The Role of Community Health Promoters in Combating Malaria in Kenya: The Case of Nyakach Sub-County, Kisumu County

https://doi.org/10.51867/ajernet.5.3.75

Authors

Keywords:

Community Health Promoters (CHPs), Endemic Zones, Epidemiological Zones, Malaria Prevalence, Malaria Surveillance

Abstract

About 250 million malaria cases are reported annually in the world. The disease disproportionately affects warm, humid regions, including many tropical countries such as Kenya. The Kenyan government has implemented measures to control malaria, including the deployment of community health promoters (CHPs). However, little is known about the effectiveness of CHPs in combating malaria cases in highly endemic areas like Nyakach Sub-County and Kisumu County. Specifically, the study assessed the impact of CHPs’ in malaria surveillance. The study was underpinned by the health belief model. A cross-sectional descriptive study design was employed, with a mixed methods approach aimed at collecting both quantitative and qualitative data from households and CHPs in the Sub-County. Cluster sampling was employed for quantitative data collection, while snowball sampling was used for qualitative data, guided by data saturation. Thematic analysis was done for themes and contingency tables developed for categories, while a multiple regression analysis was conducted to determine the relationships among the independent variable (malaria surveillance), the moderating variable (motivation and willingness of CHPs), and the dependent variable (combating malaria cases). Findings reveal that regular visits by CHPs have been effective in identifying potential malaria cases in the community. At p value=0.000, there was a moderate positive relationship between combating of malaria cases and malaria surveillance activities conducted by CHPs (r = 0.507, n=277). The study recommends strengthening existing surveillance approaches used by the CHPs. The study further recommends regular training programs for CHPs to ensure they are well-equipped with the latest techniques and knowledge for effective malaria surveillance.

Dimensions

Amboko, B., Stepniewska, K., Malla, L., Machini, B., Bejon, P., W, S. R., & Zurovac, D. (2021). Determinants of improvement trends in health workers compliance with outpatient malaria case-management guidelines at health facilities with available test and treat commodities in Kenya. PLoS ONE, 16, 11. https://doi.org/10.1371/journal.pone.0259020 DOI: https://doi.org/10.1371/journal.pone.0259020

Aron, M. B., Ndambo, M. K., Munyaneza, F., Mulwafu, M., Makungwa, H., Nhlema, B., & Connolly, E. (2023). A time-motion study of community health promoters delivering community-based primary health care in Neno District, Malawi. Human Resources for Health, 21, 51. https://doi.org/10.1186/s12960-023-00839-z DOI: https://doi.org/10.1186/s12960-023-00839-z

Assegaai, T., & Schneider, H. (2022). Factors Associated With Workplace and Interpersonal Trust in the Supervisory System of a Community Health Worker Programme in a Rural South African District. International Journal of Health Policy and Management, 11(Special Issue on CHS-Connect), 31-38. https://doi.org/10.34172/IJHPM.2021.03 DOI: https://doi.org/10.34172/ijhpm.2021.03

Bagonza, J., Kibira, S. P., & Rutebemberwa, E. (2018). Performance of community health promoters managing malaria, pneumonia, and diarrhoea under the community case management programme in central Uganda: a cross-sectional study. Malaria Journal, 13(1), 367. https://doi.org/10.1186/1475-2875-13-367 DOI: https://doi.org/10.1186/1475-2875-13-367

Chipukuma, H. M., Halwiindi, H., Zulu, J. M., Azizi, S. C., & Jacobs, C. (2020). Evaluating fidelity of community health worker roles in malaria prevention and control programs in Livingstone District, Zambia-A bottleneck analysis. BMC Health Services Research, 20(1), 612. https://doi.org/10.1186/s12913-020-05458-1 DOI: https://doi.org/10.1186/s12913-020-05458-1

David, M., Onguru, D., & Lawrence, B. (2021). Determinants of malaria prevalence among children below five years in North West Kisumu Ward, Kisumu County, Kenya: A cross-sectional study. SSRN. https://doi.org/10.2139/ssrn.3983007 DOI: https://doi.org/10.2139/ssrn.3983007

Dunning, J., Aung, N. K. Z., Ward, A., Aye, M. M., Lourenço, C., Gallalee, S., Lavenberg, S., Le Menach, A., Tun, M. M., & Thi, A. (2022). Key factors associated with malaria infection among patients seeking care through the public sector in endemic townships of Ayeyarwady Region, Myanmar. Malaria Journal, 21(1), 86. https://doi.org/10.1186/s12936-022-04088-8 DOI: https://doi.org/10.1186/s12936-022-04088-8

Elsawy, M. M., Mohamed, H. S., & Mousa, K. M. (2022). Effect of Utilizing Health Belief Model on Knowledge, Beliefs and Behaviour of Visually Impaired Women toward Breast Self-Examination. The Open Nursing Journal, 16(1). https://doi.org/10.2174/18744346-v16-e221221-2022-115 DOI: https://doi.org/10.2174/18744346-v16-e221221-2022-115

