With Living Goods’ support, Kisumu County now has a total of 2,182 DESC-enabled CHWs actively providing comprehensive health services in their communities—a nearly 3-fold increase from the end of last year. This means that CHWs are registering new households in their phones for the first time, reaching more sick children with lifesaving treatments, and more women with pregnancy support and family planning services. We are also excited about the government’s continued commitment to eCHIS scaleup.

With more than 900 CHWs trained last quarter, there was a slight drop in overall performance in Q3; this typically happens when new cohorts are introduced, since it takes time for CHWs to grow accustomed to their duties and to reach targets. There were also minor disruptions due to the political campaigns in which some government supervisors known as community health assistants (CHAs) and CHWs were actively involved.

With more than 900 CHWs trained last quarter, there was a slight drop in overall performance in Q3; this typically happens when new cohorts are introduced, since it takes time for CHWs to grow accustomed to their duties and to reach targets.

Since Kisumu is a co-financed implementation support site, the county government manages critical DESC elements including supervision and supplies, and we work closely with them to build their capacity to run their community health program. For example, we have about 30 staff coaching supervisors and managers on how to use data to drive performance, and to ensure the digital solutions are effective.

Additionally, we worked with the county to include new CHWs in commodity forecasting to ensure they are equipped with sufficient stocks of essential medicines, involved health facility leads in commodity management, and created technical working groups for community commodity management. CHW treatment levels remain below target, affected in part by the low stock levels—though CHWs are making an increasing number of referrals to health facilities in lieu of having medicines on hand.

On-time PNC visits are also below target; a deep dive revealed this is because some are lost to follow-up, meaning they received visits from CHWs but were not reported in the system, while others occur more than 48 hours after birth. We are applying learnings from Busia to improve this, including timely sharing of expected delivery date lists with supervisors to help follow up on facility deliveries and PNC, focused refresher trainings, and a continued push for client phone registrations.

CHAs supported by Living Goods successfully conducted continuous refresher trainings for all CHWs, which is important for building relationships with CHWs and addressing performance gaps, especially for newly trained cohorts. The county government also hired more CHAs, which is expected to improve supervision rates and also CHW performance.