Lea Toto Community Outreach Program

Lea Toto Community Outreach is a home-based care program in Nairobi’s informal settlements to improve the quality of life of those living with and affected by HIV/AIDS. Lea Toto provides medical attention, prevention education, counseling, and self-help skills.

Lea Toto, Swahili for “to raise the child”, is a community-based outreach program providing services to HIV+ children and their families in the Kangemi, Kawangware, Dagoretti, Mukuru, Dandora, Zimmerman, Kibera, and Kariobangi communities of Nairobi, Kenya.

Lea Toto was envisioned as a home-based, community-focused program from Nyumbani's very beginning and was officially launched in 1998. Initially based out of an office at the Children’s Home, Lea Toto workers established a support program through which HIV+ children could remain with their caregivers in their communities. In 1999, with funding from USAID, Lea Toto became a full community-based care program charged to carry out a project targeting HIV+ children in the Kangemi informal settlements of Nairobi.

The Lea Toto project uses the Home Based Care (HBC) model.  All HBC programs have one goal in common - "improvement of the quality of life of those affected through a package of comprehensive care for the client and her/his family". This package usually includes:

  • Basic medical and nursing care
  • Counseling and psychological support
  • Spiritual guidance
  • Relief for social needs
  • HIV transmission prevention education
  • Promotion of community empowerment/ownership
  • Self-help

Experience has shown that Home Based Care and counseling enables clients to live more positively and saves money that would otherwise be spent on hospital care.  In this sense HBC is cost-effective, leading to reduced in-patient hospital stays and a reduced cost per beneficiary.

Other Program Services

  • VCT (Voluntary Counseling & Testing)
  • Clinical Care for home bound clients
  • ART (anti-retroviral treatment) (since 2005)
  • Permanency planning
  • Training of Caregivers
  • Nutritional Support
  • Business development training/Income generation activities
  • Micro-credit services to caregivers.

Program Goal
Mitigate the impact of HIV/AIDS and decrease the risk of transmission through the provision of comprehensive home-based community care.


  • To facilitate the provision of high quality clinical, nursing care, counseling and testing to 11,000 infected and 48,000 other family members ever reached by 2015.
  • To facilitate provision of food to food insecure households and clinical malnutrition treatment for 3000 HIV+ or exposed children and other OVC by 2015.
  • To provide Social Support to at least 70% HIV infected children and their families and ehance the existing capacity of local communities by 2015.
  • To provide Pyschosocial Suppose (PSS) to HIV and AIDS infected and affected children (enrolled) and their households by 2015.
  • To enhance the organizational capacity of 108 staff to design, monitor and coordinate quality care services for HIV infected children and their households.
  • To enhance the capacity of COGRI-Lea Toto program to engage in sustainable activities for continued care for HIV infected children and their households by 2015.

Program Challenges

  • Poverty among the people served. Priority is given to basic needs: food & housing. 
  • Social Hindrances: illiteracy, relocation, change of the caregiver.
  • Cultural/Religious factors: beliefs, stereotypes and misinformation about ART, the program is as equally stigmatized as the disease.
  • Disclosing the HIV status to the growing children.
  • Client inaccessibility due to security reasons.
  • Possibility of accessing treatment from more than one ART provider.