Jua Mtoto Wako - An Enhanced Case Management Approach for Viral Suppression

Afya Pwani is a USAID program implemented by Pathfinder International in the coastal region of Kenya. It offers comprehensive HIV services to people living with HIV by improving and increasing access to quality health services through strengthened service delivery and institutional capacity. In June 2020, the program introduced an enhanced case management approach dubbed Jua Mtoto Wako, which means“Know Your Child” in Kiswahili. It is designed to reach children and adolescents living with HIV (CALHIV) through a family-centered approach.

Jua Mtoto Wako is collaboratively implemented by health facilities and USAID implementing partners to help the CALHIV achieve durable viral suppression and lead healthy lives. When a child is found to have a high viral load, a multidisciplinary team starts working together to determine the causes of non-suppression and with the family to agree the next steps. An individualized case plan is drawn up and a case manager is assigned to the child to accompany him or her on the journey to viral load suppression. This includes regular adherence sessions and home visits are part of that process.

The Jua Mtoto Wako process ends when viral load suppression is achieved. The process involves the consent and active participation of the caregiver in decision-making, maintaining and enhancing the effective functioning of the family unit, and supports caregivers with literacy sessions. Jua Mtoto Wako services are also matched to the children’s age and developmental level to enhance functioning and growth. The children are included in decision-making as appropriate for their age and abilities. Developing and implementing Jua Mtoto Wako involved multiple Collaborating, Learning & Adapting (CLA) approaches, as detailed in the next sections of this document.