Community health workers play a vital role in the overburdened health systems of low and middle income countries. By supporting basic health system activities at the community level such as education on health related issues, health promotion and providing referrals to the nearest health facilities, they form a link between the communities and the peripheral health system. Despite the wide utilization of community health programs to extend the reach of inadequate health care systems characterized by shortage of health workers, a lot of implementation challenges exist and pose a threat to the sustainability of these programs.
The overall objective of this study was to evaluate a community health worker program implemented in rural parts of Kenya through a public private partnership and thus provide context specific evidence on effectiveness and sustainability. The study utilized different methods to assess various components of the program including cross-sectional studies to assess uptake of maternal and child health services, health seeking behaviour for patients diagnosed with diabetes and hypertension and a case control design assessing risk reduction for diarhoea or respiratory infections following a hygiene education intervention. The work highlights evidence on the effectiveness of the program in prevention of infectious diseases, promoting well being of pregnant mothers and children and supporting patients with chronic diseases and ensuring they are retained in care. The work also highlights gaps that close to community initiatives can fill improving knowledge levels and encouraging uptake of health services