroviral treatment.

The diagram below depicts the prevalence of STIs among adults and adolescents as 0.9 % KAIS, 2012).

Fig. 1 . Prevalence of STIs among adults and adolescents (KAIS, 2012) In Kenya, condoms have been widely available since the early 1990s, with the Ministry of Health and partner organisations working closely to improve accessibility. This has led to the development of commercial and socially-marketed condoms: that is, branded products sold at retail and free condoms manufactured and distributed with the support of donor agencies, particularly the World Bank and Global Fund. Given the comparative cost between male and female condoms, the wider distribution has focused on the male condoms. Different studies have shown that condom use and efficacy peaked in the late 1990s. This was primarily because of two reasons: increased risk perception and intensive communication, education and advocacy on condom use.

The 1990’s was the time when people were exposed to messaging about the HIV virus and witnessed first-hand it’s debilitating impact. This meant more attention was given to preventative measures and access to condoms, efficacy training and distribution. When condoms are used correctly and consistently, they are up to 98% effective in reducing the risk of HIV transmission.

Kenya has made tremendous progress on the national and global targets to combat the HIV epidemic. According to the Kenya HIV estimates 2017, the national HIV prevalence, among the adult population is 4.9% with approximately 1.5million people were living with HIV. Adult new HIV infections stand at 44, 800 as of 2018.

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THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

Fig.2. New HIV infections (Kenya HIV Estimates, 2018) Adolescents and Young people age 15-24 and key populations account for 40% and 33% of new HIV infections respectively. The high new HIV infections among adolescents and young people can be attributed to lower risk perception of HIV and changing attitudes: casual sex with multiple partners (or more partners in a shorter period of time), and cross-generational sex. This has also led to high adolescent and teenage pregnancies, which this condom strategy will address.

Fig,3 New HIV infections(Kenya HIV Estimates, 2018)

Fig.4 Adolescents pregnancies in Kenya

According to KDHS 2014, 80% of women and 88% of men know that the risk of acquiring HIV can be reduced by using condoms while 92% of women and 94% of men know that limiting sexual intercourse to one uninfected partner can reduce the chances of contracting HIV. However, only 40% of women and 44% of men age 15-49 who had two or more partners in the 12 months preceding the survey reported using a condom during their last sexual intercourse in the general population. Among adolescents and young people aged 15-24 years, only 37.5% of females and 68.9% of males with more than one sexual partner in the past 12 months reported using a condom during their last sexual intercourse (KDHS, 2014).

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Contribution of new HIV infections

Fig.5 Condom use among people with multiple sexual partners Key populations have seen stabilization in condom use as reflected in the polling booth survey (PBS) 2017. The Female Sex Workers (FSW) use of condom in the last sexual act remained constant at 92% compared to 2015 which was still at 92%; for the Men who have Sex with Men (MSM) it was 79% in 2017 compared to 80% in 2015. With regard to use of condom with a regular partner and or client, the FSW an improvement was reported from 54% in 2015 to 58% in 2017 whereas for the MSM, it remained constant at 77%. 23% of FSW stated unavailability of condoms when they required the same compared to 19% in 2015. 22% of MSM did not get a condom when they needed the same compared to 25% in 2015. The use of lubricants among the MSM has also been stable with 76% in 2017 compared to 81% in 2015.

The 2017 PBS also looked into the cohort of Young KPs (YKPs) of ages 18-24 years. It was seen that the use of condoms among the YKPs and their regular partners/ lovers was very low at 44% for the young FSW and 85% for the young MSM whereas of the use of lubricants for the young MSM, was at 77%. 26% and 14% of the young FSW and young MSM respectively, did not use a condom due to unavailability of the same.

There was a noticeable decrease in STI symptoms among the KPs with the FSW recording 18% in 2017 compared to 22% in 2015; MSM recording 12% and 13% in 2017 and 2015 respectively; PWIDs recorded a 10% experience of STI symptoms. As of the young KPs, 16% of the young FSW experienced STI symptoms while 11% of the young MSM experienced STI symptoms.

Distribution of public sector condoms from health facilities into the community remains a great challenge due to lack of a clear strategy. There is also a lack of clarity on organisations tasked with the responsibility of ensuring this is done. Some civil society organisations distribute public sector condoms from the health facilities to end-users through various channels and approaches including during awareness campaigns and events as well as in social places like bars and lodgings. Another challenge is posed by limited storage at the lower level health facilities.

This has impacted negatively on effective storage and timely distribution of adequate quality condoms to meet demand.

The condom market composition includes a dominant public sector that accounts for 84% of total condom distribution, and a strong social marketing sector at 14% of the total market.

Despite Kenya’s strong economic growth and lower-middle income status, presence of a vibrant

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THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

commercial market for consumer goods, commercial brands represent below 2% market share of the total condom market. The social marketers and for-profit private sector players distribute their condoms through various channels including supermarkets in urban centres, small cornershops and retail pharmacies among other outlets (Condom landscaping Report, 2017).

