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September 1, 2024
Living Goods’ strategic plan is centered on health systems strengthening. We provide implementation support to government partners that have a strong enabling environment in place and who are committed to co-financing their community health programs. This government ownership enables sustainability, and co-financing creates accountability. By partnering closely, we can quickly share knowledge and expertise, such as using digital tools to optimize performance. After two years of learning, failing fast and improving, we are proud to say this new government-led approach is working.
Our Kisumu program in Kenya is performing well and showing continuous improvement, now hitting many of the targets set. We scaled throughout Vihiga and the CHWs are performing as well as expected at this stage. Our newest site in Busia is up and running. We have also identified a fifth county where we will be scaling this co-financed and co-implemented model. Isiolo continues to be challenging due to low disease burden and a significantly less strong enabling environment.
CHWs’ remuneration by the county government has been in arrears for 12 months now, although funding by the national government is up to date for 660 out of the total 760 CHWs. We no longer have access to data since it is now pushed directly to the National Data Center following the county’s transition to eCHIS. We are assessing the ongoing level of support we will provide.
Kisumu: CHW performance has steadily improved in Kisumu County. We are excited to see these advancements in our largest implementation support site, with nearly 2,400 CHWs actively providing community health services across the county. Since launching operations in early 2021, we have been learning how to strengthen a digitized community health program in close partnership with the county government. This quarter has been the CHWs’ highest performance. The replenishment of essential commodities from the national to county governments enabled CHWs to diagnose and treat more sick children during Q2. Kisumu remains a model for other implementation support sites.
Vihiga: Work in Vihiga County commenced with more than 1,000 CHWs now trained and digitized on the national eCHIS. We are excited to see exemplary leadership by the county governor. CHWs have completed household registration, making Vihiga the second nationally with 100% households registered on the national eCHIS dashboard.
We also conducted refresher trainings on topics like probing techniques for CHWs to accurately assess malaria, pneumonia, or diarrhea in children under 5 years old. Although some eCHIS workflow gaps prevented real-time data visibility for performance management, several issues were resolved by May, allowing for improved analysis of several KPIs.
Community Health Promoter Violet Aluso (right) attends to a pregnant, Esterina Learamo at her home in Emusire, Emuhaya sub-county in Vihiga.
A high percentage of health facility deliveries in Vihiga can be attributed to the government-led and funded Ottichilo Care, which incentivizes women with a stipend upon giving birth at a health facility. We expect this initiative to also improve performance on other KPIs, such as pregnancy registration and antenatal care visits.
Busia: We launched our newest implementation support site in in five sub-counties of Busia County. We continue to run a learning site in the two remaining sub-counties, where we innovate and are responsible for all the DESC elements along with their financing. We are now working to fully equip CHWs in the implementation support site where we are co-financing the community health program with the county government.
The transition has come with learnings from doing two models in the same county, but it has been received with goodwill from the county leadership. CHWs are currently carrying out household registration on the government eCHIS. This will help track households’ health data over time and facilitate reminders in the CHWs’ app to conduct visits once they start providing health services in Q3.