Involvement Of Community Health Volunteers In Tb Advocacy, Communication And Social Mobilization In Informal Settlements Of Kibera, Nairobi

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.