We are the doctors in the community: An Assessment of the Community Health Strategy in Gichagi Slum, Ngong, Kenya Open Access

Janes, Nicole Lee (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/sf268533p?locale=en


Background : The Community Health Strategy is part of a government initiative that has been in place in Gichagi slum, Ngong, Kenya since 2011. Through this program, local volunteers serve as community health workers (CHWs) and provide a number of basic health and preventative services, including community level health education, referral services to the primary hospital, first aid and distribution of items such as condoms and water treatment tablets. However, funding cuts have led to a decrease in the number of active CHWs. Without financial motivation and sufficient equipment to perform their duties, CHWs in Gichagi have been largely inactive.

Objectives: To assess the community's awareness, attitudes and utilization of community health services provided by CHWs in Gichagi slum, Ngong, Kenya, as well as to establish the attitudes of the CHWs who provide the community health services in Gichagi.

Data and Methods: I conducted a cross-sectional quantitative survey with a qualitative supplement through: 120 surveys on Gichagi residents' awareness, attitudes and utilization of community health services; and a focus group discussion with 10 Gichagi community health workers assessing their views of the program.

Results: Key findings included: (1) Community health services were known by 65.83% of Gichagi residents, but utilized by only 34.17%. Despite low utilization of services, survey participants expressed overwhelming satisfaction with the community health worker program. (2) CHWs who participated in the focus group discussion felt unsupported by the Ministry of Health. As residents of the slum, they perceived the loss of their stipend as highly detrimental as they lost both their motivation to perform their duties and their ability to purchase supplies for the program. Despite these negative aspects, CHWs gained increased respect and social standing in the community via their status as a CHW. Renewal of their stipend, additional trainings and recognition were established by CHWs as highly desired methods to maintain their motivation.

Discussion: Through the recommendations provided, the Community Health Strategy can increase the efficiency of the Strategy, maintain CHW participation and ultimately improve health outcomes through the provision of basic health and preventative services in Gichagi slum.

Table of Contents

Chapter One: Introduction and Background of Community Health Services in Kenya 1-5
Chapter Two: Health Issues in Informal Settlements and the Role of Community Health Workers 6-20
Chapter Three: Study Method 21-24
Chapter Four: Research Findings 25-33
Chapter Five: Discussion of Findings, Recommendations for the Community Health Strategy in Gichagi, and Conclusion 34-43
References 44-49
Appendix 1: Awareness and Utilization of Community Health Services in Gichagi, Ngong, Kenya, Ministry of Health, Kajiado North Subcounty 50-52
Appendix 2: Community Health Volunteers Focus Group Discussion Guide, Ministry of Health, Kajiado North Subcounty 53-54
Appendix 3: Community Health Volunteers Focus Group Survey Ministry of Health, Kajiado North Subcounty 55

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