“I will averagely visit around six homes in a day, says the CHV based in Lumatei, homes. If I leave at 9 a.m. I will arrive at 12 noon. I work until 4:30 then I leave for home,” says the CHV who is using a mobile app to make access to data possible.
For community health volunteer (CHV) Catherine Lesanja, popularly known as Kate, a typical day starts at around 9 a.m. in the morning.
The round trip is fraught with danger, including the risk of running into herds of elephants that sometimes cross paths with travellers on the rough, potholed roads.
She recalls one such incident. Instinctive, quick action by the CHV and a helpful passerby saved her life.
“In October 2021, I met a herd of elephants. I had to duck into the bushes. I hid there as I looked for an alternative route,” she says.
As she hid in the bush, she spotted a man passing and sent a distress signal. To her relief, he crossed over to where she was and led her away to safety.
Kate is one of the 160 CHVs serving 7,300 households in Merti, Isiolo County. The CHVs serve the households spread across a 1,500 square kilometre area.
Among a host of other tasks, CHVs refer pregnant mothers to antenatal care, children eligible for immunization, deworming and malnutrition management.
Living Goods Mobile App
According to the sub-county community health programme coordinator (SCCP) Dr Abdalla Kuno, CHVs collect the data during visits to homes. From the responses they get to questions, they will key in their findings to the mobile app that Living Goods developed.
“We used the CHVs to do household mapping of families living in the county that borders Samburu and Turkana Counties. To execute the task, we use a household mapping app that was developed in conjunction with Living Goods, a non-governmental organization (NGO),” he says.
Ms Lesanja has registered the households she serves on a mobile app that contains a family form. Using this digital form, she records the family’s details which include the number of children under five, whether the family has a pit latrine or not and ailments being experienced by members.
“When I visit a home for a consultation, I ask questions on their well-being and then key these into my app. The app will then store them for forwarding to the county health department,” she says.
The CHV who serves 88 homes has been visiting 99 homes before the 11 families migrated from the area.
“When they left, I muted their accounts on our mobile household mapping app. I will reactivate their status when they return to the area,” she says.
Dr Kuno says the CHVs have to work within a certain period of time or risk missing their appointments with clients.
“In the mornings, you will find most people going to tend their livestock because the heat is moderate. If you come to their homes at that time, you will not find them,” he says.
The SCCPC reveals that data captured in the app is subjected to a review for verification and cleaning before it is uploaded to the Demographic and Health Survey (DHS) database.
“As the county health department, we receive, authenticate and review the data before uploading it on the DHS website. The statistics are also used to update the Kenya Health Information Systems (KHIS) database,” Dr Kuno says.
Dr Kuno says the concept is vital for Isiolo County because it helps the devolved unit to get updates every six months.
“The data we collect is used to design interventions for the various communities including outreach services, cash transfer programs for vulnerable families and mass drug administration (MDAs) exercises for common challenges such as diarrhoeal disease outbreaks and deworming campaigns,” Dr Kuno adds.
Challenges
“Sometimes the apps fail and lose the stored data. Mishaps can also occur for one reason or another and the mobile devices can stop working,” he says.
To motivate the CHVs, the county government pays them a stipend of up to Sh3,000 monthly.
“We give the CHVs a stipend which consists of a Sh2,000 ordinary allowance and a Sh1,000 performance-based bonus. This is based on a target that will cover the number of referrals they will make in a month,” he says.
Dr Kuno admits that the program has been beset by a number of challenges despite its user-friendly design.
“Illiteracy levels affect the health-seeking behaviour of the people,” says the medic.
“A lot of health education is required to get the community to change their perception of the healthcare system and its importance to the incandescent of a healthy lifestyle,” he says.
