Theme: Models of Care Year: 2025
Background:
Kiambu County ranks fourth in Kenya for the number of people who use or inject drugs, with an estimated 3,312 heroin users identified by a local civil society organization. Interventions have enabled 835 individuals to access Medically Assisted Therapy (MAT) and harm reduction services.
Description of the model of care/intervention/program:
We operate a community-run safe space for MAT patients at the methadone clinic in Kiambu, complementing existing clinical services by offering clean needles and syringes, condoms and lubricants, psychosocial support, and paralegal assistance. The safe space also provides referrals for HIV and TB screening, overdose prevention guidance (including naloxone distribution where possible), monthly family engagement, peer-led counselling, and documentation of stigma and discrimination. Additional features include community sensitizations, monitoring service quality at the Karuri Methadone Clinic, and championing reintegration efforts.
Effectiveness:
On average, 644 individuals (621 men and 23 women) visit monthly. Clean needles, syringes, and 144 condoms are distributed twice weekly, while psychosocial sessions support 25 participants weekly. Legal aid is offered to 44 individuals monthly, and community engagement includes monthly clean-up campaigns with 50 participants, along with attendance at public barazas for addiction awareness. Peer educators conduct harm reduction and overdose response training, supporting both patients and families. A service quality survey conducted in December 2024 showed a high potential for sustaining quality care post-handover.
Conclusion and next steps:
Although the safe space has proven critical in helping people who use drugs reintegrate, its services remain limited to MAT beneficiaries. Outreach to active users must be prioritized, including induction of new patients and linkage to care – measures not taken in the last six months in Karuri, Kiambu. Strengthening these components could significantly enhance the continuum of care and facilitate longterm community well-being. Moving forward, partnerships with local stakeholders and enhanced outreach strategies can further bolster our efforts to reduce harm and improve overall health outcomes in Kiambu County.
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