title: Efficiency and factors influencing efficiency of Community Health Strategy in providing Maternal and Child Health services in Mwingi District, Kenya: an expert opinion perspective.
abstract: BACKGROUND
  Community Health Strategy (CHS) is a new Primary Health Care (PHC) model in Kenya, designed to provide PHC services in Kenya. In 2011, CHS was initiated in Mwingi district as one of the components of APHIA plus kamili program. The objectives of this study was to evaluate the efficiency of the CHS in providing MCH services in Mwingi district and to establish the factors influencing efficiency of the CHS in providing MCH services in the district.
  
  
  METHODS
  This was a qualitative study. Fifteen Key informants were sampled from key stakeholders. Sampling was done using purposive and maximum variation sampling methods. Semi-structured in-depth interviews were used for data collection. Data was managed and analyzed using NVIVO. Framework analysis and quasi statistics were used in data analysis.
  
  
  RESULTS
  Expert opinion data indicated that the CHS was efficient in providing MCH services. Factors influencing efficiency of the CHS in provision of MCH services were: challenges facing Community Health Workers (CHWs), Social cultural and economic factors influencing MCH in the district, and motivation among CHWs.
  
  
  CONCLUSIONS
  Though CHS was found to be efficient in providing MCH services, this was an expert opinion perspective, a quantitative Cost Effectiveness Analysis (CEA) to confirm these findings is recommended. To improve efficiency of the CHS in the district, challenges facing CHWs and Social cultural and economic factors that influence efficiency of the CHS in the district need to be addressed.
authors.affiliation: Department of Environmental Health, University of Kabianga, Kericho, Kenya.
authors.forename: Japheth Mativo
authors.initials: JM
authors.lastname: Nzioki
authors.affiliation: Department of Public Health, Maseno University, Kisumu, Kenya.
authors.forename: Rosebella Ogutu
authors.initials: RO
authors.lastname: Onyango
authors.affiliation: Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya.
authors.forename: James Herbert
authors.initials: JH
authors.lastname: Ombaka
mesh_terms: D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D003150:Community Health Workers / Q000458:organization & administration; D003625:Data Collection; D005260:Female; D006801:Humans; D007630:Kenya; D008297:Male; D008427:Maternal Health Services / Q000458:organization & administration*; D010865:Pilot Projects; D011247:Pregnancy; D011320:Primary Health Care / Q000458:organization & administration*; D012959:Socioeconomic Factors
keywords: Community Health Strategy; Mwingi district; aternal and Child Health; efficiency; factors influencing efficiency