The involvement of key players in support of the national condom programme remains limited in certain sectors of the economy. Some of the key stakeholders and target groups include the hotel industry (that would provide condoms to sexual partners who patronise their establishments), transport industry (to reach out to attendants serving in public service vehicles, riders of motorbike and bicycle who provide transport to the public or sex workers in the evenings), and the multinational companies with vast distribution networks that could be used to get the commodities widely distributed throughout the country.

An enduring partnership with the media to drive the condom agenda in the country has been limited. The media can play an important role in content development and providing an effective platform to deliver specific messages to targeted individuals and groups. Media experts can especially generate demand and encourage correct and consistent use of condoms to reduce the risk of HIV infection, other STIs and unintended pregnancies.

Male condoms are widely available compared to female condoms in the country. Female condoms are often out of stock for extended periods. This limited and irregular supply of the female condoms is, in large part, due to the high unit cost and, therefore, low volumes are procured and distributed to users in the country.

In general, financing of both male and female condoms procurement and distribution has been supported by donors, particularly the World Bank and Global Fund. Investment by the Government in the condom programme has been limited and particularly in the commitment of resources to finance procurement of the commodities. About 600,000 female condoms are procured and distributed, with donor support, every year against an estimated annual demand of about 1.8 million (Data on file, UNFPA, 2009) in Kenya. The resultant limited access to female condoms has discouraged their broader use by women to reduce the risk of HIV infection and unintended pregnancies. The female condom is also commonly used by men having sex with men (MSMs) in Kenya. This is particularly because of their durability, better lubrication and low risk of breakage.

Lubricants-water or silicone-based are complementary products to condoms because they reduce friction and risk of breakage. Silicone-based lubricants last longer and are ideal for use by men having sex with men and sex workers. However, except when procured and provided by specific projects, the Government programme does not procure and distribute lubricants to condom users. The current national guidelines have recommended procurement and provision of lubricants to condom users who need additional lubrication.

Condoms like many other consumer goods require regular recruitment of new users and constant presence in convenient locations. There is need to bring in new users from youth cohort that are entering the condom market and have never been exposed to the well-funded and successful HIV prevention condom campaigns in the past. Demand creation must focus on overcoming barriers to use among populations most at risk for HIV. Sustaining demand creation will increase condom usage among AYP and avert pregnancies HIV infection and other STIs. The Government should ensure adequate resources are provided to facilitate demand creation among the public and creation of knowledge and skills on appropriate use and proper hygienic disposal of used condoms.

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Therefore, in summary, a 10 point action plan for a sustainable Kenya condom programme are as follows:

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1

Implementation of a policy and legislative framework to scale up access to condoms in ‘areas of most need’.

2

Establishment of routine condom forecasting and quantification within national systems

3

Establishment of a supply and logistics management system for condoms within the broader supply chain management for health products

4

Deployment of a multi-sector condom supply, distribution and reporting mechanism

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Budget and funds allocation for condoms within the national commodities

6

Implementation of a reporting and tracking mechanism that includes toosl, drawdown procedures and analytics with regular reporting within national KPI monitoring frameworks.

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Targeted implementation of condom programming focusing on ‘need for condoms’ in places of high sexual activity; burden of HIV, sexually transmitted infections and unintended pregnancy

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Implementation of a policy for appropriate disposal of condoms, with a advocacy

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Population and geographic granulation for determination of approaches with a mix of private sector, social marketing and public health driven condom programming

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Implementation of geographically localized condom advocacy communication and messaging noting that sexual practices are local in nature

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The National Condom Strategy

2.1

Overall Goal

The overall goal is to ensure that every sexually active person in Kenya has access to a sustained supply of quality condoms, correct knowledge, skills and motivation to use them correctly and consistently to prevent transmission of HIV and other sexually transmitted diseases and unintended pregnancies.

2.2

The Purpose of the Condom Strategy

The purpose of this strategy is to provide a national framework to guide implementation of a comprehensive condom programme in Kenya.

2.3

Guiding Principles

Implementation of this strategy will be guided by the following principles: i. Condom programming should be evidence based. ii. Condom access as a health right: Condoms should be accessible to all without distinction of age, ethnicity, gender, disability, religion, political belief, economic status, social condition or geographic location. Condom programming should protect and respect the rights of clients and their families, providers and support staff. iii. Inclusion of key and priority populations: Special focus will be placed on facilitating access to condoms and other barrier methods for high-risk groups like key populations including sex workers, MSM and PWID. iv. Gender-responsive: Condom programming should mainstream gender issues in both planning and implementation. Special emphasis shall be placed on helping all women participate fully in the decision to use a condom. v. Promoted as part of combination prevention: Condoms will be promoted as part of prevention service package and should be integrated with those led by the Sexual Reproductive Health and its key stakeholders. vi. Multi-sectoral engagement: Condom programming will encourage and strengthen multi-sectoral collaboration to cover health sector programmes and other non-health sectors to realize efficiency.

