Bicycles: the start of better health

Community Health Workers are the backbone of the health system. They are closest to the community - living and working among their community and serving those around them. Their work is vital, but they are often forced to do more with less and their increased responsibilities leave them over-stretched. The Primary Healthcare for Malaria Elimination project, through a partnership with GSK, is setting about to change this in Busia and Siaya Counties, Kenya.

Patrick Wabuko is a Community Health Promoter (CHP - the term for Community Health Workers in Kenya) based in Khunyangu, Busia.

“Before the bicycle, I would set out at dawn and still not finish my rounds,” says Patrick. “The furthest household I serve is 3km away. It used to take me almost four hours just to get there.” With 125 households under his care, Patrick could only reach five to eight families each day.

Patrick on his new bicycle and with his CHP backpack of resources distributed as part of the PHC for ME programme (c) Amref Health Africa in Kenya 

No mobility means no malaria healthcare

“Malaria prevalence in Busia stands at 38%, nearly five times the Kenyan national average,” said Gilbert Wangalwa, Deputy Country Director at Amref Health Africa in Kenya.

Malaria is preventable and curable. Yet still, most malaria cases (94%) and most malaria deaths (95%) in the world are in Africa. (WHO data)

CHPs are on the frontlines of the efforts to tackle this burden in Kenya - going house to house to screen, diagnose, treat and support children and adults through malaria. If CHWs are unable to reach homes, then those people will often go without the malaria information and education they need to prevent illness, or the services to treat malaria infections.

His Excellency Hon. Dr. Arthur Odera, Deputy Governor of Busia, emphasised the county’s commitment to community health. “Community Health Promoters are the backbone of our primary healthcare system, managing approximately 70% of the malaria burden in our county through household testing and treatment of uncomplicated cases. We’re investing in tools and training, from oxygen tanks to ultrasound machines, to support CHPs in every way."

More time means better health

Patrick is one of 210 CHPs who this month received bicycles through the Primary Health Care for Malaria Elimination (PHC for ME) project, a partnership between Amref Health Africa and GSK, working with World Bicycle Relief and the Busia County Government.

Now, with his bicycle, Patrick says he can manage 10 to 15 household visits daily. “It will save me so much time. I can follow up on referrals, monitor children’s immunisation schedules, and educate families on malaria prevention far more consistently.”

Each bicycle handed over is a powerful tool in the broader push toward Universal Health Coverage (UHC): enabling CHPs to bring essential services to underserved, rural communities.

“This project is about equipping CHPs with practical tools that support early diagnosis, treatment, and follow-up. With every bicycle, we’re moving closer to a future where no one is left behind.”

The intervention also recognises the role of climate-resilient, sustainable solutions in public health. “Bicycles are a zero-emission transport method,” noted Dennis Mukundi Kinyua, Project Manager. “They align with our shared goals on climate action and resilient health systems.”

Measuring impact

Amref has rolled out a performance monitoring tool to collect real-time data to assess how improved mobility affects service delivery, disease detection, and prevention.

In parallel, a baseline survey using Kobo Tool is ongoing. “We would like to evaluate how bicycles influence malaria indicators i.e. vaccine uptake among children under 2 years and expectant women, referral rates, maternal health outcomes, among other health indicators,” explained Rose Betty, Monitoring, Evaluation and Learning Officer. “By tracking CHPs’ progress over three, six, and twelve months, we’ll understand what’s working and where to adjust.”

A brighter future

For Patrick, a bicycle means he can deliver a brighter future to the dozens of families who once waited days or weeks for his visits. What used to be a slow, exhausting walk is now a brisk ride. And with that, a healthier future for the community is now within reach.

The impact of this intervention extends beyond just faster visits and increased reach. By enhancing the efficiency of CHPs’ work, the bicycle initiative is also contributing to the economic resilience of local families. With fewer cases progressing to severe illness due to early intervention, households are spared the financial burden of frequent hospital visits and treatment costs. This means families can retain and reinvest their limited resources within their homes.

While the current phase of the project has reached Busia, similar efforts are soon to unfold in Siaya, where 210 bicycles will be distributed to CHPs, empowering them to further transform the landscape of community health and malaria prevention.