The effectiveness of community health worker training, equipping, and deployment in reducing Covid-19 infections and deaths in rural Western Kenya

COVID-19 and other pandemics remain significant threats to population health, particularly in rural settings where health systems are disproportionately weak. There is a lack of evidence on whether trained, equipped, and deployed community health workers (CHWs) can lead to significant reductions in COVID-19 infections and deaths. Our objective was to measure the effectiveness of deploying trained and equipped CHWs in reducing COVID-19 infections and deaths by comparing outcomes in two counties in rural Western Kenya, a setting with limited critical care capacity and limited access to COVID-19 vaccines and oral COVID-19 antivirals. In Siaya, trained CHWs equipped with thermometers, pulse oximeters, and KN95 masks, visited households to convey health information about COVID-19 prevention. They screened, isolated, and referred COVID-19 cases to facilities with oxygen capacity. They measured and digitally recorded vital signs at the household level. In Kisii county, the standard Kenya national COVID-19 protocol was implemented. We performed a comparative analysis of differences in CHW skills, activity, and COVID-19 infections and deaths using district health information system (DHIS2) data. Trained Siaya CHWs were more skilled in using pulse oximeters and digitally reporting vital signs at the household level. The mean number of oxygen saturation measurements conducted in Siaya was 24.19 per COVID-19 infection; and the mean number of temperature measurements per COVID-19 infection was 17.08. Siaya CHWs conducted significantly more household visits than Kisii CHWs (the mean monthly CHW household visits in Siaya was 146,648.5, standard deviation 11,066.5 versus 42,644.5 in Kisii, standard deviation 899.5, p value = 0.01). Deploying trained and equipped CHWs in rural Western Kenya was associated with lower risk ratios for COVID-19 infections and deaths: 0.54, 95% CI [0.48–0.61] and 0.29, CI [0.13–0.65], respectively, consistent with a beneficial effect

Disease · Economic growth · Environmental health · Health care · Health facility · Health services · Medical emergency · Pandemic · Personal protective equipment · Population · Vital signs · COVID-19 epidemiological studies · Immune responses and vaccinations · Medicine · Vaccine Coverage and Hesitancy

• Schools of public health as a cornerstone for pandemic preparedness and response

  Open Access•Rawlance Ndejjo, Honore Kabwebwe Mitonga et al.•Globalization and Health•2024

  Añadir item

• Community Health Workers in Low-, Middle-, and High-Income Countries

  Henry B Perry, Rose Zulliger et al.•Annual Review of Public Health•2014

  Añadir item

• Education as a Predictor Factor for Knowledge of Covid-19 in Portugal

  Open Access•Joana G Silva, Carla Sofia Silva et al.•Frontiers in Public Health•2021

  Añadir item

• Educational Attainment Decreases the Risk of Covid-19 Severity in the European Population

  Open Access•Masahiro Yoshikawa, Kensuke Asaba•Frontiers in Public Health•2021

  Añadir item

• Community health workers for pandemic response

  Open Access•Soumyadeep Bhaumik, Sandeep Moola et al.•BMJ Global Health•2020

  Añadir item

• Leveraging latent assets to strengthen the Covid-19 response and vaccine roll-out in Africa

  Open Access•Neema Kaseje, Kennedy Oruenjo et al.•BMJ Global Health•2021

  Añadir item

• Does Density Aggravate the Covid-19 Pandemic

  Open Access•Shima Hamidi, Sadegh Sabouri et al.•Journal of the American Planning…•2020

  Añadir item

• Community health workers and Covid-19

  Open Access•Solomon Salve, Judith Raven et al.•PLOS Global Public Health•2023

  Añadir item

• Who is a community health worker? – a systematic review of definitions

  Open Access•Abimbola Olaniran, Helen Smith et al.•Global Health Action•2017

  Añadir item

• The effectiveness of rural community health workers in improving health outcomes during the Covid-19 pandemic

  Open Access•Neema Kaseje, Meghna Ranganathan et al.•Global Health Action•2024

  Añadir item

• Training program for female community volunteers to combat Covid 19 in rural Nepal

  Open Access•Ramu Kharel, Soniya P Regmi et al.•Global Health Action•2022

  Añadir item

• Compact cities and the Covid-19 pandemic

  Open Access•Xiaomeng Zhang, Ziwen Sun et al.•Health & Place•2022

  Añadir item

• The Concept of Access

  Roy Penchansky, J W Thomas•Medical Care•1981

  Añadir item

• Too far to walk

  Open Access•Sereen Thaddeu, Sereen Thaddeus et al.•Social Science & Medicine•1994

  Añadir item

• An integrated rural health project in Saradidi, Kenya

  Open Access•Dan C Owino Kaseje, Dan Kaseje et al.•Social Science & Medicine•1989

  Añadir item

• The Health Belief Model and Prediction of Dietary Compliance

  Marshall H Becker, Lois A Maiman et al.•Journal of Health and Social…•1977

  Añadir item