2.4 The Conceptual Framework for Comprehensive Condom Programming The National Condom Strategic Plan 2018-2023 is designed around the now internationally recognised focus areas for effective condom programming (The Framework on Condom Programming, UNFPA). The figure below is a summary of the condom conceptual framework.

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2.4.0: Overall objective The overall objective is to increase the use of condoms from the current 42% to 80% by 2023 in Kenya.

The focus areas and strategies highlighted below are intended to guide the effective implementation of the conceptual framework in Kenya. This is expected to ultimately reduce new HIV infections, reduce the incidence of sexually transmitted infections and unintended pregnancies in the country.

2.4.1 Focus Area 1: Leadership and Coordination The objectives and strategies expected to achieve leadership and coordination of the condom programme include: Objective 1: To implement, monitor and sustain comprehensive condom programme for Kenya Strategy 1: Strengthen the national coordination mechanism for sustainable condom programming in the country with linkage with other SRH and commodity security Technical Working Groups

The National AIDS Control Council (NACC) will be responsible for the overall coordination of the national condom programme.

National Condom Working Group The National Condom Working Group will support coordination of activities at the highest level. This team will be charged with the implementation of the strategy through development of a roadmap, multi-sector engagement and monitoring progress of each of the key aspects outlined in the conceptual framework. The membership of the CWG will be defined in the Terms of Reference (ToRs) developed to guide the selection and conduct of its members.

The responsibilities of the NCWG include: i.

Development of condom policies and technical guidelines for use by both national and county governments;

ii.

Mobilization of resources;

iii. Provide advisory to agencies and committees of Government; iv. Development of a multi-year operational plan, with time bound costed activities with clear roles and responsibilities of all stakeholders;

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THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

GoK Expenditure

Condom Supply and Commodity Security

Private Sector: manufacturing & sales Quality Control and Assurance

Goal 1: attain 40 condoms per man per year by 2020 Goal 2: xxxxx

Quantification and forecasting Demand generation with targetted, segmented BCC Demand, Access, Utilization and Disposal

Targetted distribution Linkages and partnership Hygienic Condom Disposal

Segmented target setting Monitoring, Tracking and Evaluation

Measurement indicators Performance tracking for public & private sector

LEADERSHIP AND COORDINATION National Coordination – Condom Working Group Accountability Framework Enabling Policy and Regulation Environment

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v.

Foster strong collaboration with the commodity security committee;

vi. Liaise with the different stakeholders on condom needs and inform the commodity forecasting group; vii. Selection of key indicators to monitor and evaluate programme implementation and advice on the research agenda; viii. Recommend public-private partnership (PPP) including supporting local condoms manufacturing as guided by both the Public Procurement Regulatory Authority (PPRA) and the draft PPP Bill 2011; ix. Develop clear structure for condom distribution and demand creation, and propose areas of research and; x.

Development of a condom cascade and providing oversight on it.

National Condom Working Group Membership The proposed membership of the National Condom Working group will include representatives from Government Ministries, Departments and Agencies, Development and Implementing partners, Civil Society Organizations, Networks of People Living with HIV, Priority Populations and young people. The NACC will convene the Condom Working Group and ensure meetings are held at least once every quarter to effectively drive the condom agenda including approval of activities proposed by stakeholders and receiving feedback on performance of implemented interventions.

The NACC and NASCOP will work with relevant stakeholders to ensure mobilisation of adequate resources to finance the condom programme activities and better coordination of the efforts of all those involved in the promotion and provision of condoms and commodities in the country.

It is imperative to ensure condom programming is well coordinated and effectively implemented at the county and constituency levels to improve access in the community settings. Involvement of civil society organisations in the implementation will improve access to condoms beyond the dispensary level and their utilisation as appropriate.

The objective of this strategy is to increase domestic financing for condoms and lubricants.

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THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

Strategy 2: Ensure institutionalization of male and female condoms and lubricants as a Government budget item The national condom programme is largely dependent on donor financing for procurement and distribution of commodities. This overreliance on donor funding has huge implications on the sustainability of the condom programme. Greater country ownership including the provision of resources to finance the National Condom Strategy is necessary to ensuring long term sustainability.

For adequate financing of the condom programme by the Treasury, there is need for a welldeveloped and effectively implemented advocacy strategy targeted at key stakeholders in Government who influence resource allocation during national budget development.

Therefore, an elaborate advocacy strategy for domestic allocation of resources for comprehensive condom programming will be developed and implemented to improve country ownership of the National Condom Strategy and allocation of adequate resources for condom programming.

2.4.2 Focus Area 2: Condom Supply and Commodity Security The objectives and strategies under this focus area are: Objective 1: By end of the plan period have a comprehensive, coordinated and integrated national distribution and logistics management information system that ensures condoms reach those who need to use them in the community Strategy 1: Strengthen the forecasting system to minimise condom and lubricants stock-out in the public sector The country currently uses its distribution data to undertake its estimates to inform procurement of the condom commodity. Demand forecasting would be more accurate if consumption data were available to be used in the estimates. Reliable data will ensure procurement of the right quantities to guarantee adequate supplies are available to meet demand without straining the limited financial resources and storage facilities.

