Blog by Amber Fleck, MS2, University of Colorado:

In the United States, health education is seemingly everywhere: ads online reminding women of the importance of pap smears, TV commercials advising against smoking, or posters in bar bathrooms providing safe sex advice. With this abundance of exposure to health education, it is a striking difference to visit a country where many communities don’t have regular access to this kind of information, especially if that information regards sexual or reproductive health.

In an effort to bridge this gap and enhance community health education the Kenya Ministry of Health began using lay workers, also known as community health volunteers (CHVs). CHVs travel door-to-door in their assigned communities to educate individuals about disease management, including reproductive and maternal health, and provide referrals to the clinic when necessary. In theory, this is an excellent way to increase access to health information and care; however, these programs have had some significant challenges. One challenge is that these are unsalaried positions, which makes motivation and retention of the volunteers difficult.

In an attempt to better understand CHV motivations, experiences, and hopefully find ways to increase support and sustainability of these programs, under the guidance of Dr. Megan Huchko, I travelled to Kisumu, Kenya for about 7 weeks to conduct in-depth interviews with current CHVs, former CHVs, and their supervisors. I worked out of the new Center office in Kisumu, with Faith Otewa, site Director, helping to coordinate the study.

Due to language barriers, I conducted the supervisor interviews, while our research assistants conducted the interviews with current and former CHVs. Although I was nervous that being a foreigner with significant cultural differences would interfere with the interviews, I was pleasantly surprised to find the supervisors to be extremely open, honest, and willing to share their opinions and experiences. Overall, I found the group I interviewed to be incredibly passionate about the CHV program and excited to find ways to enhance support.

In the coming weeks, we will be analyzing the interviews and conducting dissemination meetings on our findings—you’ll find updates here. In the future we hope to implement a strategy to increase CHV impact and reduce attrition.

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