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Citation Information

Type Thesis or Dissertation - Master of Arts
Title Factors influencing effectiveness of Kenya's community health strategy in the fight against HIV/AIDS: a case of Transmara West sub County, Narok County, Kenya
Author(s)
Publication (Day/Month/Year) 2014
URL http://erepository.uonbi.ac.ke/bitstream/handle/11295/90301/Kiprono_Factors influencing​effectiveness of Kenya s Community health strategy.pdf?sequence=3
Abstract
The purpose of this study was to explore the factors that influence effectiveness of Kenya’s
Community Health Strategy in the fight against HIV/AIDS. Specifically, the study sought to establish
the influence of resource allocation, cultural attitudes and practices, supportive supervision, and
existing referral systems and linkages or networks on community health strategy in the fight against
HIV/AIDS, in Transmara West Sub-county of Narok County. The research design used was
descriptive in nature. Simple random sampling was used to select a sample size of 168 respondents
from a population of 290 CHWs, using Cochran’s 1977 formula. Census approach was used to sample
all the 10 CHEWs while purposive sampling was employed to identify KIs. The respondents were
males and females between 30 years and 50 years of age. Information was collected using a
questionnaire by the researcher and administered by two trained research assistants under the
researcher’s guidance. Data was analyzed using descriptive summaries, and findings presented by the
aid of tables. For quantitative data, analysis was done using SPSS and findings presented using tables,
too. The study concluded that among the four factors namely; cultural attitudes and practices, resource
allocation, supportive supervision and referrals, linkages and networks; resource allocation had the
greatest influence on the effectiveness of the Kenya’s Community Health Strategy in the fight against
HIV/AIDS. This was followed by cultural attitudes and practices and then supportive supervision.
Lastly, referrals, linkages and networks indicated a positive relationship with effectiveness of
community strategy, but one which was weaker than the first three factors. The CHWs rated amount
of funds allocated to Community Strategy as very high determinant as shown by a mean of 1.262 and
a standard deviation of 0.839. Also, consistency of funding and availability of CHWs kit/IEC material
and logistical support were rated as moderate determining factors at a mean of 3.114 and standard
deviation of 0.984 and 1.050 respectively. Additionally, the respondents rated staffing levels of health
centers as a moderate determining factor at a mean of 3.262 and a standard deviation of 0.911. At a
mean of 2.465 and a standard deviation of 0.376 the CHWs agreed that cultural practices have high
influence on effectiveness of community services in HIV/AIDs fight, and indicated at a mean of 2.537
and standard deviation of 0.674 that cultural beliefs and practices hindered access to proper care for
HIV clients. Regular support supervision was rated as moderately influential at a mean of 3.032 and a
standard deviation of 0.893 just as extensive coverage of indicators during supervision was rated at a
mean of 3.078 and a standard deviation of 0.675 as moderately influential. CHWs further conceded
with a mean of 2.993 and a standard deviation of 1.777 that completeness of referral process was a
high determinant of effectiveness of the community health strategy in the fight against HIV/AIDS.
The study recommends that issues around resource allocation be streamlined by the government to
ensure a smooth implementation of the program. Resource allocation determined whether effective
support supervision was achieved or not and the study thus recommends a dedicated budget to the
strategy. On cultural practices, the study recommends that communities be empowered through more
targeted community mobilizations by use of IEC materials that would bring out the real HIV issues
for better understanding. Appreciating that supportive supervision at the Community Units increases
quality of service and contribute to the uptake of community-based HIV services, there was need to
ensure consistent and adequate supply of resources to the CHEWs and SCHMT to conduct this
activity regularly and in a predetermined manner. Regular monitoring, guidance and mentorship visits
by program officials help boost morale and motivation of the beneficiaries. Communities should be
empowered and prepared to take up the responsibility of taking care of their own health through
mainstreaming of community participation in all health and development projects. Finally, for fairly
observable and measurable change on indicators, project or program implementation support period
should be longer, say 3-5 yrs. The government should strive to have all partners commit to funding
and/or technical support for periods not less than 3 years.

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