Performance of Community Health Promoters in Mwea West Sub-county, Kirinyaga County, Kenya

Abstract

Performance of Community Health Promoters program is vital in bridging healthcare services. Several countries rely on it to improve access to healthcare and attaining universal health coverage. However, performance of Community Health Promoters has been heterogeneous and at times context specific, particularly in low-resource settings. The aim of this study was to determine performance of the Community Health Promoters in Mwea West Sub-County, Kirinyaga County, Kenya. Methods: This was a mixed methods study, using explanatory sequential design conducted in the community setting in Kenya from September 2023 to December 2023. The study followed a quantitative investigation, and a qualitative approach respectively. The Community Health Workers Assessment Improvement Matrix Framework was used to obtain data on the performance of the community health promoter via the use of a structured questionnaire. The socio-demographic and environmental elements that have an impact on the performance of community health promoters were assessed. The overall score was based on the ability of community health promoters to perform more than 3 activities under 4 service domains namely, home visits, community dialogue and action days, documentation and information flow as well as program interventions. The qualitative research used Key Informant Interviews and Focus Group Discussions as methods to gather qualitative data from chosen respondents in 18 community health units located in Mwea West sub-county, Kirinyaga County, Kenya. Analysis: Data were summarized in frequencies and proportions to describe Community Health Promoters performance attributes associations between Community Health Promoters performance indicators and sociodemographic and contextual were assessed using odd ratios. Qualitative data was transcribed, and the thematic content analysis was done manually. Recurring themes and patterns of meaning were identified and utilized to prepare a schematic diagram. The study sought to assess the performance of community health promoters in Mwea West Sub- County in Kenya. The roles performed by community health promoters in the study area included home visits, community dialogue and action days, documentation and information management. The findings indicate poor performance amongst community health promoters. Factors associated with Community Health Promoters performance were found to be gender and education with female status and attainment of secondary education attributed with performance respectively, based on the overall score on the Community Health Workers Assessment Improvement Matrix Framework. The contextual factors associated with performance were refresher training, provision of Community Health Promoters Kits, reduced workload and supportive supervision. Addressing these factors will improve the performance of community health promoters, as they remain a strategic pillar in the dynamic health arena towards implementing primary health care and delivering universal health coverage....................................................