The Vital Role of Community Health Volunteers in Advancing Healthcare in Rural Kenya

In the remote regions of rural Kenya, primary healthcare is formed by dedicated individuals known as Community Health Volunteers (CHVs). These volunteers constitute the initial point of contact for many households in their pursuit of medical care, a role that becomes particularly critical in cases involving pregnancies. CHVs are indispensable to the community’s health within Kenya’s healthcare system.

The backbone of rural health
In the rural areas of Kenya, where access to healthcare resources is often limited, CHVs stand as the first responders to the healthcare needs of their communities. Pregnancies, in particular, magnify the vital role they play within this framework. CHVs are community members who have undergone specialized health training facilitated by the government, a preparation that empowers them to serve as the starting point of health and information dissemination within their communities.

Dedicated Kenyan CHVs

When a pregnancy is identified within the community, CHVs step forward, educating and supporting the expectant mother. One of their main responsibilities is the promotion of antenatal care (ANC), highlighting the importance of a minimum of eight visits to healthcare facilities throughout pregnancy. Furthermore, CHVs provide comprehensive counselling, covering topics ranging from recognizing danger signs, promoting Water, Sanitation, and Hygiene (WASH) practices, preparing for childbirth, newborn care, and family planning. Their services address crucial health issues which nurses, doctors, and midwives often do not address due to limited time during clinic visits. Consequently, CHVs are vital in Kenya’s healthcare system by offering essential support, bridging gaps in care and aiding their communities.

A closer look at the work of CHVs: Meet Catherine
To gain deeper insight into CHVs’ work and how to best support them with digital learning and health solutions, Health[e]Foundation travelled to the rural community of Isibania, a town on the border between Kenya and Tanzania. Here, we meet Catherine, a seasoned CHV who provides specialized care to pregnant women and children under the age of five in her community.

Bridging the gap between community and health facility
Our first visit brings us to Irene’s home, where she lovingly cares for her three-month-old son. We settle in her garden, while Irene shares how Catherine provided vital support during her pregnancy and delivery. Irene says:

“Thanks to Catherine’s training and advice, I had a smooth delivery, and my baby is healthy. Catherine ensured I attended my ANC visits, which helped me build a good rapport with the healthcare staff at the clinic.”

Catherine served as a crucial link, directing Irene to the appropriate healthcare services: a public health facility for ANC, a private health facility for delivery, and a dispensary for the baby’s immunizations. Beyond referrals, Catherine followed up on Irene’s appointments and monitored the well-being of her clients. Leveraging her position within the community and healthcare facilities, she ensured timely initiation of ANC/PNC and immunizations at different locations. When we asked Irene what she would have done without Catherine, she mentioned turning to her mother-in-law for information.

The Nuru and Health[e]Foundation team together with Catherine and Irene

Ensuring respectful maternal health services
Our next stop takes us to Margaret’s farm. She shares that she’s looking after her 4-month-old grandson as her daughter is still in school. In rural Kenyan communities, teenage pregnancies can carry a stigma, causing expectant mothers to hide their pregnancy and avoid seeking ANC, which increases the risk of preventable complications.

However, Catherine stepped in to assist. She accompanied Margaret’s daughter to ANC and ensured she received respectful maternal care at the clinic. Catherine also liaised with the school to enable the daughter to continue her education while expressing milk and caring for her newborn after school hours.

The Nuru and Health[e]Foundation team together with Catherine and Margaret

Promoting male involvement during pregnancy
Our final visit takes us to Juliana’s farm, where she, at 39 weeks pregnant, prepares for labor. Throughout her pregnancy, Catherine has been a valuable source of support, evident in Juliana’s confidence about her approaching delivery. Juliana shares:

“My pregnancy has been trouble-free, and I believe it’s because of the guidance I received from Catherine and the care I received at the health facility. Catherine has been like a mother to me, and I reach out to her whenever I have a question.”

In addition to counselling Juliana, Catherine actively engaged the expectant father, explaining how he could support his wife. We briefly spoke with him, and he expressed an understanding of the importance of ensuring Juliana getting rest during her pregnancy and arranging transportation for her when she goes into labor.

The Nuru and Health[e]Foundation team together with Catherine and Juliana

Enhancing Farmers’ Health in Kenya and Ethiopia

In rural Kenya, many households are engaged in farming, a demanding occupation characterized by unpredictable yields. Our partner, Nuru Kenya, provides assistance to these farmers who collaborate within cooperatives to diversify their crops, and leverage value addition to enhance their livelihoods. An integral aspect involves ensuring the health of their families.

In pursuit of this dual goal of agricultural and healthcare improvement, Health[e]Foundation has forged a partnership with Nuru Kenya and Ethiopia. This collaborative effort resides at the intersection of agriculture and healthcare, with a specific focus on enhancing the maternal and neonatal health of farmers and their families. Together, we are committed to equipping community health workers in Kenya and Ethiopia with specialized training in maternal and child health topics, empowering them to enhance the health status of their communities.

This transformative partnership between Health[e]Foundation and Nuru Kenya has been made possible through the generous support of Stichting Virtutis Opus and Dioraphte.