Role of Health System Practice on Performance of Community Health Workers in Lurambi Sub-County, Kenya

International Journal of Research and Innovation in Social Science (IJRISS) | Volume III, Issue X, October 2019 | ISSN 2454–6186

Role of Health System Practice on Performance of Community Health Workers in Lurambi Sub-County, Kenya

Wachuga James Ndaraiya¹, Cholo Wilberforce²

¹Kakamega County Public Health Office, Kenya
²Department of Public Health; Masinde Muliro University of Science and Technology, Kenya

Abstract: – The use of community health workers has been identified as one strategy to address the growing shortage of health workers, particularly in low income countries. Evaluation of community health workers ‘performance in general, is the focus of much attention at this time, as many countries invest in them as a strategy for the achievement of the sustainable development goals. The effectiveness of Community Health workers (CHWs) has been demonstrated in some studies for example, a CHW programme in India resulted in significant reduction of low birth weight, preterm births and neonatal sepsis. Understanding health system practice and policies context in which CHW interventions operate is an important precondition for the design of successful interventions. The implementation of the CHWs concept in Kenya is marked by unanswered questions of long term sustainability and program effectiveness. Despite the vast experience of CHWs the burden of disease continues to increase in magnitude and diversity and relatively little scientific evidence is available to answer basic questions notably the role of health system factors on the performance of CHW. The objectives of the study were to determine demographic factors in relation to CHWs Performance at level one and to assess the influence of health system practice and policy on the performance of CHWs in Lurambi sub-county. A descriptive Cross sectional design using both quantitative and qualitative data collection methods were used. Using systematic sampling, structured questionnaire was administered to a sample of 195 community health workers. Qualitative data were collected from community health management team (CHMT), clients (households) and community health extension workers (CHEWs). Data were analyzed using descriptive statistics to obtain frequencies, mean and standard deviation while inferential statistics were computed using regression and correlation. The majority of the participants 135 (69.2%) were females (88.7%) married, and 93.8% were Christians. Gender was statistically significant in relation to the performance of CHW in delivery of level one of health services (χ2=11.0; p=0. 04).All the key targets of CHWs Performance at level one rated below average in Lurambi Sub County (number of 51 households visited 40%, number of Baraza’s 35%, health education 28% and referral of patients 23%) while the target of attending CHW meetings rated lowest at 19%. Financial constraints (85%), lack of supplies (82%), lack of transport (65%), inadequate support (85%) and lack of supervision were highlighted by the respondents as daily challenges.

Key words: Community Health Worker, Lurambi, Health System, Extension worker

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