Lea Toto is a community-based care program of the Children of God Relief Institute (COGRI) that aims to improve the quality of life for children with HIV in its catchment area. The program currently runs CCCs with community outreach services in eight informal settlements in Nairobi County, namely, Kangemi, Kawangware, Dagoretti, Kibera, Mukuru, Dandora, Kariobangi, and Zimmerman. These clinics serve as the centers for the provision of holistic care services, including HTS and HIV treatment; they also offer food and nutrition services, psycho-social support and counseling, education and vocational training, socioeconomic support, and economic-strengthening activities.
The program focuses on children living with HIV but also supports their caregivers and other members of the households in which they live, and the community as secondary and tertiary beneficiaries. Since its inception in 1998, Lea Toto has served 10,825 beneficiaries who have been tested for HIV. The distribution across ages of children at HIV diagnosis indicates the increasing urgency to promote testing for children older than five years, resonating with increasingly strong evidence around unexpectedly higher numbers of children with HIV who are slow-progressors.
There is a great challenge in cases where youths are engaged in sexual relationships, and some of them do not disclose their HIV status to their sexual partners; those who already know their status are in some instances afraid of stigma, discrimination, and rejection if they disclose their status. Further, there is no guideline in Kenya pointing out how youth in active sexual relationships can disclose their HIV status without victimization. Therefore, the goal of this study will be to assess the challenges facing the implementation of child and family development programs in Nairobi City County: a case study of the lea Toto program.