Primary healthcare and family medicine in Kenya

Read online: Scan this QR code with your smart phone or mobile device to read online. The Kenya Government’s Health Sector Strategic Plan for 2005 to 2010, whose theme was ‘Reversing the Trends’, introduced six health service delivery levels and gave prominence to community-based services at level 1. Community-based primary healthcare services are aimed at empowering Kenyan households and communities to take charge of improving their own health.1 This is achieved by establishing a community care unit to serve about 5000 people and instituting well-trained Community-Owned Resource Persons (CORPs) who each serve 20 households. Every 25 CORPs work under a Community Extension Worker (CHEW). The recruitment and management of CORPs is carried out by village and facility health committees. This strategy was guided by extensive consultation amongst stakeholders who believed it was the best solution with regard to addressing health service inequities and would reverse the deteriorating health indicators. The objectives included: providing community services for all socioeconomic groups, building capacity of care givers and strengthening health facility–community linkages. This was rolled out in pilot districts, but is yet to cover all the Kenyan districts and/or counties. An evaluation of the programme in 2010 reported some degree of success, despite challenges.2 It is reported that many health workers in primary care facilities have not fully accepted these community-based health workers and have low levels of respect and collaboration.