Community health initiatives improve diabetes and hypertension management in Wajir North Sub County

Shamsa H. Hefow; Job Mapesa; Rose Juma

doi:10.18203/2394-6040.ijcmph20253308

Authors

Shamsa H. Hefow Department of Public Health, Human Nutrition and Dietetics, School of Health Sciences, Kenya Methodist University, Meru, Kenya
Job Mapesa Department of Public Health, Human Nutrition and Dietetics, School of Health Sciences, Kenya Methodist University, Meru, Kenya
Rose Juma Department of Public Health, Human Nutrition and Dietetics, School of Health Sciences, Kenya Methodist University, Meru, Kenya

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20253308

Keywords:

Community health initiatives, Community health promoters, Diabetes, Hypertension, Wajir North, Primary health care, Kenya, Adherence

Abstract

Background: Diabetes and hypertension drive a heavy Non-Communicable Disease burden in Kenya’s arid and semi-arid lands. Community health initiatives, led by community health promoters, may close gaps in access, adherence, and self-management, yet their performance in pastoralist settings remains under-described.

Methods: We conducted a cross-sectional survey of adults (n=378) living with both diabetes and hypertension in Wajir County, Kenya. Proportionate sampling covered seven wards. Structured questionnaires captured socio-demographics, Community Health Initiatives exposure, medication access and adherence, monitoring behaviors, and lifestyle practices, including diet, salt/sugar reduction, alcohol/tobacco, and physical activity. Analyses included descriptive statistics, χ² tests, and logistic regression for self-management outcomes.

Results: Respondents were predominantly middle-aged, married, and low-schooled, with pastoralist and unemployed groups prominent, profiles that complicate clinic-based follow-up. Community Health Initiatives' reach and awareness were high, with common services including education, screening/referral, and medication navigation. Participation was associated with better-reported medicine access, more consistent blood pressure/glucose monitoring, and higher uptake of lifestyle changes. Persistent barriers included distance to facilities, medicine stock-outs, and out-of-pocket costs.

Conclusion: In this underserved arid and semi-arid lands context, community health initiatives appear essential for translating knowledge into day-to-day diabetes and hypertension management. Strengthening low-literacy counseling, peer-supported activity, practical salt-reduction aids, alongside supply-chain reliability and mobile refills, could accelerate control. Findings support investment in integrated, culturally responsive community strategies to sustain primary health care for non-communicable diseases.

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