MCI training Urban Community Health Workers in Kisumu, Kenya

As part of the One Million Community Health Workers Campaign, the Millennium Cities Initiative is training a cadre of Urban Community Health Workers in a impoverished downtown community in Kenya’s third largest city, Kisumu.

The ongoing CHW Training program has been ably organized and led by MCI’s Public Health Specialist for Kisumu, Ms Beldina Opiyo-Omolo, with support from MCI, the Kisumu City Council Department of Health, the Urban Matters program of the Dutch NGO Cordaid and the community of Manyatta B, the informal settlement in Kisumu where the training is fast becoming an intrinsic part of the neighborhood’s public health monitoring and management plan.

The recent 11-day training of 38 Community Health Workers (CHWs) from Manyatta B, documented in this report by Ms. Opiyo-Omolo, included lessons in collecting and analyzing data at the household level; monitoring pregnancies, immunizations, disease outbreaks and signs of malnutrition; detecting danger signs, referring patients to appropriate nearby health facilities and advocating on their behalf. This comprehensive training curriculum, which draws extensively on the Government of Kenya Ministry of Public Health and Sanitation’s Community Strategy Manual, is currently being followed up by an exercise undertaken by the CHWs themselves, as they map and register all households in this community, 100 households per CHW. A community-based task force is now being trained explicitly to monitor the Manyatta CHWs and to coordinate health activities for Manyatta B.

Although Community Health Worker programs are generally assumed to be most readily applicable in rural areas, where distances between households can be as vast as access to health facilities is limited, MCI has observed that CHWs can fill an equally urgent need in low-income urban settlements, where access to timely, appropriate care is also severely constricted and public health services are increasingly stretched.

Yet urban CHW programs to-date have largely been organized by non-governmental organizations whose focus has been a specific disease, disorder or field of medicine. However well-intentioned and far-reaching such efforts have been, in MCI’s experience it is critical that CHWs be comprehensively trained, so that they might serve effectively on the front lines of healthcare delivery within the communities they know best and which they call “home.”

With this pilot project in our first Millennium City, MCI hopes to demonstrate the utility of the community-based model for delivering basic care in low-income urban settings, where the extreme density of habitation, often viewed in a negative light, actually facilitates coverage, awareness and mutual respect. The trust built between the residents of informal settlements and the CHWs can be invaluable to building faith in the entire public health system, which, in turn, is a prerequisite to that system’s successful and efficient functioning with regard to disease prevention and containment, timely treatment and referrals and effective health and hygiene education and outreach within such communities and citywide.

On May 15, with MCI support, the CHWs will meet with Kisumu Department of Health officials to discuss the household data they have gathered, after which they will hold a series of community dialogue sessions to share and discuss with residents salient issues that have emerged from their findings. A three-day training for the CHWs will follow in maternal and neonatal health, a newly mandated focus of the Ministry and the Department that is well-aligned with MCI’s efforts to help the City of Kisumu save more mothers’ and newborn lives and thereby attaining Millennium Development Goals 4 & 5. It is our hope and expectation that, as the collection, evaluation and discussion of monthly household data becomes more and more routine, the interaction between the CHWs, Manyatta B residents and municipal health officials will only solidify the already strong social cohesion and dynamic of this vibrant community, resulting in more effective and fruitful advocacy, both by the CHWs and by the residents on their own behalf.

The Training of Community Health Workers is now available on the MCI website.