Abstract:
Background: Malaria continues to be the leading cause of morbidity and mortality in Africa. Community Case
Management of malaria (CCMm) which is undertaken by engaging Community Health Workers (CHWs) to effectively
address management of malaria cases in some endemic communities was explored in this study. The aim was to
assess the needs of CHWs that would help sustain and retain their services to enhance the efficient delivery of CCMm.
Methods: Using semi-structured questionnaires, data on the needs of CHWs was gathered through a qualitative
study consisting of in-depth interviews and focus group discussions (FGDs) conducted among study participants in
five districts in western Kenya. The study participants comprised of 100 CHWs, 100 mothers of children under five
years and 25 key informants made up of public health officers and clinicians involved in the CCMm. The interviews
were conducted in English and Swahili or Dholuo, the local language. The recorded audio interviews were transcribed
later. The analysis was done using NVivo version 7 software and transcripts were coded after which themes related to
the objectives of the study were identified.
Results: All the study participants recognized the need to train and update CHWs on their work as well as remuner-
ating them for their services to enhance efficient delivery of services. The CHWs on their part perceived the provision
of gloves, rapid diagnostic test kits (RDTs), lancets, cotton wool and ethanol, bins (to dispose of RDTs and lancets),
together with drugs for treating clients as the essential needs to undertake CCMm in the communities. Other logisti-
cal needs and incentives mentioned by CHWs and key informants for the successful delivery of CCMm included:
gumboots, raincoats, torch lights, mobile phones, means of transportation (bicycles and motorbikes), uniforms and ID
cards for identification.
Conclusions: CHWs would perform tasks better and their services retained for a sustainable CCMm if: properly incen-
tivized; offered refresher trainings (and updates) on malaria; and equipped with the requisite tools identified in this
study.