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How context influences the functionality of community-level health governance structures: a case study of community health committees in Kenya

Marjolein Dieleman, Maryse Kok, Robinson Karuga, Patrick Mbindyo, Lilian Otiso, Judy Macharia, Jacqueline E. W. Broerse

a case study of community health committees in Kenya.

Community Health Committees (CHCs) are mechanisms through which communities participate in the governance and oversight of community health services. While there is renewed interest in strengthening community participation in the governance of community health services, there is limited evidence on how context influences community-level structures of governance and oversight. 

 The objective of this study was to examine how contextual factors influence the functionality of CHCs in Kajiado, Migori, and Nairobi Counties in Kenya. Using a case study design, we explored the influence of context on CHCs using 18 focus group discussions with 110 community members (clients, CHC members, and community health volunteers [CHVs]) and interviews with 33 health professionals. Essential CHC functions such as ‘leadership’ and ‘management’ were weak, partly because Health professionals did not involve CHCs in developing health plans.