Factors Influencing the Functionality of Community Health Committees: A Case Of Mombasa County, Kenya

Abstract

The achievement of better health outcomes is generally believed to be possible to secure through the development and support of health systems. In 2006, Kenya launched a strategy focusing on the health of communities in a bid to deliver crucial health packages. Community Health Committees consisting of selected community membership coordinate activities regarding the health of the community on behalf of their community, and have been identified as a useful health governance structure offering oversight and leadership in the execution of services related to the communities. Despite the investment in expansion of community health services in Mombasa, a number of challenges exist regarding the functionality and sustainability of the Community Health Committes. The study’s central objective was to assess the factors influencing the functionality of Community Health Committees in Mombasa County. Specific Objectives were: to examine the role of communication, to assess the effect of composition, to examine the role of training and to assess the role of support supervision in influencing the functionality of Community Health Communities in health service delivery in Mombasa County. The study adopted a descriptive cross-sectional research study design. The target population was 271 community health committee members in the six sub-counties in Mombasa County. Stratified random sampling was used to identify the 162 respondents in selected Community Health Units. The research instrument used in the study was a questionnaire, additionally Key Informant Interviews were administered to six key informers within the to understand their perception, understanding and knowledge of functionality of community health committees. The questionnaire was pre-tested in Kwale County to ascertain its accuracy before the main data collection exercise begun. Descriptive and inferential statistics was used to summarize the data. The findings established that communication, composition, training and support supervision had positive and significant influence on functionality of Community Health Committee. The study further established that information flow in most health committees was poor with only 32.7% of the community members attending the community dialogue days. The health committees are not properly composed with 96% having less than the requisite committee membership. While the majority (95%) of the committee members had undergone training, the scope of the training they received did not adequately cover all the skills they needed to perform their roles. It was also established that there was inadequate follow up training with only 43.9% having received any additional training. The study also established that support supervision was inadequate and infrequent with only 50% of the health committees reporting that they have been supervised. The study concluded that community health committees where there was effective communication, proper compositions, had undergone effective training and were properly supervised had better functionality and improved governance. The study recommends that the County Government should ensure that communication, composition, training and supervision are properly managed in their various Community Health Committees to realize better functionality in community health service delivery.