Audience Motivation Strategies for Community Participatory Decision-Making on Health Issues among Pastoralist Communities: Case of the Maasai Community from Kajiado County, Kenya

Several studies have examined the role of community engagement in health initiatives, revealing that resource inadequacies, cultural barriers, and a lack of awareness impede community participation. However, these studies primarily focus on single health conditions and urban or sedentary populations, leaving a notable contextual gap. Moreover, while many prior works rely on secondary data or qualitative methods, limiting the generalizability of their findings, there is a lack of research that utilizes a mixed-methods approach to provide a more comprehensive understanding. This paper addresses these methodological and contextual gaps by investigating the audience motivation strategies that can help improve community health outcomes among pastoralist populations in Kenya. It adopts a mixed-methods research design, collecting and analyzing both primary qualitative and quantitative data to provide a robust and holistic understanding of the subject. The findings explained in this paper are expected to offer actionable insights for policymakers and health organizations in order to design more effective and culturally sensitive health interventions for pastoralist communities.

Community health, pastoralist communities, Community Engagement, public participation.

1. Akwataghibe, N. N., Ogunsola, E. A., Broerse, J. E., Agbo, A. I., & Dieleman, M. A. (2022). Inclusion strategies in multi-stakeholder dialogues: the case of community-based participatory research on immunization in Nigeria. Plos One, 17(3), 1-23. [Google Scholar] [Crossref]

2. https://doi.org/10.1371/journal.pone.0264304 [Google Scholar] [Crossref]

3. Albertus, M., & Schouela, N. (2024). Fascist legacies of mobilization and co-optation: Evidence from democraticPortugal. ComparativePoliticalStudies,1-20. https://doi.org/10.1177/00104140231204243 [Google Scholar] [Crossref]

4. Ankomah, S. E., Fusheini, A., & Derrett, S. (2024). ‘Two heads are better than one’—exploring the experiences of Ghanaian communities on the role of patient and public participation in health system improvement. Health Policy and Planning, 39(6), 603-612. [Google Scholar] [Crossref]

5. Baxter, S., Barnes, A., Lee, C., Mead, R., & Clowes, M. (2023). Increasing public participation and influence in local decision-making to address social determinants of health: a systematic review examining initiatives and theories. Local government studies, 49(5), 861-887. https://doi.org/10.1080/03003930.2022.2081551 [Google Scholar] [Crossref]

6. Belay, D. G., Asratie, M. H., Aragaw, F. M., Tsega, N. T., Endalew, M., & Gashaw, M. (2022). Open defecation practice and its determinants among households in sub-Saharan Africa: pooled prevalence and multilevel analysis of 33 sub-Saharan Africa countries demographic and health survey. Tropical Medicine and Health, 50(1), 1-12. https://doi.org/10.1186/s41182-022-00416-5 [Google Scholar] [Crossref]

7. Beyene, S. A., Garoma, S., & Belachew, T. (2025). Prevalence and predictors of modern contraceptive method utilization among married couples in the pastoralist communities of Fentale district, Eastern Ethiopia. Scientific Reports, 15(1), 1-28. [Google Scholar] [Crossref]

8. Brock, T., Reed, M. G., & Stewart, K. J. (2021). Indigenous community participation in resource development decision-making: Practitioner perceptions of legal and voluntary arrangements. Journal of Environmental Management, 283, 1-20. https://doi.org/10.1016/j.jenvman.2020.111922 [Google Scholar] [Crossref]

9. Černý, V., Priehodová, E., & Fortes-Lima, C. (2023). A population genetic perspective on subsistence systems in the Sahel/Savannah belt of Africa and the historical role of pastoralism. Genes, 14(3), 1-14. https://doi.org/10.3390/genes14030758 [Google Scholar] [Crossref]

10. Coleman, E. R. (2023). The Relationship Between Social Mobilization, Crime, and Crime Control: A Longitudinal Analysis of 900 US Cities Between 1964–1995 (Doctoral dissertation, The University of New Mexico). [Google Scholar] [Crossref]

11. Correia, D., Feio, J. E., Marques, J., & Teixeira, L. (2023). Participatory methodology guidelines to promote citizens participation in decision-making: Evidence based on a Portuguese case study. Cities, 135, 1-13. https://doi.org/10.1016/j.cities.2023.104213 [Google Scholar] [Crossref]

12. Croucher, S.M (2016). Understanding Communication Theory: A Beginner’s Guide. Routledge Dada, S. (2023). An overview of the primary healthcare system in Nigeria. Int. J. Agric. Sci. Res, 1(3), 289-304. [Google Scholar] [Crossref]

13. DeHaven, M. J., Gimpel, N. A., & Kitzman, H. (2021). Working with communities: Meeting the health needs of those living in vulnerable communities when Primary Health Care and Universal Health Care are not available. Journal of Evaluation in Clinical Practice, 27(5), 1056-1065. [Google Scholar] [Crossref]