This National Condom Strategy seeks to build the capacity of the programme to gather quality data and use it to undertake demand forecasting.

Strategy 1a: To strengthen the logistics management system to ensure capturing of all data; training of staff at facilities, facilitation of planning meetings and provision of necessary tools including computer hardware and software will be key. The developed mid-term and annual procurement plans will be reviewed every quarter and adjusted as the context or data changes for public sector condoms and lubricants.

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Strategy 2: Strengthen distribution system for condoms and lubricants to ensure adequate numbers reach end users in a timely manner Kenya Essential Medicines Supply Agency (KEMSA) has the responsibility of distributing public sector condom commodities in the country. It largely moves stocks from its main warehouse in Nairobi and the six regional ones to all public sector health facilities upto the dispensary level.

However, the distribution of public sector condoms from dispensaries into the community needs to be strengthened and this has an effect on optimal access and utilization of the public sector commodity in the community.

Strategy 2a: NACC will take the lead in the development and implementation of a community strategy to improve access to condoms in the counties. This will include formal and informal sectors; i.

Civil society organisations to take condoms from the dispensaries, especially, into the community settings; ii. Civil society organisations to distribute condoms in their facilities and areas of operation; iii. Community distributors (including hotels, motels, taxi-drivers, brothels/hotspots, Bodaboda etc.); iv. Health facilities to integrate condoms among the contraceptive mix; v. Social groups to be involved in condom distribution; vi. Hospitality industry to be involved in ensuring availability of condoms within their premises for easy access by their clients.

Innovative approaches will be sought and used to ensure condoms are available and accessible to individuals in the community. Digital platforms will be explored to distribute condoms for general population. These include partnering with the private sector to redistribute and make accessible condoms in areas where they sell their commodities. The beverage and oil companies could use their trucks to distribute condoms and place dispensers in their points of sale to reach their clients.

Strategy 3: Strengthen the quality assurance system to ensure that all condoms (including those that are imported or locally manufactured, registered or distributed) in the country meet the required quality standards The quality of condoms in the private sector has been wanting in the recent past. Condoms that leak have been reported and some brands withdrawn due to quality concerns.

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THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

Strategy 3a: The national condom programme will strengthen the quality assurance system by facilitating building of capacity of both Kenya Bureau of Standards (KEBS) and the National Quality Control Laboratory (NQCL) to develop standards and sampling protocols. The NACC and KEBS will also undertake the necessary testing to establish quality of the pre- and inmarket condom commodities in the country.

Strategy 4: Strengthen storage facilities where condoms and lubricants are kept to guarantee quality and efficacy

The storage facilities are adequate in most of the high level public health facilities and the KEMSA warehouses. However, storage space available at most health centres and dispensaries in many parts of the country is limited. Condoms are essentially a bulky commodity and this makes it difficult for the lower level facilities to take in adequate stocks or to effectively store what is delivered by KEMSA.

Strategy 4a: The programme will support the expansion of storage space at lower level health facilities as appropriate to ensure effective warehousing/storage of adequate stocks of condoms to reliably meet the local demand.

Strategy 5: Condoms in Emergency situation

In emergency situations such as violence, fire, floods and epidemics which result in displacement of persons, condoms should be made available. The strategy will ensure uninterrupted supply of condoms to all sexually active populations. Male and female condoms should be part of the minimum initial service package in emergency and humanitarian settings.

Strategy 6: Plan for a local manufacturing condom plant

Condom Working Group will make a proposal for consideration by the government for public private partnership to establish a condom plant in Kenya. In order to realize costeffectiveness and sustainability, the country will consider eventually supplying condoms to the neighbouring countries at a profit making cost.

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2.4.3 Focus Area 3: Demand, Access, Utilization and Disposal The objectives and strategies under this focus area are: Objective 1: To increase the annual national demand in Kenya for male condoms to 510 million and female condoms to 8.5 million pieces among sexually active individuals by 2020 Strategy 1: Targeted behaviour change communication strategies The guiding principles supporting the design and implementation of programmes to generate demand, increase access and utilization of condoms in the country include: •

Epidemiology to inform targeting.

•

Segmentation of target populations to ensure a more responsive approach.

•

Prioritization of resources and efforts for cost effectiveness and reach.

•

Total market approach that allows all players in the condom sector make their contribution in line with comparative advantage.

•

Innovative strategies are explored and effectively implemented.

•

A culture of inclusiveness to ensure all players are involved in the national condom programming and especially the target communities and users, among other stakeholders.

The national programme plans to increase condom use by 2023 through targeting all populations through various strategies. To ensure a more coordinated approach to Behaviour Change Communication (BCC), the condom working group will take the lead in developing and operationalizing the condom BCC. This will ensure that all identified segments of the market are covered with the right message. The messages by various sector players will be well coordinated to improve reach and synergy.

