In this PIH interview, Dan Palazuelos continues his vibrant roundtable series. He sat down with Ash Rogers, Executive Director of the Lwala Community Alliance in Kenya. Lwala is known for its excellence in service delivery, and perhaps more importantly, its practice of listening to and elevating the voice of the community.
Lochuch, a CHW in Kenya, faces many challenges in her job as she tries to protect the health of those in her community. She has dealt with angry husbands and ambulance denials; actions that could lead to harm of pregnant women. Lochuch is working to ensure that women can deliver in a hospital. This article details her personal experience overcoming barriers in her community and the resilience with which she and her co-workers advocate for their clients.
Kenya does not have a strong health infrastructure to support its people causing concern with current universal healthcare goals. Kenya worries it will not be able to deliver care without a strong CHW program such as Rwanda’s. Although Kenya already has CHWs working in certain areas, they are overwhelmed with large numbers of families per CHW and are not able to provide adequate care to everyone. This article cites Rwanda’s success with a larger CHW program and results of significantly better health, pushing for Kenya to do the same.
Amref Health Africa in Kenya has developed a replicable Community Health Units (CHUs) Functionality Scorecard for measuring and managing the functionality of CHUs. The scorecard was designed and piloted at 114 CHUs in Rift Valley province in Kenya. The scorecard categorized CHUs as Functional, Semi-functional, or Non-Functional. Before and after data was used to assess the functionality. From January 2012 to September 2013, the proportion of functional CHU increased from 3.5% to 82.9%, Semi-Functional reduced from 39% to 13% while Non-Functional reduced from 58% to 4%.
In Kenya, maternal and child mortality rates are still high despite government efforts aimed at improving MCH. This study’s objective was to determine the effect of a CHW led primary health care intervention, Community Health Strategy (CHS) on focused antenatal care (FANC) in Mwingi, Kenya. Researchers employed a pretest -posttest experimental study design with 1 pretest and 2 post-test surveys in intervention and control sites. Data was collected from 422 households in each survey and the main respondents were women with a child aged 9-12 months.
This report summarizes current data from over 140 FHW-supported mHealth projects from developing countries to describe the emergent trends and best practices in the use of mobile phones, tablets, and technical platforms by FHWs over the last decade, understand the key considerations in choosing the type pf phone and platform and associated programmatic costs, present the evidence on the effectiveness of mobile approaches, and establish
a framework for systematically deploying such tools.
Maryse Kok's thesis aims to gain insight into how performance of CHWs in low-middle income countries (LMIC) can be improved, in order to contribute to the realization of better informed, more effective and sustainable CHW programmes and ultimately improved health status of poor and rural communities.
Despite the well-known benefits of community-based practitioners, there is lack of evidence regarding the cost effectiveness of their work. This study aims to address this lack of information on the cost effectiveness to meet health systems goals using literature review, mapping, and case studies. The researchers concluded that community-based practitioners are, indeed, cost effective in some settings, depending on a number of different variables. From this data they also developed an economic model reflecting their findings.
Due to deficiencies in low- and middle-income countries, policy makers are suggesting different methods to achieving universal health coverage. One strategy is the expansion of cadres of close-to-community providers, which plays an important role for connecting communities with the formal health sector. This poster from the Reachout Consortium identifies some of the challenges with this strategy and how to address quality-related issues for universal health coverage.
Using the popular mobile application WhatsApp, a mobile learning intervention was developed and designed to strengthen supervisory support for CHWs in Kenya. 6 months of conversations were analyzed and CHWs and supervisors interviewed to determine how WhatsApp was used in these settings. This preliminary data suggests that CHWs and their supervisors can be effectively trained to tailor their communication in ways that will improve supervisory support, however further research should be conducted.