Abstract:
Objectives The increasing burden of cardiovascular
diseases (CVDs) in Kenya threatens its healthcare system.
There is a need for innovative models that improve
equitable access to CVD prevention services. Community
markets are social establishments with untapped potential
to promote public health. This is a multiphased feasibility
study that explores the potential of Health Kiosks in
Markets (HEKIMA) to improve access to CVD prevention
services. In this formative phase, the aim was to assess
the readiness of primary healthcare centres (HCs) and
community markets to jointly deliver CVD prevention
services.
Design Mixed methods using concept mapping and
readiness surveys. Concept mapping with 35 stakeholders
from different sectors (health and non-health) to identify
feasible priorities for HEKIMA. The readiness questionnaire
contained 193 items which were based on the guidance of
the WHO Handbook for Monitoring the Building Blocks of
Health Systems and adapted to suit the context of a single
HC.
Setting Vihiga County is located in western Kenya and
has a population of 590 013. A total of 18 HCs and 19
markets were assessed, with 10 HCs and 15 markets
included in the evaluation.
Results 91 statements were generated from concept
mapping and distilled into 8 clusters, namely equipment
and supplies, access and referral, communication,
manpower, networks and linkages, practice, service
delivery and health promotion. Agreed actions for HEKIMA
were provision of efficient quality services, health
promotion and partnerships sensitive to the local context.
HCs and markets had established governance systems
and basic infrastructure. The majority of the HCs lacked
essential CVD medications. No HC–market interface
existed but there was willingness for a partnership.
Conclusion There was strong consensus that an HC–
market interface via community health worker mannedkiosks could have a positive impact on health systems,
markets and CVD prevention in vulnerable communities.
However, significant infrastructural, technical and resource
gaps were observed that need to be addressed.
