Acute malnutrition is a persistent problem in Kenya’s drylands. In these settings, caregivers face geographic and economic challenges in accessing health services for malnourished children, leading to low service coverage and sub-optimal treatment outcomes. This study conducted in Turkana and Isiolo counties explored community members’ perceptions regarding acute malnutrition treatment by community health volunteers (CHVs), currently called community health promoters, at home. Data were collected through focus group discussions and key informant interviews with caregivers of children, CHVs, staff of implementing organizations, supervisors of CHVs, and community leaders.
Community sensitization, availability of a functional community health structure – providing a platform for commodity management and support supervision – immediate initiation of treatment by CHVs after training, proximity of CHVs to caregivers, and provision of a stipend to CHVs (Isiolo) were the main enabling factors of the intervention. Challenges of implementing the intervention included low literacy levels of CHVs, some caregivers not accepting the new role of CHVs or refusing to be referred to health facilities where this was indicated, community expectation of a wider set of services from CHVs, interrupted supply of treatment commodities, inadequate number of CHVs, geographic barriers faced by CHVs, increased CHV workload, and lack of a stipend for CHVs (Turkana). These factors should be considered and addressed if the intervention is to be scaled up.