About 70% of child deaths in the community occur at home caused by preventable or easily curable diseases like malaria, diarrhea and malnutrition. The government of Kenya came up with a plan referred to as Community Health Strategy in 2006 which acknowledges that communities form the foundation in the provision of affordable, equitable and effective healthcare. To implement this, the government enrolled community health workers who are trained members of the community chosen by community members or organizations to provide basic health and medical care to their community. Five years in its implementation, the targets are far from being met. In the case of Kibera, only 13 Community Units (CUs) are established. The objective of this study was to use the information from community health workers to evaluate the effectiveness of the community health strategy in Kibera, Langata district using two statistical models. A cross sectional research design was used in this study. A sample size of 92 CHWs was picked from 7 CUs. The CUs included Silanga, Laini Saba, Katekwera, Soweto East, Soweto West, Kianda, and Mashimoni. The data collected was cleaned and analyzed using R. A binomial regression was used to determine the effect of support supervision, training and incentive on satisfaction. The results from the study indicated that training and incentives were the main causes of unsatisfaction to CHWs. 62% of the CHWs were unsatisfied with training because they are not fully schooled on how to address most of the health issues facing their communities. 66% of the CHWs were unsatisfied due to lack of incentives. The study noted that the most important incentives were CHW tool kits and monthly stipend. 34% of CHWs were found to be satisfied with incentives. This was also attributed to provision of tool kits (apart from cash) and the fact that most of them were self employed while others were in the informal labor market (such as Masonry, painting, tailoring and simple fundis) thus able to support themselves and their kin. 55% of the CHWs were found to be satisfied with supervisory support that they received. The results also showed that there were minimal differences in the logit and probit model. The probit model had more accurate and precise estimates. This study recommends an extension of the implementation of the Community Health Strategy period, a review on the incentives and training curriculum of the CHW. It also recommends provision of tool kits and reporting tools to CHWs as well as simplification of the reporting tools to make them user-friendly. This study did not delve into the quality of the work done by CHWs, an area that could give more information if researched on.
Date of publication:
RUFORUM Theses and Dissertations
Prof. Kamau Ngamau (JKUAT) & Dr. Charles Mutai (KEMRI)