CHWs at the heart of primary health care in Busia

CHV Jacinta Packama Papai Malaba. Busia County conducting a house hold visit to a client with an U1.

While tens of women busy themselves with house chores, some working on their farms, Jacinta Packama is not among them. Instead, the 32-year-old who works as a Community Health Worker (CHW) is busy making her way through the villages in Amagoro, Teso North Sub County within Busia County of her clients, nursing, pregnant women and children under five-years.

She stops at the tin roofed house of Caren Etyang where she is offered a seat. Etyang gave birth to her third born baby three weeks ago, although baby Mikael Mkade Singoma is reported to be healthy, Wanyonyi requests to see her.

After a brief conversation, she removes her smart phone from the bag ready to assess the baby using an application. Meanwhile, she inquiries about the baby’s wellbeing, her feeding program and any challenges of being a new mother.

She explains that her first visit was immediately when Etyang was discharged from the hospital after giving birth.

“I came to find out if the baby had Bacillus Calmette Gerin (BCG) vaccine, it is also my responsibility to note down the baby’s next visit to the health facility,” says Packama.

On her phone, she clicks the details of baby Mkade, while following the instructions on the phone, she checks on the newborn’s temperature and heartbeat using a timer. “Other things I look out for are any danger signs that could put the baby’s life at risk,” says Packama

The personal information of the baby on the mobile app also includes the next clinic visit. Meanwhile a mother will be offered with a referral letter to visit a healthy facility in case of any danger signs.CHW Jacinta expounds on nutrition to mother of an U1.

According to Ms Packama, the application always gives a constant reminder on the newborn’s next clinic visit to ensure they do not skip their routine immunization.

Apart from Ms Etyang, Jacinta who has a target of visiting 119 households per month says that she also looks out for pregnant women and children below five years.

The phone application also allows for the data entry of the information on when a pregnant woman had her last period, history of family illness, previous pregnancy complications in order to identify a high-risk pregnancy, and the number of births.

She has the responsibility of following the women and ensuring they deliver in health facilities.

“For pregnant women and children below five years, I use my Mid Upper Arm Circumference (MUAC) tape to check for any cases of malnutrition,” she says.

The phone, she says, has made household visits easier unlike in the past when she could use notebooks which could be misplaced, tattered or rained on.

But a partnership between the Busia County Government and Living Goods, a non-Government organization saw the CHWs taken through a short course on primary health care and use of the phone application.

“Living Goods also gave the 827 trained CHVs a mobile phone with an application which they use in the data entry of households,” says the Busia County Community Health Services Coordinator Emmanuel Lavai.

“The organization also engages the CHWs on monthly refresher courses to ensure they get updated while also checking their work records,” says Lavai.

Living Goods have also played a major role in paying the CHWs a monthly stipend to ensure they stay motivated while executing their duties.

According to Living Goods, Busia Regional Manager, David Watila, the aim is to ensure expectant women deliver in hospitals while the newborns attend all their antenatal clinics.

“With well-trained CHWs who are motivated, we are sure to reduce mortality rates (which stands at 362 deaths per 100,000 live births in Kenya) while we bring up a healthy generation,” said Watila.

Apart from Busia, Living Goods is co implementing a similar package in Kisumu County in partnership with the Ministry of Health and the United Nations Children’s Fund.


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