CHWs are Instrumental in Managing Malaria Cases at the Household Level

Situated in western Kenya at the border with Uganda, Busia County is a malaria-endemic area with a prevalence of 39%, way above the national rate of 19%. Its proximity to Lake Victoria and other water bodies creates humid temperatures and wet weather, ideal for mosquito breeding and waterborne diseases.

With a population of nearly 900,000 people, the county boasts several health facilities and 2,190 CHWs who bring services to people’s doorsteps. Busia County is one of our longest-standing areas of operations in Kenya. We now operate both a learning site and partner with the county government to co-implement and co-finance their community health program.

Busia County: During a household visit, CHW JosephBarasa teaches a mother about the importance of proper nutrition during pregnancy.

Busia County: During a household visit, CHW Joseph Barasa teaches a mother about the importance of proper nutrition during pregnancy.

A new cohort of about 300 CHWs is now active in two implementation support sub-counties—Malaba and Busia—in addition to about 800 CHWs in our learning sites. Over the years of Living Goods’ support in Busia, there has been a gradual improvement in the county’s health indicators.

“Statistics show an improvement in facility deliveries from 23% in 2014 to 70% in 2022,” says Luvai, Busia County’s Health Focal person. Overall, performance in Q1 has been strong, though some KPIs declined slightly due to competing priorities including malaria prevention efforts due to flooding.

 We are engaging in continuous capacity building of CHWs on work planning, collaboration with MoH supervisors and counterparts, and targeted performance improvement plans through data deep dives and revamping of workflows.

“The CHWs currently manage half of the malaria cases at the household level. We have also seen a drastic drop in the workload at health facilities. Nowadays, we no longer have long queues there,” says Luvai, adding that with Living Goods’ support, “The CHWs are equipped to detect disease outbreaks and report back using their digital tools early enough for quick management.”

Many of the CHWs’ achievements have been possible because they collect and use data to guide their daily tasks. Supervisors are supported with dashboards to tailor their support to individual CHWs’ needs. Government staff can also use the aggregated data to make health programming decisions.

“Through training, we have been able to upskill CHWs, most of whom are from humble backgrounds, to diagnose and treat several childhood diseases,” Luvai adds, attributing this to the eight-year partnership between Living Goods and Busia County.

In Q1 we kicked off eCHIS sensitization for CHWs and government supervisors in two sub-counties and aligned on the program objectives, KPI targets, and health system assessments with the county-level leadership.

Out of the 2,190 CHWs in the county, more than 96% have already been digitized and enrolled on the national eCHIS platform. The few remaining CHWs will be digitized and trained in the coming months, with technical support from Living Goods.

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