The emergence of the COVID-19 pandemic reminded us how important Community Health Volunteers (CHVs) are in guiding the community in health improvement and disease prevention. Globally, due to the rapid increase in the number of COVID-19 new cases combined with limited resources, healthcare systems were stretched putting healthcare workers under pressure. In Kenya, the Ministry of Health reported a decline in the performance of key health indicators like immunization, family planning, skilled deliveries, and nutrition services uptake. The unprecedented challenges combined with extreme drought threatened livelihoods especially those in hard-to-reach areas within Arid and Semi-arid areas. According to Marsabit County Deputy County Nutrition Coordinator, Mary Dokatu, the crisis resulted in the deterioration of nutritional status at the household level. The fear of contracting coronavirus resulted in caregivers defaulting on the referral of children under five with acute malnutrition who are among the most affected by drought.

“The effect of drought has severely impacted food security preventing vulnerable families from meeting required nutritional needs. The pandemic and long distances to health facilities also denied mothers and caregivers a chance to access referral centres for needed treatment. The dire situation has caused great fear and worries calling for urgent attention”, stated Deputy County Nutrition Coordinator, Mary Dokatu.

In response, with funding from USAID and UNICEF, Kenya Red Cross scaled up surveillance for malnutrition at the household level through the use of Family Mid-Upper Arm Circumference (MUAC), also known as Mother-led MUAC or Mama MUAC. The intervention has contributed to the capacity enhancement of Community Health Volunteers (CHVs) and caregivers in the far-flung areas in the Arid and Semi-Arid locations of Marsabit county. The trained volunteers are promoting behaviour change through homes visits, initiating dialogue with household members, determining the health situation, delivering key health messages, and undertaking necessary actions; to guide the community on health improvement and disease prevention. During these visits, they continue to sensitize mothers or caregivers with children 6 – 59 months on the Family MUAC.

33-year-old Agnes Kimogol, CHV from Kambinye, Hulahula community unit in Marsabit county has been a major player in promoting nutrition behaviour change interventions at the household level. Together with health facility technical staff, she supports mobilization for bi-monthly integrated health outreaches and regularly visits households in Kambinye location and shares guidance on nutritional needs for children under five with pregnant women and caregivers.

“My intervention at the household level is targeted at caregivers and malnourished children through behavioural change related messages and service delivery towards ending malnutrition. Being a part of the pastoralist community, I encourage caregivers to keep track records of malnutrition status and refer acute malnutrition cases to health facilities to ensure timely treatment of acute malnutrition. This discourages caregivers from migrating with children recording acute malnutrition surges during emergencies such as drought”, explained Community Health Volunteer, Agnes Kimogol.

During the outreaches, the CHVs provide pre and postnatal care for pregnant mothers and breastfeeding mothers respectively, support vitamin A supplementation, enrol acute malnourished children under supplementary feeding programs and support mobilization of community members for vaccination against COVID-19. Timely access to the needed treatment by households lightens the burden of caregivers like Rebeca Lenuk, 48, who used to walk for 25 km to receive the needed treatment.


“Bringing healthcare services to my community has lessened my burden of trekking for 25km to access medical services. Sometimes all my seven children would fall sick. I could not afford the finances to take all of them to the health facility. I also feared contracting COVID-19, forcing me to depend on home-based care treatment. The knowledge by Community Health Volunteers on how to use Family MUAC is enabling me to detect acute malnutrition among my children and refer them during the health outreaches,” said beneficiary Rebeca Lenuk.

Since the onset of COVID-19, Community Health Volunteers (CHVs) have played a significant role in expanding the provision of health care in the community they serve whilst providing solutions to community needs at the local level. Community Health Volunteer Amina Wambile shared her commitment and joy in ensuring pregnant mothers deliver at healthcare facilities and exclusively breastfeed for the first six months, introducing timely complementary feeding at six months with continued breastfeeding for two years and beyond to prevent the occurrences of malnutrition in under-fives.

“Seeing happy and healthy children during the regular household visit is satisfying. My main goal as a CHV is to train as many caregivers as possible on the use of Family MUAC to screen for malnutrition. Early detection leads to early prevention”, affirmed elated Amina Wambile.

Kenya Red Cross Society aligns its health programming with the Kenya Universal Health Coverage agenda whose goal is to ensure communities have access to safe, effective, and quality essential health care services to lead healthy lives. The Integrated holistic approach implemented across 20 sites in Marsabit County has screened over 2,000 children for acute malnutrition and those that require treatment are referred accordingly. Kenya Red Cross continues to support the scale-up of the family Mid-Upper Arm Circumference (MUAC) approach also referred to as 'mother-led MUAC' or mama 'MUAC' in 6 community health units in the county where cumulatively 550 HCWs, 718 CHVs and 11,439 caregivers have been reached nationally, while 31 HCWs, 130 CHVs and 1540 caregivers have been reached in Marsabit county.

By Communications Officer at the Kenya Red Cross Society, Martha Awinoh

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