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 Volunteers (CHVs) 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 CHVs, 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. CHVs are the primary healthcare providers in these areas, providing a wide range of services, including health education, disease prevention, and treatment. CHS provide a cost-effective way of delivering basic health services to communities, reducing the burden on formal health systems. Moreover, CHS help to improve the quality of healthcare services provided to the community, as CHVs are better placed to understand the specific health needs of their communities. CHVs 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 coverage exists, not all CHVs are trained or remunerated. Less than 100% coverage leaves some communities without access to basic health services. The lack of remuneration for CHVs has led to high rates of turnover and burnout, with many CHVs struggling to balance their volunteer work with other income-generating activities. Inadequate training and supervision also pose a significant challenge, with many CHVs lacking the necessary skills and knowledge to provide effective healthcare services. Retention is another challenge, with CHVs leaving the sector due to burnout, lack of support, or inadequate remuneration. Furthermore, supervision for CHVs is not optimal, which can lead to mistakes and errors in the provision of healthcare services. Finally, retention of CHVs is a challenge, with many CHVs leaving their work due to the lack of remuneration and support.
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 that all communities have access to basic healthcare services. Secondly, CHVs should be remunerated regularly, reflecting the critical role they play in healthcare delivery. The government and partners should support CHVs in establishing income-generating activities to supplement their income. Thirdly, CHVs 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.
Conclusion
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 CHVs, inadequate training and supervision, and retention challenges. To address these challenges, all counties should strive to achieve 100% CHS coverage, CHVs should be remunerated regularly, and the government should provide adequate training and supervision. Retention can be improved by providing CHVs 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.