Effectiveness of Utilization of Community Health Volunteers in the Identification and Management of Hypertension Cases in Kajiado County, Kenya.
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Date
2025-06
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Kenyatta University
Abstract
Hypertension, despite being a preventable and manageable non-communicable disease, significantly contributes to the overall morbidity and mortality rates. In Kajiado County, Community Health Volunteers (CHVs) offer various healthcare services, but their utilization in hypertension care has not been thoroughly explored nor emphasized. This study aims to assess the sociodemographic profiles, knowledge levels, the challenges, barriers, and facilitators that influence CHVs’ effectiveness in hypertension identification and management in Kajiado County. A cross-sectional study with a mixed-methods approach targeting 221 CHVs in Kajiado South Sub- County was conducted. Almost all respondents (99.6%) reported having a role in hypertension identification and management in the community; however, only 34.1% had ever received specific training on hypertension. The results show that CHVs play a major role in screening (32.6%), education (74.1%), and referral (99.6%). More than three-quarters stated that their work was purely voluntary, with all of them recommending a need for a monthly stipend as a motivation and enabler for their work to be effective. Hypertension screening was significantly higher among the middle-aged group (41-50 years) ( ꭓ2 8.9, p=0.031, 95% CI). A significant association was found between having received hypertension training and knowledge levels on hypertension (Fisher’s exact test, p=0.000, 95% CI). Screening was conducted more among those who had been trained on hypertension (χ2= 9.06, p= 0.003, 95% CI). Multiple logistic regression in our final model found that the odds of identifying hypertension cases in the community was 3.74 times higher among CHVs who knew the symptoms of hypertension as compared to those who lacked this knowledge. CHVs received support from healthcare personnel through training (100% for basic CHV training and 34.1% for hypertension-specific training) and supportive supervision (94.7%). Additionally, CHVs who received supportive supervision (Fisher’s exact test, p=0.029) and had automatic digital Blood Pressure machines (Fisher’s exact test, p=0.001) were more likely to identify hypertension cases in the community than the rest who lacked this support and essential equipment. The study recommends intensified training of CHVs to improve knowledge on hypertension in the basic module and continuous updates, supportive supervision, and provision of automatic digital blood pressure equipment to empower them and support their activities in hypertension care.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology and Disease Control) in the School of Health Sciences of Kenyatta University, June 2025.
Supervisor
1. John Paul Oyore
2. Gordon Ogweno