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Background: The performance of community health workers remains an area of significant global focus. The role of community health workers in sub-Saharan Africa has evolved over time in response to changing health priorities, disease burdens, and workforce demands. Recently, Kenya revised its community health strategy in response to challenges faced with the implementation of grassroots primary health care initiative. Implementation of community health programs is often inconsistent, and they vary widely in many attributes. The purpose of this study was to explore factors influencing performance of community health workers in Vihiga County, Western Kenya in light of the political devolution. Methods: The study was a cross-sectional study design that involved a quantitative method of data collection. A sample of 309 participants was selected through cluster and simple random sampling. A self-administered and -structured questionnaire was used to gather data, s, and those who were not able to respond individually were guided by the research assistants. Results: The community health workers were 75.2% females and 24.8% males. Performance was significantly associated with not being employed, (OR = 2.4; 95% CI, 1.4–4.4), secondary education (OR = 0.7; 95% CI, 0.5–1.1), lack of conflict resolution mechanism (OR = 2.2; p = 0.017), lack of support (OR = 1.5; p = 0.03), and community health work not seen as important (OR = 1.5; p = 0.041). Poor communication skills were also more likely to influence performance of community health workers (OR = 0.5; p = 0.050) and poor road network (OR = 0.361; p = 0.000). Conclusions: These findings offer a deeper understanding of the interaction between CHWs contextual situations, structural challenges, and performance. Addressing influential factors of CHWs performance in multi-task settings is important in preventing overtaxing their work capacity and to maintain quality performance as countries move towards universal health coverage. Strategies for incentivizing, attracting, and sustaining men in CHWs is important to broaden perspectives about this critical role in society.

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Introduction: The current higher education environment in the United States of America (USA) and worldwide is focused on providing people an opportunity to access a quality education at a competitive price and one that is flexible enough to meet the needs of a diverse student demographic. It is therefore necessary for course delivery methods to accommodate these diverse needs without sacrificing rigor necessary for accreditation due to the diverse backgrounds, occupations, and time constraints of students in today's environment Purpose: The purpose of this study was to establish the students' perception of the online and face-to-face components of a blended course design at a South Western Public University in the USA. Methods and material: The sample of this study consisted of 200 students drawn from four different blended courses in the Department of Health and Kinesiology at a medium sized public university in South West of USA. A modified questionnaire from Sitter et al., (2009) with 19 questions was used to collect responses from students. The survey instrument employed a 5-point Likert scale ranging from strongly agree (5), to strongly disagree (1). Results: Majority of the students have a positive view of the blended learning including the online and face-to-face components. A consistent minority of the students expressed disagreement especially pertaining to technology-based communication, preferred mode of delivery, online discussion participation and grade scores. Discussion: Although the majority of students perceived blended learning and its components positively, there is need for instructors to address the communication, technology, and online learning facilitation challenges if all learners are to learn effectively. Conclusions and recommendations:It is clear that the majority of students are ready and have accepted blended learning course designs at this medium sized public university in south