Seven months later, CHP programme yet to fully take off

Public Health PS Mary Muthoni (right) and CFO Samuel Macharia before the Committee on Health on May 21, 2024. [Elvis Ogina, Standard]

Kenya Kwanza’s health agenda could soon be in limbo after it emerged that at least 22 counties have not paid Community Health Promoters (CHP).

Five counties, including Vihiga, Tana River, Marsabit, Mandera and Garissa, are yet to roll out the electronic programme.

Principal Secretary (PS) Public Health Mary Muthoni was tasked by the Committee on Health to explain why 20 counties are not paying, including the five where the gadgets are gathering dust.

Appearing before the committee recently during the presentation of budget estimates, Muthoni did not have a clear explanation.

“20 counties have not been able to pay, and are not paying, only 27 are paying”, Muthoni told the committee.

“Look at the counties, most of them were highly affected by El Nino and recent floods,” she added, referencing five counties yet to actualise the programme.

But she was quickly stopped by Endebess MP Robert Pukose, who also chairs the Parliamentary Committee on Health. Pukose questioned when a county like Vihiga in the Western region experienced floods.

“Stop there, Vihiga has never had floods,” he interjected.

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Pukose said failure to have the 20 counties actualise the programme, including five yet to roll out the initiative, is likely to attract the Auditor General’s probe because the failure is a waste of taxpayers’ money.

“Gadgets were bought, and distributed to communities but they are gathering dust. If the promoters are not working, this is wrong. Seven months later, gadgets were distributed, people trained but not getting services”.

In defence, Muthoni said the ministry is in talks with respective counties and the Council of Governors (CoG) to settle the matter.

Some of the counties, she said, are facing challenges in the installation of the gadgets, having been supplied by partners, while others suffered the impact of floods.

Pukose said there is a need to streamline the programme for its success.

According to the Endebes MP, proper structures in actualising the programme will avoid a blame game between counties and national governments, at a time when counties are accusing the National government of allegedly usurping their roles.

Meanwhile, Mombasa and Nyamira counties have not received payment dispatch from the National Government after they submitted extra names of Community Health Promoters.

According to set CHP operating structures, payments of the promoters are a shared responsibility between the national government and the counties.

Each of the institutions pays Sh2,500 to the promoters who were officially enrolled in November last year.

“If they (counties) are not able to put part of their bargain, we shall not give out our money, the first batch was the one payment that allowed us to come with one operation.

Muthoni had appeared before the National Assembly Health Committee to defend budget estimates for the Department of Public Health.

She said the ministry has supported counties with CHP kits, smartphones and stipends for 107,831 promoters.

Under the 2024/25 The National Treasury provided the ministry with Kshs 2.5 billion for payment of stipends, despite request of Kshs 3.2 billion, leaving a deficit of Kshs 650 million.

The PS defended the programme, saying promoters are a critical resource in the health sector.

Under the new health scheme-Social Health Authority (SHA), primary healthcare is fully funded by the government.

“These are people who move from one household to another. One community health promoter serves 100 households,”

The promoters were officially flagged off by President William Ruto in October last year.

In a previous interview with The Standard, the Head of Community Health Program in the Ministry of Health, Dr Maureen Kimani, said promoters have been operating within health system structures since 2006, previously known as community health volunteers.

The operators also operate within legal structures established under the Health Act 2017 which recognises community health as level 1 of the health system.

Initially, the promoters would educate community members on safe drinking water, availability of toilets and handwashing facilities made of locally available materials, apart from reporting any events in the villages such as cases of diarrhoea, cholera and malaria.

With their recognition under the Kenya Kwanza government, counties are therefore expected to adopt the structures and fund the programme through its budget, whereas the national level provides training and supervisory roles.

“A trained community health promoter is able to screen community members by conducting blood sugar tests and taking blood pressure, taking body temperature and where they identify abnormalities, they refer the community member to a health facility for immediate medical attention” says Kimani.