Focus Areas

OSIEA and OSI's Public Health Program partner to promote a rights based approach to public health in East Africa. The Public Health Program works with civil society organizations to promote the participation and interests of socially marginalized groups in public health policy and foster greater government accountability and transparency through civil society monitoring and advocacy.

The Law and Health Initiative (LAHI) aims to foster collaboration among legal, human rights, medical, and public health practitioners to promote the use of legal remedies as a creative tool to advance public health. By bringing together legal rights and public health, the LAHI works to integrate legal and paralegal services into health provision; to support human rights responses to HIV/AIDS; to promote human rights in patient care; and to develop civil society work around law and health.

The Sexual Health and Rights Project (SHARP) works to improve the health and advance the rights of those stigmatized because of their sexual practices, real or perceived sexual orientation, and gender identity.

The following are some examples of recent Health and Rights activities:

Making Legal Services Part of HIV/AIDs Response

OSIEA and LAHI are working to assist health advocates to integrate legal services into HIV/AIDS programs. Increased HIV prevention and treatment programs are giving hope to millions of people living with AIDS in East Africa. But what if a person is evicted from her home for being HIV-positive, or unlawfully stripped of her property on the death of her spouse? What if a child born to HIV-positive parents is kicked out of school? Criminalization of sex workers, men who have sex with men, and people who use drugs contribute to high levels of police harassment and violence, driving these vulnerable groups away from much-needed HIV services. Women and girls are often subjected to domestic violence or sexual exploitation that raises their risk of HIV infection. People whose rights are violated face slow and corrupt courts, expensive legal fees, and traditional authorities often unaware of or unwilling to apply the law. With OSIEA/LAHI assistance, ten hospitals in Kenya now integrate legal services into their HIV treatment. Additionally, legal assistance programs are being introduced into post rape care centers and domestic violence programs in Kenya and Uganda. We are also fostering discussions around hotly contested issues, such as the criminalization of HIV transmission and model AIDs laws that are being enacted in Africa.

Improving Access to Health and Rights for Sex Workers

In 2008, Akina Mama wa Afrika, OSIEA, SHARP and LAHI brought together 35 activists and experts to address the health risks and abuses faced by sex workers in the region. In East Africa, sex workers encounter high levels of physical violence, including rape, and are also subject to extortion and demands for bribes and sexual favors from police and clients. Government agencies regularly refuse to help sex workers who have been abused or whose rights have been violated. These abuses, coupled with discrimination from society in general, frequently force sex workers into hiding, effectively blocking their access to the most basic health, justice, and social care services. The objective of the meeting was to discuss the difficult environment sex workers face in East Africa, and to share information regarding access to rights and safety. Such discussions are critical to reduce risk for HIV and other sexually transmitted diseases and to improve overall health and wellbeing.

Ensuring Sex Workers Are Not Denied HIV and Reproductive Health Services

The Bar Hostess Empowerment and Support Programme (BHESP), an organization for and by sex workers and women working in bars, promotes HIV services and human rights awareness for sex workers. Sex workers are at high risk for HIV transmission, but lack access to quality, affordable health services and often face discrimination and judgmental treatment from healthcare workers. With support from OSI's Public Health Watch, BHESP is carrying out community based monitoring in Nairobi, Mlolongo, and Thika to document barriers to access to HIV and reproductive health services through interviews and focus group discussions with sex workers, healthcare workers, police, and other stakeholders. BHESP will use the results of this monitoring effort to advocate for improved access to HIV and reproductive health services for sex workers.

Promoting the Rights of Sexual Minorities

Working on the premise that all persons should enjoy their human rights without distinction or discrimination, OSIEA/SHARP provided support to a regional human rights convening of gay rights groups, mainstream rights organizations and donors. Hosted by the Kenya Human Rights Commission (KHRC) and the Gay and Lesbian Coalition of Kenya (GALCK), the meeting discussed ways in which lesbian, gay bisexual, transgender and intersex (LGBTI) related rights could be better recognized within the mainstream human rights discourse. The convening provided a forum for participants to reflect and share experiences and strategies on how human rights groups, donors, intermediary organizations and individual activists can work towards the protection, promotion and mainstreaming of LGBTI rights.

Leveraging Resources from the Global Fund to Fight AIDS for Women and Girls

In East Africa, women now account for almost 60% of people living with HIV and AIDS. Yet few of the grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria contain components that are aimed at meeting the specific needs of HIV-affected women and girls. As the Kenyan government prepared its round 8 proposal to the Global Fund, OSIEA and the Public Health Program supported two coalitions of women's rights and HIV/AIDS organizations to ensure a focus on women and girls' needs for comprehensive HIV prevention, treatment, care and support. The coalitions have received training to strengthen their knowledge of the Global Fund, proposal development processes, and evidence-informed interventions for women and girls as well as support for their proposal development and advocacy activities.