Efficiency and factors influencing efficiency of Community Health Strategy in providing Maternal and Child Health services in Mwingi District, Kenya: an expert opinion perspective

Abstract

IntroductionCommunity Health Strategy (CHS) is a new Primary Health Care (PHC) model in Kenya, designed to provide PHC services in Kenya. In 2011, CHS was initiated in Mwingi district as one of the components of APHIA plus kamili program. The objectives of this study was to evaluate the efficiency of the CHS in providing MCH services in Mwingi district and to establish the factors influencing efficiency of the CHS in providing MCH services in the district.MethodsThis was a qualitative study. Fifteen Key informants were sampled from key stakeholders. Sampling was done using purposive and maximum variation sampling methods. Semi-structured in-depth interviews were used for data collection. Data was managed and analyzed using NVIVO. Framework analysis and quasi statistics were used in data analysis.ResultsExpert opinion data indicated that the CHS was efficient in providing MCH services. Factors influencing efficiency of the CHS in provision of MCH services were: challenges facing Community Health Workers (CHWs), Social cultural and economic factors influencing MCH in the district, and motivation among CHWs.ConclusionThough CHS was found to be efficient in providing MCH services, this was an expert opinion perspective, a quantitative Cost Effectiveness Analysis (CEA) to confirm these findings is recommended. To improve efficiency of the CHS in the district, challenges facing CHWs and Social cultural and economic factors that influence efficiency of the CHS in the district need to be addressed.

Factors associated with retention of community health workers in maternal, newborn and child health programme in Simiyu Region, Tanzania

“…However, CHW programmes face challenges, namely low attraction and motivation for new CHWs, including poor training, inadequate supervision, lack of supplies and poor relationships with communities. 3 , 21 , 22 , 23 One of the most frustrating elements of many CHW programmes is their high attrition rates. 3 Globally, the reported annual CHW attrition rates are between 3.2% and 77.0%, and it is mainly thought to be because of lack of appropriate remuneration, as CHWs are expected to be volunteering their time.…”

Community health worker interventions are key to optimal infant immunization coverage, evidence from a pretest-posttest experiment in Mwingi, Kenya

“…Community Strategy (CS) also commonly referred to as Community Health Strategy (CHS) is a CHW led Primary Health Care (PHC) intervention which was designed in 2006 to support the delivery of Kenya Essential Package for Health at level one (community level) [ 13 ]. In Mwingi west sub county, the intervention was initiated by the Ministry of Public Health and Sanitation (MoPHS) in partnership with the African Medical and Research Foundation (AMREF) in March 2011 as a component of Aphia plus Kamili project [ 14 ].…”

Community Health Worker Program Sustainability in Africa: Evidence From Costing, Financing, and Geospatial Analyses in Mali

“…Complying with standards can reduce program spending to achieve the same service volume, generating savings to be invested elsewhere in the ECC program. For example, CHW supervision, often considered one of the weakest links in CHW programs (although noted as critical for CHW effectiveness and efficiency), 7 , 22 was severely underfunded in 2015, meeting only 26% of the normative cost required. While donor funding provided adequate total funding for most aspects of the CHW program, we found internal inefficiencies and misalignments of funding.…”