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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. Human Immunodeficiency Virus (HIV) finds special mention in 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 un-infected children).
            The incidence of HIV has been known to be more wide spread in cities when compared to rural areas. Nairobi,
            the capital city of Kenya also finds itself in a similar predicament. With the high prevalence rate of HIV among
            children in Nairobi and the resultant negative effects on their health, it is of paramount importance that
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            infants with 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
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            prolong their life 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 University of Kansas Medical Center with other partners),
            adopted in the city of Nairobi to allow for early diagnosis and reduction in the infant mortality rate associated
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            with HIV.
            1.2     Challenge and response

            The  National  AIDS  and  Sexually  Transmitted  Infections  Control  Programme  (NASCOP)  in  Kenya,  had
            established the National Pediatric Early Infant Diagnosis (EID) Guidelines more than a decade ago in 2006.
            These  guidelines  also  underscored  crucial  strategies  aimed  at  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 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






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            27   Ensure healthy lives and promote well-being for all at all ages.
            28   Kenya AIDS Response Progress Report. 2014.
            29   Lessons  learned  from  implementing  the  HIV  infant  tracking  system  (HITSystem):  A  web-based  intervention  to
               improve early infant diagnosis in Kenya. 2015.
            30   Uses  of  information  and  communication  technologies  in  HIV  self-management:  A  systematic  review  of  global
               literature. International Journal of Information Management,75-83. 2017.
            31   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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