By: June Musau, Wendy Wakhusama
“The greatest asset of a company is its people.”- Jorge Paulo Lemann (Co-founder, Banco Garantia)
With the incoming of new county leadership and building on the existing goodwill of the former government to strengthen an integrated community health service, the County government of Nairobi has huge commitments and strides towards a community health service that is functional and sustainable while remaining a critical component in advancing Universal Health Coverage. Key to note is the commitment to allocating funds for a Community Health Volunteer (CHV) stipend for 7460 CHVs The County community health services has 7460 community health volunteers spread across 17 sub-counties and providing services to 60% of the Nairobi residents who reside in the informal settlements where access of the most needed health services remains a challenge.
The County is among the few with an existing legal framework that guides the coordination and management of the community health workforce. This framework, among others, allows for the planning and budgeting of community health volunteers’ stipends. With a new leadership team in place following the elections in August 2022, there are commitments made towards ensuring the allocation of resources for the CHV stipend. In addition, the recently disseminated Health Reforms Taskforce Report (Jan 2023) and the Health Wellness and Nutrition Sector County Integrated Development Plan 2023-2027 have given prominence to community health services providing recommendations for improvement. Key recommendations for scaling up access to integrated community health services include:
- Translating the Community Health Services Act 2019 into action/practice
- Fully equipping all the existing community health units according to the CHS policy guideline on kits and tools
- Operationalizing the CHV stipend and paying outstanding stipends
- Strengthen the CHUs to fully function in line with the level of scope and service package
- Increase the number of community health assistants, ultimately affecting the CHV supervision and quality of services provided
- Strengthen the community health referral system by enhancing the existing accountability mechanisms, linkages, and outreach services
- Expand community health coverage through the establishment of the additional required CHUs
The Financing Alliance for Health, in collaboration with the Health Wellness and Nutrition Sector, has been at the forefront of championing transformative community health services through working with the community health services to develop a five-year costed implementation plan. In February 2023, the FAH and the sub-national community health coordinators validated the costing of the plan. This session highlighted key cost-driver considerations based on health financing and overall county financing governance reforms. In addition, the team identified indicators, intervention areas, and data needs for use in the development of the county community health investment case. In focus during the first quarter and going into the second quarter is to continue collaborating with the county in exploring financial options and solutions for integrated community health systems.
Article written by: June Musau – Country Engagement and Support Coordinator