The Influence of Community Health Volunteers Practices on Advancing Social Accountability in Nairobi County, Kenya * Corresponding Author: Malkia Moraa Abuga, Email: malmoraa815@gmail.com Department of Health System Management Kenya Methodist University, Nairobi, Kenya

Abstract

Background: Community Health Volunteers position in the health system allow them to act as community mouthpieces, fighting inequities and advocating for community rights and needs to government structures. However, questions about how they carry out this role, specifically how they present community concerns to the health system and vice versa, remain unanswered. The purpose of this study was to evaluate the practices of community health volunteers that promote social accountability. Methods: The study used a cross-sectional research design across two sub-counties that were purposefully chosen due to their health indicators status. The quantitative data sample size was 180 Community Health Volunteers (Embakasi North 90, Embakasi Central 90) who were sampled using stratified sampling. Focus group discussions, key informant interviews and document review were used to collect qualitative data. Results: In Embakasi North and Embakasi Central, respectively, the study found that 66 (73.3 %) and 64 (71.1 %) of Community Health Volunteers rarely recorded complaints, 68 (75.6 %) and 53 (58.9 %) of Community Health Volunteers always reported complaints to the Community Health Assistant, and 67 (74.4 %) and 47 (52.2 %) of Community Health Volunteers always provided feedback to clients on the complaints raised. Conclusion: There was sub-optimal and inconsistent implementation of social accountability practices by the Community Health Volunteers in the two sub-counties. This was influenced by inadequate information on their mandate in social accountability, a lack of reporting indicators targeting social accountability and a lack of awareness about formal channels of complaint handling mechanisms at community health systems. Keywords: Social Accountability, Community Health Volunteers, Community Health Systems