“Community Health Promoters (CHPs) play an integral role in advancing Kenya’s primary healthcare system and supporting the government’s ambitious BETA transformative agenda. Their role is key to realizing Universal Health Coverage (UHC), as they work at the grassroots level to deliver essential health services and offer promotive and preventive health education.” Dr Joseph Lenai

Nonetheless, their empowerment must go beyond the recent provision of equipment, digitization, and remuneration by the national government. To fully equip them for their responsibilities, there is a pressing need for comprehensive and standardized training materials to equip them with the necessary skills to improve their service delivery.

Community-based primary health services is one of the key initiatives to improve population health outcomes. To offer community-based primary health care services, it requires a fit-for-purpose community health system including capacitated community health workers. In the last two years, Kenya has supported the professionalization of community health promoters (CHPs) to offer comprehensive quality community health services to the population. This however begs the question, can a curriculum developed before the professionalization of CHPs support the delivery of the envisaged comprehensive and quality community health services?

Dr Maureen Kimani, Head Division of Community Health, soundly responded NO! She says, “Production of a well-trained community health personnel requires a current, integrated, and comprehensive curriculum based on the current and future community health package. Therefore, as a State Department of Public Health and Professional Standards, we decided to partner with partners such as UNICEF, WHO, Amref Health Africa, USAID, CDC, and Kenya Red Cross to come up with a new curriculum based on the current occupational competency standards for Community Health Workforce and Primary Health Care Act, 2023. We would love to see a Community Health Workforce that is not only capacitated but also gets an opportunity for career progression.”

Dr Maureen added, “We are not only working on the curriculum, but we are also deploying it to train the community health workforce in the country. In partnership with Amref Health Africa, we have deployed the basic CHP curriculum to train all the Community Health Officers and over 9,000 Community Health promoters throughout the country. This process has also integrated the other community lay workers who support disease verticals such as HIV and TB. Moreover, after the training, the Ministry will embark on a process to update the CHW registry based on a new and improved system that links to the electronic Community Health Information System (eCHIS). This whole process will track the production, remuneration, service delivery and supervision for CHPs in the country to strengthen performance management and possible career progression.”

CHP curriculum development process

The whole process has been all-inclusive to ensure the whole of government and society approach for strengthening the community health program. Funders, implementing partners, government entities such as Kenya National Qualifications Authority, Ministry of Labor, Public Service Commission, Kenya Medical Training College (KMTC), Universities, Technical and Vocational Education and Training Authority (TVETA), and other stakeholders.

For CHPs to effectively carry out their health promotion and disease prevention roles, they require more than just practical tools. Proper training is essential in delivering health education and assessing health-related issues in the community and identifying appropriate actions. Training must be well-structured, and easy to understand, considering the varying levels of capacity and experience among CHPs. The use of a standardized training manual is critical in ensuring consistency in how CHPs are trained.

The State Department of Public Health and Professional Standards through the Division of Community Health is in the process of developing the technical modules of the CHP curriculum. Over the past few months, the Division has actively collaborated with a wide range of stakeholders to create a robust curriculum. Technical Working Groups (TWGs) made up of subject matter experts from different departments have contributed to the development of technical modules, which are tailored to address specific health challenges at the community level.

Technical CHP Modules

The technical modules include Reproductive Health, Communicable Diseases, Water Sanitation and Hygiene, and Non-Communicable Diseases (NCDs) consisting of Cancer, Mental Health, Gender-Based Violence (GBV), Primary Eye Care, Ear Care, Oral Health, Disability, and Healthy Aging. The involvement of specialized departments ensures that CHPs receive well-rounded training that encompasses both preventive and promotional health knowledge.

Speaking during one of the workshops, Johnson & Johnson Foundation’s, Anthony Gitau noted the importance of equipping CHPs with the right knowledge and support for the disease areas they cover. He reiterated the foundation’s support to Community Health Promoters to bridge health to communities.

As Kenya continues to push toward UHC, proper CHP training, supported by a well-organized curriculum is important. The success of CHPs, and by extension, the Primary Health Care system, depends on how well they are equipped with knowledge and skills. In this light, ongoing efforts to refine and expand the CHP training curriculum mark a positive step toward achieving the broader goals of UHC and improved health outcomes for all Kenyans.

CHU4UHC platform partners, i.e. Amref Health Africa, Financing Alliance for Health, and Kenya Red Cross, have been supporting the Division by providing technical and financial support for the various workshops to develop and finalize the training modules.

“To help countries on their path to Universal Health Coverage, we start by strengthening primary health care. That means putting an emphasis on bolstering health systems, investing in frontline health workers, and shifting our collective focus to connecting people to care.” Atul Gawande, USAID Assistant Administrator for Global Health