All Good Things Come to an End: Celebrating Eight Years of Maanisha

AMREF’s Maanisha Programme, a community focused initiative commenced in 2004 and came to a close in 2012. In its eight years of existence, Maanisha, a Swahili word meaning ‘to give meaning’,  has been largely successful in the sustained reduction of HIV/AIDS and other STIs in Kenya. The programme also aimed at the reduction of HIV related morbidity and mortality and social protection of HIV infected and affected persons.

Implemented by AMREF in partnership with Government of Kenya (GOK) structures, Civil Society Organisations (CSOs) and Private Sector Organisations (PSOs), the programme was co-funded by the Swedish International Development Cooperation Agency (Sida) and United Kingdom’s Department for international Development (DfID) to the tune of US$ 30 million.

The programme targeted Most-At-Risk Populations (MARPS), People living with HIV (PLHIV), caregivers, orphans and widows in Nyanza, Western and Eastern provinces and the Lake Victoria basin districts of the Rift Valley. The programme’s objectives included capacity building of CSOs and PSOs; strengthening the coordination environment and mechanisms; promotion of safer sexual behaviour; enhancing the quality of care for vulnerable population groups; and influencing policy and practices.

Through a needs assessment in 2005 and a baseline survey in 2008 in Nyanza, Rift Valley, western and Eastern provinces, Maanisha revealed weak coordination and inadequate involvement of local communities among other as the hindrance to effective HIV response. In 2009, Maanisha implemented a health system linkages, collaboration and coordination strengthening framework in the 4 provinces.

The framework, which was developed in consultation with National AIDS Control Council (NACC) and the Ministry of Medical Services/Ministry of Public Health (MOMS/MOPHS), outlines actors in the health system as well as linkages necessary for creating a vibrant coordination environment amongst various players; which are trust, meaningful involvement, information systems, capacity building, quality assurance, referral system and community health care financing.  

Operationalisation of the Maanisha framework in these provinces proved useful in linking grassroots CSOs and the communities they work with, with the formal health system and creating synergies between all sectors contributing to health. Through this, Maanisha over passed most if not all of its target. Some of Maanisha’s notable achievements include:

  • 99 % of CSOs using finances as per approved work plans and budgets (target - 80%)
  • 99 % of organizations led by elected leaders (target - 80%)
  • 95 % of CSOs reporting on time to Maanisha (target - 80%)
  • 97 % of clients satisfied with CSO service (target - 80%)
  • 99% of grantees reporting to Constituency AIDS Control Committee (CACCs) using the Community Organisations Programme Based Report (COBPAR) tool
  • 250 coordination forums facilitated by Maanisha (target - 188)
  • 276 CSOs participated in joint annual planning meetings (target - 200)
  • 1,905,031 MARPs and special groups reached with Behaviour Change Communication (BCC) interventions by grantees against a target of 1,000,000
  • Handled 304 cases on land and property disinheritance - 283 cases  were successfully concluded
  • 86% of CSOs provided HCBC according to GOK-approved guidelines (target - 80%)
  • 115,305 referrals were reported between CSOs and health facilities (target - 46,800)
  • 106,046 PLHIV were supported to adhere to ART by CSOs (target - 22,453)
  • 103,401 PLHIV were receiving nutritional support (target - 93,553)

Over the project implementation period, the programme published and disseminated a BCC toolkit, Organisational Development and Systems Strengthening (ODSS) capacity building and Grant Management toolkits.

Building on the Maanisha experience, the ODSS capacity building model was later adopted by NACC and AMREF appointed as national quality assurance agency for the NACC Total War against AIDS (TOWA) capacity building component to train, supervise and assure the quality of work for Regional Facilitating Agencies appointed by NACC to build the capacity of TOWA funded CSOs countrywide.

The grant management information system (GMIS) developed and used to manage CSO grants was further adopted by NACC to track capacity assessments and outcome of ODSS among CSOs.

These toolkits and guides have further been used by AMREF to design new projects such as Global Fund TB and Malaria, APHIAPlus IMARISHA and the recently launched Linda Afya ya Mama na Mtoto project.

The incorporation of home to home testing following increased awareness and acceptance of HIV/AIDS and increased Support of PLHIV groups resulting in expanded People with Positives (PWP) interventions among PLHIV has also led to the success of the programme.

Knowledge sharing forum is another attribute to the success of the Maanisha programme. CSOs cascaded Organisational Development and System Strengthening (ODSS) to their affiliates and health facilities enabling them to get funding.

AMREF Deputy Country Director, Dr Meshack Ndirangu, UCAHA Member, Catherine Owour, Sida Rep., Nicholas Imbungua, AMREF Country Director, Dr Lennie Bazira Kyomuhangi, Deputy Director NACC, Dr Sobbie Mulindi, NASCOP Rep., Dr Ann Ng’ang’a, Dr Njeri Mwaura and ESHG member, Rose Ekwenye cut the cake during the Maanisha dinner party.

From Left: AMREF Deputy Country Director, Dr Meshack Ndirangu, UCAHA Member, Catherine Owour, Sida Rep., Nicholas Imbungua, AMREF Country Director, Dr Lennie Bazira Kyomuhangi, Deputy Director NACC, Dr Sobbie Mulindi, NASCOP Rep., Dr Ann Ng’ang’a, Dr Njeri Mwaura and ESHG member, Rose Ekwenye cut the cake during the Maanisha dinner party.

To say goodbye and thank all involved in the Maanisha programme, the Maanisha team, organised a dinner at the Sarova Panafric on December 11, 2012 dubbed ‘Celebrating Maanisha’s Success’ graced by stakeholders involved in the programme. These included former Maanisha staff, donor representatives from Sida and DfID, Government representatives from NACC and National AIDS and STIs Control Programme (NASCOP) and beneficiaries from Blind and Low Vision Network (BLINK), Ugenya Community against HIV/AIDS (UCAHA) and Essenyi Self Help Group (ESHG), CSOs supported by the programme. Also present were AMREF Country Director, Dr Lennie Bazira S Kyomuhangi, Deputy Director Dr Meshack Ndirangu, and NACC Deputy Director, Dr Sobbie Mulindi as Chief Guest.  

With the beneficiary feedback given at the dinner and overview of the programme’s End term Evaluation report, it is beyond doubt that the Maanisha programme left millions of beneficiaries in Kenya empowered to tackle HIV/AIDS, the ripple effects of the programme being felt from grassroots to national level.

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