Busia County Family

USAID 4TheChild Project Turns Despair into Determination for a household in Busia County

In Busia County, a mother once struggled desperately to understand the cause of her young daughter’s deteriorating health. They moved from one health facility to another with no answers.

The family almost resorted to traditional healers when a routine test at the Busia County Referral Hospital (BCRH) in 2019 revealed the cause for the young daughter’s ill health: both the mother, Wilkister, and her six-year-old daughter were HIV-positive. The facility immediately initiated them into HIV treatment.

Wilkister in her cane farm

It was meant to be a fresh start, but they struggled to accept their status. As HIV-related stigma set in, they missed doses, further compromising their health. As a single mother with no income, Wilkister struggled to provide for her family. BCRH referred them to the USAID 4TheChild Project, where her daughter was enrolled in the Children Living with HIV (CALHIV) care and support program.

Using the Case Plan Achievement Readiness Assessment (CPARA), the project identified critical gaps in health (inconsistent treatment), food security (inability to provide two meals daily), and education (irregular school attendance). The CPARA tool, used annually, measures whether families have met their case plan goals and identifies gaps for further action—ensuring targeted and effective support.

To address urgent needs, the project provided KES 12,000 (about $93 USD) in emergency funds for food and essential medication. A dedicated caseworker was assigned for regular follow-up visits and counseling support.

Over time, both the mother and child embraced their HIV status and began to adhere to treatment plan. Their health stabilized as Wilkister enrolled in parenting sessions that helped her rebuild her relationship with her daughters. She also attended entrepreneurship training and joined a village savings and lending group. Equipped with agribusiness skills, she began farming maize and sugarcane, and opened a small retail kiosk that later grew into a shop as her yields and income increased.

In November 2022, the household was reassessed and supported with a KES 9,000 ($70 USD) business grant and KES 10,000 ($77 USD) in school fees for her daughter. She used this money to expand her business and from the proceeds she kept her child in school without interruption.

“I thank USAID 4TheChild for transforming our lives. We now support others in fighting HIV and taking charge of their health. My daughter is healthy in school, understands how to prevent HIV, and we are both virally suppressed and doing well,” Wilkister says.

In December 2024, the household achieved all 9 CPARA benchmarks and was graduated from the program after three months of monitoring. Wilkister is now regarded as a model caregiver—proof that, with the right support, vulnerable households can transform their own lives.

Busia County faces significant challenges with HIV prevalence at 5.4%—above the national rate of 4.3%—and Mother-to-Child Transmission (MTCT) at 10.5%—higher than the national average of 8.9% and above the 5% elimination threshold—.

Since its launch in 2021, USAID 4TheChild has invested KES 217,509,957 (approximately $1.7 million USD) in the county to improve health and education outcomes for orphans and vulnerable children. At inception, the project enrolled over 20,000 OVC;. It currently serves 11,000, including 2,545 children living with HIV who are on treatment with a viral load suppression rate of 91% as of June 2025. The project has paid school fees for 713 OVC, provided uniforms to 1,645, and supplied sanitary towels to 2,371 girls.

The project has also equipped caregivers with business kits, financial literacy, and agribusiness skills—helping 20% of households reach stability. Nearly all school-age OVC are now in class, and 91% have birth certificates which are esssential for accessing other government services.

USAID 4TheChild is a five-year (2021–2026) U.S. State Department–funded initiative implemented by Moi University College of Health Sciences through the Academic Model Providing Access to Healthcare (AMPATH) Kenya.

Its Kiswahili name—Tuungane Tulinde Tuwekeze Tuboreshe Afya na Elimu ya Mtoto—means “coming together to protect, invest in, and improve the health and education of the child.” The project works closely with national and county governments, sub-recipients, and other partners.