Factors influencing the performance of Kenyan community health volunteers

Community Health Volunteers (CHVs) play a crucial role in linking the community to the formal health system, particularly in low- and middle-income countries. In Kenya, CHVs are the eyes and ears of the health system on the ground, working to improve the health and well-being of their communities. However, despite their important role, CHVs working in urban informal settlements in Kenya often face a myriad of challenges that affect their wellbeing and work performance.

A study conducted by Ogutu et al. examined the factors that influence the performance of CHVs in urban informal settlements in Nairobi, Kenya. The study was conducted in two urban informal settlements in Nairobi County and involved focus group discussions and key informant interviews with a range of respondents. The study found that several key programme design factors influenced the performance of CHVs working in urban informal settlements. These included CHV recruitment, training, availability of supplies and resources, and CHV remuneration.

In addition to program design factors, health system factors also influenced CHV performance. These included the nature of the relationship between healthcare workers at local referral facilities and community members, the availability of services and perceived corruption at referral facilities, and CHV referral outside of the local health facility. Broader contextual factors that affected CHV performance at the community level included demand for material or financial support, perceived corruption in community programs, and neighborhood insecurity.

These findings suggest that CHVs working in urban informal settlements in Kenya, like other CHVs working in rural and peri-urban areas, face a number of challenges that affect their well-being and work performance. Several measures should be considered to improve the well-being and performance of CHVs. These include adequate and timely remuneration for CHVs, appropriate holistic training, adequate supportive supervision, and ensuring a satisfactory supply of resources and supplies. In addition, at the health facility level, health workers should be trained on appropriate and respectful relationships with both the community and CHVs, clarity of roles and scope of work, ensuring availability of services, and safeguarding against corrupt practices in public health facilities.

In conclusion, CHVs play an important role in improving the health and well-being of communities in urban informal settlements in Kenya. However, they face many challenges that affect their ability to perform their roles effectively. Addressing these challenges through measures such as adequate remuneration, training, supportive supervision and ensuring a satisfactory supply of resources can help to improve their well-being and performance.