Why Kenyans need permanent Community Health Workers
By Lilian Kaivilu
Many Kenyans are still coming to terms with the loss of their loved ones following the absence of doctors in the various hospitals across the country. This was as a result of the more than 100 days of the strike by Kenyan doctors, who were demanding, among others, better pay and working conditions.
But although this strike affected many patients countrywide, some Kenyans were spared from the effects of the strike, thanks to the intervention by the community Health Workers.
ImpactHub Media spoke to Dr Joachim OsurDirector, Regional Programs and Field Offices at Amref Health Africa to establish the vital role that Community Health Workers played during the doctors strike, and the gap that they continue to bridge within the health sector…
Why are Community Health Workers so important in Kenya’s health sector?
There are communities who do not even know that there was a doctor’s strike.
And in most places where Amref works there are no doctors since these areas are so remote and hard to reach. The only people available to provide healthcare are community health workers. They help in transporting difficult health cases to the nearest health centres. In some instances, these health centres are as far as 50 or 100 kilometres away.
So, in your opinion, should they be included in the health system on a permanent basis?
For universal health coverage and improving health access, community health workers become very important in the healthcare chain and especially in helping communities. That is why we are doing the campaign. The only way we can change the health indicators is by having functional community health workers. These people promote health, do disease prevention, link up the people with health facilities, do health education and collect data. This way, we are able to plan for health from an informed position. They are also in charge of mobilising people for immunization.
Ethiopia has reportedly done well in her strategy for Community Health Workers. What can Kenya borrow from them?
All these countries in Africa have very good strategies and thinking around community health work. But what is missing is that they want to make these people volunteers. The challenge has been that these countries do not want to pay the community health workers. This is because there is this belief that they (community health workers) are expensive. So what happens is that they are trained by NGOs or government and after a few weeks they drop out.
What exactly is Amref health Africa pushing for in regard to Community Health Workers?
For us, our campaign is to have these people as part of the civil service because they are doing a great job and the only way to retain this work is to pay them. The government has always had a strategy on community health workers.
So what is the problem?
Implementation is the problem. So NGOs take the strategies and try to implement in bits and piece based on what their interests are. This is because most of the NGOs have a specific thing that they are trying to achieve. It could be immunization, malaria or HIV. So they will take the strategy and implement just a bit of it to suit their interests. Hence they won’t cover the whole problem. We need the government to really take charge. NGOS can train and employ, but the government has to show the way.
Kenya is marking five years since the introduction of devolution. What are your thoughts about the progress thus far, in the health sector, and in the issue of Community Health Workers in particular?
We have seen some good progress. We have seen like Siaya county starting to put this in their budget. They are beginning to pay their community health volunteers. However, the national government needs to move and implement a policy that would guide county governments in paying these workers. These people are as important as the subordinate staff in our government offices. They are so important. So why aren’t they being paid like anybody else?
The long doctors’ strike has just ended. Do you think Community Health Workers cushioned Kenyan patients during the crisis?
The community health workers have a very different role compared to the nurses and doctors. Their role is at the household level. They walk from house to house doing their work. They advise families on how to maintain sanitation and stick to treatment whether for HIV, diabetes or hypertension. This is a very specific scope of work. If this is done well, congestion in hospitals will be greatly reduced. And this can be made better if we paid the health workers.