Perceptions towards management of acute malnutrition by community health volunteers in northern Kenya.
Authors:   1African Population and Health Research Center, P.O. Box 10787-00100, APHRC Campus, Nairobi, Kenya, Wambui1 Elizabeth , Wilunda1 Calistus ,   1African Population and Health Research Center, P.O. Box 10787-00100, APHRC Campus, Nairobi, Kenya, Pythagore Pierre Donfouet1,2 Hermann ,   1African Population and Health Research Center, P.O. Box 10787-00100, APHRC Campus, Nairobi, Kenya;  2The World Bank Health Nutrition and Population Global Practice, Washington, USA., Mwangi1 Bonventure ,   1African Population and Health Research Center, P.O. Box 10787-00100, APHRC Campus, Nairobi, Kenya, Alemu Zerfu1,3 Taddese ,   1African Population and Health Research Center, P.O. Box 10787-00100, APHRC Campus, Nairobi, Kenya;  3International Food Policy Research Institute, Addis Ababa, Ethiopia, Daniel4 Tewoldeberha ,   4UNICEF Eastern and Southern Africa Regional Office, Nairobi, Kenya, Agutu5 Olivia ,   5UNICEF Kenya County Office, Nairobi, Kenya, Samburu6 Betty ,   6Ministry of Health, Nairobi, Kenya, Kavoo6 Daniel ,   6Ministry of Health, Nairobi, Kenya, Karimurio6 Lydia ,   6Ministry of Health, Nairobi, Kenya, Charle Cuellar7 Pilar ,   7Action Against Hunger, London, United Kingdom, Keane8 Emily ,   8Save the Children UK, London, United Kingdom, Schofield8 Lilly ,   8Save the Children UK, London, United Kingdom, Njiru9 James ,   9 Save the Children International, Nairobi, Kenya., Chabi10 Martin ,   10World Health Organization, Kenya Country Office, Nairobi Kenya, Gathigi Maina5 Lucy ,   5UNICEF Kenya County Office, Nairobi, Kenya, Okoth5 Peter ,   5UNICEF Kenya County Office, Nairobi, Kenya, Raburu5 Judith ,   5UNICEF Kenya County Office, Nairobi, Kenya, Gichohi6 Grace ,   6Ministry of Health, Nairobi, Kenya, Mutua6 Alex ,   6Ministry of Health, Nairobi, Kenya, Matanda6 Charles ,   6Ministry of Health, Nairobi, Kenya, Kimani-Murage1 Elizabeth ,   1African Population and Health Research Center, P.O. Box 10787-00100, APHRC Campus, Nairobi, Kenya
Published: January 2025

Child undernutrition is a persistent challenge in arid and semi-arid areas due to low and erratic rainfall,
recurrent droughts and food insecurity. In these settings, caregivers face several challenges in accessing
health services for sick and/or malnourished children, including long distances to health facilities, harsh
terrain, and lack of money to pay for transportation costs to the health facilities, leading to low service
coverage and sub-optimal treatment outcomes. To address these challenges and optimize treatment
outcomes, the World Health Organization recommends utilizing community health volunteers (CHVs) to
manage acute malnutrition in the community. This study explored the perceptions of community members
regarding acute malnutrition treatment by CHVs in Turkana and Isiolo counties in Kenya. The study utilized
a cross-sectional study design and included a purposive sample of caregivers of children, CHVs, officers
who trained and supervised CHVs and community leaders in the intervention area. Focus group discussions
and key informant interviews were used to explore perceptions towards the management of acute
malnutrition by CHVs. Generally, caregivers and CHVs perceived the intervention to be beneficial as it
readily addressed acute malnutrition treatment needs in the community. The intervention was perceived to
be acceptable, effective, and easily accessible. The community health structure provided a platform for
commodity supply and management and CHV support supervision. This was a major enabler in
implementing the intervention. The intervention faced operational and systemic challenges that should be
considered before scale-up.
Keywords: community health volunteers, community management of acute malnutrition, integrated
community case management, acute malnutrition, wasting.