By Samwel Doe Ouma@samweldoe
Government needs to explore ways of implementing reforms to strengthen community health workforce programs to improve outcomes and access to basic health services.
Community Health Workers (CHWs) play a critical role in primary healthcare by bridging the health workforce gaps.
They contribute to increased access to the formal healthcare system or improved patient adherence to treatment regimens, among numerous other roles.
In addition to the shortage of health workers at all levels, access to healthcare is challenged by scarcity of health facilities—with some regions having coverage of of just one facility within a 50-200km radius.
According to Daniel Kavoo Ag head of Community Health and Development at Ministry of Health, the government has come up with standards, policies and regulation framework to strengthen community health systems through community health workforce to enhance quality and access to healthcare services.
He adds that CHWs contribute to increased access to the formal healthcare system or improved patient adherence to treatment regimens, among numerous other roles.
“Government is committed to invest in CHWs to achieve most of its objectives of increasing access and achieving equitable health outcomes,” Kavoo said.
Kenya relies on a robust community health workforce to fill critical gaps while delivering quality, affordable services closer to underserved patients.
However lack of sustainable way of sustaining Community health workers and motivating them coupled with lack of proper coordination on their overlapping roles contributes to challenges of increasing availability and functioning of services to the community level.
Meshack Ndirangu, AMREF health Africa Country Director said community health workers play a big in bridging healthcare workforce gaps as volunteers.
“Government should not only invest in them but also recognize them as a cadre in healthcare,” Ndirangu said.
He said CHWs supervise treatment of patients living with terminal illness, serve as counsellors, help poor patients overcome barriers that prevent them from seeking healthcare, act as healthcare educators and provide vital education about healthcare options.
According to 2015 study by WHO and UNICEF titled Strengthening primary healthcare through community health workers, expanding access to community services could prevent up to 3 million deaths annually while substantially reducing patients’ out-of-pocket costs.
Kenya is among countries facing health workforce crisis according to WHO 2014 study which revealed that for every 10,000 people, there are only 1.9 doctors and 8.6 nurses and midwives.
WHO notes that investing one dollar in a community-based health workforce in sub-Saharan Africa can produce an economic return of ten dollars.
The government plans to employ Community health workforce and train them to improve community health outcomes.
“National government is encouraging counties to employ community health workers and put them on a stipend of between Shs. 2,000 to Shs, 5,000 for the work they do,” Kavoo Said.
He adds that the community health workforce once recruited by the county government will undergo a four month training at Kenya Medical Training Institute (KMTC).The program has since been rolled out in Universal Health Coverage pilot counties.
Data from Kenya demographic Health Survey (KDHS) shows 66 percent of all births in Kenya are attended by a skilled health worker of any kind, a reality that contributes to Kenya’s high under five mortality rate: for every 1,000 live births in Kenya, 52 children will die before they reach their fifth birthday (KDHS, 2014).
Jacqueline Rioba, Director and nutrition expert at World Vision, Kenya said WV has CHWs working in certain areas but they are overwhelmed with large numbers of families per CHW and are not able to provide adequate care to everyone.
“Even though they are volunteers, we need to find ways of motivating the CHVs so they can continue doing the good work that they do,” she added.
CHVs boost maternal and child health by sensitizing mothers on the need for good nutrition during pregnancy and once the child is born.
Through World Vision program CHV from Elgeyo Marakwet County have been promoting the consumption of nutrient rich local foods such as the orange-fleshed sweet potatoes that are rich in Vitamin A and Iron fortified beans.
Once the baby is born, they encourage the mother to exclusively breastfeed their new-born for six months and thereafter give them the right types of food as well as micronutrient supplements so as to prevent malnutrition.
In addition, the CHVs ensure that mothers take their children to hospital so they can get all recommended vaccines.
They also conduct household visits and encourage mothers to attend antenatal care visits (medical check-ups) during pregnancy, as well as deliver in hospital so as to give birth safely.