Kenya

Rose Thomas - Community Health Worker, Community Based Health Management Information System (CBHIMS) Project

Rose Thomas is a volunteer community health worker (CHW) from Ngomano village in Kibwezi District.
Rose is 49 years old, married and has four sons. She is actively involved in sensitising mothers and giving them education on the importance of ante-natal care, delivery at health facilities and immunisation. Because of the efforts of Rose and others involved in this project, the percentage of mothers delivering at the health centre has grown from 30% in 2005 to 63% in 2008 while immunisation coverage has also risen from 89% to 100%.

Rose Thomas collects data during one of the routine home visits by the CHWs

How does she work?

Rose is involved in collecting data from households and providing health education. She enters the data she collects into a computer using a simple package, produces summaries which she has been trained to interpret and use to develop action plans. She shares the information with the community and educates them on improving their health based on this information.

Working conditions

Makindu division, situated about 200km south east of Nairobi, is semi-arid characterised by prolonged drought, insufficient and unreliable rains. Because of the dry spells, population is low and sparsely distributed, so distances covered during data collection are considerably long and covering ten households could take a whole day.

Community health workers like Rose work on a volunteer basis, receiving no payment. This can be discouraging as they have to walk long distances in the heat to make home visits and collect data. Moreover, some members of the community are not comfortable about disclosing health information to the community health workers.

The community health workers are elected by the community members themselves. Because of this, they owe their allegiance to the same people they collect data from. They therefore serve the people they know and who have confidence in them, despite a few cases of community members who do not disclose information very easily.

The collaboration and support of the provincial administration and the Ministry of Health gives them a sense of recognition and ensures the co-operation of the community members. The provincial administration assists them in calling for meetings and the Ministry of Health provides technical assistance and supervision.

What difference has she made in her community?

Information has become available for use in planning owing to regular data collection. The community and decision makers at health facilities and other levels are now using the information generated to monitor various health needs and activities unlike before. In addition, the community is able to follow trends in common diseases. The percentage of mothers delivering under skilled health care in Ngomano village has risen from 35% in 2004 to 48% in 2008. The number of children under 5 years who have not been immunised has gone down from 4% to 0% within the same period. The communities are also able to demand services from the government based on their needs.