Critical Health Services for Young Women and Girls: DREAMS Opens First Wellness Centre in Nairobi Settlement

By Betty Adera, DREAMS Chief of Party, Nairobi

One of the surest ways to ensure that people with HIV get the treatment they need is by knowing their status. Without that knowledge, their health invariably deteriorates and they may unknowingly infect others. The theme of this year’s World AIDS Day on December 1 is “Know Your Status,” and just a few days prior, the DREAMS Wellness Centre will open in the Pumwani informal settlement of Nairobi. The first of its kind, the Centre will offer HIV testing and health management as part of the PEPFAR-funded, USAID-supported DREAMS program. The goal of DREAMS is to reduce new HIV infections among adolescent girls and young women (AGYW) in part by providing age-appropriate HIV and gender-based violence prevention interventions.

The Centre is particularly important in Kenya, where cultural norms prevent many families from discussing sexual health and other sensitive topics. In a country with high rates of HIV, an environment that offers accurate information and support with their peers is vital for the young women and girls of Nairobi, especially since their rates of HIV infections are among the highest. Also, we know from experience how important peer counseling is; previously, many girls were not comfortable seeking help from much older health workers they could not relate to, so they would either not seek help at all or self-medicate.

DREAMS is funded by PEPFAR and implemented by Global Communities in partnership with St. John’s Community Center, Kenya Girl Guide Association and Nairobi County Health Department.

Since 2015, Global Communities has reached more than 12,000 AGYW aged 10–24 years, both in and out of school, with a number of life-saving interventions around knowledge and skills for preventing HIV, other sexually transmitted infections and unintended pregnancies; accurate information on interacting safely with male sexual partners, prevention and mitigation of all forms of gender-based violence; comprehensive health services; education and economic support, and various forms of social protection including cash transfers to help the girls access services that will keep them healthy, or if they are unwell, improve their health.

The Wellness Centre, which will be staffed by nurses and HIV counselors from the Nairobi County and trained Peer Mentors, and will provide a safe space for girls. All girls from Nairobi County — not just those enrolled in DREAMS — will be welcome to visit for health education on various topics, have access to trained Peer Mentors and receive various DREAMS-like quality health services.

DREAMS uses the safe space group model whereby girls are segmented in groups according to their age cohorts and given age-appropriate information regarding HIV prevention. The segments are for girls 10–14 years, 15–19 years and 20–24 years, and also breaks them down further to in and out of school, married or single, and with or without children, to ensure that the groups are as specific to their needs as possible. In the safe space groups the girls have access to a trained mentor who provides them with information on social asset building; financial literacy; knowledge and skills on how to delay sexual debut, avoid negative peer pressure and handle risky situations; and self-esteem and confidence building.

Additionally, girls are given information on condom use/demonstration; HIV testing; youth-friendly post-violence care, screening for sexually transmitted infections, tuberculosis, alcohol addiction and linkages to contraceptive and other forms of care.

The timing of the Centre’s opening coincides well with the upcoming World AIDS Day, where advocates and experts from around the world will be addressing many of the same topics that will be prevalent at the Centre. The fact that we can count on Hon. Esther M. Passaris, Nairobi County Women Representative and Member of the National Assembly, to be alongside the girls as we formally launch the Centre is indicative of how important the Centre is to this community and County and the commitment that elected officials are showing to the Centre already; it has received support in the form of paint from Galaxy Paints due to our public-private partnership with them.

Community-led change has been proven to empower communities and put them at the center of their own advancement. History shows that one success builds on the last. The DREAMS Wellness Centre will spur further community action, leading to additional improvements for the girls and women of Nairobi County and their families.