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A comparative study of an NGO-sponsored CHW programme versus a ministry of health sponsored CHW programme in rural Kenya: a process evaluation.

Aridi JO, Chapman SA, Wagah MA, Negin J - Hum Resour Health (2014)

Bottom Line: The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues.This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya.One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme.

View Article: PubMed Central - PubMed

Affiliation: The Ford Family Program in Human Development Studies and Solidarity, University of Notre Dame, Nairobi, Kenya. Jackline.Oluoch@gmail.com.

ABSTRACT
The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues. This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya. One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme.

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The Kenyan community health model. A Level One Care Unit serves a population of approximately 5,000. Between 1 and 2 trained and certified public health officers (CHEWS) each manage a cadre of 25 community health workers (CHWs), each of who are responsible for providing services to 20 households. Typically, there would be between 35 and 45 CHWs per village of 5,000. Village Health Committees work with CHEWs to mobilize and educate the community on issues of public health.
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Fig1: The Kenyan community health model. A Level One Care Unit serves a population of approximately 5,000. Between 1 and 2 trained and certified public health officers (CHEWS) each manage a cadre of 25 community health workers (CHWs), each of who are responsible for providing services to 20 households. Typically, there would be between 35 and 45 CHWs per village of 5,000. Village Health Committees work with CHEWs to mobilize and educate the community on issues of public health.

Mentions: The Kenya National Health Sector Strategic Plan II (NHSSP 2005-2010) was introduced in 2005. The plan laid great emphasis on taking the Kenya Essential Package for Health (KEPH) to the community and delivering improved services to the lowest level of health service delivery through a primary health care approach [20]. Key to this strategy was the training of local community members to provide basic health services, and in so doing empowering Kenyan communities to take charge of their own health. This included the establishment of a Level One Primary Health Care Unit; a Community Unit (CU) to serve 5,000 people with a comprehensive well-trained volunteer CHW providing services to approximately 20 households. The CHWs were expected to provide basic health promotion and disease prevention services within the community. For every 25 CHWs there was to be one Community Health Extension Worker (CHEW) providing supervision and technical support. CHEWS were trained health personnel with certification in nursing or public health, and were MoH employees. Their responsibilities within the community health strategy included: facilitating trainings in the community, providing facilitative supervision to CHWs, and providing a link between CHWs and health facilities. At the same time, Community Health Committees (CHCs) were expected to organize community dialogue sessions to raise awareness of maternal and child health issues with the aid of data displayed on a community chalk board. Deliberations on community dialogue days were intended to inform the planning of community action days for health service delivery in the community. The recruitment of CHWs was to be done by each village in partnership with the CHCs (FigureĀ 1). The strategy aimed towards reaching 16 million Kenyans or 3.2 million households [21].Figure 1


A comparative study of an NGO-sponsored CHW programme versus a ministry of health sponsored CHW programme in rural Kenya: a process evaluation.

Aridi JO, Chapman SA, Wagah MA, Negin J - Hum Resour Health (2014)

The Kenyan community health model. A Level One Care Unit serves a population of approximately 5,000. Between 1 and 2 trained and certified public health officers (CHEWS) each manage a cadre of 25 community health workers (CHWs), each of who are responsible for providing services to 20 households. Typically, there would be between 35 and 45 CHWs per village of 5,000. Village Health Committees work with CHEWs to mobilize and educate the community on issues of public health.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230347&req=5

Fig1: The Kenyan community health model. A Level One Care Unit serves a population of approximately 5,000. Between 1 and 2 trained and certified public health officers (CHEWS) each manage a cadre of 25 community health workers (CHWs), each of who are responsible for providing services to 20 households. Typically, there would be between 35 and 45 CHWs per village of 5,000. Village Health Committees work with CHEWs to mobilize and educate the community on issues of public health.
Mentions: The Kenya National Health Sector Strategic Plan II (NHSSP 2005-2010) was introduced in 2005. The plan laid great emphasis on taking the Kenya Essential Package for Health (KEPH) to the community and delivering improved services to the lowest level of health service delivery through a primary health care approach [20]. Key to this strategy was the training of local community members to provide basic health services, and in so doing empowering Kenyan communities to take charge of their own health. This included the establishment of a Level One Primary Health Care Unit; a Community Unit (CU) to serve 5,000 people with a comprehensive well-trained volunteer CHW providing services to approximately 20 households. The CHWs were expected to provide basic health promotion and disease prevention services within the community. For every 25 CHWs there was to be one Community Health Extension Worker (CHEW) providing supervision and technical support. CHEWS were trained health personnel with certification in nursing or public health, and were MoH employees. Their responsibilities within the community health strategy included: facilitating trainings in the community, providing facilitative supervision to CHWs, and providing a link between CHWs and health facilities. At the same time, Community Health Committees (CHCs) were expected to organize community dialogue sessions to raise awareness of maternal and child health issues with the aid of data displayed on a community chalk board. Deliberations on community dialogue days were intended to inform the planning of community action days for health service delivery in the community. The recruitment of CHWs was to be done by each village in partnership with the CHCs (FigureĀ 1). The strategy aimed towards reaching 16 million Kenyans or 3.2 million households [21].Figure 1

Bottom Line: The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues.This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya.One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme.

View Article: PubMed Central - PubMed

Affiliation: The Ford Family Program in Human Development Studies and Solidarity, University of Notre Dame, Nairobi, Kenya. Jackline.Oluoch@gmail.com.

ABSTRACT
The varied performance of Community Health Worker (CHW) programmes in different contexts has highlighted the need for implementation of research that focuses on programme delivery issues. This paper presents the results of process evaluations conducted on two different models of CHW programme delivery in adjacent rural communities in in Gem District of Western Kenya. One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya's National CHW programme.

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