This study looked at the effectiveness of CHW projects in rural Kenya that aimed to promote better maternal newborn health knowledge and to increase deliveries under skilled attendance. Some pieces of information that were examined included: relevant demographic items, knowledge about maternal and newborn health, and whether a retrospective birth history of women’s children using oral interviews of women were subject to CHW health delivery messages.
Community health workers (CHWs) are used increasingly in the world to address shortages of health workers and the lack of a pervasive national health system. However, while their role is often described at a policy level, it is not clear how these ideals are instantiated in practice, how best to support this work, or how the work is interpreted by local actors. CHWs are often spoken about or spoken for, but there is little evidence of CHWs’ own characterisation of their practice, which raises questions for global health advocates regarding power and participation in CHW programmes.
Background: Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change.
Kenya’s third largest city, Kisumu, serves as a trading and transportation hub for west- ern Kenya and bears the dubious distinction of having Kenya’s worst set of health indicators and one of the nation’s highest poverty levels.
Volunteer community health workers (CHWs) form an important element of many health systems, and in
Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case
identification, and timely referral to trained health care providers. This study examines the effectiveness of a community
health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health
and to increase deliveries under skilled attendance.
Community engagement is increasingly emphasized in biomedical research, as a right in itself, and to strengthen ethical practice. We draw on interviews and observations to consider the practical and ethical implications of involving Community Health Workers (CHWs) as part of a community engagement strategy for a vaccine trial on the Kenyan Coast. CHWs were initially engaged as an important network to be informed about the trial.
This study aims to determine whether results from an evaluation that involved observation of community health workers while they performed patient consultations in a hospital reflected normal everyday practices. We found that community health workers made treatment errors less frequently when they were observed in a hospital in-patient or outpatient department than when they were not observed in the community. Evaluations that involve the observation of community health workers in a hospital setting might overestimate the quality of care that they normally give in their villages.
This report summarizes the CHW evaluations conducted in 1998, 1999 and 2001. It also characterizes community health worker (CHW) performance using an algorithm for managing common childhood illnesses in Siaya District, Kenya. Results showed deficiencies were found in the management of sick children by CHWs, although care was not consistently poor. Key reasons for the deficiencies appear to be guideline complexity and inadequate clinical supervision; other possible causes are discussed.
The COPHIA program emphasizes the provision of home-based care and support services by multi-purpose community-based health workers to vulnerable households coping with the burden of caring for seriously ill family members or orphans and vulnerable children. The COPHIA community-based health workers, with the support of clinical and non-clinical supervisors, provide the direct physical and emotional care and support services to people living with HIV/AIDS (PLWHA) and orphans and vulnerable children in the project catchment area.
In rural areas of Kenya, where the majority of the population lives, contraceptive use remains low compared with that in urban areas (37% vs. 47%). Inadequate access to family planning services in rural areas is partly due to fewer health facilities and the shortage of health care workers. Community-based access to injectable contraceptives can improve access for rural populations and expand the range of contraceptive methods available.