A Comparative Analysis of Non-Communicable Diseases Screening and Linkages among Community Health Volunteers in Intervention and Control Groups in Nyeri County, Kenya

Purpose: Community Health Volunteers (CHVs) are critical to the early identification and linkage of individuals with non-communicable diseases (NCDs) to appropriate health services, particularly in resource-limited settings. However, evidence on the impact of structured capacity-building interventions on CHV performance remains limited. This study compared NCD screening and linkage levels among Community Health Volunteers (CHVs) in the intervention and control groups in Nyeri County. Methodology: A quasi-experimental mixed-methods design was adopted. Quantitative data were collected using structured Likert-scale questionnaires assessing CHV capacity in screening and linkage, alongside referral records documenting completed NCD screening services. Statistical analyses included descriptive statistics, one-way ANOVA, and ANCOVA to control for baseline differences. Qualitative data were obtained through focus group discussions (FGDs) and key informant interviews (KIIs) and were analyzed thematically. Findings: Community Health Volunteers (CHVs) in the intervention group demonstrated significantly higher capacity across multiple domains, including role recognition (M = 3.49 vs. 3.24, p = 0.010), screening engagement (M = 3.41 vs. 3.11, p = 0.001), and household monitoring (M = 3.27 vs. 2.98, p < 0.001). Analysis of covariance (ANCOVA) further revealed a significant effect of the intervention on linkage to care (F = 5.905, p = 0.016). Referral outcomes also showed higher completion rates for blood pressure measurement, anthropometric assessments, and body mass index (BMI) evaluation among clients referred by intervention CHVs Qualitative findings complemented these results, indicating that CHVs in the intervention group experienced improved knowledge, confidence, and clarity of roles in NCD service delivery. They reported enhanced community trust, increased acceptance of screening services, and greater commitment to follow-up of referred clients. Improved understanding of referral processes contributed to more proactive linkage practices, although persistent challenges, including limited resources, weak feedback systems, and a lack of incentives, were noted across both groups. Structured capacity-building interventions significantly enhance CHV screening and linkage performance for NCDs. Strengthening CHV training, supervision, and resourcing is essential for effective community-based NCD control. Unique Contribution to Theory, Practice and Policy: The study demonstrates that structured capacity-building interventions significantly improve CHV performance. It contributes to community health systems theory by reinforcing the role of capacity strengthening in task-shifting models. Practically, it supports investment in CHV training, supervision, and tools. From a policy perspective, it provides evidence to guide scaling of standardized CHV interventions for NCD control in Kenya and similar settings.