Employ more community health workers

Sunday July 05 2020

John Kaguchia, the Speaker of Nyeri County Assembly. PHOTO | FILE | NATION MEDIA GROUP


One of the realities of Kenya at 57 is that the country is facing a harsh strain on its health sector.

The threat of Covid-19 pandemic coupled with an ailing health system openly reveals cracks that need to be addressed moving forward.

In the words of the President, “this crisis requires a long-term strategy and a reflection on what must be done.”

What must be done is a question that requires the input and goodwill of all stakeholders for us to formulate a strategy and find solutions.

Top of the list is the creation of a framework that will allow both the county and national governments to work seamlessly in a bid to rescue our healthcare and save our people.



The old saying that prevention is better than cure should be emphasised as the model of our comprehensive public health approach, especially at the county level.

In a bid to boost the healthcare ecosystem, it is important to relook at the role of community health volunteers (CHV) and appreciate the contribution they make in community health sensitisation.

Their status should be raised from volunteers to community health workers (CHW) who are well endowed with healthcare equipment and a pay.

These workers will then be charged with the responsibility of overseeing community zones with the intention of achieving preventive healthcare and ensuring access to health services in compliance with Article 43 of the Constitution.

It is important to appreciate that some of these strategies, though beneficial, face the reality of a financial burden which county governments do not have the capacity to currently bare as stated by the chairman of the Council of Governors Wycliffe Oparanya.


This is the reason behind the call by governors that the Senate should withdraw the proposed law sponsored by nominated senator Agnes Zani that requires counties to hire community health workers.

But as earlier stated, this tug-of-war can be successfully navigated by emphasising that the model of the healthcare system especially at the community level should be preventive rather than curative.

The curative aspect of the healthcare system should be taken back to the national government by allowing them to fully manage level four facilities while county governments be charged with the responsibility of dealing with Level Three and Two facilities as hubs for preventive primary care.


This will then shift the county budget for curative levels to preventive levels and thus the incorporation of community healthcare workers as key players in the provision of primary healthcare at county levels, a system that has revolutionised Cuba’s healthcare over the past 30 years.

Ultimately, the national government should create a health service commission to stimulate healthcare at level four facilities. As we face mutating healthcare challenges at global, national and community levels, the question of what must be done should be addressed with urgency, expertise, innovation and goodwill if we are to stay on top of endemic and hyper-endemic levels of disease.

John Kaguchia is an advocate and the Speaker of Nyeri County Assembly