Ishizumi, A., Sutton, R., Mansaray, A., Parmley, L., Eleeza, O., Kulkarni, S., Sesay, T., Conklin, L., Wallace, A. S., Akinjeji, A., Toure, M., Lahuerta, M., & Jalloh, M. F. (2021). Community health promoters' Experiences in Strengthening the Uptake of Childhood Immunization and Malaria Prevention Services in Urban Sierra Leone. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.767200 DOI: https://doi.org/10.3389/fpubh.2021.767200

Kamer, H., (2023). Combating malaria in Kenya through collaborative population health education: a systematic review and pilot case study. Infectious Diseases, 55(10), 664-683. https://doi.org/10.1080/23744235.2023.2231082 DOI: https://doi.org/10.1080/23744235.2023.2231082

KNBS. (2019). 2019 Kenya Population and Housing Census, Volume II: Distribution of Population by Administrative Units. KNBS, Nairobi.

Kubai, E. (2019). Reliability and Validity of Research Instruments. Journal of Research Methods, 7, 112-125.

Lee, H., Ho, P.-S., Wang, W.-C., Hu, C.-Y., Lee, C.-H., & Huang, H.-L. (2019). Effectiveness of a health belief model intervention using a lay health advisor strategy on mouth self-examination and cancer screening in remote aboriginal communities: A randomized controlled trial. Patient Education and Counseling, 102(12), 2263-2269. https://doi.org/10.1016/j.pec.2019.07.001 DOI: https://doi.org/10.1016/j.pec.2019.07.001

MacArayan, E., Papanicolas, I., & Jha, A. (2020). The quality of malaria care in 25 low-income and middle-income countries. BMJ Global Health, 5, 2. https://doi.org/10.1136/bmjgh-2019-002023 DOI: https://doi.org/10.1136/bmjgh-2019-002023

Maniga, J. N., Samuel, M., Rael, M., Odda, J., Martin, O., Ntulume, I., Bwogo, P., Mfitundinda, W., & Akinola, S. A. (2022). Trend of Malaria Burden Among Residents of Kisii County, Kenya After More Than a Decade Usage of Artemisinin Combined Therapies, 11-Year Laboratory Based Retrospective Study. Infection and Drug Resistance, 15, 5221-5232. https://doi.org/10.2147/IDR.S370218 DOI: https://doi.org/10.2147/IDR.S370218

Marita, E., Langat, B., Kinyari, T., Igunza, P., Apat, D. O., Carter, J. V., Kiplimo, R., & Muhula, S. (2021). Implementation of community case management of malaria in malaria endemic counties of western Kenya: are community health volunteers up to the task in diagnosing malaria? Malaria Journal. https://doi.org/10.21203/rs.3.rs-845559/v1 DOI: https://doi.org/10.21203/rs.3.rs-845559/v1

Moh, D. R., Bangali, M., Coffie, P., Badjé, A., Paul, A. A., & Msellati, P. (2022). Community health promoters. Reinforcement of an Outreach Strategy in Rural Areas Aimed at Improving the Integration of HIV, Tuberculosis and Malaria Prevention, Screening and Care Into the Health Systems. "Proxy-Santé" Study. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.801762 DOI: https://doi.org/10.3389/fpubh.2022.801762

Mugenda, A., & Mugenda, O. (2013). Research methods: Quantitative and qualitative approaches. Nairobi: ACTS Press.

Napier, H. G., Baird, M., Wong, E., Walwyn-Jones, E., Garcia, M. E., Cartagena, L., Mngadi, N., Vanisaveth, V., Sengsavath, V., Vilay, P., Thongpiou, K., Visser, T., & Cohen, J. M. (2021). Evaluating Vertical Malaria Community Health Worker Programs as Malaria Declines: Learning From Program Evaluations in Honduras and Lao PDR. Global Health: Science and Practice, 9(Supplement 1), S98-S110. https://doi.org/10.9745/ghsp-d-20-00379 DOI: https://doi.org/10.9745/GHSP-D-20-00379

Nepomuceno, R. C. A., Barreto, I. C. H. C., Fleet, A. C., Ribeiro, K. G., Ellery, A. E. L., Loyola, F. A., & Andrade, L. O. M. (2021). The work of community health agents in light of the communities of practice theory. Ciencia E Saude Coletiva, 26, 5. https://doi.org/10.1590/1413-81232021265.04162021 DOI: https://doi.org/10.1590/1413-81232021265.04162021

Nkya, T. E., Fillinger, U., Dlamini, M., Sangoro, O. P., Marubu, R., Zulu, Z., Chanda, E., Mutero, C. M., & Dlamini, Q. (2021). Malaria in Eswatini, 2012-2019: a case study of the elimination effort. Malaria Journal, 20(1). https://doi.org/10.1186/s12936-021-03699-x DOI: https://doi.org/10.1186/s12936-021-03699-x

Oribhabor, C., & Anyanwu, C. (2019). Research sampling and sample size determination: A practical application chinelo. Federal University Dutsin-Ma Journal of Educational Research (Fudjer), 2(7), 67-78.