Strategy 2: Strengthen the links and partnerships with the community to improve reach by expanding community-based distribution of free, social marketed and private sector condoms via non-traditional outlets The promotion of public sector condoms is largely done by health providers at the different levels of the health system including facilities from the national referral hospitals down to the dispensaries. The linkage between health facilities and the community needs to be strengthened for effective distribution of condoms to users. To address this gap, NACC will work with Huduma centres and support civil society and community based organisations to promote public sector condoms in community settings. The

14

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

NACC regional and county officers will work with the county governments and national administration officials responsible for licensing of entertainment establishments to ensure availability of condoms in their premises is part of the requisite for issuance of licence. This will ensure that the hotel and bar industry provide condoms to the clients who patronise their establishments as need arise. The involvement of public service transport, motorbike and bicycle riders will also be key if we are to realize the goals of this strategy.

Strategy 2a: Support the NACC to strengthen both Public and Private sector HIV work place programs to expand implementation of the National Condom Strategy to increase accessibility of male and female condoms and lubricants to populations; plus education materials and other training aids to service providers to facilitate the education of users, at no cost.

The Government and partners will intensify support of workplace programmes. Currently, there are about 8,000 workplace HIV programmes in the country and especially in the private sector which promote and provide condoms to staff. Under this plan, these workplace programmes will be supported to scale up condom intervention to increase access within the community.

Strategy 3: Create an enabling environment for condom uptake The Condom Working Group will engage and involve all stakeholders both in the National and County Governments in the national condom programme. This will include but not limited to Political leaders, Local administration, Media, Religious leaders, Social Services, Private sector; and other stakeholders including peer networks, support groups, associations etc.

Strategy 3a: To create an enabling environment for the provision of relevant information and condoms. Targeted advocacy messages will be drafted according to the target audience. The relevant legislation and policies will be put in place to ensure availability and accessibility of condoms in all hotels and lodgings. Reproductive health and HIV policies and guidelines will be reviewed to highlight current legislations and make recommendations for better access to condoms to anyone at risk of HIV and other sexually transmitted infections, and unintended pregnancy. Condoms will also be placed in easily accessible, strategic points to promote access and uptake.

Strategy 3b: The national condom programme will seek to take advantage of organised groups like civil society organisations, social networks/chat rooms, young people networks, and women’s groups to promote and provide condoms to their membership as appropriate. The use of social media, microfinance groups and welfare groups at county level is expected to ensure both THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

15

individuals and groups in the community have the right skills to improve their ability to negotiate condom use with partners, and actually use them to reduce the risk of HIV transmission, other STIs and unintended pregnancies.

Action 1a: Market Research: The CWG will ensure execution of a market research to understand knowledge, attitudes and practices of condom consumers. The CWG will conduct annual surveys which will inform the communication plan. It will facilitate market segmentation that will contribute to a better understanding of consumer needs and preferences. The evidence gathered will inform development and implementation of a responsive marketing plan which takes into consideration the following core elements of effective marketing:

Right product: Need to have different variants to increase choice.

Right place: Placement or location of the commodity to improve access to or by target consumer.

Right price: Need to ensure there is a product available for each segment.

Right people: Identification of the right audience to be targeted with the commodities and messages.

Action 1b — Condom Communication plan This will ensure greater message consistency for the same target audience, irrespective of the segment player, to avoid creating confusion in the mind of the consumer. The CWG will facilitate the development of a National Condom Communications Strategy to support demand creation and an enabling environment for effective condom programming. The plan will seek to; i.

Create meaningful and enduring partnership with media, and especially media networks including Kenya Union of Journalists, Kenya Editors’ Guild, Association of Media women in Kenya and Inter-news,

ii.

Advocate for greater and appropriate use through national condom awareness campaigns such as condom awareness months, International Condom Day, special events and during public holidays,

iii. Strengthen coordination of messaging to target audience by different implementers for greater impact, iv. Efficacy training, v.

CSR component targeting the private sector to provide targeted training to all populations, and,

vi. The strategy will advocate for a 3D approach that involves discussing, demonstrating and distributing the condoms.

16

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

Action 2: Stakeholder’s engagement framework A stakeholder engagement framework will be developed that include; 1. Mapping of stakeholders 2. Memorandum of understanding (MOU) 3. Engagement plan Appropriate evidence based advocacy messages will be developed and delivered through the right platforms. Targeted messages will be developed and communicated to relevant stakeholders and target groups through the appropriate media, if the implementation of this strategy is to be realized.

Strategy 3c: Strengthen disposal of used condoms

The disposal of used condoms has for a long time been a grey area in condom programming.

The National Condom Working will ensure that as part of the communication for scaling up condom use, there is also information on safe, proper and hygienic disposal of used condoms. The packaging and labelling of condoms will include information on safe and hygienic disposal of used condoms. The packaging will also consider braille for people with disabilities to increase access and uptake.

Public sensitization on disposal of used condom through various modes of communication which include media, adverts and trainings will be key in this strategy.

