By: Dennis Munguti, Wendy Wakhusama
Community health workers (CHWs) will play a critical role in the success of Kenya’s primary health care (PHC) approach. PHC is a comprehensive and integrated approach to health care that aims to provide accessible, affordable, and quality health services to individuals and communities. CHWs will be key to the approach’s success as they bridge the health system and communities, ensuring that health services reach those who need them most.
In 2019, the government of Kenya launched the Primary Health Care Strategic Framework 2019-2024, which aims to provide access to quality and affordable healthcare services for all Kenyans. The framework emphasizes the importance of primary health care services, health promotion, disease prevention, and strengthening the overarching health systems.[1] Community health workers (CHWs) are critical to the framework’s implementation. They link communities and health facilities, providing a range of health services, including health education, promotion, and prevention, and identifying and referring health problems to appropriate primary healthcare facilities.
In Kenya, CHWs are trained to provide a range of health services, including prenatal care, immunization, nutrition education, and treatment of common illnesses. They work closely with communities to identify health needs, provide health education and information, and refer individuals to health facilities for more specialized care when necessary. CHWs also play a crucial role in monitoring their communities’ health and reporting any disease outbreaks to the relevant health authorities. One of the main advantages of CHWs is that they are members of the communities they serve and are, therefore, familiar with the culture, values, and beliefs of the people in their communities. This knowledge enables them to build trust with communities and provide culturally appropriate services. In addition, CHWs can reach remote and underserved areas where formal health services may not be available, making them an essential component of the PHC approach.
Despite the significant contributions of CHWs to the PHC approach in Kenya, they face several challenges, including a lack of resources, limited recognition, and limited opportunities for professional development. One of the main challenges that CHWs face is inadequate resources. CHWs often work in resource-limited settings, with insufficient supplies and equipment to provide quality health services. This can make it difficult for them to perform their duties effectively, leading to frustration and burnout.
Another challenge that CHWs face is limited recognition and support. CHWs are often not recognized as formal health workers, and their contributions are not always appreciated or compensated adequately. This can affect their morale and motivation to perform their duties, leading to high attrition and turnover rates. A third challenge that CHWs face is limited opportunities for professional development. CHWs may lack opportunities for training and continuing education, which can limit their ability to keep up with new developments in health care. This can also limit their ability to provide high-quality health services to their communities.
Finally, inadequate supervision and support can be a significant challenge for CHWs. CHWs may lack adequate supervision and support from the health system, affecting their ability to perform their duties effectively and safely. Addressing these challenges will require investment in the training, recognition, and support of CHWs, as well as addressing broader health systems challenges such as resource constraints and weak health infrastructure. By supporting and empowering CHWs, the health system in Kenya can improve the delivery of primary healthcare services and achieve better health outcomes for the population.
Studies have shown that the involvement of CHWs in healthcare delivery can significantly improve health outcomes. A study by the World Health Organization (WHO) found that CHWs can play a critical role in increasing access to and utilization of health services, particularly in rural areas where there is a shortage of health workers.[2] The study also highlighted the importance of community involvement in the selection, training, and supervision of CHWs, which can help to ensure their effectiveness and sustainability.
In addition, a review of the literature on the role of CHWs in PHC in sub-Saharan Africa found that CHWs can improve health outcomes through various mechanisms, including increasing access to health services, improving health education, and strengthening health systems.[3] The authors also emphasized the importance of adequate funding, training, and supervision of CHWs to maximize their effectiveness and impact.
Another study conducted in Nairobi, Kenya, found that CHWs effectively increased knowledge of health issues and improved community health behaviors, including maternal and child health practices.[4] The study concluded that CHWs are an essential resource for communities and can help to reduce health disparities and improve health outcomes.
These studies provide further evidence of the important role that CHWs play in the success of the PHC approach in Kenya and the need for continued investment in their training, support, and recognition. CHWs have, and will continue to play a vital role in the success of the PHC approach in Kenya by providing health services and education to communities, particularly in remote and underserved areas. With adequate support, CHWs can help improve health outcomes and contribute to the overall health and well-being of all Kenyans.
Article by: Dennis Munguti – Country and Engagement and Health Financing Manager
References
[1] Ministry of Health. Kenya Primary Health Care Strategic Framework 2019-2024. Nairobi, Kenya: Ministry of Health Kenya; 2019.
[2] WHO. (2010). Community health workers: what do we know about them? A systematic review of the literature from 1990–2007. World Health Organization.
[3] Nkhoma, M., Muthuri, S., Mwaura, J., & Røttingen, J. A. (2017). The role of community health workers in primary health care in sub-Saharan Africa: a systematic review. Human resources for health, 15(1), 100.
[4] Wang, M. L., Smeeton, N. C., Maitland, K., & Clarke, A. E. (2011). Community health workers’ role in maternal and child health in Nairobi slums: a qualitative study. Human resources for health, 9(1), 14.
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