By Ann Irungu and Florence Onyango

Kenya’s primary healthcare infrastructure faces unprecedented challenges as extreme heat endangers Community Health Workers (CHWs), who provide 59% of community health services nationwide. These essential frontline workers, comprising Public Health Officers, Community Health Promoters, Assistants, and Volunteers, deliver crucial services, including prenatal care, immunisation programmes, nutrition education, and basic illness treatment.

The impact is particularly severe in remote and marginalised communities, where CHWs are often the sole healthcare providers. This emerging climate-related threat poses significant risks to both healthcare delivery and the well-being of these vital professionals.

Climate change is driving temperatures to unprecedented levels, making the already demanding work of CHWs increasingly hazardous. Kenya, is experiencing the brunt of this heat. A recent dissemination workshop hosted by the Heidelberg Institute of Global Health revealed the alarming findings of a qualitative investigation into heat stress among Kenyan CHWs and volunteers. The study paints a stark picture of frontline workers struggling to perform their duties safely amidst rising temperatures.

The UN Weather Agency has officially declared 2024 the hottest year on record, with global temperatures soaring 1.55°C above pre-industrial levels. This breach of the 1.5°C target set by the Paris Agreement underscores the urgency of climate action. Scientists attribute this alarming temperature rise to anthropogenic activities such as burning fossil fuels, deforestation, and industrial emissions, as outlined in the IPCC reports on climate change attribution.

Despite international commitments, many nations, including Kenya, are still working towards aligning their emissions reduction targets with the levels needed to protect human health. As these efforts continue, vulnerable populations, including CHWs working in Kenya’s hottest regions, remain on the frontlines of the climate crisis.

The Heidelberg Institute of Global Health initial study findings reveal the devastating health impacts of extreme heat on CHWs. Workers reported experiencing a range of heat-related illnesses, including nausea, dizziness, fatigue, dehydration, heat rashes, sunburn, and skin irritations. For those with pre-existing conditions such as hypertension, diabetes, and cardiovascular diseases, extreme heat exacerbates their ailments, placing them at heightened risk of complications.

“There are times when it is extremely hot, such that at a time like this, you do not even want to leave the house, but the work needs you. We feel it is challenging in such times, but the work must be done,” one CHW poignantly shared. Another described a near-incapacitating experience: “There was a time when there was so much heat that I could not walk, breathing was difficult for me, and even eating was not possible. My blood pressure had also risen significantly.”

The extreme heat in Kenya’s coastal counties is also fuelling the spread of vector-borne diseases such as malaria and dengue fever, as reported by the World Health Organization and the Kenyan Ministry of Health. These diseases further strain CHWs, who often work in under-resourced and poorly equipped environments. Limited government support and infrastructure challenges compound the crisis. Many CHWs operate in informal settlements and rural areas devoid of cooling stations or hydration units. The lack of reliable transportation forces them to walk long distances under scorching temperatures, often carrying heavy medical supplies. As disease burdens increase with the heat, CHWs are stretched thinner, attending to more patients while simultaneously battling the effects of heat stress themselves.

Without immediate intervention, this unsustainable situation risks driving CHWs to abandon their vital roles, exacerbating Kenya’s existing healthcare shortages. Mitigating this crisis requires prioritising climate-resilient healthcare systems and implementing protective measures for CHWs.

Key Policy Recommendations:

• Establishment of cooling infrastructure: The Kenyan Ministry of Health should prioritise establishing shaded workspaces, cooling stations, and hydration units for CHWs.
• Provision of protective gear and hydration solutions: Providing suitable protective clothing and electrolyte hydration solutions can help mitigate the impacts of extreme heat.
• Regular medical check-ups: Regular health screenings, especially for those with underlying conditions such as hypertension, are crucial for monitoring and managing heat-related risks.
• Capacity building: Training programmes can equip CHWs with the knowledge to recognise and respond to heat-related illnesses in themselves and their patients.
• Sustainable transportation: Expanding access to sustainable transportation options such as bicycles, motorbikes, tuk-tuks, and providing transportation stipends can significantly reduce heat exposure.
• Heatwave early warning systems: Implementing heatwave early warning systems will enable CHWs to adjust their schedules and minimise exposure during extreme heat events.
• Strengthening climate policies: The Kenyan government needs to strengthen its climate policies to reduce emissions and mitigate global warming, addressing the root cause of the problem.

These measures, combined with broader climate adaptation efforts, are essential to protect Kenya’s CHWs and safeguard the country’s public health system. The growing impacts of extreme heat not only endanger these frontline workers but also threaten the health and well-being of the communities they serve. Investing in the resilience of CHWs is an investment in the health of the nation.

© ARIN Press, 2025