2.4.4 Focus area 4: Monitoring, Tracking and Evaluation Activities and targets set in the operational plan will be tracked through measurement of the agreed indicators on a regular basis. Indicators will be reviewed in order to track performance of new elements in the National Condom Strategic Plan. The Condom Working Group will ensure inclusion of additional indicators into the national M & E Framework; and ensure their measurement as needed.

The setting of the operations research agenda, its implementation, monitoring and evaluation of programme activities is to allow planners and implementers to better understand context, identify strategies and methodologies that work and right timing for success. Operational research, monitoring and evaluation of programme activities will have a consistent presence during the strategic plan period.

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

17

Objective 1: Have an effective monitoring and evaluation system that integrates into the Community AIDS Programme Report (CAPR) tool, Health Management Information System (HMIS) and National Monitoring and Evaluation Framework to support evidence-informed implementation of the condom response for better outcomes by the end of plan period Strategy 1: Strengthening of human and institutional capacity to design and implement comprehensive condom programmes The beginning point for the development and effective implementation of an M&E plan is to have a work plan. A responsive work plan will be adopted to enable programme officers have the right knowledge and skills to identify needs and fitting interventions/activities to be implemented.

Strategy 1a: Strengthen the knowledge and skills of programme officers through training, creation of learning linkages and mentorship through exchange programmes with their counterparts in other countries.

Strategy 2: Integrate effectively the coordination system for monitoring, evaluation and research (to support the comprehensive condom programme) into HMIS and the National M&E framework The use of more integrated tools for sharing of the emerging evidence across service levels to drive synergy and efficiency will be adopted by using common platforms especially the HMIS and the national M&E framework. Community data and any other data from outside the health sector will be captured through the Community AIDS Programme Report (CAPR) tool for integration and reporting with other service data. Therefore, a more coordinated approach to M&E will be adopted through advocacy for and adoption of integrated data gathering tools and reporting mechanisms.

Strategy 2a: Integrate condom related indicators into existing programmes’ M&E tools. This will reduce the number of tools that service providers have to fill and facilitate collection of condom related data and reporting for better planning and implementation to improve access and utilization.

Strategy 3: Secure adequate financial support for M&E activities to generate strategic information for Comprehensive Condom Programme Quality reliable data is a prerequisite for effective planning and implementation of the national comprehensive condom programme elements. Therefore, there is need to advocate for allocation of adequate funding to ensure the M&E system has the necessary resources.

18

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

Strategy 3a: In line with the international standards, the condom working group will advocate for 15 percent annual allocation of the overall condom programme budget to M&E. This budget will be used to strengthen M&E to provide strategic information to guide planning and implementation of interventions for better outcomes.

2.5

Implementation

This National Condom Strategic Plan spans five years from 2018 to 2023. To ensure its effective operationalization, an initial three year plan will be concurrently developed to support resource mobilization. A more detailed annual operational plan will be developed to support effective implementation. The preparation of an annual operational plan will allow regular appraisal of both internal and external environments and review of the proposed broad strategies as necessary.

The work plan and budget developed must have clear links to the set objectives, strategies and activities in line with this condom strategy.

In the implementation process, the focus will be on all populations. However, there will be investment on 100% condom programming for high incidence counties as per the Kenya HIV Estimates, (2018) shall reference the Condom Mapping Report of May (2018). The medium and low incident counties will also be targeted as well as the different hot spots. The other target population which is crucial for the success of the condom programming is priority populations; to include young people in higher institutions of learning, without leaving behind youth out of school to be reached through non-medical settings like community and village polytechnics and; other social places and service industry like the transport sector.

This National Condom Strategy will be communicated and disseminated to relevant stakeholders, including donor agencies to ensure it is understood for optimal resource mobilization and successful implementation.

