SEEP’s Value Initiative Program in Kenya (VIP Kenya) supported AMPATH , a holistic healthcare provider with a strong focus on HIV-positive persons in Kenya’s Westerns and Rift Valley provinces, to create increased income opportunities for HIV/AIDS affected vulnerable households. The overarching goal of this demonstration project focused on facilitating interventions to address market constraints along the passion fruit value chain in this area, but the specific focus of this case study is about AMPATH ’s economic strengthening approach with its most vulnerable, food insecure HIV+ patients. These are only a segment of the overall target group reached by VIP Kenya, and consist of predominantly single mothers, with minimal education, without social support, and without sufficient income to meet minimum nutrition requirements. At the time of the program, AMPATH was already supporting these households through healthcare, psychosocial support groups, access to legal counsel and other related services. In addition, these highly food insecure households receive a monthly food prescription from AMPATH.

To prepare them for a life without dependence on routine food support and taking into account their lack of viable income opportunities, the program envisioned a strategy of first increasing their (cash and food) income to meet daily survival needs, and once more secure, to help them integrate into more profitable and growing value chains, especially passion fruit growing and processing.

While some urban households received training and inputs to generate income from micro-processing of fruit or vegetables into salads and/or juice, the majority living in rural and peri-urban areas started out by growing African leafy vegetables (ALVs) on a small-scale. Given VIP Kenya’s wider efforts on strengthening the passion fruit value chain in Western Kenya, there was much interest in trying to link many of the most vulnerable households into that value chain eventually as well.

AMPATH ’s Family Preservation Initiative (FPI) was established in 2003 as an income generation program in close coordination with AMPATH ’s social and healthcare assistance services. The goal of the FPI is to provide avenues for poor HIV infected and affected households to achieve sustainable economic security, by increasing their skills, knowledge, productivity and overall quality of life. But until the start of VIP Kenya, FPI’s ability to provide income opportunities was limited to employing patients in a number of social enterprises including a handicraft workshop, a restaurant, a fruit processing facility and a fruit tree seedling nursery.

While the overall VIP Kenya projected targeted more than 7,000 HIV/AIDS affected households for participating in expanding the passion fruit value chain, an additional 1,066 very vulnerable AMPATH clients participated in a carefully sequenced approach intended to help them transition from food aid dependency to increased economic self-reliance. This sequenced graduation model starts from AMPATH ’s already existing health and food assistance to participation in community savings groups, and introduction of easy-to-grow, nutritious crops such as African leafy vegetables (ALV), and ultimately moving towards higher-value income activities such as passion fruit, livestock and other activities.