| dc.description.abstract | The World Health Organization (WHO) recommends using Community Health
Volunteers (CHVs) to deliver nutrition services, contributing to Universal Health
Coverage (UHC), a broader goal that encompasses nutrition. Thus, various programs
have been implemented worldwide utilizing CHVs. Nevertheless, poor nutrition
outcomes persist in households under the care of CHVs, leading to high rates of
malnutrition and mortality. Poor hygiene and sanitation practices also contribute to
malnutrition and infections, worsening nutrition challenges. Using the Donabenian
Model of Quality in Health Care, this study evaluated the performance of CHVs on the
nutrition outcomes of households with children aged 6-59 months in Alego Usonga, Siaya
County, Kenya, where nutrition and health outcomes are poor. A cross-sectional study
design was employed, using purposive, multi-stage, and systematic sampling methods to
gather data from 356 households and conduct 3 focus group discussions (FGDs). A
structured questionnaire and FGD guide were utilized to collect quantitative and
qualitative data. The study was carried out from February to May 2024. Statistical
Package of Social Sciences (SPSS) Version 28 was used to analyze quantitative data,
while NVivo 14 was used for qualitative data analysis. Fisher's Exact Tests and
Multinomial Logistic Regression Analysis, at a 95% confidence level, were employed to
establish the relationship between CHVs' service delivery and nutrition outcomes in
households with children aged 6-59 months. The main economic activity was farming at
36.7%, with 78% of households earning less than USD 77 monthly. Key nutrition and
health outcomes included: low Minimum Dietary Diversity (MDD) – 6.1%, low
Minimum Acceptable Diet (MAD) – 2.7%, high bottle-feeding – 44.6%, high food
insecurity – 60.4%, and low handwashing uptake – 15.7%. Despite these findings, a
significant relationship was established between CHVs’ service delivery (household
visitations, referrals, follow-ups, counseling services) and various nutrition outcomes. In
conclusion, CHVs remain essential in nutrition service delivery, even though they visit
only 71.9% of the targeted households every month. Therefore, to improve CHVs’ service
delivery, the Government of Kenya should review CHVs’ policies and strengthen their
capacity. | en_US |
