Implementation Research for Malaria Prevention and Control: Barriers and Lessons Learnt in Capacity Building of Community Health Volunteers in Malindi, Kenya

Abstract

A two-year implementation study was undertaken in Malimo and Kakuyuni of Malindi, Kenya. The study combined data collection and intervention in three phases from November 2015-September 2017. These phases were: 1) CHVs recruitment and need assessment; 2) Curriculum and development of training guide; 3) CHVs implementation activities. Implementation activities were carried out for six months where selected CHVs conducted home visits, created awareness on malaria prevention and control activities, and collected monthly data using prescribed forms. Workshops, field visits, and formal and informal meetings were used to collect information on challenges faced by the CHVs and the lessons learned in the intervention phase. Seventy-seven (77) CHVs were identified. Twenty (20) were randomly selected, trained, and assigned to 20 households each to implement malaria prevention and control activities. The challenges identified included low literacy levels of CHVs leading to the introduction of peer-to-peer; weak referral system and poor linkages of CHVs to health facilities; insufficient supervision and missing coverage and also a multiplicity of CHVs’ roles. Identification and use of need-based capacity strengthening and follow-up are crucial in addressing challenges facing CHVs and enhancing their capacity for successful implementation of CHVs activities in malaria prevention and control.