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AMPATH originally started with a purely educational partnership between Indiana University Medical School (IUMS) and Moi University, with the purpose of developing a collaborative relationship between the two universities. Following this, a number of other North American universities joined the effort, forming the America/Sub Saharan Africa Network for Training and Education in Medicine (ASANTE) Consortium. This consortium currently includes Indiana University School of Medicine, Brown Medical School, Duke University School of Medicine, Lehigh Valley Hospital and Health Network, Providence Portland Medical Center, the University of Utah School of Medicine, and the University of Toronto Faculty of Medicine.

AMPATH is an academic medical partnership in its response to the HIV/AIDS pandemic in sub-Saharan Africa

the tri-partite mission of care, training and research, three components which are all essential for successfully addressing the short and long-term challenges of global health. Training (nearly 1,000 Kenyan and American medical students have participated in the program and thousands of Kenyan health care providers have been trained by AMPATH) and research (AMPATH researchers have published over 160 articles and attracted over $59 million in cumulative funding for AMPATH-related research projects from NIH, Gates Foundation, and other sources) are critical components of that effort, and we are dedicated to leading with care.

For many patients, anti-retroviral drugs alone are not enough for full recovery, because of malnutrition and food insecurity. Therefore AMPATH made the effort to ensure the full health and prosperity of its patients by setting up food support, agricultural, and nutrition programs. In conjunction with the World Food Program (WFP) and United States Agency for International Development, AMPATH established high-production farms in order to advance local self-sustainability in addition to mere food distribution.

AMPATH uses an comprehensive electronic system designed by the School of Industrial Engineering at Purdue University called Nutritional Information System (NIS) to record, organize, and assist effective food distribution.

The WFP/AMPATH partnership began in 2005, and currently has distributed more than 250 metric tons of food, feeding over 30,000 people and 7,000 households per day. Each patient receives 6 kgs of maize, 1.8 kgs of pulses, and 0.45 kgs of vegetable oil per month. AMPATH feeds all of its nutrition-deficient patients (including those with tuberculosis and cancer), orphans, and HIV+ prisoners (who meet certain eligibility criteria of having a BMI less than 18.5) ^[1]

Dry foods like maize, beans, lentils, palm oil, RUTF, and fortified corn-soy blend are provided by the WFP and USAID, and fresh vegetables are provided by AMPATH-run production and training farms. ^[2]

AMPATH manages 4 high-production farms and 2 teaching model farms, which produce approximately 6 tons of vegetables per week, with capacity to produce 11 tons/week. With a continuous source of water, these farms are able to produce a reliable, year-round supply of fresh vegetables.

AMPATH has in the last year started a new approach of production which can be termed "client feed client," or "Kenyans feeding Kenyans." It goes by several other names such as "P4P Plus" or "Ampath E-Voucher Vegetable Production." This model builds on the knowledge gained from the conventional farming system in the AMPATH-run farms. Patients are given a chance to produce vegetables on contract. The farms are distributed around a clinic catchment in such a way that there is minimal travel to collect products. Clients are given monthly prescriptions and just walk-in to the nearest site and collect whatever they need at any time, as frequently as is convenient but without surpassing prescribed amount. Total value collected from the farmer is paid electronically at the end of each month. This has many advantages: economic empowerment of clients, frequency of collection ensures freshness, reduced cost of collection, cuts down on logistic cost to AMPATH of hauling produce from centrally located farms, encourages weaning-off since the contracted farmers have to be off the feeding program, appropriate choice of varieties for each locality, wider transfer of skills/technology.

Nutrition assessment, education and counseling. Providing therapeutic feeding for the severely malnourished. This is a community therapeutic feeding program (CTF) where the severely malnourished are identified through the clinic and they are prescribed a ready-to-use therapeutic food (RUTF) to take home and are followed up weekly at the clinic until they are stable. Providing supplementary feeding for the moderately malnourished and the vulnerable groups. The vulnerable groups include pregnant women, lactating mothers, patients co-infected with TB and HIV, and orphans and vulnerable children (OVC). This is aimed at correcting mild and moderate malnutrition. Food support for the food insecure households - especially those of malnourished clients and orphans and vulnerable children (OVC). The food is from World Food Programme and AMPATH's production farms. A weaning process for the clients enrolled on food. Currently feeding up to 31,000 individuals (index clients and their households).