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

19

20

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

4,004,400

4,004,400

1,042,929

584,377

100.00%

9.05%

9.05%

11.38%

1.80%

1.55%

4.21%

2.45%

1.37%

9.05%

2.56%

1.77%

3.02%

0.65%

0.28%

0.77%

Kenya

Nairobi

Nairobi

Central

Nyeri

Nyandarua

Kiambu

Murang’a

Kirinyaga

Coast

Mombasa

Kwale

Kilifi

Tana River

Lamu

Taita Tateva

334,042

119,641

282,958

1,307,185

765,831

1,106,444

3,916,101

1,795,999

659,848

767,560

4,850,713

2,476,762

883,435

2,089,326

9,652,074

5,654,804

8,169,842

28,926,243

4,381,149

7,818,976

13,464,833

4,946,962

5,754,481

36,366,402

28,918,083

28,918,083

347,195

123,842

292,885

1,353,042

792,698

1,145,259

4,054,921

596,030

1,063,721

1,831,800

673,000

782,864

4,947,415

4,232,087

4,232,087

47,784,126 319,607,215 49,074,297

319,607,215 2019

2018

Pop

Condoms

Pop

County/ National %

2,613,481

932,202

2,204,659

10,184,876

5,966,954

8,620,824

30,522,995

4,622,992

8,250,590

14,208,103

5,220,039

6,072,133

38,373,857

30,514,385

30,514,385

337,249,798

337,249,798

Condoms

BASELINE

BASELINE

County Populations

2018/19

2017/18

Annex 1: National Forecasting and Quantification Report, March 2018

347,195

123,842

292,885

1,353,042

792,698

1,145,259

4,054,921

596,030

1,063,721

1,831,800

673,000

782,864

4,947,415

4,232,087

4,232,087

50,350,229

2020

Pop

673,000

596,030

1,063,721

792,698

1,145,259

2,761,943

985,156

2,329,896

347,195

123,842

292,885

10,763,438 1,353,042

6,305,913

9,110,538

32,256,883 4,054,921

4,885,606

8,719,273

15,015,207 1,831,800

5,516,568

782,864

40,553,721 4,947,415

32,247,784 4,232,087 6,417,067

356,407,597

Condoms

2,761,943

985,156

2,329,896

10,763,438

6,305,913

9,110,538

32,256,883

4,885,606

8,719,273

15,015,207

5,516,568

6,417,067

40,553,721

32,247,784

32,247,784

51,659,335 377,235,491

2021

Pop

BASELINE

2020/21

32,247,784 4,232,087

Condoms

BASELINE

2019/20

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

21

1,167,480

939,879

442,371

685,510

0.73%

0.36%

3.41%

0.92%

1.30%

2.55%

2.77%

2.23%

3.63%

0.98%

1.04%

1.61%

14.23%

2.20%

Marsabit

Isiolo

Meru

Tharaka

Embu

Kitui

Machakos

Makueni

N. Eastern

Garissa

Wajir

Mandera

Nyanza

Siaya

941,724

6,085,121

416,389

1,544,270

1,075,866

548,569

388,202

1,441,361

152,332

309,557

6,023,246

14.27%

Eastern

Pop

7,040,800

45,495,473

5,149,467

3,323,008

3,127,867

11,600,342

7,116,962

8,840,142

8,147,068

4,153,782

2,939,525

10,913,967

1,153,368

2,343,727

45,608,548

Condoms

Pop

963,007

6,222,651

697,922

450,385

423,931

1,572,238

949,298

1,179,215

1,086,599

554,079

392,094

1,455,849

153,875

312,698

6,083,707

7,429,458

48,006,860

5,433,722

3,506,440

3,300,528

12,240,691

7,509,824

9,328,125

8,596,792

4,383,075

3,101,790

11,516,427

1,217,035

2,473,102

48,126,178

Condoms

BASELINE

BASELINE

County/ National %

2018/19

2017/18

County Populations

Annex 1: (Continued...)

963,007

6,222,651

697,922

450,385

423,931

1,572,238

949,298

1,179,215

1,086,599

554,079

392,094

1,455,849

153,875

312,698

6,083,707

Pop

153,875

312,698

6,083,707

Pop

BASELINE

949,298

1,179,215

1,086,599

554,079

392,094

697,922

450,385

423,931

7,851,496

963,007

50,733,936 6,222,651

5,742,390

3,705,627

3,488,018

12,936,035 1,572,238

7,936,426

9,858,018

9,085,142

4,632,059

3,277,990

7,851,496

50,733,936

5,742,390

3,705,627

3,488,018

12,936,035

7,936,426

9,858,018

9,085,142

4,632,059

3,277,990

12,170,628

1,286,170

2,613,589

50,860,031

Condoms

2020/21

12,170,628 1,455,849

1,286,170

2,613,589

50,860,031

Condoms

BASELINE

2019/20

22

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

1,288,290

668,863

2.52%

2.40%

3.01%

1.56%

27.26%

2.33%

1.40%

0.61%

2.23%

1.51%

2.44%

Homa Bay

Migori

Kisii

Nyamira

R. Valley

Turkana

West Pokot

Samburu

Trans Nzoia

Baringo

Uasin Gishu

5,000,785

9,631,900

7,666,577

8,056,338

8,099,072

888,435

2.05%

1.09%

4.37%

2.32%

Nandi

Laikipia

Nakuru

Narok

1,003,672

1,891,739

470,965

436,631

E l g e y o 1.01% Marakwet

1,054,805

655,641

966,197

264,284

605,033

1,009,225

7,405,730

13,958,377

3,475,100

6,555,462

3,221,740

7,783,002

4,837,695

7,129,144

1,950,081

4,464,338

7,446,659

11,806,601 87,116,402

1,025,422

1,077,554

1,083,268

2.53%

Kisumu

Condoms

Pop

1,039,837

1,959,880

487,934

920,445

452,360

1,092,803

679,256

1,001,005

273,804

626,832

1,045,579

12,231,928

683,979

1,317,407

1,048,602

1,101,901

1,107,755

7,814,532

14,728,891

3,666,929

6,917,329

8,212,630

5,104,740

7,522,679

2,057,727

4,710,774

7,857,721

91,925,300

5,276,833

10,163,588

8,089,779

8,501,055

8,546,148

Condoms

BASELINE

BASELINE

County/ National %

2018/19

2017/18

County Populations

Pop

Annex 1: (Continued...)

