Shortage of community health workers in rural Kenya: What to do?
Many rural parts of Kenya, such as Baringo County, still face an enormous shortage of community health workers (CHWs) to penetrate the largely remote areas inhabited by marginalized communities. The rural and marginalized population in the Baringo can hardly afford to commute to the far stationed health centres, and need the services of community health workers to access quality healthcare.
Since the inception of devolution in Kenya ten years ago, Baringo County has made significant efforts to improve health services. From 2013, the County Government has invested heavily in health infrastructure and human resource.
The county has been allocating over Kshs. 150 million annually to procuring medicine and pharmaceuticals. As of 2018, the Baringo County Department of Health reported that it had operationalized 175 dispensaries and 28 health centers across the expansive region to improve population health.
Nevertheless, many health clinics are severely understaffed and underequipped to meet the health and care needs of the locals. The shortage of CHWs in areas such as Orus Location further makes it harder for the county residents to access quality healthcare services.
Most healthcare professionals are in urban areas yet many Kenyans live in the rural areas. Baringo County is largely an arid and semi-arid region, with most health practitioners shunning the rural areas to work in health facilities based in the urban centers.
A case in point is an Orus-based dispensary with only one midwife the only healthcare professional working in the entire facility. She serves an area with a population of over 3000 people. She’s not only overwhelmed by the number of patients but also by the multiple diseases and conditions that require specialized diagnosis and treatment which she and the facility cannot handle.
Many healthcare professionals are unwilling to work in the rural areas due to lack of major infrastructure and amenities such as roads, housing, mobile network, internet, electricity, water and security. Cases of insecurity have been reported in many pockets of Baringo County, further alienating the residents from accessing quality health services, as health workers stay away.
To save the situation, a number of community organizations, religious organizations and local and international non-governmental organizations have ventured into various aspects of health and affiliated building blocks.
Maternal Aid for Mothers in Africa (MAMA) Kenya works to strengthen and promote maternal and child health in marginalized and rural areas, and has ongoing programs in Baringo County with a similar goal. MAMA trains CHWs and community health volunteers (CHVs) to build capacity, empowering them to educate and provide professional care to the locals.
MAMA also trains and equips traditional midwives (TMs), also known as traditional birth attendants (TBAs), to ensure mothers deliver safely and reduce the possibility of infections to the mother, the baby or both during childbirth.
The health interventions by organizations such as MAMA alleviates the shortage of community health workers in rural and marginalized areas, while strengthening and promoting quality reproductive health among girls and women living in vulnerable communities.
The national and county government as well as other development partners can go a little further to improve public infrastructure and amenities to better the working environment for health workers, and attract more CHWs to work in the rural areas. Opening up the rural areas will entice more health professionals to work in health facilities based there, making healthcare more accessible to rural communities.
Article by David Njiru