Abstract:
Kenya is ranked 15th among the 22 high Tuberculosis burden countries. Slum residents in Nairobi experience
a high mortality burden (50%) mainly caused by TB and HIV and AIDS. Despite Community Health Volunteers
being largely utilized in the Advocacy, Communication and Social Mobilization strategy for TB prevention and
control, there is little evidence to show how the CHVs are involved. The objective of the study was therefore
to examine the nature of involving CHVs in an ACSM strategy within Kibera. Kibera was chosen because; due
to its slum conditions and the TB predisposing factors, it attracts many health organizations that use CHVs. A
descriptive cross sectional research design was used. A questionnaire was administered to 201 participants
randomly selected across 13 community units. Chi square tests of association revealed a significant association
between preference for CHVs who were well known and adherence to laws and policies during CHV
involvement (P-value = 0.071). In addition, training of CHVs regardless of their literacy level and any support
received increased their confidence during implementation (P-value = 0.011). Support offered to the CHVs was
also significantly associated with high satisfaction of their involvement in the TB ACSM strategy (P-value =
<0.001). Involvement of CHVs as community representatives in the community strategy therefore resulted in
better TB advocacy, communication and social mobilization activity implementation in Kibera. In an informal
setting, sufficient training of CHVs had better effects on TB prevention and control efforts regardless of their
education and support. The study therefore recommends reviewed standard operating procedures for increased
and meaningful CHVs involvement, operational budget, clear terms of reference, remuneration and a TB
focused curriculum. Adopt innovative training approaches like Amrefs’ M- learning strategy, certification and
favorable conditions for all CHVs. Harmonized approaches by the MOH and TB partnerships to maximize on
CHV support towards achieving TB ACSM goals.
