Across the vast plains of Kieni East subcounty in Nyeri lies Warazo Community Health Unit (CHU). Loosely translated, Kieni means vast plains of land with nothing growing on it. And that is the case for Kieni subcounty in Nyeri. Unlike the other 7 sub-counties in Nyeri that are green and luscious, this sub-county lies on the leeward side of Mt. Kenya and does not grow the primary crops grown in other parts of the county. 

Kieni East consists of 4 wards. In addition to the 2 Community Health Units listed above, Kieni East is supported at the community health level by 33 Community Health Units, which have 330 Community Health Promoters (CHPs). These CHPs serve their local communities promoting health through education and creating awareness. They offer health promotion and prevention education.  

Other than providing health education, 2 community health units are environmentally cautious and have started innovations that contribute to their environment in one way or another. CHPs from Warazo and Thegu CHUs have been at the forefront of mitigating climate change, which ties with the recent climate agenda discussions globally. 

Tree nursery in Warazo CHU 

In May 2023, 20 CHPs from Warazo Community Health Unit came together to discuss how best they could conserve their environment, supplement the stipends paid by the County Government of Nyeri and serve their communities. 

CHU4UHC caught up with the lead CHP in Warazo CHU, Julia Wachira. She tells us that this innovation was started as a welfare project where they could all benefit from selling the seedlings and vegetables from their nursery. 

Julia said, “The 10 CHPs from our CHU each contributed Ksh 500 to purchase the seeds and the polytubes to plant the seedlings in. Our link facility, Warazo Health Center, offered us a small piece of land where we could grow and nurture the seedlings ready for the market. 

We have so far grown 10,000 seedlings and taken 5000 to the market. We sell each seedling at 40 thus making us over Ksh 20,000 in earnings. This has motivated us to grow more seedlings, ready for the next rainy season.

We are proud that we are not only gaining some additional income but we are also helping protect the environment, even as we see the current effects of climate change in Kenya and beyond. We hope that with our small efforts, if replicated countrywide, we will help the Government of Kenya plant 15 billion trees by 2032, as pledged by the president. 

“The same is seen at Munyu Community Health Unit, where the CHU4UHC caught up with Margaret Wambui, who reported, “To keep the project running and ensure that we are all responsible,  we came up with a duty rota that assigned every member days to come to the facility and water the plants. Our CHU has so far been able to nurture 5000 seedlings, which we have taken to the market'” 

Their project was boosted in November 2023 with the onset of the long rains that were happening across the country.  

As a way to give back to their communities, the members gave vegetable seedlings to the elderly and the  community to supplement their diets and have a fully balanced diet. “Whenever we go to the households for our routine visits, we are always teaching the community members the importance of a balanced diet. We emphasize the need for vegetables to be included in their diet and the need to have kitchen gardens for anyone with a small piece of land where they can plant something.” Margaret adds 

“Among the challenges we face are lack of proper water storage for the dry seasons, fencing and lack of polytubes to plant the seedlings in. Our appeal to the Nyeri county Government is to support us with the provision of a water tank, which would make our project easier to run. 

To partners, we are appealing; for capacity building trainings on how to manage the proceeds we get from our sales and lessons on how to take care of our nursery” 

Speaking to CHU4UHC, Michael Kahuthu, a CHEW attached to these Community Health Units noted how this project has resulted in stronger collaboration among the CHPs. ” This collaboration makes it easier for CHPs in their service delivery because, through this project, they meet more often than before and it is in these meetings that they support each other in their work. We are thankful to Amref Health Africa for the technical assistance offered to CHPs through training, and capacity building, eg the recent digitization in the county that has eased the reporting by CHPs.  

Community Health Promoters Transformation of Thegu CHU Through Waste Management Initiatives, Protecting Health and Environment Alike 

“In March 2023, dedicated CHPs and community members united to tackle the growing issue of waste disposal afflicting Thegu Community Health Unit, a peri-urban settlement of Chaka, Kieni West. Our main concern was the poor disposal of used diapers along the roads that emitted foul odors, attracting flies, and obstructed drainage systems.” Nyawira Muchiri, the lead CHP notes.  

“We initiated targeted household visits, specifically to homes with young children in diapers. Through these visits, we embarked on a health promotion campaign, enlightening the community about the importance of responsible waste management. We highlighted the environmental hazards posed by improper waste disposal and explained the potential health risks associated with exposure to such unsanitary conditions, especially during the rainy seasons when the risk of diseases is heightened. This campaign was well received, and we now have coordinated garbage collection days with the Department of Health that happen on Mondays and Thursdays.”

Lawrence Kimuri, a dedicated CHA overseeing community health initiatives in Kieni East, emphasized his commitment to providing unwavering support to the CHPs in their vital role of delivering preventative and promotional health services to the community. “ I am happy to see the changes in this community and for the health promotion education conducted by CHPs. Children are no longer exposed to health hazards and the community has managed to restore the environment,“ he notes.  

Fast forward one year later, and the transformation is palpable—the once unsightly dumping sites have disappeared from the area, replaced by a cleaner, more hygienic environment. The Thegu community now stands shielded from the looming threat of diseases that could have arisen from the unchecked waste disposal practices of the past. 

Other than CHP training, Amref Health Africa has supported Nyeri County Community Health Services. It has supported the enactment of the CHS Bill, which is now an Act, CHAs training and scholarships to KMTC, CHCs training, eCHIS training for 2375 CHPs, Community Scorecard rollout, and the establishment of PCNs in 4 sub-counties. Through support from Amref Health Africa, CHU4UHC reiterates its support for Nyeri County.