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{
    "id": 1485014,
    "url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1485014/?format=api",
    "text_counter": 276,
    "type": "speech",
    "speaker_name": "Molo, UDA",
    "speaker_title": "Hon. Kuria Kimani",
    "speaker": null,
    "content": "sell their land because even recruiting or hiring a health professional to take care of that loved one becomes very expensive. Maybe, we should include chronic disease management as one of the trainings that those community health workers should undergo. Community health workers in Bangladesh have strong community ownership because they are recruited from their localities, just the same way Kenya is proposing to do it. Most importantly, we need extensive training and supervision, so that there is a proper team leader and job description. This should be followed by extensive continuous training of those people. Our neighbours, Ethiopia, launched their programme in 2004. They call them health extension workers. They provide preventive and curative services, and health education. An interesting thing in the Ethiopian model is that those workers are also salaried. You can see that where there is the best practice, community health workers are not volunteers. They are salaried people, whether through performance-based or incentive-based models. They earn an income. Why are we emphasising on those community health promoters? It is because research has shown that 40 to 80 per cent of both communicable and non-communicable diseases can be prevented with proper public health measures, vaccination, lifestyle changes and environmental intervention. For non-communicable diseases, up to 80 per cent of premature deaths such as heart diseases, stroke and type two diabetes are preventable. About 40 per cent of cancers can be prevented by addressing the risk factors such as tobacco use, alcohol abuse, unhealthy diets and exposure to environmental pollutants. This means that, at least, 40 per cent of cancer cases can be prevented by intervening in those particular measures that I have outlined. Infectious diseases such as Measles, Polio and Hepatitis B can be prevented through vaccination. That is why that performance-based or incentive-based models based on particular health outcomes should be the basis for those community health workers. This will ensure our children get all their vaccinations. As you have seen, even those infectious diseases can be treated by vaccination. Vector-based diseases such as Malaria, Dengue Fever and Zika can be prevented through vector control. Malaria can be prevented 100 per cent by vector control. We can get all that information, including on diarrhoea, which is the loss of water through frequent bowel movements. It shows that taking enough water and sanitary hygiene can prevent that disease. Science backs that 40 to 80 per cent of communicable and non-communicable diseases can be prevented. The way to prevent them is to engage the community health workers into the community health management. We should also find a way of managing them by giving them an incentive and measuring it either by making their contract performance-based or incentive- based. There must be particular measures of outcome that we need to give to those people before we remunerate them, in addition to the extensive and continuous training. With those remarks, I beg to support the Bill and congratulate the Member for Ndhiwa for bringing it."
}