The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya - Abstract
Background Information: Globally, Non-Communicable Diseases (NCDs) account for 63% of mortalities. Approximately, 80% of these NCD-related deaths occur in LMICs and they contribute to at least 50% of hospital admissions. NCDs affect individuals, households, communities, and health care systems leading to increased expenditures at all levels. In Kenya, the National and County governments prioritized Communicable diseases more than NCDs. Consequently, NCDs continued to affect the skewed, ill-equipped health systems resulting in an upsurge in disease morbidity and mortality. This led to the introduction and use of CHVs at the grassroots levels to mitigate this upsurge and morbidity related to NCDs. Objective: This study evaluated the interventional capacity of Community Health Volunteers in the screening and linkages of Non-Communicable Diseases
in Nyeri County, Kenya. Methodology: A quasi-experimental study utilizing a non-equivalent pre-and post-test was carried out from May 2022 to March 2023 with 370 study participants. Multistage cluster sampling was used at the primary and secondary levels to select 10 community units, each unit is comprised of 10 households and each household is served by three CHVs, therefore 150 CHVs were randomly selected to form a control unit and 150 formed interventional group. Data collection was made through a questionnaire uploaded to a KOBO app. Six (6) homogenous FGDs comprised of 10 members and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0 and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. Results: The study shows that 59.3% of respondents have minimal information and 92.7 % ( n=139) have no clear understanding of NCDs with a preintervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD±5.7) %
which increased to 68.28 (SD±7.6) %, p<0.001. Conclusion: A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management through leveraging CHV capacity-building programs that will enhance screening and linkages of NCDs.