Amref, Safaricom, M-Pesa Foundation and Safaricom Foundation commit to providing 10,000 CHVs with mobile training and supervision, thereby strengthening the implementation of the Kenya Ministry of Health Community Health Strategy. Over the next five years, Amref and Safaricom will build the capacity of 10,000 CHVs to offer community health services by enrolling CHVs in a continuous mobile training program, Leap, to address priority health issues in Kenya.
The Leap platform allows more flexibility in how CHVs access trainings - they are able to engage in mobile based training from their homes and communities at a pace that fits their schedules. Leap also enables CHVs to easily communicate with their peers and supervisors, enabling them to share best practices and lessons learned. Leap was developed and tested with 3,000 CHVs and is now ready to be rolled out on a larger scale. The test phase of the program has realized impressive learning and health outcomes which include a 92% learning completion rate, a 15% improved knowledge retention in comparison to face to face approaches, and an 85% reduction in attrition.
Through the rollout of this program, Amref Health Africa will increase the effectiveness of CHVs so they are better equipped to serve their communities and communicate community health needs in support of the Kenya MoH Community Health Strategy. Following these interventions, the 10,000 CHVs will improve the effectiveness of health service delivery by providing 1) critical health education on healthy lifestyles, 2) basic first aid, 3) referral and follow-up of clients to approximately 3,000,000 community members, and 4) maintenance of an updated health activities record conducted within the community in rural, urban, and nomadic geographies.
Amref Health Africa is taking a three pronged approach to the implementation of this commitment. Amref Health Africa will provide expertise around community mobilization through the identification of priority Community Units, which comprise several villages and serve a population of approximately 3,000 household members, in rural, urban, and nomadic settings in Kenya. Additionally, it will develop technical mLearning content aligned with the National MOHs curriculum used to train CHVs. Lastly, Safaricom and Amref Health Africa will work together through a public-private partnership to build the capacity of 10,000 CHVs across the different geographies to address complex health issues affecting their communities through mLearning. The mLearning program will leverage the Safaricom network, which has the best coverage in Kenya, to reach the CHVs in urban, rural, and nomadic geographies.
The CHVs enrolled in this innovative program will empower over 500,000 household members to take charge of their own health, providing them with quality healthcare while simultaneously delivering comprehensive health education. Additionally, data collected using the mobile tool will enable Amref Health Africa to reinforce successful elements and course-correct where data shows weak results.
Expected challenges include anticipated network challenges in some of the rural and nomadic sites where coverage will prohibit rollout.
The project will engage in the following activities during the five-year implementation period:
1) Stakeholder engagement will start immediately and will occur throughout every quarter of the five-year implementation period.
2) Scoping of the intervention will occur in Q1 and Q2 of Year 1 and will include the identification of Counties, Sub-counties, Community Units, and community health workforce (CHW) to benefit from the intervention.
3) Content development on priority health issues of the national CHW curriculum will occur throughout Year 1, at the end of which a blended training curriculum and mobile learning content will be ready for deployment.
4) Training deployment will start in Q4 of Year 1 and will continue throughout the rest of the project implementation period.
5) Monitoring, Evaluation and Learning will start in Q1 of Year 1 and will continue throughout the five-year implementation period.
The expected outcomes of the project include the following:
1) Content development completed (30 additional m-learning health modules developed
2) Stakeholders engaged in 10 counties
3) 10,000 CHVs trained
4) Baseline, midterm and end terms evaluation reports conducted
5) 80% performance in learning evaluation
6) CHV attrition reduced to less than 10%
The Kenya Ministry of Healths (MoH) Community Health Strategy is a community based primary care approach providing high quality healthcare and health knowledge at the household level through a community health workforce comprised of Community Health Extension Workers (CHEWs) and the Community Health Volunteers (CHVs). The approach deploys community health volunteers (CHVs) who generate demand for and deliver health services, health education, basic first aid, and referral service. CHVs also lobby for the inclusion of continued health financing for community health interventions in County budgets.
The MoH has developed a national, standardized curriculum to ensure CHVs are equipped with a uniform set of skills and knowledge, enabling them to effectively serve their communities. However, the traditional face-to-face training method has proven costly both in terms of MoH resources and CHV time away from their practice. Attrition and low motivation of CHVs has resulted in reduced health service delivery and reporting, reducing the MoHs ability to track the effectiveness of trained CHVs and the community health strategy generally. Feedback from supervisors indicates that 30-40% of CHVs trained leave the workforce 12 within months following training.
CHVs need continuous training and supportive supervision in order to perform effectively, remain engaged, and motivated to carry out their duties. To address this and remedy the underperformance and high attrition rates of CHVs, the MoH, in partnership with Amref Health Africa, has developed a blended approach to training CHVs that incorporates Leap, a mobile training platform through which health workers can access continued training and supervision through their mobile device.