community perceptions and participation in health in the context of the community health strategy in...

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Community perceptions and participation in health in the context of the Community Health Strategy in KenyaNelly Muturi1, Maryline Mireku1, Robinson Karuga1, Kelvin Ngugi1, Geoffrey Ombui1, Rosalind McCollum2, Miriam Taegtmeyer2 and Lilian Otiso1

1Research and Strategic Information Department, LVCT Health, Nairobi, Kenya2Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK

Nelly MuturiLVCT HEALTH, Kenya23rd Feb 2017

CHWSymposiumKampala_Nelly

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Community Participation (CP)

“the process by which individuals and families assume responsibility for their own health and welfare and for those of the community, and develop

the capacity to contribute to their and the community’s development.”

The Alma Ata declaration, 1978

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Background

• Community participation (CP) is key in strengthening and sustaining health systems

• CP;– Improves accountability– Improves equity– Improves health service delivery and uptake

of services• The Community Health Strategy (CHS)

in Kenya founded on community participation

Photo by Nelly Muturi

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CP in Health in Kenya

Facility Health Management Committee

CHC Meetings Dialogue days Action days

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Aim

1. Assess occurrence of community meetings

2. Determine facilitators of community participation

3. Determine the barriers of community participation

Photo by Robinson Karuga

Study DesignExploratory study design

Study sites4 Community Health units

Sample selectionPurposive (Community members, CHVs, CHEWS, CHC members and Supervisors of CHEWS)

Data collectionIn depth interviewsFGDs

Methods

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Key findings

CHC Meetings• Not happening monthly• CHEW not always a

member or rarely present

• CHCs non-existent in some areas

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“First and foremost actually I would say we are ill equipped some of my members don’t even know their roles in the CHC because we have never had any formal training.” CHC member

Key findings

Dialogue days•Not happening quarterly•Not well represented by stakeholders•Not informed by community data- Did

not always lead to an Action day•Attendance from community leaders

was a facilitator–Chief barazas utilized as a forum for CP in health

• Lack of budgetary support

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“”You know most of the meetings people attend

to in the community have been organized by the chief and that’s a good

forum for CHW to explain to the civilians as there’s

a quorum.” Male community member

Key findings

Action days• Most frequently reported

form of CP- little costs involved

• Not informed by Dialogue days

• Lack of community support- least supported– Attendance pegged on incentives

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“… It is difficult for one to volunteer and then go buy gumboots, gloves, only a few have them.” Community member

“During the action day the committee members come maybe two of them and we team up with them.” CHV

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Conclusion and Recommendations

• There is need for regular monitoring of CP to address gaps between policy and practice

• Community members should be sensitized on their crucial role in implementation of CHS

• Budgetary allocation needs to be considered for effective implementation of CP e.g.– Training of CHC members– PA system, meeting venue

Photo by James Mboloi

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Nelly M. Muturi Research Officer; LVCT Health

nmuturi@lvcthealth.org @nellymuturi

www.lvcthealth.org www.reachoutconsortium.org

REACHOUT is funded by the European Union Seventh Framework Programme ([FP7/2007-2013] [FP7/2007-

2011]) under grant agreement n° 306090