14. Domokwang, S. D. (2022). Assessment of vulnerability of pastoralists to the adverse impacts of climate change: A case study of West Pokot County, Kenya (Doctoral dissertation, University of Nairobi). [Google Scholar] [Crossref]

15. European Agency for Safety and Protection of Health at Work (EASHW) (2010). European Survey of Enterprises on New and Emerging Risk. Last revision. [Google Scholar] [Crossref]

16. http://osha.europa.eu/en/slc_cse_search_results. [Google Scholar] [Crossref]

17. Gichuki, P. M., Kimani, B. W., Kanyui, T., Okoyo, C., Watitu, T., Omondi, W. P., & Njomo, D. W. (2024). Using community-based participatory approaches to improve access to mass drug administration for trachoma elimination in a pastoral conflict area of Kenya. PLOS Neglected Tropical Diseases, 18(11), 1-15. https://doi.org/10.1371/journal.pntd.0012653 [Google Scholar] [Crossref]

18. Greene, J. C., Caracelli, V. J., & Graham, W. F. (1989). Toward a conceptual framework for mixed-method evaluation designs. Educational Evaluation and Policy Analysis, 11(3), 255–274. https://doi.org/10.3102/01623737011003255 [Google Scholar] [Crossref]

19. Hola J, (2012). The Importance of Internal Communication in Hospital Management. Profese, 5(1),56-58 . DOI:10.5507/pol.2012.002. [Google Scholar] [Crossref]

20. Johnson, R. B., Onwuegbuzie, A. J., & Turner, L. A. (2007). Toward a definition of mixed methods research. Journal of Mixed Methods Research, 1(2), 112–133. [Google Scholar] [Crossref]

21. https://doi.org/10.1177/1558689806298224 [Google Scholar] [Crossref]

22. Kaoga, J. O. (2021). Appraisal of the Climate Change Resilience of a Pastoral Social ecological System-a Case Study of the Maasai Community in Kajiado County, Kenya (Doctoral dissertation, University of Nairobi). [Google Scholar] [Crossref]

23. Karuga, R.N, Kok M, Mbindyo, P, Hilverda, F, Otiso, L, & Kavoo, D. (2019). It’s like these CHCs don’t exist, are they featured anywhere?”: Social network analysis of [Google Scholar] [Crossref]

24. community health committees in a rural and urban setting in Kenya. PLoS ONE, [Google Scholar] [Crossref]

25. 14(8),10-13. https://doi.org/10.1371/journal.pone.0220836. [Google Scholar] [Crossref]

26. Kelly A. Mitra S. Elung’at J. Songok J. Jackson S & Christoffersen-Deb A (2020). Can the financial burden of being a community health volunteer in western Kenya exacerbate poverty? Health Promotion International, 35(1), 93-101. [Google Scholar] [Crossref]

27. Kenny, L., Bhatia, A., Lokot, M., Hassan, R., Hussein Aden, A., Muriuki, A., & Hossain, M. (2022). Improving provision of family planning among pastoralists in Kenya: Perspectives from health care providers, community and religious leaders. Global Public Health, 17(8), 1594-1610. https://doi.org/10.1080/17441692.2021.1944263 [Google Scholar] [Crossref]

28. Kimaru, J. (2023). Viability of Hay Production as a Drought Resilient Climate-smart Strategy for the Pastoralist Systems of Kajiado (Doctoral dissertation, University of Nairobi). [Google Scholar] [Crossref]

29. Kim, D.K., Sighal, A.,& Kreps, G.L (2014). Health Communication. Peter Lang Publishing Inc Loewensen, R. and K. Tibazarwa, Annotated Bibliography: Social power, participation and accountability in health. (2014), TARSC, EQUINET with COPASAH: Harare. [Google Scholar] [Crossref]

30. Ministry of Health (MOH), (2017). The Investment Case for Community Health in Kenya. MOH; 2018.https://livinggoods.org/wp-content/uploads/2019/06/Investment-Case-for-Community-Health-inKenya.pdf. [Google Scholar] [Crossref]

31. Mpembeni, R.N, Bhatnagar, A, LeFevre, A, Chitama, D, Urassa, D.P. & Kilewo, C. (2015). Motivation and satisfaction among community health workers in [Google Scholar] [Crossref]

32. Morogoro Region, Tanzania: nuanced needs and varied ambitions. Human [Google Scholar] [Crossref]

33. Resource Health. 4(10), 1344-48. pmid:26044146. [Google Scholar] [Crossref]

34. Muchiri, G., Okwii, M., Bukuluki, P., Willems, J., Amanyi-Enegela, J. A., Yibi, M., & Sankar, G. (2023). Challenges and strategies for the uptake of mass drug administration among pastoralist communities in South Sudan. Frontiers in Tropical Diseases, 4, 1-10. [Google Scholar] [Crossref]

