For years, residents needing medical attention have had to make their way to health facilities, but Nairobi Governor Johnson Sakaja says community health promoters are reversing that approach by taking healthcare services into homes and neighbourhoods.
Sakaja said the expansion of community health promoters (CHPs), together with stronger primary healthcare and increased support for health facilities, was helping change how healthcare is delivered across the country.
Speaking on Tuesday during the opening of the Kenya Health Summit at the Kenyatta International Convention Centre (KICC), the governor said Nairobi had built a large community health network that was helping connect households with the formal healthcare system.
The county currently has 7,820 community health promoters serving about 780,000 households.
Sakaja said the figures demonstrate the growing role of community-based healthcare in ensuring residents can access health information, preventive services and referrals without having to wait until they need hospital treatment.
Community health promoters operate within neighbourhoods and households, where they provide health education, identify possible health concerns, make referrals and follow up on patients. Their work is mainly focused on prevention and promoting good health, allowing problems to be identified before they develop into more serious conditions.
The governor said this model had changed the relationship between residents and health facilities by moving some services closer to where people live.
“Before we used to tell the people to go to hospital. These days, with the CHPs, the hospital is going to the people, and that has reduced greatly the cost of health service delivery in this country,” he said.
He said the community health programme would form part of the discussions during the two-day health summit, which is also expected to look at primary care networks, essential services and maternal healthcare.
Sakaja said Nairobi's health facilities were recording changes as the county invested more in services and infrastructure.
He cited Pumwani Hospital, saying the facility had achieved 0% maternal mortality out of 16,500 deliveries, a development he contrasted with the problems that had previously drawn public attention to the hospital.
“Over the next two days, we'll have opportunities to go into the details of this transformation from our primary care networks, where we have CHPs in Nairobi of 7,820, covering 780,000 households, to the provision of essential services, Your Excellency's reduction of maternal mortality, hospitals like Pumwani, which would be on the news every day for the wrong reason, have now 0% maternal mortality out of 16,500 deliveries,” Sakaja highlighted.
He also pointed to Riruta Hospital, which he said was now recording about 100 deliveries every month.
Maternity services have also been introduced at Kayole and Madaraka North, adding to the range of services available to residents within their communities.
Sakaja further spoke about the money being allocated to health facilities, saying increased funding was giving hospitals and other centres room to improve services and put resources into areas that previously received little support.
“We have facilities that would get 100,000 shillings in two years, in a year, getting 4 million shillings a month, allowing them to invest in healthcare and to invest in serving our people.”
The governor said the changes should be viewed within the wider constitutional requirement for the government to ensure citizens can enjoy their rights, including access to healthcare.
“Our constitution has been hailed as being one of the most progressive on the continent. It has mainly been hailed as being progressive because of the kind of rights, the first generation rights, are civil liberties, where government is asked to step back to allow people to have the right to do a number of things. But the second generation rights are what we call positive obligations. Positive obligations require government to actually do something,” Sakaja said.
He said the right to healthcare must result in actual services for citizens rather than remain a constitutional promise.
Sakaja argued that medical care should not be limited to those who can afford it, saying families should not be forced to sell livestock or investments simply because they need treatment.
He also highlighted the role of technology in the reforms, saying more than three million people had registered for digital health services in Nairobi, while more than one million were actively contributing each month.
The governor said the digital systems were giving authorities a clearer picture of registration and contributions, information he said could also assist in planning and improving healthcare services.
Sakaja said the combination of community health promoters, improved health facilities and digital systems was creating a different approach to healthcare delivery and could leave a lasting mark on the country's health sector.