DEVELOPING DATA ESTIMATES – MAKING ADOLESCENTS AND YOUNG PEOPLE COUNT TO REACH THOSE MOST AT RISK AND IN NEED By: Ulrike Gilbert-Nandra, Chief HIV, UNICEF KENYA

Objectives & Methodology Objectives: To generate and utilize adolescent HIV data estimates for national level and counties Between late 2015 and June 2016: Review of programme data, estimates development using Spectrum, consultations with government, CSOs and development partners. In partnership with the NACC led national HIV estimates working group, NASCOP, CDC, UNAIDS, WHO, NEPHAK, Avenir Health and other partners 9 million adolescent girls and boys between 10-19 years 2014 declared L-MIC with 42% living in poverty 2013 Devolution - From 8 provinces to 47 counties with health functions assigned to county governments National HIV Estimates and since 2014 county HIV profiles No adolescent aged disaggregated HIV programme data Critical for UNICEF to support our partners to generate new data on adolescent to inform plans, programmes and allocation of resources

RESULTS: New HIV Infections in Adolescents and Young People in Kenya Nearly half of all new HIV infections in young people, with 2/3 in girls Every day, 49 new HIV infections in 15-19 year olds According to UNAIDS Kenya saw 78.000 new HIV infections in 2015, or 213 new infections ever day. Of these new infections nearly half were among young people 15-24 years, with 2/3 or 65% in girls and young women. Even more important to note is the high number of new infections in girls 15-19 years, where every day we see 49 new infections. Kenya is a large country with vast variations in its HIV epidemic across the counties. So it was important to understand where adolescent living with HIV live. This motivated the partners to further disaggregate the data for subnational level and by age. Source info here: UNICEF NACC Analysis of Kenya HIV Estimates for 2015

Adolescents 10 to 19 years living with HIV by county Nearly 50% of all adolescents living with HIV, live in six counties: Homabay Kisumu Siaya Nairobi Migori Mombasa We found that nearly half of all adolescents living with HIV (65.431 of the 133.455) live in only six of the 47 counties: ranging from 15323 in Homabay, 13988 in Kisumu to 5005 in Mombasa. Why is this important? This is important to inform target setting for programmes, allocation of resources and monitoring of progress. Source : UNICEF-NACC Analysis of Kenya HIV Estimates for 2015.

AIDS related death in adolescents 10-19 years old by county Nearly 80% of AIDS related deaths among adolescents occur in five other counties Two adolescents living with HIV die every day in Kiambu county Of the 2793 deaths in adolescents living with HIV, AIDS related deaths are highest in Kiambu county with 635, then Muranga with 476 Source : UNICEF-NACC Analysis of Kenya HIV Estimates 2015.

HIV infections in adolescents 10-19 years by county 62% of new infections in adolescents occur in same six counties Every day in Homabay, 8 adolescents get HIV Every day in Mombasa, 2 adolescents get HIV Ranging from Homabay with 2945 new HIV infections (8 infections every day) , Kisumu 2688 to Mombasa with 681 new HIV infections Source : UNICEF-NACC Analysis of Kenya HIV Estimates 2015.

Deep Dive: Adolescent Assessment for Mombasa County Mombasa county total population 1.2 million people with 17% (202.668) adolescents 10-19 years Net secondary school enrollment: Girls 22% (12,335), Boys 31% (15,207) Children Cash Transfer Coverage Number of children Number Coverage Children living in poverty                                   154,983   Orphans                                     29,920 CT-OVC 13,117 Other NSNP                                        2,648 TOTAL NSNP                                     15,765 10.2% Source : UNICEF Analysis of Estimates, Data from Kenya NSNP Single Registry, Census 2009, KHIBS 2005

Deep Dive: Adolescent Assessment for Mombasa County Results of the adolescent assessment informed the new County AIDS Strategic Plan Demand for data from decision makers Accountability at all levels

Conclusions Critical to strengthen age/sex disaggregated data at sub national level to re-sharpen the focus: WHO, WHERE and HOW LONG Complement HIV data with sectoral data to inform the WHAT and HOW ‘Who is dying where’ pointing to issues related to quality of services in medium and low burden counties Demand for data from decision makers that its being used Data alone is not sufficient - Views and spaces for adolescent and young people living with HIV (Sauti Skika)

ACKNOWLEDGEMENTS National AIDS Control Council Kenya (NACC) National AIDS and STI Control Programme (NASCOP) Communities of people living with HIV: NEPHAK, WOFAK, Sauti Skika County governments and NGOs (LVCT Health) UNICEF Headquarters and UNICEF East and Southern Regional Office Avenir Health

THANK YOU