Engaging communities: an approach to strengthen health systems in Kenya

Abstract

In traditional Africa, there were lower preventable burdens of diseases and mortality because health was viewed collectively by the community. Therefore, community members worked collaboratively to prevent and manage diseases. However, a large proportion of sub-Saharan countries today, including Kenya, bear one of the highest preventable burdens of diseases and mortality in the world. Community engagement initiatives can be used as an effective means for addressing the determinants of diseases and mortality. This is best achieved through people’s active participation, especially at the community level. The aim of this paper is to stimulate debate on the significant role played by community engagement in strengthening health systems. The paper argues that communities should be an integral part of health systems and proposes that community engagement should be a subject of mainstream concern, a staple discussion in national and subnational government levels, academic forums and with policy makers. The paper will realize its objectives through literature review and a case study on the community engagement activities of the Maternal and New born Improvement project (MANI). Kenya has some of the highest rates of maternal and new born mortality in the world. Thus, the MANI project supported by the Department for International Development is working with the Bungoma county government to strengthen the local health system and increase survival of mothers and new borns in the county. Through the case study, the paper assesses the efficacy of community engagement in strengthening health systems by evaluating the impact of the projects’ community engagement activities on the health system.