A Day in the Life of a Professionalized Community Health Worker

Amidst the congested surroundings of Dago Thim village in Nyahera, on the outskirts of Kisumu City, Joyce Muyesu sets out on her routine visits to households armed with her
health kit bag and a wealth of knowledge. She finds a mother and her baby at their home, and uses the opportunity to educate the mother about sanitation and nutrition before checking the immunization status of the child.

Joyce is among the nearly 3,000 CHWs in Kisumu County. They are well trained to provide health education, collect data, diagnose and treat common illnesses in children under 5 and  make referrals to health facilities. Joyce attends to more than 120 households and aims to visit each of them at least once a month. But when a child is sick, or when the app reminds her to visit a pregnant woman or follow up on family planning, she is always on call.

The County Government of Kisumu, with support from Living Goods, provides digital tools to all its CHWs, equips them with medicines and health commodities, carries out regular supervision, coaches them based on performance needs, and pays them a stipend. The phones are installed with the recently designed and piloted government electronic community health system (eCHIS) app that makes it easy for CHWs to collect critical health data within their communities.

The app collects data that helps health managers at the sub-county and county levels to monitor health indicators and respond with appropriate interventions. It also serves as a decision support tool for CHWs. “The app helps me a lot. It asks if the immunization status of a child is up to date. When I click yes, it shows me all the vaccines due at that age. I counter-check in the MoH Maternal and Child Handbook to confirm that the child has received the same vaccines,” explains Joyce.

In partnership with Gavi, the Vaccine Alliance and the health ministries of Kenya and Uganda, Living Goods trained and digitally empowered CHWs to educate households about childhood vaccines, track under-immunized and zero-dose children and make referrals and follow-up visits to ensure all inoculations happen on schedule. This resulted in a significant increase in coverage in the areas where we work, with full immunization coverage improving between the baseline and endline evaluations by 36% in Uganda and 69% in Kenya. The number of children aged 6 weeks to 59 months who had never received any vaccines dropped 56% in Uganda and 70% in Kenya, whilst the percentage of zero-dose children fell from 5.2% to 0.7% in Kenya and 13.2% to 7% in Uganda.

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