Performance of Community Health Workers in Njiru District, Nairobi County, Kenya

Abstract

In 2006, World Health Organization report recognized shortages of health workers as an ingredient in primary health services. In mitigation the Alma-Ata declaration of 1978 promoted the use of Community Health Workers (CHWs) to provide selected services at level one of health care services. In Kenya, CHWs workforce were adopted as a component of cost effective strategies however the performance of CHWs as change agents has been called into question. The study aimed at describing the factors which influence performance of CHWs in Njiru District, Nairobi County, Kenya through a descriptive cross-sectional survey. Mixed methods (quantitative and qualitative methods) and systematic sampling method were applied. Data was analyzed using Statistical Package for Social Science (SPSS) version 20.0. Findings showed that performance of CHWs was low (34.7%). The performance of CHWs was low in four key monthly targets (referral of patients; number of houses visited; CHWs meetings; number of Baraza but average in health education. Age, gender, marital status, community reception, religious practices, cultural norms, use of feedback, period of training, field allowance and social class were key factors in CHWs performance. From this study the implementation and realization of the key CHWs targets in Peri- urban setting is challenging, there is need therefore to develop a clear contextualized CHWs guideline tailored for Peri- urban settings.