By: Mark Mwenda
Community health volunteers (CHVs) are an essential part of Kenya’s health system. They are responsible for providing primary health care services, health promotion, and disease prevention in communities across the country. Despite their importance, CHVs are not paid by the government, making it difficult for them to sustain their lives while also contributing effectively to the health sector. In this article, we will explore the story of Paul Karitu and his colleagues, who are CHVs operating in the Malaba Community Health Unit, Kiambu County, Juja Sub-County, Witeithie Ward.
The Malaba Community Health Unit serves a peri-urban location that is densely populated by middle-income households. Despite the area’s high population density, there is a significant shortage of waste disposal and drainage systems. As a result, residents often direct waste waters and garbage into open trenches on the road, leading to health and environmental problems. In 2019, Paul Karitu and his colleagues identified this challenge and took the initiative to address it through their business, the Witeithie Garbage Collector.
The Witeithie Garbage Collector is a garbage collection business that operates in households within the Malaba Community Health Unit. CHVs collect garbage every Monday and charge KSHs 50 ($ .39 cents) per month from each household. The business provides a supplemental source of income for CHVs while also promoting the health and hygiene of community members. The Witeithie Garbage Collector has been successful in reducing the amount of waste materials in the area. As a result, sanitation and hygiene have improved while the risk of disease outbreaks has been reduced.
Despite its success, the Witeithie Garbage Collector business faces challenges. One significant obstacle is the lack of a waste disposal culture among residents. Many households fail to pay their monthly subscriptions despite the work done by CHVs. Additionally, some households do not separate their waste materials, making it harder for CHVs to dispose of the garbage efficiently. These challenges highlight the need for community engagement and education to promote waste disposal practices and culture.
The Malaba Community Health Unit’s garbage collection business is an excellent example of how CHVs can contribute to the health sector while also generating income. However, it is not a long-term solution to the problem of unpaid CHVs. On average, CHVs work approximately 21 hours a week in their CHV roles, but they also dedicate at least 15 hours a week to the garbage collection business they have initiated in order to make a living. They face the daunting task of balancing their roles as health workers and business operators. On top of their CHV duties, which require their time and effort, they have to engage in the operations and manage logistics of the garbage collection business to ensure its viability. This dual role puts a strain on their capacity to fully focus on their health-related responsibilities, potentially compromising the quality of care they can provide to the community.
CHVs require support and resources to provide high-quality health services to communities. The government should recognize the critical role CHVs play in the health sector and prioritize their compensation. Paying CHVs a sustainable salary will motivate and empower them to contribute fully to the health sector. It will also attract more individuals to become CHVs, increasing the number of primary health care providers in the country.
The story of Paul Karitu and his colleagues in the Malaba Community Health Unit highlights the essential role of CHVs in the health sector. Their garbage collection business is a creative solution to the waste disposal problem in their community. However, it is not a sustainable solution to the problem of unpaid CHVs in Kenya and it underscores the lengths CHVs need to go to make ends meet. The government should recognize and compensate CHVs adequately to ensure the provision of high-quality health services and achieve universal health coverage. It is time for all health stakeholders in Kenya and the world to join hands and advocate for the rights of CHVs.
