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August 28, 2024
The Government of Kenya has made significant strides in strengthening community health as part of its goal to achieve Universal Health Coverage (UHC). Over the past year, the government demonstrated its commitment by providing mobile phones and kits to 107,000 CHWs—called community health promoters (CHPs) in Kenya—across all 47 counties to enhance their ability to diagnose, monitor, treat, refer, and improve the quality of care given to clients.
However, to maximize the performance of the community health workforce and deliver the best care possible, CHWs need to be adequately trained and given supportive supervision. At Living Goods, we have spent over 16 years honing best practices for implementing highimpact community health programs and solving the problem of underperformance.
A Living Goods peer coach trains CHWs in Vihiga County.
In Kenya, over the last five years, we have learned many lessons from scaling our government-led implementation support approach. Alongside partners like USAID, we are supporting the government in reviewing the supervisor-to-CHW ratios to ensure effective supportive supervision.
The vision is for each CHW to understand what good performance looks like, how they are doing against targets, and to be regularly visited by and coached by their supervisor; for each supervisor to know how their CHWs are doing and where they need support; and for government staff to have easily readable and digestible data and to know how to adjust their program. CHW training has also been revised, ensuring that all CHWs are capacitated uniformly moving forward.
Without these performance management best practices in place, the Kenyan community health program will not move the needle on health outcomes— regardless of the level of investment. We remain hopeful that despite the withdrawal of the Finance Bill which was expected to generate additional income for various sectors, including health, existing government projects will proceed as planned.
We will continue to advocate for the sustenance of the critical health budget lines, including community health.
To truly optimize Kenya’s community health workforce, we must go beyond digitization.
We call on the Kenyan government and other stakeholders to invest in comprehensive training and consistent supervision for CHWs using digitally powered performance management approaches. Through a radically collaborative approach, we can support the health needs of populations at the last mile— today and sustainably into the future.