Compliance with World Health Organization COVID-19 preventive behaviors in rural counties in Western Kenya: a cross-sectional study.

Introduction: the World Health Organization (WHO) recommended various measures to tackle COVID-19, and were adopted by many governments, targeting behavior change among citizens to lower the transmission. There was a paucity of data on the patterns of compliance with different measures within individuals and whether people adhere to all recommended measures or cautiously prefer few but not others. Understanding compliance behaviors and associated factors is important for developing interventions to increase compliance. Methods: cross-sectional study was conducted among adults in the western region of Kenya. A sample of 806 participants was selected using a stratified sampling method. A structured questionnaire was used to gather data from the participants. Compliance was assessed with six behaviors: hand sanitation, proper hygiene, no handshaking, social distancing, and other guidelines. Latent analysis was used to identify behavioral patterns. Descriptive statistics were used to assess demographic characteristics, in terms of frequency distribution, and percentages. Multinomial logistic regression was used to assess the association between demographic characteristics and compliance level. Results: compliance was highest for masking (85.3%), and was lowest for social distancing (60.2%). The majority of participants were found to be full compliers (class 1: 40.5%), there was an increased probability of full compliance among those aged between 18-30 years (OR= 1.042; 95% CI: 0.307-13.052, p < 0.040) compared to those aged ≥70. Conclusion: using facemasks had the highest rate of compliance, followed by hand sanitization and proper hygiene. However, overall, the findings showed that while compliance with some protocol behaviors is high, individuals comply consistently across recommended compliance behaviors.

Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya.

Background: The performance of community health workers remains an area of significant global focus. The role of community health workers in sub-Saharan Africa has evolved over time in response to changing health priorities, disease burdens, and workforce demands. Recently, Kenya revised its community health strategy in response to challenges faced with the implementation of grassroots primary health care initiative. Implementation of community health programs is often inconsistent, and they vary widely in many attributes. The purpose of this study was to explore factors influencing performance of community health workers in Vihiga County, Western Kenya in light of the political devolution. Methods: The study was a cross-sectional study design that involved a quantitative method of data collection. A sample of 309 participants was selected through cluster and simple random sampling. A self-administered and -structured questionnaire was used to gather data, s, and those who were not able to respond individually were guided by the research assistants. Results: The community health workers were 75.2% females and 24.8% males. Performance was significantly associated with not being employed, (OR = 2.4; 95% CI, 1.4-4.4), secondary education (OR = 0.7; 95% CI, 0.5-1.1), lack of conflict resolution mechanism (OR = 2.2; p = 0.017), lack of support (OR = 1.5; p = 0.03), and community health work not seen as important (OR = 1.5; p = 0.041). Poor communication skills were also more likely to influence performance of community health workers (OR = 0.5; p = 0.050) and poor road network (OR = 0.361; p = 0.000). Conclusions: These findings offer a deeper understanding of the interaction between CHWs contextual situations, structural challenges, and performance. Addressing influential factors of CHWs performance in multi-task settings is important in preventing overtaxing their work capacity and to maintain quality performance as countries move towards universal health coverage. Strategies for incentivizing, attracting, and sustaining men in CHWs is important to broaden perspectives about this critical role in society.