In October 2019 President Uhuru Kenyatta of Kenya declared that his country would lead the way by achieving universal health coverage (UHC) by 2022, eight years ahead of the 2030 Sustainable Development Goals (SDG) deadline. Now, his vision is a step closer to becoming a reality, with the launch of the Kenya Community Health Strategy 2020-2025 (KCHS).
Led by the Kenyan Ministry of Health and supported by the Johnson & Johnson Foundation, the strategy has community health workers (CHWs) at its heart, acknowledging their vital role in bridging communities to health systems. It was developed through a multi-stakeholder and multi-sectoral participatory process, with input from County Governments, Civil Society, Development Partners and, crucially, community members themselves.
The KCHS is the latest step in a process that started with the launch of the Community Health Units for Universal Health Coverage (CHU4UHC) Platform in early 2020. Co-created by the Johnson & Johnson Center for Health Worker Innovation with the Ministry of Health and other stakeholders, the platform aims to break down silos, integrate CHWs formally into the health system and deliver preventative and promotive healthcare.
Building off the Kenya Community Health policy 2020-2030, which launched in August 2020, the KCHS has seven core focus areas, including:
- Strengthening management and coordination of community health governance structures at all levels of government and across partners
- Building a motivated, skilled, equitably distributed community health workforce
- Increasing sustainable financing for community health
- Strengthening the delivery of integrated comprehensive and high-quality community health services
- Increasing availability, quality, demand and utilization of data
- Improving the availability and rational distribution of safe and high-quality commodities and supplies
- Creating a platform for strategic partnership and accountability among stakeholders and sectors at all levels within community health
Together, these seven areas set out a holistic approach to creating a standardized and robust community-based primary healthcare system.
A community-led approach
One of the most important priorities of the KCHS is encouraging communities to own their health challenges and, where possible, to suggest local solutions. To do this, you need the right governance structures in place. Accordingly, the strategy suggests the creation of formalized Community Health Committees, consisting of three to seven key members of the community, to coordinate community-led health activities within their area and solve problems with local resources, as far as they can.
Remuneration & Recognition
The consistent compensation of CHWs has long been a challenge at the heart of Kenyan healthcare policy, with different counties taking different approaches. The KCHS calls for consistent and fair compensation structures for CHWs across Kenya, in order to boost motivation, attraction and retention. In addition to monetary compensation, this could include important support like National Hospital Insurance Fund coverage, to ensure that no CHW suffers financial losses due to health challenges.
Boosting community health through data
While the CHU4UHC Platform has already done significant work to strengthen community health data management, the KCHS aims to address the gaps that still exist. This includes developing and implementing a digital community health information system (eCHIS), which in turn will help enhance the capacity of CHWs to collect, collate and report on their work.
Until this point, community health workers are reporting manually, filling in registers that are handed to their supervisors and then to the District Health Records Officer to digitize. The eCHIS will integrate the work of each individual into a wider system by enabling workers to enter information on their mobile phone wherever they are, removing a lot of the reporting burden. The system will also provide prompts to support the CHWs in their patient interactions and treatment.
As well as being useful to spot potential stock shortages in advance, health data is a vital tool when it comes to advocacy, allowing the work of CHWs to be visible in real time and illustrating their value to their communities and beyond.
Putting the strategy into practice
There are multiple organizations involved in community health in Kenya and so the KCHS hinges on the establishment of a strong health partnership framework. Moving forward with a shared vision and commitment to change will be vital to transform the strategy from a static document into transformative action.
The launch of the Kenya Community Health Strategy 2020-2025 is a key step in getting us to where we want to be regarding community healthcare. The focus now is on supporting the Ministry of Health and other partners to implement it. At the Johnson & Johnson Center for Health Worker Innovation, we are committed to using our resources and influence to ensure that stakeholders at every level will truly commit and deliver on this strategy.