Assessing the Enablers and Challenges on Performance of Community Health Volunteers During the Covid-19 Pandemic: a Mixed-methods Study of Machakos County
Abstract
Background: The Coronavirus disease 2019 (COVID-19) pandemic, imposed a strain on
healthcare systems around the world posing significant obstacles for healthcare providers
everywhere in the world. Weaker health systems which are synonymous with the developing
countries were the most affected with serious impairment in health service delivery. There is,
however, limited information on the enablers and challenges of community health workers’
performance during the COVID-19 pandemic.
Objective: This study assessed the enablers and challenges on performance of community health
volunteers in Machakos County, Kenya during the COVID-19 pandemic.
Methodology: A cross sectional mixed methods survey was carried out. Data was collected from
community health volunteers (CHVs) from various community health units (CHUs) in different
sub-counties in Machakos County. Structured questionnaires and focused group discussion
guides were used to collect data on the enablers and challenges faced by CHVs during the
COVID-19 pandemic while data on the CHVs’ work output, for the period 2019 - 2021, was
extracted from the Kenya Health Information System (KHIS). The data was entered and cleaned
in Excel then analyzed with SPSS version 25.0. Quantitative data derived from the
questionnaires and the MoH 515 was analyzed through descriptive statistics in the form of
frequencies and percentages. This was summarized and presented in tables, graphs and charts.
Qualitative data emanating from the FGDs and open-ended questions in the questionnaires were
analyzed through thematic analysis from which conclusions were generated and findings
presented verbatim.
Results: The common enablers of CHVs during the COVID-19 pandemic were belonging to a
social support group in their community (85.1%, n = 240) and appreciation of the CHVs efforts
by their communities (99.3%, n = 280). However, the leading challenges experienced by the
CHVs during the COVID-19 pandemic were inadequate or delayed stipends (100%, n = 282);
concerns about contracting COVID-19 during their work (82.3%, n = 232); excessive workload
(90.4%, n = 255); difficulties in transport (94.7%, n = 267) and lack of tools and materials
(92.2%, n = 260). Contrary to the multiple challenges experienced by CHVs, their work output
level seemingly improved as marked by an increase in the number of women aged 15 - 49 years
provided with FP commodities that rose from 3,691 in 2020 to 4,212 in 2021. The number of
pregnant women counseled on ANC services rose as well from 406 in 2020 to 1,742 in 2021.
Conclusion: Belonging to a social support group and appreciation of CHVs efforts by the
community constituted the enablers of CHVs, while lack of recognition and inadequate stipend
were the leading challenges experienced by the CHVs as they had to bear the high cost of living
and transport experienced during the COVID-19 pandemic. The performance of CHVs in
Machakos County improved during the COVID-19 pandemic.
Recommendations: Performance of community health volunteers in Machakos County
remained impressive during the COVID-19 pandemic despite the challenges encountered. The
county government of Machakos should make efforts to enhance the performance of CHVs in
the county through providing better working conditions and reviewing their remuneration. There
is a need to create more awareness on the role of CHVs in improving the health of communities.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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