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Evaluating the Integration of Legal Support and Health Care in Kenya: Findings from the Second Phase of the Evaluation

By: Harvard School of Public Health

This is a report prepared by the Program on International Health and Human Rights, Harvard School of Public Health.

The Open Society Institute Law and Health Initiative (LAHI) has supported the integration of legal and paralegal services into health care in Kenya since 2006 including post-rape care, health services addressing violence against women, as well as general HIV/AIDS clinical care. For socially marginalized groups, access to legal services is not only a right but can improve health outcomes by addressing human rights violations underlying poor health. Four non-governmental organizations (NGOs) have been integrating legal aid into health services: CARE-Kenya, the Legal Aid Centre of Eldoret (LACE), the Christian Health Association of Kenya (CHAK), and the Coalition on Violence Against Women (COVAW). With support from LAHI, these NGOs have been able to bring together legal and health providers to implement integrated programs that support the health and human rights of socially marginalized groups. A detailed summary of the NGOs and their legal integration efforts can be found in Annex I.

In Kenya, people living with HIV/AIDS (PLHA), and women and children more generally, face human rights violations that undermine their health and quality of life and limit their access to legal services. As simply one example, a 2008 report by the Institute of Development Studies points out the high prevalence of gender-based violence in Kenya, with 50 percent of women in Nairobi having experienced some form of violence since the age of fifteen. Despite the enormity of the problem, the report goes on to emphasize that the availability of and funding for violence rehabilitation, mechanisms for justice, and appropriate medical care remain very limited despite a high demand for such services highlights that while human rights abuses including sexual violence, stigma and discrimination fuel the epidemic especially among socially marginalized groups, access to affordable legal services is extremely limited.  Barriers include lack of information, limited faith in the justice system, economic constraints, and corruption.

The assessment goes on to recommend several interrelated approaches for strengthening access to legal services including: the incorporation of legal and human rights advocacy into existing HIV/AIDS services; educating people about their rights; supporting informal and traditional health and legal service providers.