Investment In COMMUNITY BASED HEALTH CARE towards Achieving the Millenium DEVELOPMENT Goals In Butere District, Kenya

Community Based Health Care (CBHC) is a strategy for health service delivery adopted by the Kenya Government Ministry of Health (MOH) since 2006.  This was after a rigorous search to test its effectiveness in reversing the observed worsening health indicators particularly maternal and child mortality rates.  Since then the MOH has invested both financial and human resources in the implementation of the strategy. This paper presents findings of a study carried out to determine the investment levels for human resources towards implementation of the strategy by parners.  Comparison is made of investment by Government, the community, and the Tropical Institute of Community Health (TICH) as key stakeholders in the implementation of the strategy.  Data were collected over a period of eight months regarding time invested in the various activities involved in the implementation of the strategy in Butere, a rural District in Western Kenya.

Results: In an average month, community invests the largest amount of time, a total of 204.8 man-days, through the work of community health workers (CHW), and Community Health Committees (CHC) followed by the University (2.5 man days), in facilitation, training, data collection and analysis. The Government invests the least (1.1 man-days) in the implementation of the strategy through time spent by the District health management Team (DHMT) in meetings and Community Health Extension Workers (CHEW) in supervisory support to the Community Unit (CU) activities.  This translates into total monthly manpower cost of Ksh.118333 (USD 1246), contributed by community (87%), TICH (11%) and DHMT (2%).

Conclusion: The community has owned the CBHC strategy as demonstrated by their massive investment of time.  While the government has shown goodwill through policy enactment, it needs to upscale its commitment through time investment by its relevant staff.