In Kenya, health doesn’t always begin in a clinic. It starts with a knock on the door, in villages beyond tarmac roads and in crowded informal settlements where medical facilities are distant or overstretched. Here, health begins at home. A Community Health Promoter (CHP) arrives not in an ambulance, but on foot or motorbike, carrying more than a kit; she brings trust, knowledge, and continuity of care. She settles under the shade of a tree beside a mother and asks gently, “How’s the baby? Are you taking your medication? Is the water safe today?” These quiet, familiar exchanges are not routine; they are the first line of defence in Kenya’s health system. They mark the start of a journey: to safe childbirth, complete immunisations, timely treatment, and ultimately, to a healthier, more resilient nation.
For years, CHPs worked behind the scenes as volunteers, often without pay, supervision, or tools. They served with heart but lacked recognition. That changed in September 2023, when Kenya took a bold step. At a national event presided over by H.E. Dr. William Ruto, the government distributed 100,000 digital kits and smartphones to Community Health Providers (CHPs) across the country. It was more than a ceremonial gesture; it was a turning point.
These men and women, once unseen, were now being formally recognised as essential health workers and empowered as the backbone of Kenya’s primary health care system.
Today, over 107,000 CHPs have been professionalised. They are trained, digitised, equipped, and remunerated. They deliver care directly to households, monitoring pregnancies, supporting immunisation, promoting hygiene and nutrition, and spotting danger signs early enough to save lives. For many Kenyans, especially in remote or underserved areas, the CHP is not just the first responder; they are the only provider of health care. They bring not just medical knowledge, but trust, continuity, and dignity into communities where formal facilities are often far away or overstretched.
But CHPs don’t work in isolation. Kenya is also rolling out Primary Care Networks (PCNs), a model designed to link Community Health Providers (CHPs) to nearby health facilities, referral hospitals, and county health teams. This approach strengthens referral systems, improves supervision, and ensures CHPs are supported by a broader system that allows them to be more effective. Amref Health Africa, in close collaboration with the Ministry of Health and county governments, has been instrumental in operationalising 74 PCNs across the country. These networks are connecting care, strengthening data use, and closing the gaps between communities and the health system.
Behind this transformation is a powerful engine of policy and partnership. Through the Community Health Unit for Universal Health Coverage (CHU4UHC) platform, Amref has convened over 26 partners, united in their vision to strengthen Kenya’s community health architecture. This platform has collaborated closely with the Ministry of Health to develop legislation and strategy, contributing to the enactment of the Primary Health Care Act (2023) and the Facility Improvement Fund Act (2023). These legal frameworks have established community health as an integral part of Kenya’s broader health system and secured the government’s commitment to paying Community Health Providers (CHPs) in all 47 counties.
Amref’s role has spanned from grassroots implementation to high-level advocacy. The organisation has supported the digitisation of community health services through the rollout of the Electronic Community Health Information System (eCHIS), which now enables CHPs and health managers to collect and access real-time data to inform their decisions. This shift has enhanced accountability, improved patient follow-up, and enabled more timely, targeted interventions.
The results are tangible. In areas where CHPs are supported, immunisation coverage is rising. Pregnant women are accessing antenatal care at an earlier stage. Children with fevers are being diagnosed more quickly. Outbreaks are being detected before they spread. Across Kenya, families are no longer waiting for help to arrive; they are already connected to the care they need.
Investing in community health is one of the most effective and cost-efficient strategies for any healthcare system. Global evidence shows that every dollar invested can yield up to ten dollars in economic return through healthier populations, reduced pressure on hospitals, and stronger, more resilient systems. Kenya is living proof. By directing resources to where care begins—at the household level, the country is laying a sustainable foundation for Universal Health Coverage.
Health systems are ultimately built on people. And Kenya’s 107,000 Community Health Promoters are demonstrating what’s possible when we invest in the right people, equipped with the right tools, and supported by the right systems. For donors, development partners, and investors, this is a moment of opportunity. The CHP and Primary Care Network model is not just a program; it’s a pathway to equitable, people-centred health care. By professionalising, digitising, and integrating this workforce, Kenya is showing that lasting change starts from the ground up, with those who show up every day, ready to care.
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By: Maureen Rovinnah