Abstract
BackgroundThe government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors.MethodsThe main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area’s CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed.ResultsFactors significantly associated with a lower prevalence of diarrhea among children under five were the child’s increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea.ConclusionsAlthough this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on the community, as demonstrated and promoted by appropriate health-seeking behavior and treatment for childhood diarrhea.
Highlights
The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program
The community unit (CU) is defined as level one of the Kenyan Health System. It consists of a community health committee (CHC), two community health extension workers (CHEWs) and community health workers (CHWs)
The final sample included in this study was restricted to 4,955 children under five and their family members; this number was used to determine factors relating to childhood diarrhea
Summary
The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). To empower households and communities to improve their own health, the Kenyan Government developed and launched the Community Health Strategy (CHS) in 2006. One of the main purposes of this strategy was to enhance access to health care services in order to improve productivity and reduce poverty, hunger, and child and maternal deaths. In this strategy, the community unit (CU) is defined as level one of the Kenyan Health System. It consists of a community health committee (CHC), two community health extension workers (CHEWs) and community health workers (CHWs)
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