Kisumu County’s investment in community and primary health care.
About 2500 community health workers (CHW) are set to benefit from 45 million shillings set-aside by the county government of Kisumu as stipend.
The amount has been budgeted to cover for 6 months stipend before the next financial year commences. Each of the CHW’s will be receiving Ksh 3000 on a monthly basis.
Governor Peter Anyang Nyong’o will on 12th of April launch the payment at Angola hospital in Kisumu East Sub-county, during which he will pay off the first batch of 16 million shillings to the CHW’s.
The remuneration is in line with the promise given by the County Government of Kisumu as an appreciation for the services rendered by the health volunteers who are equally distributed and designated at the units.
Kisumu’s county government had committed to pay stipends following a community health policy that was reviewed by the council of governors.
As part of capacity building for volunteers and CHW’s, a 13 module curriculum was also developed including 6 basic and 7 technical manual for the community volunteers.
This step will go a long way in the impact created by Universal Healthcare (UHC) which is linked directly to health at the household level through primary health care.
Primary health care encompasses correct health seeking behavior, the correct knowledge about health and wellness, use of clean water for drinking, proper house hold hygiene and excreta disposal and adequate nutrition of a balanced diet, child immunization and monitoring of pregnant women and sufficient mental health and stability and oral health. (Continuum of health care)
One of the challenges under UHC was the decision to pay community health workers a stipend as a way of appreciation to their work in promoting health and providing services to communities.
Numerous arguments and counter have been advanced on the ability to sustain the payment to community health workers since the onset of their usage in 1978 when they started working as volunteers known as CHV’s.
The Kisumu county government realizing their immense value has taken a bold step to begin paying this providing remuneration that will go a long way in incentivizing this cadre of workers to have faith and perform better in their work places.
In Kisumu County the CHW’s form the largest single health work force and have been delivering services pro- bono.
It’s a major land mark in history that the governor will unlock the door of non -payment to this faithful and dedicated workers.
Apart from the stipend the county government is embarking on programs to develop their income generating base to guarantee their adherence and sustainability to the work as well as their medical cover under NHIF.
Angola health center, situated in Kisumu East sub county is a shining example of an integrated development program where practical skills are offered to the community especially the vulnerable groups and knowledge and appropriate attitude change is exchanged and grounded .
Angola is one of the designated places benefitting from food security programs and enterprise programs, clean water provision, early child hood development and youth stroke adolescent empowerment.
The overall result is predictable development of all age groups. This programs will adapt well to the new dispensation of making the villages centers and engines of development within the sub counties in particular and the county overall.
“It our intention to replicate this model in all the sub counties in Kisumu.” Governor Nyongo says.
The community unit structure comprises CHCs, CHVs, CHWs, households, and affiliate health facilities. The nearest health facility is the community’s link for seeking all health services.
The community unit, which draws its membership from the catchment area, is led by the CHC and office personnel to support the CHVs in their community-related health work. Post- devolution, there is increased investment by counties on the community strategy, with revision of the strategy designed to reach communities mainly through employed staff with the support of volunteers (5 CHWs from 2 per 1000 HHs). A community health policy has been drafted and is being reviewed by the Council of Governors.
It seems that all basic preparations have been made and what is remaining is getting consensus and endorsement by MOH and counties with agreed design changes if necessary and scale up to ensure that Kenya is investing more on prevention and promotion. Currently, there are 4587 community units established with 4048 CHWs and 90758 CHVs, and only 7 counties met average of deploying 2 CHWs per county.
There is however need to re-examine and strengthen the community strategy as a means of reaching the community. This should include the mobilization of additional resources for community based interventions and leveraging the use of community health workers in enrolling the population on to the National Hospital Insurance Scheme.
Comprehensive and integrated care for the bulk of the assorted health problems in the community is more efficient than relying on separate services for selected problems, partly because it leads to a better knowledge of the population and builds greater trust.
By Lorraine Anyango