35. Muga, G. O., Onyango-Ouma, W., Sang, R., & Affognon, H. (2021). Indigenous knowledge of Rift Valley Fever among Somali nomadic pastoralists and its implications on public health delivery approaches in Ijara sub-County, North Eastern Kenya. PLOS Neglected Tropical Diseases, 15(2), 1-19. https://doi.org/10.1371/journal.pntd.0009166 [Google Scholar] [Crossref]

36. Muhummed, A. M., Alemu, A., Maidane, Y. O., Tschopp, R., Hattendorf, J., Vonaesch, P., & Cissé, G. (2024). Knowledge, attitudes, and practices of rural communities regarding antimicrobial resistance and climate change in Adadle District, Somali Region, Ethiopia: a mixed-methodsstudy. Antibiotics, 13(4),1-21. ttps://doi.org/10.3390/antibiotics13040292 [Google Scholar] [Crossref]

37. Mulatya, D. M., Were, V., Olewe, J., & Mbuvi, J. (2021). Willingness to pay for improvements in rural sanitation: evidence from a cross-sectional survey of three rural counties in Kenya. PLoS One, 16(5), 1-19. https://doi.org/10.1371/journal [Google Scholar] [Crossref]

38. Naanyu, V., Njuguna, B., Koros, H., Andesia, J., Kamano, J., Mercer, T., & Akwanalo, C. (2023). Community engagement to inform development of strategies to improve referral for hypertension: perspectives of patients, providers and local community members in western Kenya. BMC Health Services Research, 23(1), 1-1-13. https://doi.org/10.1186/s12913-023-09847-0 [Google Scholar] [Crossref]

39. Nasr-Azadani, E., Wardrop, D., & Brooks, R. (2022). Is the rapid development of visualization techniques enhancing the quality of public participation in natural resource policy and management? A systematic review. Landscape and Urban Planning, 228, 1-15. [Google Scholar] [Crossref]

40. https://doi.org/10.1016/j.landurbplan.2022.104586 [Google Scholar] [Crossref]

41. Ng’ang’a, P. N., Aduogo, P., & Mutero, C. M. (2021). Strengthening community and stakeholder participation in the implementation of integrated vector management for malaria control in western Kenya: a case study. Malaria Journal, 20, 1-14. https://doi.org/10.1186/s12936-021-03692-4 [Google Scholar] [Crossref]

42. Odawa, G. O., Rambo, C. M., Otieno-Omutoko, L., & Wambui Richu, S. (2024). Influence of Participatory Decision-Making on Performance of HIV/AIDS Community Health Projects in Kisumu County, Kenya. European Journal of Management Issues, 32(3), 153-165. [Google Scholar] [Crossref]

43. Oketch, A. O., Nalugala, R., Akoth, S. O., Mwalwa, S., & Mbinda, H. K. (2024). Integrating Maasai cultural beliefs and practices into universal health care in Kajiado County, Kenya. International Academic Journal of Health, Medicine and Nursing, 2(1), 463-485. [Google Scholar] [Crossref]

44. Olonite, O.A (2022). Olonite Sampling Technique and Taro Yamane Sampling Method: The Paradigm Shift. Department of Accounting, Faculty of Management Sciences. University of Abuja, Nigeria. [Google Scholar] [Crossref]

45. Patton, M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice (4th ed.). SAGE Publications. [Google Scholar] [Crossref]

46. Perry, C. L., Barnowski, t., & Parcel, G. s. (2017). How individuals, environments, and health behavior interact: social learning theory. in K. Glanz, F. M. Lewis & B. K. rimer (eds.), Health Behavior and Health Educaiton: Theory Research and Practice.Francisco, CA: Jossey-Bass. [Google Scholar] [Crossref]

47. Sakeah E, Aborigo RA, Debpuur C, Nonterah EA, Oduro AR, Awoonor-Williams J. K. (2021) Assessing selection procedures and roles of Community Health Volunteers [Google Scholar] [Crossref]

48. and Community Health Management Committees in Ghana’s Community-based [Google Scholar] [Crossref]

49. Health Planning and Services program. PLoS ONE, 16(5), e0249332. [Google Scholar] [Crossref]

50. https://doi.org/10.1371/journal.pone.0249332. [Google Scholar] [Crossref]

51. Salve, S., Raven, J., Das, P., Srinivasan, S., Khaled, A., Hayee, M., & Gooding, K. (2023). Community health workers and Covid-19: Cross-country evidence on their roles, experiences, challenges and adaptive strategies. PLOS Global Public Health, 3(1), 1-12. https://doi.org/10.1371/journal.pgph.0001447 [Google Scholar] [Crossref]

