From a Pilot Program to Combating COVID-19: HopeCore's Powerful CHV Program

Community Health Programs (CHPs) have been recognized globally as an effective way to improve health care delivery and address the heavy burden of disease and, therefore, contribute to health and socio-economic development.

 Community Health Volunteers (CHVs) are members of the community, nominated from within, who are tasked with improving the community’s health and well-being and linking individuals to primary health care services. The CHVs are agents for behavior change in underserved communities. Through routine household visits, CHVs can promote good hygiene, demystify myths and misconceptions, and most importantly, promote health-seeking behavior in their community health units.

HopeCore involvement with the CHVs dates back to 2016 with the Mother-to-Mother (M2M),  peer-to-peer education program for mothers within the Kiera zone. Thirty mothers were recruited and trained on simple topics such as hygiene and nutrition. The mothers were then sent to the community to sensitize fellow mothers on small doable health actions like how to assess a sick child, proper breastfeeding, and weaning at six months. In 2018, HopeCore piloted the CHV project with 47 mothers and one father. The 48 were called Neighborhood Community Health Volunteers (NCHV). The 48 had formal training, monthly feedback, and refresher training.

In early 2019, we formally adopted and established the CHV program with 96 CHVs. The 96 underwent formal training, monthly feedback, and refresher training. By the end of 2019, the program had expanded to 206 CHVs from Mwimbi and Muthambi sub-counties. In January 2020, 188 of the 206 CHVs underwent a five-day training on basic modules.

The Role of CHVs in Combating COVID-19

Kenya declared their first incidence of COVID-19 on March 12, 2020. Nothing was known because it was a new virus, resulting in disinformation and panic. HopeCore took on training 676 CHVs from the sub-counties of Mwimbi, Muthambi, Chuka, Igambang'ombe, and Tharaka North. The CHVs were then handed flipbooks with important messages about COVID-19 and distributed to households to familiarize them with the relevant information. Because knowledge is constantly changing, we planned regular refresher training to keep everyone up-to-date. From March through July, 115,000 households were visited by CHVs as part of the campaign. During this time, 62,620 new handwashing stations were installed in homes, with 93 percent of households having functional handwashing stations. The CHVs were subjected to field-based support oversight during this time. Based on the successes of the COVID-19 campaign approach, in July 2020, the CHV flipbook campaign approach for training and household education was formally adopted in four sub-counties: Chuka, Igambang’ombe, Mwimbi, and Muthambi.

Expansion to the 5th Sub-County

Tharaka South sub-county has poor transport infrastructure, low levels of socioeconomic status, and long distances to health facilities. CHVs have the potential to enhance primary care access and quality by providing linkages between hard-to-reach communities and facilities and increasing community referrals.

In March 2022, HopeCore expanded our CHV program to the Tharaka South sub-county, conducting the first-ever training on water and hygiene for the CHVs. A total of 250 CHVs were reached in 27 community units. The CHVs underwent a pretest before the activity to measure their knowledge so that the trainer could know how to deliver the content. They were trained through lectures, PowerPoints, demonstrations, and mock presentations, and the CHVs were given flipbooks as job aids.

We have a satellite office at Marimanti (at the Tharaka South sub-county offices) where our CHOs work. They conduct field-based support supervision of the CHVs to evaluate various aspects of the CHV work and provide constructive feedback.

We will be conducting training on technical modules every three months, with this year’s topic being TB & pneumonia and maternal nutrition.