1,048,602

1,101,901

1,107,755

Pop

5,576,588

683,979

10,740,941 1,317,407

8,549,326

8,983,965

9,031,620

Condoms

BASELINE

5,576,588

10,740,941

8,549,326

8,983,965

9,031,620

Condoms

2020/21

1,039,837

1,959,880

487,934

920,445

452,360

1,092,803

679,256

1,001,005

273,804

626,832

1,045,579

487,934

920,445

452,360

1,092,803

679,256

1,001,005

273,804

626,832

1,045,579

8,258,444

1,039,837

15,565,580 1,959,880

3,875,232

7,310,274

3,592,699

8,679,157

5,394,720

7,950,012

2,174,618

4,978,374

8,304,086

8,258,444

15,565,580

3,875,232

7,310,274

3,592,699

8,679,157

5,394,720

7,950,012

2,174,618

4,978,374

8,304,086

12,231,928 97,147,205 12,231,928 97,147,205

683,979

1,317,407

1,048,602

1,101,901

1,107,755

Pop

BASELINE

2019/20

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

23

County/ National %

1.87%

2.07%

1.97%

11.13%

4.26%

1.42%

4.19%

1.25%

County Populations

Kajiado

Kericho

Bomet

Western

Kakamega

Vihiga

Bungoma

Busia

1,812,330

532,746

1,780,280

605,379

Pop

4,006,316

13,387,914

4,552,544

13,628,947

35,575,722

6,304,166

6,601,461

5,983,446

541,859

1,810,717

615,734

1,843,320

4,811,630

885,163

926,903

840,127

4,227,468

14,126,938

4,803,849

14,381,276

37,539,532

6,652,161

6,965,867

6,313,738

Condoms

BASELINE

BASELINE Condoms

2018/19

2017/18

4,730,735

854,383

894,673

810,918

Pop

Annex 1: (Continued...)

541,859

1,810,717

615,734

1,843,320

4,811,630

885,163

926,903

840,127

Pop

885,163

926,903

840,127

Pop

BASELINE

615,734 4,467,614

541,859

14,929,433 1,810,717

5,076,736

15,198,219 1,843,320

4,467,614

14,929,433

5,076,736

15,198,219

39,672,001

7,030,043

7,361,570

6,672,396

Condoms

2020/21

39,672,001 4,811,630

7,030,043

7,361,570

6,672,396

Condoms

BASELINE

2019/20

Annex 2: List of Drafters and Reviewers 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

24

Dr. Emmy J. Chesire..................................................................................NACC Dr. Celestine Mugambi.............................................................................NACC Ms. Helgar Musyoki…………………………………........................................ NASCOP Mr Joab Khasewa.....................................................................................NACC Mr. Timothy Kilonzo…………………………………….................................... NASCOP Mr. Joshua Gitonga……………………………………............................................NACC Ms. Lillian Langat……………………….............................…………………..........UNFPA Dr. Michael Kiragu…………………………………………........................................PWG Dr. Jean Patrick……………………………………………...........................................DRH Dr Heather Njuguna……………………………………...................................... KEMSA Ms. Mary Nyaguthii ………………………………........................................………AHF Mr. Andrew Juma…………………………………………................................…PS Kenya Ms. Catherine Mwangi………………………………................................……NASCOP Ms. Gloria Bille…………………………………………................................. …....UNAIDS Mr. Ezekiel Mwabili……………………………………............................................NACC Ms. Bethryn Kitavi………………………………………...........Pathfinder International Mr. Onesmus Musau…………………………………............................... LVCT Health Mr. Stanley Ngara………………………………....................................... .LVCT Health Mr. William Wandera …………………………….................................................. FKE Ms. Damaris Oyando ………………………………..........................................WOFAK Ms. Samantha Ariri …………………………………..........................................WOFAK Ms. Wambere Kibicho ……………………………........................Latex EAST AFRICA Ms. Joyce Mogaka……………………………………………............University of Nairobi Ms. Faith Kamau……………………………………………..............................AHF Kenya Ms. Jane Nganga…...………………………………………....................... Inerela +Kenya Pst. Geoffrey Munialo……………………………………….................... Inerela + Kenya Mr. Bonface Gakuru ………………………………………................................... KESWA Mr. Joel Karanja ………………………………………….............................AVEP Kenya Dr. Tabiitha Wangeri ………………………………………...............Kenyatta University Ms. Martha Ngera ............................. ……………………………Kenyatta University Ms. Rahab Mwaniki ………...............................………………………………....KANCO Ms. Nadine Odwari ……………………………................................…………… KANCO Mr. Simon Macharia ………………………………………................................... MADO Mr. Paul Maina ……………………………………..............Urban Community Initiative Mr. Nicholas Njoroge ……………………………................................ ………….KEMSA

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

THE NATIONAL CONDOM STRATEGY 2018–2023 ~ ‘Providing Kenyans with a Choice’ that Protects’

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