52. Schilling, J., & Werland, L. (2023). Facing old and new risks in arid environments: The case of pastoral communities in Northern Kenya. PLOS Climate, 2(7), 1-16. [Google Scholar] [Crossref]

53. https://doi.org/10.1371/journal.pclm.0000251 [Google Scholar] [Crossref]

54. Singh, R., & Kerven, C. (2023). Pastoralism in South Asia: Contemporary stresses and adaptations of Himalayan pastoralists. Pastoralism, 13(1), 1-10. https://doi.org/10.1186/s13570-023-00283-7 [Google Scholar] [Crossref]

55. Teddlie, C., & Tashakkori, A. (2009). Foundations of mixed methods research: Integrating quantitative and qualitative approaches in the social and behavioral sciences. SAGE Publications. [Google Scholar] [Crossref]

56. Tolulope, O. Y., Bamidele, J., Eleke, U. P., Joel, O. J., Joel, A. F., & Sennuga, S. O. (2025). Adapting to environmental changes and climate impacts in rural communities: A comprehensive review. Global Journal of Earth and Environmental Science, 10(1), 1-7. [Google Scholar] [Crossref]

57. Tschopp, R., & Kidanu, A. G. (2024). Knowledge-attitude and practice of Anthrax and brucellosis: Implications for zoonotic disease surveillance and control in pastoral communities of Afar and Somali region, Ethiopia. PLOS Neglected Tropical Diseases, 18(4), 1-21. [Google Scholar] [Crossref]

58. https://doi.org/10.1371/journal.pntd.0012067 [Google Scholar] [Crossref]

59. Tugendhaft, A., Hofman, K., Danis, M., Kahn, K., Erzse, A., Twine, R., & Christofides, N. (2021). Deliberative engagement methods on health care priority-setting in a rural South African community. Health Policy and Planning, 36(8), 1279-1291. [Google Scholar] [Crossref]

60. Tugjamba, N., Walkerden, G., & Miller, F. (2023). Adapting nomadic pastoralism to climate change. Climatic Change, 176(4),1-20. https://doi.org/10.1007/s10584-023-03509-0 [Google Scholar] [Crossref]

61. Wafula, W. M., Wasonga, O. V., Koech, O. K., & Kibet, S. (2023). Factors influencing migration and settlement of pastoralists in Nairobi City, Kenya. Pastoralism, 12, 1-14. [Google Scholar] [Crossref]

62. Wangui, E. (2024). Pastoral livelihoods in Africa. In Handbook of African Economic Development (pp. 359-374). Edward Elgar Publishing. [Google Scholar] [Crossref]

63. Waruguru, M., Kingori, J., Lackey, D., Musomi, J., Ngugi, J. G., & Okpaku, S. O. (2021). Mental Health Care in Nomadic Populations: The Case of Kenya. In Innovations in Global Mental Health (pp. 347-361). Cham: Springer International Publishing. [Google Scholar] [Crossref]

64. Watson, D., Mhlaba, M., Molelekeng, G., Chauke, T. A., Simao, S. C., Jenner, S., & Barker, M. (2024). How do we best engage young people in decision-making about their health? A scoping review of deliberative priority setting methods. International Journal for Equity in Health, 22(1), 1-24. https://doi.org/10.1186/s12939-022-01794-2 [Google Scholar] [Crossref]

65. World Health Organization (WHO) (2019). Guidelines on Physical Activity and Sedentary Behaviour. Br J Sports Med . 2020 Dec;54(24):1451-1462. doi: 10.1136/bjsports-2020-102955. [Google Scholar] [Crossref]

66. Wulifan, J. K., Dordah, A. D., & Sumankuuro, J. (2022). Nomadic pastoralists' experience accessing reproductive and maternal healthcare services in low and middle-income countries: a contextual scoping review. Pastoralism, 12(1), 1-18. https://doi.org/10.1186/s13570-022-00261-5 [Google Scholar] [Crossref]

67. Yamane, T. (1967), Statistics, An Introductory Analysis, 2nd Ed, Harper and Row, New York Zhang, Q. F. (2024). Producers’ transition to alternative food practices in rural China: Social mobilization and cultural reconstruction in the formation of alternative economies. Agriculture and Human Values, 41(2), 615-630. [Google Scholar] [Crossref]

• Migrant Health in Morocco: Between Law and Reality
• CaknaMinda: An Educator-Centred Mobile App for Early Screening of Mental Health and Schizophrenia Risks
• Health System and Nursing Strategies for Enhancing Male Participation in Family Planning: Evidence from Tema General Hospital, Ghana.
• From Īśvara-Praṇidhāna to Parā-Bhakti: Convergent Paths of Aṣṭāṅga Yoga and Bhakti Yoga
• Evidence-Based Psycho-Oncological Interventions: A Multimodal Approach to Supportive Care