By Evance Odhiambo

Forty percent of Kisumu City residents reside in the informal settlements including Nyalenda. With such a population, access to proper healthcare has not been a walk in the park due to low income and the distance to health facilities.

Over the past years, Community Health Volunteers (CHVs) have acted as a linkage between the residents and the health facilities. The distance between the residents and health facilities as well as many households to be covered hindered the efforts of CHVs to conduct visits and referrals.

Elisha Ogonda, a CHV in Nyalenda, displaying CHV kit

According to Elisha Ogonda, a CHV in Nyalenda, he is supposed to cover 100 households in a month. He says covering all these households wasn’t possible before July last year due to mobility challenges.

“I was walking literally from house to house on my routine visit to check on the health of households under my care. This was tough since the county government is not promising in giving us the monthly stipend of Ksh. 2,500 (about 25). The stipend delays for months. I couldn’t afford to board a motorbike. The houses are far away from Kowino Health Center where I  am supposed to make referrals to. I could only cover up to 30 households instead of 100 in a month,’’ says Ogonda.

The mobility challenge that was facing the CHVs is now a thing of the past, thanks to Cycling out of Poverty Kenya (CooP Kenya), a non-governmental organization (NGO) that initiated the distribution of bicycles to Community Health Volunteers within Nyalenda. According to CooP Kenya Programs Officer, Joab Oluoch, over 200 bicycles have been distributed to the CHVs since July last year, 2021.

“We are working with health facilities within Nyalenda such as Kowino, Dunga, Joel Omino among others to map out the number of CHVs. With this, the facilities identify the beneficiaries based on their performance in conducting household visits and referrals. Also, we have partnered with United Destiny Shapers (UDS), a Community Based Organization in Nyalenda, to help mobilize and train the CHVs. The impact of these bicycles so far is amazing,’’ says Oluoch.

Peter Owiny, UDS coordinator noted that the bicycles have so far increased the household coverage by Nyalenda CHVs thus increasing access to healthcare provided by them.

According to Lydia Digo, a CHV covering households within Dago area of Nyalenda, the bicycle have helped in reducing disease burden among the children. Sick children are referred to health facilities in time. She says that expectant women are also now visiting health facilities due to persistent visit by CHVs.

Lydia Digo, a CHV covering households within Dago area of Nyalenda

“The bicycles have eased our household visits. Since I received my bicycle, I have made over 20 referrals for expectant mothers. They are now attending clinics,’’ says Digo.

Digo said that she is able to save the little amount she was using on transport to make visits. This money she can now channel to other needs.

‘’Before I received this bicycle, I was using over Ksh. 500 (about USD 5) in a month on household visits. I can now save it and am planning to start a small business to keep me busy whenever I am not conducting my CHV duties. The bikes came in handy and I am glad that we also use them to carry the sick to the facilities,’’ she says.

Eunice Nyang’ara, a health officer at Kowino Health Center noted that they are overwhelmed with the hospital visits since the bicycles were distributed to the CHVs. Unlike before, Nyang’ara says even cases of maternal mortalities have decreased.

‘’Mothers are now making regular prenatal visits and this has saved lives and complications related to expectancy. Here at our health facility, we have been attending to over 50 expectant mothers daily, thanks to mobilization by CHVs through their bicycles,’’ says Nyang’ara.

Emma Okumu, an expectant mother, noted that through the household visits by CHVs, she is sure of delivering well later in March this year. She narrated how she used to boycott pre-natal visits before, a CHV attached to Dunga Dispensary visited her and made her see the reason of visiting the heath facility while expecting.

Mr.Joab Oluoch conversing with CHVs

In as much as this is a good initiative with positive impact, JOluoch, CooP Kenya says that there are some challenges they are facing in implementing it. He noted that the number of CHVs in need of bicycles is overwhelming. This is forcing them to look for other partners to help facilitate the distribution. He is therefore appealing to likeminded organizations to join hands and help in purchasing the bikes for CHVs.

Ogonda, a CHV, noted that they incur maintenance cost of the bicycles due to wear and tear. The spare parts of these bicycles he says are scarce and expensive.

‘’Yes, the bicycles are helping us in conducting visits and referrals, maintenance is still a burden. The bikes are unique and getting their spare parts is quit cumbersome. I know CooP Kenya will address this,’’ says Ogonda.

Oluoch said that their aim is to distribute the bicycles not only to the informal settlements but also to the remote parts of the country as a way of contributing to primary healthcare provided by CHVs. He attributed this plan to the positive impacted created so far in Nyalenda.

Though the project started with Nyalenda area, there are plans to start a similar project in Gem, Siaya County.