Community Health Volunteers (CHVs) are an integral part of the healthcare system in Kenya, serving as the first point of contact between communities and formal health systems. These volunteers provide a wide range of Community Health Services, including health education, disease prevention, treatment, and referrals to formal health facilities. Despite the crucial role played by CHVs in improving community health outcomes, the majority of them in Kenya are not remunerated for their services. This position paper discusses the importance of remunerating CHVs in Kenya and the need for the government to take responsibility for ensuring that these volunteers receive fair compensation for their work.

The Role of CHVs in Community Health Services

Community Health Volunteers (CHVs) are trained members of the community who work as a link between the community and formal health facilities. They are responsible for providing basic health services such as health education, disease prevention, and treatment. CHVs play a crucial role in addressing health inequalities by bringing essential health services closer to the people, especially those in rural and underserved areas. CHVs also help to reduce the burden on formal health systems by identifying and treating minor illnesses before they become serious and referring patients to formal health facilities when necessary.

Remuneration of CHVs

The remuneration of CHVs is a critical aspect of ensuring that these volunteers are motivated to continue providing services to their communities. Despite their crucial role, CHVs in Kenya are not remunerated, with more than 80% of them working on a voluntary basis. This situation has led to high rates of turnover and burnout among CHVs, as they struggle to balance their volunteer work with other income-generating activities. Furthermore, the majority of CHVs are women, and the lack of remuneration places a disproportionate burden on them, especially those with caregiving responsibilities.

Remunerating CHVs can have several benefits for both the volunteers and the communities they serve. First, it can help to reduce turnover and burnout among CHVs, as they will have an incentive to continue providing services to their communities. This, in turn, can help to improve the quality of healthcare services provided to the community. Second, remuneration can help to attract more volunteers, especially among men, who may be more likely to volunteer if they know that they will be compensated for their work. Finally, and most importantly remunerating CHVs can help to reduce the burden on formal health systems by providing an effective and efficient way of delivering basic health services to communities.

The Responsibility of the Government

It is the responsibility of the government to ensure that CHVs receive fair compensation for their services. The government should develop a policy framework that outlines the minimum standards for CHV remuneration and ensures that these standards are met. The policy framework should also provide for the regular review of CHV remuneration to ensure that it remains fair and adequate. The government should also allocate sufficient resources to support CHV remuneration, including developing a budget line item for CHV compensation.

The role of developmental partners should be to capacity build the compensated CHVs. This is because the government’s compensation ensures that there is sustainability and continuity of services even with changes in the donor landscape. Moreover, the government can hold the CHVs more accountable if they are compensating them regularly and adequately.

We laud the Kenyan Government in committing to pay the stipends for the 100,000 CHWs in the country. The commitment supported by funding from bilateral, multilateral and private sector will go a long way in providing sustainable and quality community health services in the country.

Conclusion

Community Health Volunteers (CHVs) play a crucial role in improving health outcomes in Kenya, particularly in underserved areas. However, the majority of these volunteers are not remunerated, leading to high rates of turnover and burnout. Remunerating CHVs can have several benefits, including improving the quality of healthcare services provided to the community and reducing the burden on formal health systems. It is the responsibility of the government to ensure that CHVs receive fair compensation for their services by developing a policy framework that outlines the minimum standards for CHV remuneration and allocating sufficient resources to support CHV compensation.