The Diverse Roles of Community Health Workers: Cues for Technology Innovations

Community health workers (CHW) in rural Kenya have great influence in their society and the potential to affect positive change in community health, yet their training is largely inconsistent and their community role is not well understood. This study explores the role of CHW and considers their ability to operate a telemedicine system designed by the Humanitarian Engineering and Social Entrepreneurship (HESE) Program at Penn State. Methods: Qualitative field research allowed exploration of CHWs in their natural environment in Nyeri, Kenya. Data were collected in the form of focus groups and direct observations, and analysis was performed using the constant comparative method. Results: Nyeri CHWs report identifying with many roles including public health advocate, a teacher, a healthcare provider, and a community role model. Conclusions: Nyeri CHWs are highly motivated to improve the health of their community, yet lack the knowledge and training required to meet the key objectives of the Ministry of Health. Through telemedicine utilization, CHWs could both increase their knowledge of diseases and provide an opportunity for large-scale health surveillance. While this study focused on one specific region, the observations are transferrable to CHW programs in similar resource-constrained settings around the world. (C) 2014 Elsevier Ltd.