Related News:

What did we learn at the Inspiring Communities workshop?
17 June 2017

Revolutions in the economics of health systems: iHEA Congress 2017
13 June 2017

Inspiring communities in global health: Community Health Workers and Universal Health Coverage
26 May 2017

How does community health relate to wider development discourse?
08 May 2017

Research uptake: Learning from policy makers in Kenya
05 April 2017

Emerging issues related to gender and community health workers
27 March 2017

Women in the changing world of community health work
17 March 2017

What does trust have to do with Community Health Workers and the Sustainable Development Goals?
06 March 2017

Community health workers – optimizing the benefits of their position between communities and the health sector
23 February 2017

Achieving Equity: Women at the interface of community health systems
15 February 2017

REACHOUT at the Kampala Community Health Worker conference
11 February 2017

Building a resilient and responsive health system needs strong community support
10 February 2017

Online discussion on community health workers: Join in
04 January 2017

Four tips for embedding quality improvement in community health worker programmes
09 December 2016

Community health workers: great potential for resilient and responsive health systems
28 November 2016

Indigenous knowledge and intersectionality: “Incremental radicalism” and front line health workers
23 November 2016

REACHOUT at the 2016 Global Symposium on Health Systems Research
23 August 2016

The challenges of implementing research in the context of health system devolution in Kenya
18 July 2016

Announcing our new USAID SQALE project: Strengthening community health in Kenya
08 July 2016

Exploring lessons learnt from Close-to-Community Health Worker Programmes: A symposium
20 June 2016

How equitable are Community Health Worker programmes?
31 May 2016

How relationships shape community health workers’ performance in Ethiopia, Kenya, Malawi and Mozambique
13 May 2016

Co-constructing knowledge about health with the young people of Korogocho informal settlement
28 April 2016

Working with what we’ve got – an(other) reflection on human resources for health
16 February 2016

Webinar: Community health workers - the gender agenda #HSGGENDER
08 February 2016

Panel on community health workers at the Prince Mahidol Award Conference
07 January 2016

Putting the politics into international public health
05 January 2016

Quality improvement cycles to strengthen close-to-community services: REACHOUT reflections
10 December 2015

Kenya develops guidelines to strengthen Community Health Dialogue
07 December 2015

A learning agenda and “NICE guys”: reflections on capacity
16 November 2015

REACHOUT at the Canadian Conference on Global Health
03 November 2015

Alignment, engagement and collaboration: approaches to ensuring Quality Improvement is embedded
02 November 2015

Why we use a group supervision approach in REACHOUT
22 September 2015

Global Strategy on Human Resources for Health: How can it support close-to-community providers?
10 September 2015

Why do health inequities persist in Kenya? What difference can community health workers make?
09 June 2015

Implications of the community health policy change in Kenya in light of world health worker week #WHWWeek
10 April 2015

Kenya and Sierra Leone: A wake up call in light of Ebola
14 March 2015

A REACHOUT update from Kenya
02 December 2014

REACHOUT honourable mention in photo competition
20 October 2014

From dawn til dusk Bonding over data in Nairobi
30 May 2014

Related Resources:

Find more resources relating to Kenya

Kenya: current situation

Kenya has a strong health component in its ‘Vision 2030’ policy, which aims to build a prosperous country with a high quality of life. Within this policy the delivery of community based services are a flagship project. Kenya revised its Community Strategy in 2007 as the vehicle to deliver the National Health Sector Strategic Plan. Vertical programmes use close-to-community providers to deliver services including maternal and child health, HIV, TB and malaria with varying degrees of success. These programmes have assisted the government to increase the number of trained community health workers and functional community units. The government through the Division of Community Health Services has recently developed a scheme of service for close to community providers and is reviewing the community strategy model based on lessons learnt and experiences from other countries.

Although the Community Strategy has been in use in Kenya since 2007, it has not been fully integrated into all programmes, especially those for HIV, and it lacks clear quality assurance and reporting structures to make it fully functional. The Division of Community Health Services has developed a scheme for community health extension workers as the primary caregivers at the community level and redefined the roles of community health workers  so that they are ‘mobilizers’. The implementation of the scheme needs to be informed by evidence, and include quality assurance, to ensure its success.

Kenya: health systems priorities and baseline knowledge gaps

HIV is a major public health concern in Kenya. Through the Community Strategy, Kenya wants to expand HIV services at community level to ensure identification and effective referral and linkage of clients to HIV prevention and treatment. But there are areas where capacity needs to be developed, for example in: standardised human resource management, including remuneration and training; a strategy to deal with high attrition rates; clear links with existing health management systems; and a standardised community-based health information system that reflects key public health priorities. Quality assurance within the community strategy needs to be addressed based on lessons learnt from HIV programmes: Clear guidelines, standard operating procedures, supervision mechanisms, quality indicators, and other tools are all needed to address this gap.

Kenya: initial baseline capacity assessment

At provider level there is a willingness to embrace and implement the Community Strategy and the role of community health workers within the Community Strategy is legitimised by the national strategy document. However the Community Strategy has not been uniformly implemented and there has been limited documentation of work or sharing of best practice, including human resource management, reporting, monitoring and supervision. There are no guidelines on how to monitor and standardise services offered by community health workers nor are there mechanisms for quality assurance of close-to-community services.

At policy level there are mechanisms that encourage interaction between policy makers, practitioners, and researchers in the form of technical working and interagency coordinating committees. Policy makers are increasingly well versed in current trends in various fields including community strategy. Kenya has become a regional leader in HIV policy development and implementation and encourages the sharing of knowledge. Despite this technical capacity to interpret and use research, at times there is lack of coordination between different policy making organs which results in duplication and lack of integration.

Kenya: what REACHOUT research and capacity development will add

In Kenya REACHOUT will build on existing expertise to respond to identified issues affecting community health workers providing HIV-related services. The focus will be on developing and testing comprehensive quality assurance approaches and on monitoring and evaluation and data collection mechanisms.  The evidence generated will provide a basis for future efforts to improve monitoring and evaluation and quality assurance of community health programming in other parts of the health system. The approach will also contribute to developing a human resource management system that addresses factors that influence the sustainability of community health worker programmes in Kenya. These factors include training and supervision needs, and motivation and incentives. The impact of this approach has already been demonstrated in facility-based services. The project will also provide evidence and a model for integrating HIV into the community strategy.The project will capitalise on close links with policy makers and coordinating agencies to help inform a coordinated approach to policy and practice relating to Kenya’s Community Strategy.

 

This project is funded by the European Union.
This project is funded by the European Union.