Otambo, W. O., OCHPedo, K. O., Omondi, C. J., Lee, M.-C., Wang, C., Atieli, H., Githeko, A. K., Zhou, G., Kazura, J., Githure, J., & Yan, G. (2023). Community case management of malaria in Western Kenya: performance of community health volunteers in active malaria case surveillance. Malaria Journal, 22(1). https://doi.org/10.1186/s12936-023-04523-4 DOI: https://doi.org/10.1186/s12936-023-04523-4

Otambo, W. O., Onyango, P. O., OCH Pedo, K., Olumeh, J., Onyango, S. A., Orondo, P., Atieli, H., Lee, M.-C., Wang, C., Zhong, D., Githeko, A., Zhou, G., Githure, J., Ouma, C., Yan, G., & Kazura, J. (2022). Clinical malaria incidence and health seeking pattern in geographically heterogeneous landscape of western Kenya. BMC Infectious Diseases, 22(1). https://doi.org/10.1186/s12879-022-07757-w DOI: https://doi.org/10.1186/s12879-022-07757-w

Owek, C. J., Oluoch, E., Wachira, J., Estambale, B., & Afrane, Y. A. (2017). Community perceptions and attitudes on malaria case management and the role of community health promoters. Malaria Journal, 16(1). https://doi.org/10.1186/s12936-017-1916-7 DOI: https://doi.org/10.1186/s12936-017-1916-7

Paintain, L., Willey, B., Kedenge, S., Sharkey, A., Kim, J., Buj, V., Webster, J., Schellenberg, D., & Ngongo, N. (2014). Community health promoters and stand-alone or integrated case management of malaria: a systematic literature review. The American Journal of Tropical Medicine and Hygiene, 91(3), 461-470. https://doi.org/10.4269/ajtmh.14-0094 DOI: https://doi.org/10.4269/ajtmh.14-0094

Rogers, A., Lee, L., Joseph, J., Starnes, J., Odhong, T., & Okoth, V. (2022). Predictors of under-five healthcare utilization in Rongo sub-county of Migori County, Kenya: results of a population-based cross-sectional survey. Pan African Medical Journal, 41, 108. https://doi.org/10.11604/pamj.2022.41.108.31618 DOI: https://doi.org/10.11604/pamj.2022.41.108.31618

Rosenthal, P. J. (2022). Malaria in 2022: Challenges and Progress. The American Journal of Tropical Medicine and Hygiene, 106(6), 1565-1567. https://doi.org/10.4269/ajtmh.22-0128 DOI: https://doi.org/10.4269/ajtmh.22-0128

Sunguya, B. F., Mlunde, L. B., Ayer, R., & Jimba, M. (2017). Towards eliminating malaria in high endemic countries: the roles of community health promoters and related cadres and their challenges in integrated community case management for malaria: a systematic review. Malaria Journal, 16(1). https://doi.org/10.1186/s12936-016-1667-x DOI: https://doi.org/10.1186/s12936-016-1667-x

Taherdoost, H. (2016, August 10). Validity and reliability of the research instrument: How to test the validation of a questionnaire/survey in a research. SSRN. https://doi.org/10.2139/ssrn.3205040 DOI: https://doi.org/10.2139/ssrn.3205040

The Lancet. (2022). Malaria in 2022: a year of opportunity. The Lancet, 399(10335), 1573. https://doi.org/10.1016/s0140-6736(22)00729-2 DOI: https://doi.org/10.1016/S0140-6736(22)00729-2

https://doi.org/10.1016/S0140-6736(22)00729-2

Wang, X., & Cheng, Z. (2020). Cross-Sectional Studies: Strengths, Weaknesses, and Recommendations. Chest, 158(1S), S65–S71. https://doi.org/10.1016/j.chest.2020.03.012 DOI: https://doi.org/10.1016/j.chest.2020.03.012

WHO. (2023, March 29). Malaria. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/malaria

WHO. (2020). World malaria report. Roll Back Malaria. World Health Organization.

WHO. (2021). Millennium development goals report: 2007. World Health Organization.

Published

2024-08-31

How to Cite

Were, E. M. (2024). The Role of Community Health Promoters in Combating Malaria in Kenya: The Case of Nyakach Sub-County, Kisumu County. African Journal of Empirical Research, 5(3), 886–898. https://doi.org/10.51867/ajernet.5.3.75