How HopeCore is working to address healthcare worker shortages in rural Kenya
Written by, Melavin Muthamaki
Community Health Volunteers
Community Health Volunteers are lay members of the community who work either for pay or as volunteers in association with the local health care system in both urban and rural environments. CHVs usually share ethnicity, language, socioeconomic status, and life experiences with the community members they serve (CHVs typically serve where they live). They are frontline agents of change, helping to reduce health disparities in underserved communities.
Village HopeCore has 207 CHVs across 21 Community Units. The CHVs are recruited in collaboration with Tharaka Nithi County Government. The community Unit is made up of 10 Villages. Each CHV is in charge of 1 village. The 10 CHVs are in charge of 1 Community Unit. Each Community Unit has a Public Health Officer and Community Health Nurse who support the CHVs.
How Village HopeCore International Supports CHVs
- Free health education training on essential healthcare for mothers and children. HopeCore invites CHVs to attend the HopeCore Maternal-Child Health clinics to learn how to conduct growth monitoring and conduct basic health education.
- Free business training for how to start and run a successful business for the Community Health Volunteers who are interested.
- A CHV’s business-in-a-bag: HopeCore provides all CHVs with a bag fully equipped with a T-shirt, First Aid Kit, Growth Monitoring charts and educational materials.
- Smartphones are provided to each CHV by HopeCore, with monitoring Health tools to support reporting of CHV’s health activities (the Smartphone data entry application is CommCare and all CHVs receive training on how to use the monitoring tool in the smartphone)
- Ongoing training through regular meetings with Village HopeCore International staff. This is done at least once per month as a group (CU) or on an individual basis in the field
- HopeCore supports in advocating for CHVs needs to the stakeholders e.g. County government and ministry of health
Roles of the CHVs
- Creating connections between vulnerable populations and healthcare systems
- They gather the data at the community level. Village HopeCore uses an android application called CommCare to collect this data. Each CHV is assigned a smartphone that they use for data collection.
- Facilitating healthcare and social service system navigation
- Managing care and care transitions for vulnerable populations
- Reducing social isolation among patient populations
- Determining eligibility and enrolling individuals into health insurance plans
- Ensuring cultural competence among healthcare professionals serving vulnerable populations
- Educating health system providers and stakeholders about community health needs
- Providing culturally appropriate health education on topics related to chronic disease prevention, physical activity, and nutrition
- Advocating for underserved individuals to receive appropriate services
- Collecting data and relaying information to policymakers to inform policy change and development
- Providing informal counseling, health screenings, and referrals
- Building capacity to address health issues
HopeCore’s expectations from CHVs
- Following up with identified high risk medical and nutrition cases
- Conduct mosquito net monitoring in every home that has been given a net by HopeCore
- Ensure that all homes in the community have handwashing stations with soap and a latrine
- Refer any medical cases to our nurses and the nearest Health Centre
- Mobilize for the Maternal-Child Health (MCH) clinics in nearby schools and organize community MCH when the schools are closed
- Mobilize for outreaches during market days in their community
- Follow up with identified pregnant women to ensure that they attend all the clinics and get appropriate follow-up care
- Follow up with breastfeeding mothers to ensure that the mothers are exclusively breastfeeding for the first six months. Also, answer any questions concerning weaning and other common concerns
- Monitor water quality in the tanks at the schools located in their region
Advantages and Outcomes of CHVs
- Improved access to health care services.
- Increased health and screening.
- Better understanding between community members and the health and social service system.
- Enhanced communication between community members and health providers.
- Increased use of health care services.
- Improved adherence to health recommendations.
- Reduced need for emergency and specialty services.
CHV, Wilson Kirimi, identifies immunization defaulters and follows to ensure the children are immunized
Dennis Muchemi, our community health nurse, helped two households whose children had defaulted on immunization. Dennis had identified the defaulter cases during a net monitoring exercise in Muragara. Net monitoring is conducted by making door-to-door household visits educating clients on malaria prevention and monitoring on correct usage of the treated mosquito nets issued. Dennis then linked up with the area Community Health Volunteer (CHV), Kirimi to ensure effective follow up of the cases. Dennis and Kirimi conducted several follow-ups to persuade the parents to take the children for immunization. In one case, Dennis had to take the mother and children to a Health Centre to ensure that they were immunized. After health education, the mother realized the importance of immunization and is continuing with the rest of the immunization as scheduled without any follow up. Of the six (6) children that Dennis was following up, five (5) are now up to date with their immunization schedule. We however, have one child whom the team could not follow up as the mother relocated to another area. This represents a success rate of over 80%.
Community health volunteers is an important network of individuals that focus on providing access to health care through health education, creating health awareness, follow ups and referral services to families who may not otherwise have access to the service due to some reason. During one of his routine household visits, Wilson Kirimi, one of our CHVs managed to identify two parents who had defaulted on their children immunization schedule. The two children, both from Muragara, have since had their vaccine shots and can now enjoy one of the best features of modern medicine: prevention. The community’s herd immunity has further been reinforced in the process
A CHV (Community Health Volunteer) helps a TB medication defaulter
Benson Kirigu had for some time been following up on one client diagnosed with Tuberculosis in one of the households he visits who had defaulted on his anti-TB medication. Together with the family members, they were able to convince the client to resume medication. The client was later taken to Magutuni Sub-County Hospital where he was admitted for further care.
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