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Community workers can relieve pain in ailing health sector

nurses

For over 200 days now, the health sector’s personnel have not functioned as a unit due to strikes by various workers. FILE PHOTO | NMG

This has been a tough year for the health sector. For over 200 days now, the sector’s personnel have not functioned as a unit due to strikes by various workers.

First was the 100-day doctors’ strike which ended in March. Then came the nurses strike, currently past the 130-day mark.

In mid-September, clinical officers also downed their tools for some time before giving agreeing to negotiations. And now medical laboratory officers have issued a seven-day strike notice.

These recent strikes have shined a light on the acute shortage of health workers around the country. According to the 2017 Kenya Health Workforce Status Report, the ratio of workers is one per 725 people, far below the WHO recommended ratio of one to 225.

While universal health coverage is recognised as one of the best ways of achieving the Sustainable Development Goal targets for health, shortage of workers remains a stumbling block.

An effective community-based approach can mitigate this, while alleviating pressure on higher level healthcare facilities.

Community Health Volunteers (CHVs) live in the locations they serve and have rich social networks that they leverage to spread health education.

They visit families in the convenience and privacy of their homes, where they check children’s health, support pregnant mothers and advise parents on health practices.

The familiarity makes them trusted advisors. Families know they can call them at any time when in need and get accurate diagnosis and treatment of minor ailments and/or referrals to health facilities as appropriate.

In malaria endemic zones such as Busia, CHVs have been used to great effect in dealing with infections. So far in 2017, over 203,000 malaria tests and treatments have been undertaken by CHVs in the county.

Though public health facilities offer ‘free’ services, patients’ families usually pay transport costs to the facilities. They also spend time travelling and waiting in queues, which for most translates to lost income.

Delivering healthcare directly to a patient’s home saves precious time and money. It is also a lot easier and more convenient .

CHVs are essential in rapidly responding to health crises, delivering routine care, and providing linkages to the health system—yielding life-saving results.

However, CHVs are often, though they are often unpaid -— largely relying on implementing partners and donors. As a result, they split their time between community health work and eking a living, leading to high attrition rates.

To ease pressure on health facilities, counties should prioritise community health by providing medicines and supplies, basic tools, financial and non- financial incentives, training, programme support and supervision of CHVs.

With proper support, community health will improve patient outcomes, reduce costs to health systems and patients as well as mitigate effects of health worker strikes and shortages and the effects of diseases to the households.