A REACHOUT update from Kenya

By Kate Hawkins

Main messages
There is an urgent need for enhanced supervision among community-level staff in Kenya
Formal policies for supervision of CHWs and CHEWS don’t currently exist
By testing group supervision, peer supervision, and other tools LVCT Health hope to support the Government in strengthening the Community Health Strategy
LVCT Health will work with NGO partners to adapt best practice
They may face challenges due to health system devolution and the withdrawal of funding for community health worker programmes from some donors
The REACHOUT team will be looking at supervision and the role of the Community Health Committees in monitoring. They are going to be giving supportive supervision training to the Community Health Workers (CHWs) peer supervisors, the Community Health Extension Workers (CHEWs) and the people who manage the CHEWs in the County and sub-County Health Management Teams. The CHWs work in a Health Unit but there are no supervisory tools in the government programme. LVCT Health are planning to map the tools used by other non-governmental, vertical programmes and adapt them and hope the government will take them up.

To monitor the intervention they will collect the referral reports from facilities on service utilisation. They will look at data collected by CHWs in the Community Based Health Information System. Notes from supervisory meetings will be analysed. They have a programme assessment tool and will use a motivation questionnaire that will also support data collection.

Stakeholder engagement has been key to the process. The team have involved the Government from the very beginning of the research process and have provided them with the findings from the context analysis. They have linked with monitoring and evaluation and standards staff in Government too and will ask them to review the tools that will be used in the study. A staff member from the Community Health Service is part of the research team.

The team have an opportunity to influence change in Kenya. There is a demand for supervision tools as none exist in Government programmes at present. However, challenges remain, funders appear to be pulling out of community health services as a lack of documentation means that they cannot see the impact of them.