Challenges and Opportunities for promoting Maternal, New born, and Child Health in urban informal settlements: perspectives of Community Health Volunteers in Nairobi, Kenya

Osindo, Jane; Bakibinga, Pauline; Ngomi, Nicholas; Kamande, Eva; Muriuki, Peterrock; Kyobutungi, Catherine

doi:10.11564/30-3-927

Cited by 3 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the articles, seven [ 36 , 38 , 41 , 42 , 44 – 46 ] were qualitative and six [ 9 , 37 , 39 , 40 , 43 , 47 ] were mixed method studies. The review covered five countries in total with seven [ 39 , 41 – 45 , 47 ] of the studies undertaken in Sub-Saharan Africa (Kenya and South Africa), five [ 9 , 36 – 38 , 40 ] in Asia (Bangladesh and India) and one [ 46 ] from Latin America (Brazil). The papers covered a wide range of health issues.…”

Section: Resultsmentioning

confidence: 99%

“…Financial incentives were identified in ten studies as indicated in Tables 4 and 5 as one of the key motivating factors for CHVs. The studies were from Kenya [ 42 , 43 , 45 ], South Africa [ 41 , 44 ], India [ 36 ] and Bangladesh [ 9 , 37 , 38 , 40 ]. Those CHVs who depended on their role for financial support were more likely to remain as CHVs and more likely to be active [ 9 , 36 – 38 , 40 – 45 ] compared to their counterparts.…”

Section: Resultsmentioning

confidence: 99%

“…The studies were from Kenya [ 42 , 43 , 45 ], South Africa [ 41 , 44 ], India [ 36 ] and Bangladesh [ 9 , 37 , 38 , 40 ]. Those CHVs who depended on their role for financial support were more likely to remain as CHVs and more likely to be active [ 9 , 36 – 38 , 40 – 45 ] compared to their counterparts. In these studies, CHVs mainly depended on the financial incentives to sustain their livelihoods.…”

Section: Resultsmentioning

confidence: 99%

“…As such, they easily dropped out of programmes that offered no financial incentives in preference for personal income generating activities, as they found it difficult to provide for their families including paying for their children’s education [ 9 , 40 , 41 , 43 – 45 ]. To help compensate for the lack of financial income, CHVs undertook supplemental income generating activities such as selling cooked food/’street food’ in their local area or undertaking casual paid domestic work [ 43 , 45 ]. This consequently, led to limited time devoted to CHV work [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…These were noted to either impact positively or negatively on the CHVs motivation and their performance in turn. For instance, in Kenya, India, Bangladesh and Brazil, being appreciated and recognized by the community for the role they played, gave the CHVs a sense of identity [ 36 , 38 , 45 , 46 ]. The CHVs also felt that they were saving lives and improving the health of their community members, which motivated them to continue playing their role [ 36 , 38 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Factors influencing the performance of community health volunteers working within urban informal settlements in low- and middle-income countries: a qualitative meta-synthesis review

et al. 2021

View full text Add to dashboard Cite

Background There is limited information on community health volunteer (CHV) programmes in urban informal settlements in low- and middle-income countries (LMICs). This is despite such settings accounting for a high burden of disease. Many factors intersect to influence the performance of CHVs working in urban informal settlements in LMICs. This review was conducted to identify both the programme level and contextual factors influencing performance of CHVs working in urban informal settlements in LMICs. Methods Four databases were searched for qualitative and mixed method studies focusing on CHVs working in urban and peri-urban informal settlements in LMICs. We focused on CHV programme outcome measures at CHV individual level. A total of 13 studies met the inclusion criteria and were double read to extract relevant data. Thematic coding was conducted, and data synthesized across ten categories of both programme and contextual factors influencing CHV performance. Quality was assessed using both the Critical Appraisal Skills Programme (CASP) and the Mixed Methods Assessment Tool (MMAST); and certainty of evidence evaluated using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach. Results Key programme-level factors reported to enhance CHV performance in urban informal settlements in LMICs included both financial and non-financial incentives, training, the availability of supplies and resources, health system linkage, family support, and supportive supervision. At the broad contextual level, factors found to negatively influence the performance of CHVs included insecurity in terms of personal safety and the demand for financial and material support by households within the community. These factors interacted to shape CHV performance and impacted on implementation of CHV programmes in urban informal settlements. Conclusion This review identified the influence of both programme-level and contextual factors on CHVs working in both urban and peri-urban informal settlements in LMICs. The findings suggest that programmes working in such settings should consider adequate remuneration for CHVs, integrated and holistic training, adequate supplies and resources, adequate health system linkages, family support and supportive supervision. In addition, programmes should also consider CHV personal safety issues and the community expectations.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Factors influencing the performance of community health volunteers working within urban informal settlements in low- and middle-income countries: a qualitative meta-synthesis review

et al. 2021

View full text Add to dashboard Cite

show abstract

“We are their eyes and ears here on the ground, yet they do not appreciate us”- Factors influencing the performance of Kenyan community health volunteers working in urban informal settlements

