Assessment of HIV/AIDS Behaviour Change Communication Strategies Employed by NGOs in Kakuma Refugee Camp, Kenya

This report summarises the work of Nations High Commissioner for Refugees (UNHCR) with non-governmental organisations (NGOs) in Kakuma, Kenya, to provide HIV/AIDS services to refugees. Approximately 82,000 refugees, mainly from Sudan, Somalia, and Ethiopia, live in the Kakuma area. The International Rescue Committee helps provide health services to refugees there. NGOs have adopted behaviour change communication strategies for different groups, including adolescents, young women, and commercial sex workers. UNHCR recommends a series of specific actions to increase the effectiveness of these strategies.

Executive summary

"This study used qualitative methods including key informant interviews, focus group discussions, participatory observation and field visits. Data was collected between 11 November and 3 December 2002.

Quite consistently, HIV/AIDS has not been taken at a personal level by refugees in Kakuma refugee camp. Abstinence and remaining faithful to one partner are acceptable, but by the same breath, the communities of different ethnicities conceded that it is difficult for men to refrain from sex and that they do have premarital and extramarital sex. It was a consensus that due to women's subordinate role and their strict upbringing, they are much more unlikely to engage in sex before marriage or extramarital sex than men.

The major difficulty that emerged throughout this study lies in condom availability, promotion and use. Condoms are viewed by the Sudanese and Somalis as going against religion and culture. The Sudanese are a polygamous society and their wealth dictates how many wives they can have. A sex industry exists in the camp but is "ignored" and these women are subject to a lot of stigma and human rights abuses.

Targeted HIV/AIDS educational materials that are cultural, religious, age and gender specific are missing as are the curricula including that of schools produced by the Kenyan Ministry of Education (MoE).

The flowchart for the treatment of sexually transmitted infections (STIs) is not being fully followed. The omitted areas are compliance, counselling, condom use and contact treatment. This is the main behavioural change communication (BCC) in STI patient care. Voluntary counselling services have started at two sites in Kakuma and they are of a good standard. Capacity building regarding STI/HIV/AIDS and networking is a necessity and upgrading should be considered once a year.

Pages 16 and 19 of the report show specific gaps and recommendations made based on the findings. Figure 1 captures the recommended integrated approach. The suggested work plan for Kakuma is contained on page 22. There are 16 recommendations that should be implemented together with United UNHCR's Strategic Plan 2002-2004. Furthermore, it is necessary to have HIV/AIDS focal points in both Dadaab and Kakuma UNHCR offices as well as at partner level."