Community Health Volunteers in Kenya
Meet Puritan and Alexander. They are community health volunteers (CHVs), part of an important network across Kenya working to provide health education and services to families who may not otherwise have access to care. CHVs have been vital in creating demand for family planning at the community level, as well as linking women and families to the health system.
In Kenya, CHVs are selected by their neighbors and live in the areas they serve. For Puritan and Alexander, these communities are starkly different. Puritan lives in Lunga Lunga, a densely populated informal settlement in Nairobi. Alexander is from Tharaka Nithi, a rural county in Eastern Kenya, where many must travel long distances to reach a health facility. But both go door-to-door, discussing the health benefits of family planning, dispelling myths and misconceptions, and counseling women and their partners to find a contraceptive method of their choice. The CHVs recognize the importance of family planning for the health of women and children, and the broader economic and social challenges their neighbors face in their day-to-day lives.
The community health volunteer model is not unique to Kenya, as many countries recognize the importance of linking communities with health facilities. However, significant questions remain around how to best organize and compensate CHVs. In Kenya the national government recommends that CHVs should be paid, but most are not, which makes retention a challenge. Given its impact, the sustainability of the CHV model is an issue Kenya must address as it looks to consolidate and build on recent improvements in family planning.
Click through the photos below to learn more about the work of CHVs in Kenya.

CHVs are trained on a variety of health issues, including HIV/AIDS, nutrition, malaria, and family planning. The volunteers are tasked with providing information on the different family planning methods, providing condoms and pills, and making referrals to facilities if a client chooses a long term option.
Photo: Sala Lewis

The volunteers also work to chip away at myths and misconceptions surrounding family planning, especially among male partners. Many people spoke about the importance of male involvement, noting that while historically men have been resistant to family planning, they were generally more comfortable discussing their concerns about in the privacy of their homes. One CHV explained that a woman’s access to family planning often hinges upon her husband’s consent: “you cannot plan your family alone. It is important the man knows what is happening in the home, and this would result in conflict. Now men know what is happening and things are easier.
Photo: Sala Lewis

Nairobi is home to many informal settlements and slum areas, where men and women struggle to find work on a daily basis. According to one community health worker, “most people want jobs and are daily or casual laborers…if they don’t work, they can’t pay.” The limited hours of public health facilities, coupled with long wait times, is often a deterrent for women who are otherwise interested in family planning. That is where CHVs come in. Often times, people prefer a visit from a CHV instead of going to a clinic, because it is time-saving and more confidential.
Photo: Sala Lewis

Alexander Karonga Peter, a CBD does a home visit with Frindatt Waithinha Binaka as a follow up visit. Frindatt uses injectable family planning and this can be administered by Alexander from his home.
Photo: Sala Lewis

In the rural county of Tharaka Nithi, the terrain is rough and sparsely populated; many women would have to travel for miles to reach a facility. Accessing health care is so challenging that under a recent government policy, Tharaka Nithi was designated a hard to reach and underserved county, which means that CHVs can be trained to provide injectable contraception -- depo provera, which lasts for three months -- at the household level.
Photo: Sala Lewis