Ogutu

Kamui

Abuya

et al. 2023

Preprint

View full text Add to dashboard Cite

Community Health Volunteers (CHVs) play a crucial role in linking the community with the formal health system, particularly in low- and middle-income countries. Studies in Kenya have focused on the implementation of the Kenya Community Health Strategy (CHS) in rural, nomadic, and peri-urban areas; with limited information on the factors that influence CHV performance in urban informal settlements. This study therefore explored factors that influence CHV performance in urban informal settlements within Nairobi Kenya and ways in which CHVs can be supported to enhance their wellbeing and strengthen community strategies. The study was undertaken in two urban informal settlements within Nairobi County. Thirteen focus group discussions (total of 123 participants) and three key informant interviews were conducted with a range of respondents. Various topics covering the design of the Community Health Strategy (CHS) and broader contextual factors that affect CHVs’ performance, were discussed and the data analysed using a framework analysis approach. The key programme design factors identified as influencing the performance of CHVs working in urban informal setting included: CHV recruitment; training; the availability of supplies and resources; and the remuneration of CHVs. Health system factors that influenced CHVs performance included: nature of relationship between healthcare workers at local referral facilities and community members; the availability of services and perceived corruption at the referral facilities; and CHV referral outside of the local health facility. Whereas the broader contextual factors that affected CHV performance at the community level included: demand for material or financial support; perceived corruption in community programmes; and neighbourhood insecurity. These findings suggest that like other CHVs working in both the rural and peri-urban settings, CHVs working in urban informal settlements in Kenya face a myriad of challenges that impact on their wellbeing and work performance. Therefore, to enhance CHVs’ well-being and improve their performance, the following should be considered: adequate and timely remuneration for CHVs, appropriate holistic training, adequate supportive supervision, and ensuring a satisfactory supply of resources and supplies. Additionally, at the health facility level, healthcare workers should be trained on appropriate and respectful relations with both the community and the CHVs, clarity of roles and scope of work, ensure availability of services, and safeguard against corrupt practices in public health facilities. Lastly, there is a need for improved and adequate security measures at the community level, to ensure safety of CHVs as they undertake their roles.

show abstract

“We are their eyes and ears here on the ground, yet they do not appreciate us”—Factors influencing the performance of Kenyan community health volunteers working in urban informal settlements

Ogutu,

Kamui,

Abuya

et al. 2023

PLOS Glob Public Health

View full text Add to dashboard Cite

This study explored factors that influence CHV performance in urban informal settlements (UIS) within Nairobi Kenya and ways in which CHVs can be supported to enhance their wellbeing and strengthen community strategies. The study was undertaken in two UIS within Nairobi County. Thirteen focus group discussions and three key informant interviews were conducted with a range of respondents. Various topics covering the design of the Community Health Strategy (CHS) and broader contextual factors that affect CHVs’ performance, were discussed and data analysed using a framework analysis approach. The key programme design factors identified as influencing the performance of CHVs working in UIS included: CHV recruitment; training; availability of supplies and resources; and remuneration of CHVs. Health system factors that influenced CHVs performance included: nature of relationship between healthcare workers at local referral facilities and community members; availability of services and perceived corruption at referral facilities; and CHV referral outside of the local health facility. Whereas the broader contextual factors that affected CHV performance included: demand for material or financial support; perceived corruption in community programmes; and neighbourhood insecurity. These findings suggest that CHVs working in UIS in Kenya face a myriad of challenges that impact their wellbeing and performance. Therefore, to enhance CHVs’ well-being and improve their performance, the following should be considered: adequate and timely remuneration for CHVs, appropriate holistic training, adequate supportive supervision, and ensuring a satisfactory supply of resources and supplies. Additionally, at the facility level, healthcare workers should be trained on appropriate and respectful relations with both the community and the CHVs, clarity of roles and scope of work, ensure availability of services, and safeguard against corrupt practices in public health facilities. Lastly, there’s a need for improved and adequate security measures at the community level, to ensure safety of CHVs as they undertake their roles.

show abstract

Challenges and Opportunities for promoting Maternal, New born, and Child Health in urban informal settlements: perspectives of Community Health Volunteers in Nairobi, Kenya

Cited by 3 publications

References 0 publications

Factors influencing the performance of community health volunteers working within urban informal settlements in low- and middle-income countries: a qualitative meta-synthesis review

Factors influencing the performance of community health volunteers working within urban informal settlements in low- and middle-income countries: a qualitative meta-synthesis review

“We are their eyes and ears here on the ground, yet they do not appreciate us”- Factors influencing the performance of Kenyan community health volunteers working in urban informal settlements

“We are their eyes and ears here on the ground, yet they do not appreciate us”—Factors influencing the performance of Kenyan community health volunteers working in urban informal settlements

Contact Info

Product

Resources

About