This document outlines Kenya's community health strategy. It discusses how community health units empower communities to take control of their health, hold leaders accountable, and improve health outcomes. The strategy aims to enhance access to healthcare through sustainable community services. Key points include: - Community health units are a key part of Kenya's healthcare system and Vision 2030 goals. - Over 4587 units had been established by 2015, serving over 40,000 communities. - The strategy has contributed to improved maternal and child health indicators in Kenya. - Continued support is needed to ensure resources, training, and data systems for community health volunteers and units. - Research shows community health strategies can increase healthcare utilization and reduce childhood mortality.

1. Presented by S. N. NjorogePresented by S. N. Njoroge
Community Health and Development Unit
Ministry of Health

2.  Is a strategy that empowers individuals, households and the
community so that they are informed
 Informed communities can hold policy duty bearers to be
accountable and
 Are able to take control of their own health
Note:
 Communities are at the foundation of affordable, equitable
and effective health care
 They are the core of the Kenya Essential Package for Health

3. Goal -To enhance community access to health
care
Methodology – Establishment of sustainable
community health services
Aim - Promoting dignified livelihoods across all the
stages of the life cycle

4.  A key pillar in Kenya’s Vision 2030
 A flagship program in MTP II
 Focus on community empowerment and participation in
their own health
 Provides a platform for convergence not only within the
health sector, but also with other sectors
 Aim at reaching the unreached and the vulnerable
populations

5. CHU position in the Health Care
System
Primary health care ( Tier 2)
Community Health care (Tier 1)
10 CHVs CHVs CHVs
5 CHEWs
5,000 people
National & County referrals
( Tiers 1&2)

6.  By end of 2015 a total of 4587 Community Units
had been established
 There were 4048 CHEWs giving services at the
community
 A total of 90579 were giving services at the
community level

7. Master Community Health Unit Listing (MCHUL)
The MCUL is an extension of the Master Facility
List (MFL), which is a list of all approved health
facilities in the country
URL: http://mfl.health.go.ke/mcul/
From the MCHUL, one can quickly generate and
stratify CHUs by functionality status

8.  Development of Policy documents: draft policy;
KQMH standards for level 1; Training curriculums
 Evaluation of CHS: (
http://www.unicef.org/evaldatabase/files/14_2010_HE_0
)
 Improved child health indicators and maternal
health indicators

9.  Lack of prioritization of CHS in some counties
 Inadequate resources (finances, human, skills)
 Non uniform supervision
 Partner vested interests, down scaling
 Proper governance of CHS
 High turn over/low retention of CHVs
 Management of CHIS: cost, skills, coordination

10.  Recruitment and retention of CHEWs and CHVs
 Allocation of funding by the county to the
community health activities
 The UHC program in MOH-CHSS
 CHIS: Digitalization
 Advocacy and communication
 County sharing of information/best practices
 Awareness on Global commitments/support
 Formation of IGAs at CHUs level

11.  Research driven CHS
 Devolution
 Partners: PPP
 NHIF
 Free maternity services: Birth Companions
 Riding on other MOH and non health sector
programs
 RMNCH implementation in Kenya
 UHC implementation
 Global movements: 1 Million CHWs Campaign

12.  Planning for health care to include CHS
 All programs to mainstream CHS
 HSS: Should be inclusive of CSS
 CHS implementation should be guided by the policy
documents available
 CHIS should be digitalized
 Sustainable mechanisms for CHEWs, CHCs and CHVs
be explored
 Implementation should be M& E
 Routine CHIS should be taken as a priority

13. In Kenya, a study in Busia County
conducted from 2008-10 showed
that community health contributed
to:
Increase in women attending at least
four ANC visits (39% to 62%)
Increase in share of deliveries by skilled
birth attendants (31% to 57%)
Increased testing for HIV during
pregnancy (73% to 90%)
Increase in exclusive breastfeeding
(20% to 52%).
Increase in women receiving intermittent
preventive treatment for malaria (23% to
57%)
• Source: Wangalwa et al, 2012 (AMREF)
 Analysis of the Countdown to 2015
Report shows that countries with the
strongest progress in reducing under-5
mortality also have strong CHW programs
– this includes Brazil, Ethiopia, Nepal,
Bangladesh, and Rwanda
 By frequently visiting homes and building
trust with families, CHWs are uniquely
positioned to change behavior that leads
to better health outcomes, and even the
reduction of childhood mortality.

14.  Homegrown research needed on evidence that
CHS works
 Need to have evidence based CHS implementation
 Research on cost benefit analysis of CHS
 Evidence on Inter/intra sectoral action/collaboration
& PPP
 Evaluation of CHS needs to be done

15. Afya Yetu, Jukumu Letu
(Our Health, Our Responsibility)
Asante Sana