The total population of Lurambi is 113,425 persons. The primary target group for the intervention was men and women of the sexually active 15–49 age group. However, people younger than 15 years or older than 49 years were not denied services.

Vestergaard Frandsen conceptualized the IPD and was the program sponsor. The Kenya Ministry of Health and CHF International were the campaign implementers.

Evaluation of this campaign will provide valuable information on the feasibility and scalability of integrated public health campaigns targeting HIV, malaria and diarrhoea together and will guide the design of similar integrated campaigns in future. The evaluation will provide objective evidence to be used for advocacy for an integrated disease campaign approach.

Testing was confidential, and counselling was one-on-one. Every effort was made to ensure that testing was private, anonymous and confidential. All data recorded during VCT and commodity distribution was kept anonymous and participants were identified by a unique identification code. This number was not linked to any record of the subject's name or to any other details that would allow them to be identified as individuals.

HIV prevalence is estimated at approximately 10%. Malaria is the most frequent cause of outpatient attendance, accounting for 46% of the total outpatient workload. Diarrhoea is the 4th most important cause of outpatient morbidity accounting for 5% of total outpatient attendance. The morbidity pattern for Lurambi division reflects that of the entire district.

A distribution campaign that addresses all three diseases can reach very large numbers of people very quickly and economically. Until now, there has not been an integrated distribution that targets adults, especially adult males. Low rates of VCT may be offset by providing the encouragement of a lifesaving CarePack™ in return for HIV testing. Bed nets have a very real perceived value among people living in regions where malaria is a serious problem. And there are very few donor funds for water in spite of diarrhoeal disease being a leading cause of mortality among people living with HIV/AIDS. We believe these obstacles can be, at least partially, overcome by encouraging people to take an HIV test through the free distribution of valuable health products.

Malaria and diarrhoeal diseases are a major cause of morbidity and mortality in Kenya, and are of particular concern amongst HIV positive individuals. Addressing these three diseases together through mass HIV counselling and testing, and promoting the use of PermaNet® long-lasting insecticide-treated bed nets (LLINs), LifeStraw® water purifiers, condoms and educational materials, has the potential to reduce episodes of malaria, diarrhoea and sexually-transmitted diseases. Ultimately, this may also delay disease progression in HIV positive individuals residing in areas where both malaria and diarrhoea are endemic. By delaying the progression of HIV disease and the need for ART, these interventions can potentially result in cost savings for health programs in Kenya and beyond.

The benefits of knowing one’s HIV status are well established. It provides an entry point for HIV positive individuals to access antiretroviral treatment (ART). ART has dramatically improved the quality and duration of life for many Kenyans living with HIV, and may also reduce the risk of transmission by decreasing viral load. HCT affords people tested the opportunity to access other HIV/AIDS prevention, care and treatment services. For the majority of Kenyans who are not infected, HCT is a first step towards risk reduction, linking clients with prevention services.

The IPD campaign aimed at contributing towards the Kenyan national scale-up plan for voluntary HIV counselling and testing (VCT) that aims to test 80% of Kenya’s adult population by 2010. Using this approach, Vestergaard Frandsen wanted to break down the policy and funding barriers that have traditionally separated these diseases, and create a more efficient and affordable way to address them.

Through the IPD, Vestergaard Frandsen also wanted to create a scalable and replicable approach, which could rapidly contribute to the United Nations Millennium Development Goals by reducing the incidence of malaria, diarrhoea and HIV.