Community and health worker perspectives on resource availability and service accessibility for visceral leishmaniasis management in Baringo County, Kenya

Abstract

Background Leishmaniasis remains a neglected tropical disease in endemic counties such as Baringo. Effective control requires timely diagnosis, adequate treatment, reliable commodity supply, trained personnel, and community- level prevention. Services are concentrated in a few facilities, with residents facing long travel distances, stockouts, and limited outreach. This study assessed community and health worker perceptions of access to visceral leishmaniasis (VL) resources and health facility readiness for diagnosis, treatment, prevention, and control.

Methods A cross-sectional design was used, involving 422 household heads from VL endemic communities and 32 health workers from the Kimalel and Chemolingot health facilities. Data were collected via semi-structured questionnaires and analyzed using descriptive statistics and exploratory χ2 tests.

Results Most household (73.7%) respondents knew someone affected by VL; 68.5% reported the affected person received treatment, and 96.2% completed the full dose. However, 70.1% reported no organized VL prevention/control program, and 74.4% accessed facilities on foot. No sex differences emerged for awareness, completion, prevention awareness, or access mode, (all P > 0.05). Among health workers, 62.5% had received VL-related training with significant differences by cadre (χ2 = 18.35, P = 0.001), training duration, and organization (χ2 = 32.00, P < 0.001). Commodity source (χ2 = 5.40, P = 0.020), stock-out status (χ2 = 9.41, P = 0.002), clinician availability (χ2 = 4.88, P = 0.027), and laboratory/ pharmaceutical readiness (χ2 = 6.53, P = 0.011) were significant. Outreach involvement and perceived community burden were non- significant (P = 0.102 and P = 0.168, respectively).

Conclusion Communities demonstrated familiarity with VL, and treatment completion is high once treatment is started. However, access, prevention outreach, commodity security, and facility readiness remain inadequate. Strengthening diagnostics, ensuring continuous antileishmanial drug and laboratory supplies, expanding refresher training across all relevant cadres, and institutionalizing community outreach are necessary to improve VL outcomes in Baringo.