Community health workers in Kenya need pay

In 2015, Brian Sepashina received a distress call to help save a pregnant woman’s life in Laramatas village in Kajiado County. The woman had been in labour for some hours and the traditional birth attendant who was handling her case had run out of ‘wisdom’ to help out.

“I later found out that the expectant woman had previously given birth via caesarian section. I knew right away that she needed specialised care,” Brian says.

Within two hours, Brian had organised for a car to pick the woman and ferry her to Kajiado Level 5 hospital where her case could be handled. The woman underwent another c-section for her second birth.

“The doctor said had we let the traditional birth attendant proceed with the birth both mother and child would probably have died in the process,” Brian says.

When villagers called on him to assist, Brian says, it was because they understood that he was a community health worker (CHW) — with some knowledge on the right course of action. However, for his dedication, no one pays Brian. He has to make a living from herding goats and cattle, which he sells.

“I was trained to be a community health worker by Amref Health Africa in 2014,” he says.

“I had been chosen by elders of the community to receive the training. I have always loved serving other community members.”

CHWs play a critical role in saving lives, especially at the community level where people lack access to the formal health system

On March 7, 2017, at Africa Health Agenda International Conference in Nairobi, a campaign to get community health workers paid and formally integrated into our health system was rolled out.

Presently, community health workers are neither paid nor remunerated across many African countries, including Kenya.

According to Amref, CHWs play a critical role in saving lives, especially at the community level where people lack access to the formal health system.

“More than 50 per cent of Africans cannot access these formal health system and it is community health workers who provide this vital link,” said Dr Githinji Gitahi, Amref Health Africa Group CEO.

So far, only Ethiopia, South Africa, Nigeria, Malawi and Rwanda have national CHW programmes which legitimise CHW’s work and offer a sustainable career path.

The World Health Organisation (WHO), represented at the conference, voiced its support for a community based health system, saying this is where the health care need was most pressing.

“Community health workers need stable incomes,” said Dr Matshidiso Moeti, Director – WHO Africa Regional Office.

Support for Kenyan CHWs is currently being driven by Amref and GlaxoSmithKline Kenya.

“If we can be included into a national system I believe we will save many more lives,” comments Bahati Abdalla, a CHW in Port Reitz, Mombasa. It is only last year that Bahati recalls her efforts to direct a TB patient to a medical facility helped him get well.

“He had been sick for some time and his condition was getting worse. I was told about him and I asked that we take him to the hospital. He was diagnosed with MDR TB. Who knows what would have happened to him had we not insisted that he be checked?” Bahati says.

The Kenyan government, as a signatory of ‘1 million community health workers’ campaign, by WHO, which underlines importance of primary healthcare, recognises the existence of CHWs.

“We even have an official curriculum for community health work that was launched by former Health Cabinet Secretary, James Macharia,” says Anne Thitu, head of community health at Kajiado county’s ministry of health.

Here is the Toolkit for integrating CHWs into the formal healthcare system.

By Gardy Chacha

Published by the Standard Newspaper on Wednesday, March 15, 2017