MOHAMED KARAMAPRINCIPAL RESEARCH OFFICERKENYA MEDICAL RESEARCH INSTITUTE THE BASIC HEALTH CARE PROVIDED AT THELOCAL LEVEL WHICH IS ACCEPTABLE AND
ACCESSIBLE AS WELL AS AFFORDABLE BY THE
PEOPLE . IT MUST BE SCIENTIFICALLY SOUNDAND MUST INVOLVE THE PEOPLE IN THE
PLANNING, DEVELOPMENT AND
IMPLEMENTATION THROUGH THEIR OWNSUPPORT. IT MUST ALSO BE SUSTAINABLE.

 HEALTH EDUCATION
 LOCALLY ENDEMIC DISEASE CONTROL AND

CONTROL OF COMMUNICABLE DISEASES IMMUNIZATIONS MENTAL HEALTH ESSENTIAL DRUGS NUTRITION SANITATION WATER SUPPLY PRIMARY HEALTH CARE WAS BASED ON THEFAMOUS ALMA ATTA DECLARATION OF 1978BY THE WORLD HEALTH ASSEMBLY.
 IT WAS INTENDED TO ADDRESS THE GAPS INHEALTH CARE WITHIN AND BETWEENNATIONS IT HAS BEEN ADOPTED BY COUNTRIESDIFFERENTLY UNDER DIFFERENT NAMES IN KENYA IT IS ADOPTED AS COMMUNITYSTRATEGYCategory SNo. Item Description Unit of Measure Replenishment
Plan Medicines 1 Albendazole 400mg Tablet Quarterly 2Paracetamol 500mg Tablet Quarterly 3 Tetracycline EyeOintment 1% Tube Quarterly 4 Low Osmolarity Oral Rehydration
Salts (ORS) 20.5g/L Satchet Quarterly 5 Zinc Sulphate 20mg
Tablet Quarterly 6 Combined Oral Contraceptives Tablet
Quarterly 7 Vitamin A 100,000 IU Capsule Quarterly 8 Vitamin A
200,000 IU Capsule Quarterly 9 Povidone Iodine Solution Bottle
Quarterly Equpment 10 Salter Scale No. Once 11 Colour Coded
Salter Scale No. Once 12 Digital Thermometer No. Once 13 Timer
No. Once 14 MUAC Tape No. Once Others 15 First aid box (spirit,disposable gloves cotton, wool, strapping, crepe bandage) No.
PRN 16 Chlorine / flocculant (coagulant and disinfectant) – forturbid water Satchet Quarterly 17 Chlorine – clear water Tablet
Quarterly 18 Lavibond Comparator (For measuring chlorine levelin drinking water) No. Once 19 DPD Tablets (used with LavibondComparator) Tablet Quarterly 20 IEC materials No. PRN 21
Commodity Register No. PRN 22 Male condoms No. Quarterly 23
Medical Dispensing Envelopes Pack Yearly COMMUNITY ARE AT THE FOUNDATION OF

AFFORDABLE, EQUITABLE AND EFFECTIVE
HEALTH CARE AND ARE THE CORE OF THE
KENYA ESSENTIAL PACKAGE FOR HEALTH
WHICH IDENTIFY SPECIFIC LIFE COHORTS FORCARE WHICH INCLUDE : PREGNANCY TO 2WEEKS, 2 WEEKS TO 6 YEARS, 6 TO 12 YEARS,
12 TO 24 YEARS, 24 TO 59 AND 65 AND
ABOVE.

 Mobilizing resources for health actions.
 Coordinating CHWs activities.
 Organization and implementation ofCommunity Health Days.
 Reporting to Level 2 on priority diseases andother health conditions.
 Leading community outreach and campaign

initiatives.
 Advocating for health in the community.

 It is recommended that a CHW should be theTreasurer while the Community Health
Extension Worker (CHEW) should be theSecretary. The CHC should have 9 members
who may include representatives of: Youth,Faith groups, Gender, Women’s group, NGOs,People Living With Aids (PLWA), People With
Disability (PWD) and any others.

 Role and functions
The role and functions of the CHC include: Identification of community health priorities
through regular dialogue.
 Planning for community health actions.
 Participating in community health actions.
 Monitoring and reporting on planned healthactions.

 The lowest health governance structure is

the CHC, elected in such a way that allvillages in the Community Unit (app. 1000villages) are represented. The CHC is elected
at an Assistant Chief’s baraza (PublicMeeting) under chairmanship of the AssistantChief. The committee is chaired by arespectable member of the community.

 The Community services will comprise of all community based

demand creation activities, organized around the Comprehensive
Community Strategy defined by the Health Sector.
 The Primary care services will comprised of all dispensaries, healthcenters and maternity homes for public and non public providers.
Their capacity will be upgraded, to ensure they can all provide
appropriate demanded services
 The County referral services will include primary referral facilities(all level 4 / district hospitals) operating in, and managed by a given
County. Together, all these facilities in a given County form its
County Referral System, with specific services shared amongst theexisting County Referral facilities to form a virtual network ofcomprehensive services.
 The National Referral Services will include the facilities providing
tertiary referral services (all Provincial and national level facilities)
that provide specialized health care services, across a number ofcounties, including hospitals, laboratories, blood banks and research
institutions??? These shall operate under a defined level of autonomy• Building the capacity of the community
health extension workers (CHEWs) andcommunity-owned resource persons (CORPs)
to provide services at level 1.

 The community strategy intends to improve thehealth status of Kenyan communities through theinitiation and implementation of life-cycle focusedhealth actions at level 1 by:• Providing level 1 services for all cohorts andsocioeconomic groups, including the “differentlyabled”, taking into account their needs andpriorities.

 • Strengthening the community toprogressively realize their rights foraccessible and quality care and to seek
accountability from facility based healthservices.

• Strengthening health facility–community
linkages through effective decentralizationand partnership for the implementation of
LEVEL ONE SERVICES.

 First, it is possible to build capacity at village level tomanage community-based activities effectively.
 Second, the CORPs as volunteers can provide services at
the household level that include a community-based information system, dialogue
based on information,
 health promotion, disease prevention, simple curative
care using drugs supplied through a revolving fund generated from users, and areferral system established by local health committees.
 Third, because incentives are lacking, it is difficult tosustain the morale and motivation of CORPs for long.
 • Fourth, community health extension workers(CHEWs) tend to be recruited by the health system and assigned to the local structures.
 Fifth, effective community health services require

well thought out theoretical and practical training modules andprogrammes.

 funds.
 Taking KEPH to the Community 7
 Finally, critical to the success of the community

approach are coordinating structures that bring together key players atnational and provincial levels to organize and guide the implementation of policy

guidelines and key activities.

 THE PRIMARY HEALTH CARE SYSTEM WILL GO

ALONG WAY IN REDUCING THE DISEASE
BURDEN AT THE HOUSEHOLD LEVEL
 THERE IS MAJOR CHALLENGES IN SUSTAINING
THE PROGRAMME AS BOTH COMMUNITYHEALTH WORKERS AND THE COMMUNITYHEALTH COMMITTES OPERATE ON
VOLUNTARY BASIS.

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