{The Public Health and Environment Unit of the City of Kigali (CoK), works towards a functioning healthy people in a healthy city, charged with promotion of health standards especially tracking down the spread of diseases through enhancing hygiene, community awareness, prevention and treatment of diseases especially HIV/AIDS. In its mandate, the City of Kigali has initiated programs that support a health and environment unit in Kigali city council through capacity building, equipping hospitals in the city and mobilizing for environmental health}.
“HIV/AIDS prevalence stands at 7.3% in Kigali city, compared to the entire country’s 3%,” says Patricie Mukangarambe, Director of Public Health & Environment Unit, City of Kigali. Statistics indicate that prevalence rates in the country tend to be higher in cities and growing centers, along highways and in the fishing communities around Lakes. However it is highest in the most densely populated city of Kigali than any other places. “There is need for very strong partnership between the city of Kigali and civil society to bring down the prevalence rates,” says Mukangarambe.
The city of Kigali harbors different social groups of people such as female sexual workers that hatch the scourge’s prevalence rates to continuously surge upwards from time to time. “This is a danger that needs more sensitization mainly in awareness and prevention,” she says. In efforts to reduce sexual workers in the city, campaigns to bring sexual workers into forming cooperatives so as to receive support to engage in commercial activities have been initiated by the City of Kigali authority.
To reduce the high prevalence rate, strategies of prevention have been put up by the city authorities to see that there are means of raising awareness among the city communities in a way that reaches those most at risk and affected by the epidemic. “We are working in line with the theme for World AIDS Day 2015 ‘Getting to zero.’ Zero New HIV Infections, Zero Discrimination and Zero AIDS-related deaths,” Mukangarambe explains. The city of Kigali authorities maintain that use of condoms along with other prevention methods can further reduce the risks of getting HIV. According to Mukangarambe, the more prevention methods used the safer one is bound to be. The community is advised to abstain and if not use the preventive methods.
In a bid to further reduce the AIDS prevalence, the City of Kigali promotes strategies aimed at directly involving PLWHA in creation of awareness and prevention. Communities are advised to form organizations that aim at fighting for their rights and advocacy for proper treatment. The already HIV positive persons with full-blown AIDS are supported, treated given care.
Among other strategies, the City of Kigali is working towards getting near to the more vulnerable groups, like sex workers, youths and pregnant mothers to sensitize them on prevention, sexual abstinence, early testing and adherence to treatment and absolute change of behavior. “We also emphasize enhancement of programs aiming at fighting the scourge within our hospitals especially the PMTCT program in order to reduce the spread to unborn children,” says Mukangarambe.
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Working in line with the HIV/AIDS strategic Plan
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The City of Kigali Health and Environment Unit follows the strategy set by the government focusing on reduction of the HIV prevalence in the country. The government of Rwanda has set itself a target to eliminate all transmission of the disease by 2018. It is very fortunate that as the country has a relatively low rate of HIV prevalence, estimated at about 3%, the goal of achieving an HIV-free generation by 2018 appears likely.
{{Challenges }}
In amidst of all this hope, there are many challenges identified especially when it comes to eliminating transmission of HIV from mother to child. Much as there is a high coverage of antenatal care facilities that offer AIDS prevention services, only a few HIV positive pregnant women receive ARV. “As a result, only 50% of the children between the ages of 0-14 that are in need of ARVs are able to access this treatment,” Mukangarambe notes. In order to address this problem, policies and standards are needed to guide HIV testing, treatment, and monitoring of children in health centers. Access to early testing and treatment for infants (as well as longer term care and support) will be critical if the majority of HIV positive children are to survive and thrive.
{{Addressing the stigma associated with HIV}}
Children affected by HIV are often amongst the most vulnerable in a community, requiring nutritional and psycho-social care and support to go to school. This negatively influences adherence to treatment and compromises overall health outcomes. One of the strategies to address this challenge is to ensure access to holistic care, but stigma and low coverage of social protection interventions remain significant barriers.
Young people, especially girls, lack inclusive knowledge to prevent HIV infection, which means that despite low prevalence rates, over 90% of Rwanda’s population and future generation remains at increased risk of HIV infection unless behavioral change programs reach and are understood by key audiences.
The City of Kigali Public Health and Environment Unit is in charge of Public health and environment. The unit is charged with maintaining health for all people living in the Rwandan capital. The main functions include Public sanitation and waste management, greening and beautification, Environment inspection, Public and Community Hygiene and primary health care.
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