Community health services (CHS) in Kenya are a critical aspect of healthcare delivery, particularly in underserved areas, serving as a bridge between formal health systems and communities. It is essential in promoting and maintaining the health of individuals and communities. Community Health Promoters (CHPs) play a crucial role in providing basic health services to communities, including health education, disease prevention, and treatment. Despite the importance of CHS, the sector faces several challenges, including inadequate coverage, lack of remuneration for CHPs, inadequate training and supervision, and retention challenges. This position paper discusses the importance of CHS in Kenya, the challenges facing the sector, and recommendations for addressing these challenges.
Importance of Community Health Services in Kenya
Community health services are essential in improving health outcomes, especially in underserved areas. CHPs are the primary healthcare providers in these areas, providing a wide range of services, including health education, disease prevention, and treatment. CHS provides a cost-effective way of delivering basic health services to communities, reducing the burden on formal health systems.
Moreover, CHS helps to improve the quality of healthcare services provided to the community, as CHPs are better placed to understand the specific health needs of their communities. CHPs are the first point of contact for many communities, and they help to reduce the burden on formal health systems by identifying and treating minor illnesses before they become severe. CHS is, therefore, essential in addressing health inequalities by bringing essential health services closer to the people, especially those in rural and underserved areas.
Challenges Facing Community Health Services in Kenya
Despite the critical role played by CHS in Kenya, the sector faces several challenges. Not all counties have 100% CHS coverage, and even where absolute coverage exists, not all CHPs are trained or remunerated. Less than 100% coverage leaves some communities without access to basic health services. The lack of remuneration for CHPs has led to high rates of turnover and burnout, with many CHPs struggling to balance their volunteer work with other income-generating activities. Inadequate training and supervision also pose a significant challenge, with many CHPs lacking the necessary skills and knowledge to provide effective healthcare services. Retention has been another challenge, with CHPs leaving the sector due to burnout, lack of support, or inadequate remuneration. Furthermore, supervision for CHPs is not optimal, which can lead to mistakes and errors in the provision of healthcare services.
BETA Plan on Community Heath Services
The current government has prioritized Primary Health Care (PHC) for delivery of universal health coverage (UHC). With the political commitment community health promoters have received a comprehensive CHP kit and a smartphone to deploy Electronic Community Health System (eCHIS). Moreover, the government launched the stipend payment for all the 100,000 CHPs in the country during the official launch of the CHP Program on 25th September. The government’s plan to do a co-payment of the CHP stipends between the national and county governments in Kenya giving the CHPs a total of Kes. 5,000 per month.
Recommendations for Improving Community Health Services
To address the challenges facing CHS in Kenya, several recommendations can be made. Firstly, all counties should strive to achieve 100% CHS coverage, ensuring all communities have access to basic healthcare services. Secondly, CHPs should be remunerated regularly, reflecting the critical role they play in healthcare delivery. The government and partners should support CHPs in establishing income-generating activities to supplement their income. Thirdly, CHPs should receive adequate training and supervision to ensure that they have the necessary skills and knowledge to provide effective healthcare services. The government should provide the necessary resources to support training and supervision activities. Lastly, retention can be improved by providing CHVs with adequate support, including regular supervision and access to counseling services.
Community health services are critical in improving health outcomes, particularly in underserved areas. However, the sector faces several challenges, including inadequate coverage, lack of remuneration for CHPs, inadequate training and supervision, and retention challenges. To address these challenges, all counties should strive to achieve 100% CHS coverage, CHPs should be remunerated regularly, and the government should provide adequate training and supervision. Retention can be improved by providing CHPs with adequate support. By addressing these challenges, CHS in Kenya can continue to play a crucial role in improving health outcomes and reducing health inequalities.