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Reducing Vulnerability Of Marginalized
Drug Dependent Communities In Nairobi
Kenya Through Socio-economic
Opportunities
Hezron Ogembo1, Calleb Angira1, Beth Mbugua2,
Reychad Abdool2, Saade Abdallah2
1.
2.
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Nairobi Outreach Services Trust (NOSET)
United Nations Office on Drugs and Crime, Regional
Office for Eastern Africa (UNODC ROEA)
Introduction
• People who use drugs in Kenya, including PWID
suffer from socio-economic marginalization due
to crime and HIV risk-related behaviour
• There are an estimated 18,327 PWIDs in Kenya
• HIV prevalence rate 18.3% among IDUS, versus
6.3% among general adult population
• HIV prevalence is 44.5% among female IDUs
and16% among males
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Nairobi Outreach Services Trust
• Located in Ngara, Nairobi
• Offers HIV prevention, care & treatment
for PWUD since 2005
• Operates in 2 broad districts of Westlands
and Eastlands
• Covers 23 IDU drug use hot spots
• Through UNODC, implements OFIDfunded Sustainable Livelihood Project
since 2011
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Vulnerability Context
Decrease in
protective factors:
health hazardous
behavior
Poverty,
Marginalization,
deprivation
Vicious
circle
Exclusion from
development process
and socio-economic
services
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Drug dependence,
imprisonment
and related HIV
infection
Stigmatization,
discrimination
Interventions
HIV and Drug Use
Prevention & Treatment:
• Drop-in-Centre: HTC,
• Nursing, addiction
counseling;
• Outreaches: IEC, NSEP
• Referral: ART for HIVpositive clients,
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Sustainable Livelihood
Interventions
• Daily meals and showers
• Shelter for women with
children
• Microcredit training with
loan provision
• Vocational training in IGAs
Methods
• Simple Excel cohort monitoring tool used to
extract data for beneficiaries of SLP
• Inclusion criteria: at least two documented
encounters for SLP interventions; Jan to Dec
2013
• Total enrolled: 160 recovering PWUDs in cohort
• Retrospective review of service coverage and
effects of basic socio-economic support and
other PWUD interventions
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Baseline Status
180
160
140
120
100
80
60
40
20
0
158
98.8%
127
79.4%
Got Basic
support
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127
79.4%
Living alone Unemployed
62
38.8%
54
87.1%
Injecting
Drugs
Sharing
Needles
Immediate Outputs
Basic Socio-Economic Support:
• 936 DUs, 624 IDU’s and 421 Females
received daily meals
• 40 FWUDs received shelter
• 822 DUs, 1023 IDUs and 533 Females
got Psychosocial and life skills support:
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Medium/Long term Support
• 56 trained on basic entrepreneurship skills
• Micro credit groups:5 (30 DUs, 25 IDUs, 10
Females)
• Issued loans:42 (22 DUs, 12 IDUs, 8 Females)
• Servicing loans: 24 (10 DUs, 7 IDUs, 7 Females)
• Fully repaid :10 (8 DUs and 2 IDUs),defaulters:7
• New enterprises:34(shoe selling, water
containers, transportation using trolleys among
others)
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Behavioral Outcomes
180
160
158
98.8%
127
79.4%
140
120
100
80
60
40
20
0
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62
38.8%
84
52.5%
62
38.8%
36
58.1%
24
15.0%
Conclusion
Socioeconomic interventions for PWUDs
can lead to:
• Reduced risky sexual and drug use
behavior.
• Reduced criminality
• Reduced vulnerability to HIV infection
• Increased potential to self reliance
• Improved general health
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IGA Training by Jamii
Bora Bank Staff
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Beneficiary FWUD with
Children
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Lessons learnt
• Lunches, bathing & washing services
attracted more clients to DIC services,
including mothers with young children.
• A viable enterprise can sustain feeding
programme.
• Recovering PWUD can successfully service
loans and accrue small savings.
• As Kenya embarks on methadone
maintenance treatment (MMT), socioeconomic empowerment is vital to assure
retention of female heroin users.
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Acknowledgements
• OPEC Fund for International Development
(OFID)
• Kenya’s Ministry of Health: NASCOP and
Mental Health Directorate
• United Nations Office on Drugs and Crime
(UNODC ROEA and HQ)
• Nairobi Outreach Services Trust (NOSET)
• Project Beneficiaries
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