Orphans And Vulnerable Children Program (OVC) The Sally Test Pædiatric Centre

AMPATH has established a number of partnerships to improve the clinical and public health services in Kenya with members of its partnering AMPATH consortium of universities in North America. These partnerships and programs are focused on different areas of health, including but not limited to: dentistry, emergency medicine, orthopedics, surgery, anesthesia, radiology, medicine, family medicine, and palliative care. Many of these programs are focused on training, but AMPATH has also been forming centers such as the Drug Information Centre (DIC). ^[3]

HCT workers enroll every individual in each community and register them in a database. In addition to testing for HIV, they also screen for tuberculosis and other chronic diseases such as diabetes and hypertension, treat children for intestinal worms, deliver treated bed nets to prevent malaria, and provide nutritional counseling. It costs $1.50 per person to provide all of the services that are covered with HCT, except for the cost of the treated bed nets.

Imani Workshops is a handmade crafts business that reinvests 100% of its income to benefit its employees, all of whom are HIV+ AMPATH patients in Western Kenya. During and even after recovery, many AMPATH patients struggle with financial security and independence, made even more difficult by the social stigma associated with HIV+ individuals. Formed in January 2005, Imani Workshops is a part of The Family Preservation Initiative, aiming to give their AMPATH patients, focusing on women, income-generating opportunities in order to be self sustainable and support their families. Imani Workshops creates workshops with jobs for these women to produce high quality handmade jewelry, accessories, clothing, bags, and other accessories. Currently there are 30 full-time employees and around 220 part-time employees working as a part of Imani Workshops.^[4]

The Kenya Value Initiative Program (VIP) works to increase incomes for microenterprise owners and workers in underserved, conflict-affected, and HIV/AIDS-impacted areas of the Western and Rift Valley provinces of Kenya, primarily through refining the passion fruit value chain. The poor of the AMPATH clients and their communities were targeted for incorporation into the value chain development interventions. AMPATH experience has shown that clients within this target are generally female, with children, minimal education and without a stable source of income. They have lost their social support, source of income (whether farm or business) and health, along with hope. As one of the final steps in implementation of the Value Initiative Program, AMPATH has developed a web-based publication that shares VIP's experiences and highlights learning points on: how to effectively reach vulnerable populations, and how to include them in value chain development approaches as well as the business service market.

AMPATH has partnered with the Kenyan government to provide improved access to primary healthcare to all children and extensive medical care to over 22,000 HIV-infected or exposed children. The program targets those children who have been infected or exposed to HIV from HIV-infected mothers, and offers HIV testing, antiretroviral medicines, preventative medicines, nutritional support, disclosure counseling, and adolescent support groups in 55 different locations in Western Kenya.

Formed in 2007 between the University of Toronto, Duke University, and Indiana University, the AMPATH Reproductive Health program aims to improve reproductive health in Western Kenya through the ALARM international program and the AMPATH Cervical Cancer Screening and Treatment Program.

The ALARM (Advances in Labor and Risk Management) international training program is a five-day training program mainly targetting health professionals designed by the Society of Obstetricians and Gynaecologists of Canada. The main purpose of the program is to help reduce death and injury caused by pregnancy, childbirth and unsafe abortion.The program emphasizes discussion of sexual and reproductive rights as well as hands-on practice of clinical procedures. ^[5]

The Cervical Cancer Screening Program (CCSP) began in 2008, aiming to ultimately reduce the amount of cervical cancer in Kenya. Since then, over 1,100 women have been screened, 80 have gone through curative treatment for cervical dysplasia (LEEP), and 19 have had hysterectomies performed on them. ^[6]

Riley Mother and Baby Hospital (RMBHK), the vision of Dr. James A. Lemons of Indiana University School of Medicine, opened April 29, 2009 in Eldoret, Kenya, and is part of the Moi Teaching and Referral Hospital. RMBHK is focused on providing family-oriented services for pregnant mothers as well as their babies through education, training and research. The hospital accomodates 12,000 deliveries a year, serves as the teaching hospital for nearly one-third of all doctors in Kenya, and includes the first and only neonatal intensive care unit in East Africa. ^[7]

AMPATH will deliver comprehensive primary healthcare to a target population of 500,000 people through 5 innovation sites. The project will emphasize delivery of an essential health care package at the community, dispensary, and health centres

AMPATH has started to transition its HIV clinics into more comprehensive clinics that address many other chronic diseases, including a diabetes program, an oncology center, and cardiovascular and pulmonary care. ^[8]

The AMPATH Research Network was founded in 1998, overseeing research projects aimed to improve the health and health care systems of Kenya. Over 170 publications have resulted from these collaborations between more than the 19 universities have taken part in the research program, which include Brown, Yale, Columbia, UCSF, Duke, Purdue, Stanford, NYU, and University of Toronto. The program has received over $67 million in direct costs in research grants ^[9]

There are currently over 60 AMPATH urban and rural clinic sites. This map shows some of the various sites across the country and the details of the involvement and work.