Living Goods is doubling-down on driving system-level change that supports government to truly own community health, and it’s a core element of the new 5-year strategic plan we’re launching in September.  Our work in this realm has enabled us to become one of the Kenyan government’s leading partners for strengthening the community health system and enabling environment. Living Goods is excited to support government as it operationalizes a national program that will extend digital performance management best practices and the DESC approach to all 95,000 CHWs in the country. Consequently, we initiated major changes to our Kenya operations in Q2.

At the end of July, Living Goods began transitioning back to government the support we had been providing to more than 1,300 CHWs in Kisii, Kiambu, Nakuru and Kakamega counties, who will ultimately receive similar support through the Kenyan government’s national program. We are providing county governments with some resources through the end of 2021 so that upskilled CHWs in these counties can keep their phones, government supervisors can still access data, and we’ll also support governments to lead performance management by facilitating regular data review meetings.

We are now working to drive greater impact by supporting the Kenyan government to sustainably operationalize and finance its own community health systems at scale. We’ll expand implementation support in counties like Kisumu and Isiolo, where government makes the commitment to co-finance the costs to implement the DESC elements.  Busia county will remain a learning site for innovation and showcasing the best of what’s possible in community health and is the one Kenyan county where Living Goods will continue funding all elements of DESC if required. Our high-level plan going forward is to partner with the Kenyan government in the following ways.

1. Implementation support for government-led scale up of eCHIS for national impact by supporting the upcoming eCHIS pilot with at least 3,800 CHWs in Kisumu and Isiolo. As the policy is fully operationalized, we plan to support more than 10,000 additional CHWs across the country to optimize the performance of CHW workforces using DESC components.
2. Strengthening service delivery through a learning site that directly provides community health services in Busia County—a malaria-endemic region where we support more than 850 CHWs (40% of the county’s CHWs) and have had a particularly high impact. This will enable us to continuously adapt and innovate.
3. Strengthening the enabling environment by continuing to work as a key partner in providing technical support to government to digitize its eCHIS platform for community health, with a focus on performance management and improving health outcomes. We will also partner with national and county governments to accelerate other aspects of the enabling environment, including foundational policies, practices, costing, and the financing needed to sustain effective community health services at national and subnational levels.

The new operational structure in Kenya necessitated a redesign of our internal structure, which unfortunately meant that many of our Kenyan staff were impacted—with about 10% of roles changing significantly or ceasing to exist. We developed and implemented plans to address both the external and internal changes, and to support county governments, CHWs and our staff through the transition.

Our journey in Kenya has been unique and impactful and we are proud of the value we have provided in upskilling thousands of CHWs to deliver-lifesaving care in these counties, and for the role these efforts have played in influencing progressive county and national-level policies and practices. We’re excited about what this means for the country and thrilled about government’s continued commitment to leading and making DESC-enabled community health attainable at scale.