Community Strategy – The Kenya Essential
Package for Health (KEPHS)
Community Strategy
Rationale
• The Kenya Essential Package for Health (KEPH) is the new
approach through which the goals of the National Health
Sector Strategic Plan (NHSSP II) will be accomplished.
• Realizing the importance of empowering households and
communities in the delivery of the KEPH at level 1, the
Ministry of Health and sector partners developed and
launched a Community Strategy in 2006.
• The strategy outlined the type of services to be provided at
level 1, the type of human resources required to deliver and
support level 1 services, the minimum commodity kits
required, and the management arrangements to be used.
Why Community Health
• The community based approach is the mechanism
through which households and communities
strengthen their role in health and health-related
development by increasing their knowledge, skills
and participation.
• The intention is to strengthen the capacity of
communities to assess, analyse, plan, implement
and manage health and health-related development
initiatives so that they can contribute effectively to
the country’s socio-economic development.
How does it work
• The Community Strategy spells out the linkage structures
at district, divisional, health facility and community levels
that are expected to provide citizens with sufficient
representation and voice in all issues affecting service
provision at level 1.
• The health facility in-charges (supported by the district
health management team - DHMT), community health
extension workers (CHEWs), community health workers
(CHWs/VHTs), village elders and chiefs, and other
extension workers are the sinews that bind these
structures and enable sustained community leadership in
addressing health problems, through the formation of
linkage committees at all these levels
Objectives of the community strategy
The Community Strategy intends to improve the health status of
Kenyan communities through the initiation and implementation of
life-cycle focused health actions at level 1. Its objectives are to:
• Establish community health service linkage structures through
effective decentralization and partnership for the implementation.
• Launch and manage the Community Strategy.
• Build the capacity of the community health extension workers
(CHEWs) and community health workers (CHWs) to provide
services at level 1.
• Establish a communication strategy that effectively improves
health seeking behavior.
• Establish mechanisms for evidence-based dialogue informed by
community and facility based information systems.
Services offered at level one
• Disease prevention and control to reduce morbidity, disability
and mortality
• Family health services to expand family planning, maternal,
child and youth Services
• Hygiene and environmental sanitation
• Health promotion through educating the communities
• Referrals to the health facilities for better management
Actors at level one
• Households
• Community –structured committee
• Community Own Resource Persons including CHWs, opinion
leaders and other structures (women groups, youth groups etc)
• Community Health Extension workers
• Health facility i/c
• They are linked to catchments of health facility
Roles of the CHEWS in Tupange Pamoja
• Oversee CHWs and the Level one service implementation
according to guidelines
• Training of CHWs in family planning
• Support CHWs in distribution of contraceptives and educating
the communities
• Compiling reports
• Receiving and communicating feedback from L2 and L3
• Follow-up on action plans
• Facilitating establishment of CBHI system and indicators
Roles of CHWs under Tupange
Pamoja
• CHWs to be identified by the communities as
outlined in the community strategy
• Each CHW to be attached to a health facility within
the catchment area
• CHWs to be trained by Tupange in all the six
modules and FP as the technical area
• CHWs to be able to promote, refer clients for
LAPM ,offer pills, LAM,SDM and condoms to
community members
• Complete the registers for contraceptive
distribution
• Attend the monthly feedback meetings where their
supplies are replenished
Important to note
• Each CHW must be linked to the constituent health facility
• Effective referral is dependent on effective linkage
• Effective referral is necessary for continuum of care and uptake
of LAPM
• Community health work needs the facility to be effective
• The primary actors are the households
• Community participation is key to sustainable FP promotion and
health improvement