The Kenyan healthcare system is divided into six tiers, where the top three provide curative care and lower three deliver preventative care. The first level of the preventative care is the Community Health Volunteer (CHV), who is considered to be the backbone of healthcare in Kenya. Their responsibilities are many – including community health education, addressing gender-based violence, assisting HIV and tuberculosis patients with treatment routines, providing antenatal care, making referrals, and much more. CHVs are often the first and only point of contact for community members when they fall ill. They are vital to the Kenyan healthcare system, yet are faced with several significant barriers to properly performing their significant role.
GHS-A students worked with CHVs from the Karagita settlements in Naivasha to learn about the barriers they face and to develop mechanisms to empower these critical members of the Kenyan healthcare system.
The majority of CHVs are women with families and jobs outside of their voluntary healthcare roles. The demanding duties as CHVs often overshadow their opportunities to engage in income generating activities – yet they volunteer because they care deeply for their communities. However, CHVs are given limited training when they register, and they lack the necessary equipment to perform their duties. CHVs are not provided with any medical supplies, including first aid kits, and they are required to carry large and heavy books and also have no means to identify themselves as CHVs to their community. Without recognition of the important role they play – both lack of financial compensation, lack of adequate training and supplies, and lack of being recognized within the community – CHVs often feel demoralized, leading to high attrition rates.
After meeting with the local CHVs and representatives of the District Hospital, the GHS-A students identified empowerment, through identification and provision of basic supplies, as the first step to improving this vital component of the health care system. GHS-A students developed a strategy whereby local businesses could sponsor an apron (for identification), a bag (to carry supplies), and a first aid kit. These three items would serve several purposes (1) identify the CHV as a healthcare worker to the community, (2) provide advertising space for the sponsor, and (3) serve a practical purpose for the duties of the CHV. The students are actively engaged in implementing this first step, with support from the QEII Scholars community outreach program. In the long term, supporting CHVs and preventative care will reduce the need for curative medicine thus relieving pressure on other levels of the healthcare system.
Group 3 – CHV Empowerment. Amin Farah, Olivia Petersons, Lucy Reid and Jason Were (MMASc in Global Health Systems in Africa Candidates)