Effectiveness of community health workers on the implementation of Centres for disease control and prevention projects in Karemo Division Siaya District, Kenya
Opole, Joseph O
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The purpose of this study was to examine the effectiveness of Community Health Workers on the implementation of Centers for Disease Control and Prevention projects in Karemo Division. The study had the following objectives: To investigate the extent to which competencies of Community Health Workers affect the implementation of CDC projects in Karemo Division, to establish the level at which strategies used by the CDC in handling Community Health Workers affect the implementation of CDC projects in Karemo Division, to assess the level at which challenges faced by the Community Health Workers affect the implementation of CDC projects in Karemo Division and to identify suggestions that can be used to improve the participation of Community Health Workers in the implementation of CDC projects in Karemo Division. The involvement of community members to render certain basic health services in their communities has been in existence for the last 50 years. The Chinese barefoot doctor program is the best known of the early programs since the early 1950s (Kauffman et, al, 1997). 1n Thailand and the United States, participation of trained workers was documented since the 1950s and countries like Indonesia, India, Gambia, Kenya followed suit in engaging the Community Health Workers, which had been recognized to be very important since they capture hard to reach population. One of the greatest challenges within the African health sector is a critical shortage of human resources, the average doctor-to-patient ratio across Africa is 1:20,000 (Gill, 2008), so Community Health Workers becomes very critical to bridge the gap in terms of project implementation. The descriptive survey design was used in this study. A description and explanation as well as quantitative and numeric descriptions of a sample of the CHW s from Karemo were done. Community Health Workers were selected by using the simple random sampling technique, but, for the CDC field staff supervisors, census sampling method was applied, since they were very few totaling to eleven people. The study used questionnaires to collect data through face-to-face interviews and by self administration by the respondents and these data was entered and analyzed using SPSS for Windows version 9.1 to generate frequencies and percentages. The study found that Community Health workers are effective in their work; however there are challenges which must be looked at to make them more effective. The study recommends that CHW s model be given much attention in the provision of primary health care in Kenya and more studies are invited to give more incites in this area. From the research findings there was sufficient evidence that there was a relationship between Community Health Workers competencies and their effectiveness. This was established from self rating of the CHWs on the functions that they usually do for the CDC project, so was concluded that competencies support effectiveness on the project implementation and the study further, found that unreliable and poor pay were the major challenges followed by poor supervision which does impede the implementation of CDC projects in Karemo Division, hence, had a direct relationship to the effectiveness of CHW s. CHW s from the findings needs close supervision to be effective. Community mobilization was found to be the best performed function by the Community Health Workers, but overall the CHWs are effective in all their functions as expected from them by the CDC. The study recommended a comparative study to look at CHW s working for different organizations to see whether different results can be generated. The study further recommended, an in depth study to be carried out in order to get the perceptions of various groups who are stakeholders in the medical fraternity. Such a study will help to get more information from Focus Group Discussions and Key Informants.