We love our work, but CHWS should not be volunteers

By Josephine Motuku, CHW in Kisii County, Kenya

As a widowed mother of five, I work hard to make ends meet. Although I spend hours each day farming various crops like maize and bananas, since 2013 I have also been supporting expectant mothers and helping to address childhood illnesses as a community health worker (CHW) in my neighborhood in Kenya’s Kisii County.

Serving my community is certainly rewarding in non-financial ways, but the work is not easy. I am among the few who remain from my initial group of CHWs. Many were understandably discouraged by their volunteer status within the government and meager monthly stipend averaging 2,000 shillings ($20) from an NGO that was supporting us. I stayed on because I could not ignore the dire needs in my community. Mothers were giving birth at home without professional assistance leading to needless maternal and newborn deaths. Many people were also unable to access timely care at health facilities when their children fell sick. I imagined these families in need as my own kin and decided to continue serving as a volunteer.

In 2018, I started working with a new NGO called Living Goods. While my work remained the same, the way I was doing it changed dramatically. I started receiving regular training on key aspects of my work and no longer had to carry bulky manual registers because everything is now done digitally on my smartphone. I was glad that my stipend also increased as I was now able to earn incentives based on performance. This motivated my colleagues and I to work harder and every extra cent went a long way in helping me keep up with the financial needs of my household.

However, at the onset of the COVID-19 pandemic, our clients were negatively affected and our incomes plummeted in the period before we received personal protective equipment and training on new COVID protocols to safely resume services. Thankfully, Living Goods also adjusted our compensation structure to cushion us by combining a fixed stipend with performance-based incentives. I’m proud that my work as a CHW is contributing to helping fight the COVID-19 crisis in my community by ensuring people continue to receive the care and information they need to maintain good health.

I’m grateful for the support I have received so far but worry that NGOs will not always be there to support us. While the COVID crisis has energized local and global conversations about the need for better terms for CHWS, ultimately government needs to get involved. I fondly remember the day I had the opportunity to meet and shake hands with our county governor during my CHW cohort’s graduation in 2018. Seeing political leaders like the governor at local community health events gives me hope that the importance of our work is slowly becoming more visible. I’m optimistic that as we continue providing lifesaving care in our communities, the big people will eventually note our efforts and elevate us from being volunteers to becoming officially recognized and compensated health workers.

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