Page 36 - Connecting cities and communities with the Sustainable Development Goals

United for Smart Sustainable Cities
Connecting cities and communities with the Sustainable Development Goals

1 Introduction

1.1 Background
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Advancing on global health issues remains an indispensable component of Goal 3 of the Sustainable
Development Goals (SDGs). Human Immunodeficiency Virus (HIV) finds special mention in the targets of Goal
3. Recent trends have shown that the burden of HIV has profound implications for developing countries, in
particular, those in the African subcontinent. The adverse impact of HIV in Africa has been well noted.
Countries like Kenya have documented high rates of HIV-related ailments and have also recorded a high
mortality rate among children, which threatens the country’s future development and overall health
infrastructure. Infants with HIV often develop life threatening infections early on in life (compared to
uninfected children).
The incidence of HIV is known to be more widespread in cities as compared to rural areas. Nairobi, the capital
city of Kenya also finds itself in a similar predicament. With the high prevalence of HIV among children in
Nairobi and the resultant negative effects on their health, it is of paramount importance that infants with
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HIV are identified and diagnosed at an early stage. This will allow them to be provided with adequate HIV
care, including anti-retroviral treatment (ART), which can improve their quality of life and prolong their life
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spans.
Information and communication technologies (ICTs) are being utilized increasingly to aid HIV treatment. The
main technological advances have mostly extended to the field of HIV management and future ART schedule
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setting.
In light of the above, this case study will examine one of the key strategies, namely the HITSystem (as
implemented in a pilot project carried out by the University of Kansas Medical Center and other partners),
adopted in the city of Nairobi to allow for early diagnosis and a reduction in the infant mortality rate
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associated with HIV.

1.2 Challenge and response
The National AIDS and Sexually Transmitted Infections Control Programme (NASCOP) in Kenya, had
established the National Paediatric Early Infant Diagnosis (EID) Guidelines more than a decade ago in 2006.
These guidelines also underscore crucial strategies aimed at the early diagnosis and management of HIV
infections among infants. However, following the implementation of these guidelines in the subsequent
years, it was found that children still had a disproportionate and limited access to the required treatments.
In 2011, it was estimated that only 28% of the HIV-infected infants were receiving HIV care. This left majority
of the HIV-positive children directly vulnerable to infections, sickness and possible mortality within one year.
Furthermore, it was realized that mortality rates were the highest among children aged under the age of two
and that neglect along with the absence of consistent treatment could result in nearly half of the infected
children dying by their second birthday. The main problem associated with the diminished treatments
application was the lack of a systematic follow-up system. In response to the growing need for a monitoring

18 Ensure healthy lives and promote well-being for all at all ages.

19 Kenya AIDS Response Progress Report, 2014.
20 Lessons learned from implementing the HIV infant tracking system (HITSystem): A web-based intervention to
improve early infant diagnosis in Kenya, 2015.
21 Uses of information and communication technologies in HIV self-management: A systematic review of global
literature. International Journal of Information Management, pp 75-83, 2017.
22 Lessons learned from implementing the HIV infant tracking system (HITSystem): A web-based intervention to
improve early infant diagnosis in Kenya. 2015.

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