By: Rose Njiraini and Salim Hussein
Kenya’s Community Health Strategy aims to provide basic prevention and care services. Community Health Volunteers (CHVs) make home visits and deliver health promotion messages, treat common ailments and illnesses, and establish protocols for Community-Based Maternal and Newborn Health, among others. CHVs are supervised by Community Health Extension Workers (CHEWs) and operate within Community Health Units encompassing about 5,000 Kenyan citizens. The areas that have an active community health program have demonstrated improvements in antenatal care visits, testing and treatment for diseases like HIV and malaria, and child immunizations.
Background
The Kenyan Community Health Strategy was launched in 2006 as a means of delivering basic health prevention and promotion services. A new Community Health Policy is expected to be released in 2020.
Implementation
Kenya’s community-based health workers are called Community Health Volunteers (CHVs). CHVs deliver services in a defined geographical area location called a Community Health Unit. These Community Health Units are composed of approximately 5,000 people (or 1,000 households) and are served by approximately 10 CHVs. CHVs are supervised by Community Health Extension Workers (CHEWs), who are government employees mandated to provide health services at the household and community levels and make referrals and linkages to health facilities. As of end of 2019, Kenya had approximately 6,000 Community Health Units out of an expected 10,000. These Community Health Units are supported by 86,000 CHVs. CHVs are supported by 1,569 Community Health Extension Workers (CHEWs).
Roles/responsibilities
The main duties of CHVs are to (1) make visit homes, initiate dialogue with household members, determine the health situation, deliver key health messages, and undertake necessary actions; (2) guide the community on health improvement and disease prevention; (3) register households at frequencies stipulated in current guidelines; (4) treat common ailments and minor injuries; and (5) with support and guidance from CHEWs, implement protocols for Community-Based Maternal and Newborn Health and Integrated Community Case Management of Childhood Illness.
Training
Trainings for CHVs are based on a curriculum with 13 modules. The full curriculum takes approximately three months and consists of 324 facilitator-led contact hours in a classroom setting and 160 hours of practical experience.1
Supervision
Each CHV should receive supportive supervision monthly from a CHEW, at either the health facility or in the community. The supervision consists of training, review of reports, and household visits with a CHEW. CHEWs follow a checklist to ensure quality supervision.
Incentives and remuneration
At the end of 2018, 14 out of 47 of Kenya’s counties were paying monthly incentives to CHVs out of their own budget. The amounts varied from county to county but are in the range of US$ 20 – 60 a month.
Impact
Kenya’s community health program has led to improvements in key health indicators. Geographic areas that implement community health services have had better health indicators than those that do not. Uptake of community health services contributed significantly to improvements in antenatal care visits, deliveries by skilled birth attendants, testing for HIV during pregnancy, receipt of intermittent preventive treatment for malaria during pregnancy, exclusive breastfeeding during the first six months of life, and childhood immunization coverage.
Author Affiliations
- Rose Njiraini is a Community Health Specialist at the UNICEF Kenya Country Office.
- Salim Hussein is the Head of the Department of Primary Healthcare Services, Ministry of Health, Kenya.
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Am happy to be a CHV (COMMUNITY HEALTH VOLUNTEER) in NAIROBIS KAWANGWARE AREA…I have enjoyed this article and hope to learn more for subscribing.Thankyou and GODS blessings
how did you enrol
I’m a private practitioner in a community setup.Kindly advise on how we can engage our staff in this program to serve our community better.
Am happy to be a CHV in mbayo 2 villange meru.I enjoy the work.God bless
Looking forward to working with you. Chv from limuru central ward. Kiambu
Am Hassan Odhiambo
Happy to be a CHV in Siaya, my passion is saving lives
I’m Cypriano, happy to be aCHV in Laikipia, Ndindika/Kinamba Unit. It’s really an amazing grace.
I am Lucy kamau a CHV at mutuini am very proud at initiating dialogue with my household members
Am happy serving my community as a Chv in Njiru
Am happy to be chv at Bomet county
I would like to request for enrollment in the CHV Program anywhere in Kiambu West.
How do i apply?
Thanks for your question. We recommend checking with your district health office.
hello, how does one become a CHW volunteer or how can one enroll
In Kenya, there are several options. There is a national Community Health Extension Worker program implemented by the Ministry of Health. In other cases, local NGOs hire and training CHWs for specific services. Check with your local health facility or council health department, they should be able to let you know where you learn of opportunities.
Happy to be one of the community Health Volunteers. Service to humanity is service to God.
Am a student at murang’a university of technology pursuing degree bachelor of science in community health. This article is very helpful and I enjoyed getting information from it
Am Monica kariuki a CHV since 2018 in kiambu but without pay. I love this service to the community. Am requesting to be empowered with more skill and trainings for better performance. If I can get a scholarship to learn more it my joy.
Am pennina Nthiwa from NAIROBI, a community health worker linked to Dandora 1 health facility I have enjoyed the article and looking forward to get more trainings for Chw.
Am pennina Nthiwa from NAIROBI KENYA am happy to be a CHW in for serving my community voluntarily I pray very soon to be considered by MOH and get more trainings.
I am a c h v in Muranga county and our new government has said it doesn’t recognize the c h vs regarding them as ghost workers. Imagine from 2006 we have been doing our role as volunteer and now we have no use since after election
I am Hezron Ngesa from Nairobi county, Embakasi East, lower Savannah, Bahati B unit. I love working and helping my community.
Iam a chv and I enjoy serving my community, from kericho county road
My name is Jane. I have a certificate in community health programs from Harvard. How can I join?
Hi Jane, what are you looking to join? For CHW Central, you can simply subscribe to our newsletter and read the latest news, features and events on our website. If you’re looking to become a CHW, you can usually find training by visiting your local health department’s website or, if you’re in the US, visit the NACHW website or that of the network or association in the state in which you reside.
Am in Kenya and I want to train as a community health volunteer.
Hallo am Jane kyalo and interested in community health volunteers job,how can I get the training?
my name is Jane I have loved your article. I am in Nakuru Elmentaita, I’m a psychological counselor by profession would like to serve my community as a chv how do I go about it.
Hi Jane,
Contact your county health department. They should be able to tell you where to access available CHEW training or which local NGOs are training volunteers.