A seat at the table for caregivers in Kenya

UN Women’s flagship report Progress of the World’s Women 2015-2016: Transforming Economies, Realizing Rights calls for long overdue reforms to the global policy agenda to transform economies and make women’s rights a reality. Included is a series of case studies from all over the world which illustrate how governments, women’s organizations and feminist actors, both women and men, are working to transform the economic landscape for gender equality. In this blog post, Violet Shivutse, a 47-year old farmer and founder of Kenya’s branch of the Home-Based Care Alliance, describes how she applied the lessons of farming to grow an entire network of effective, organized caregivers.


As a female farmer in Kenya, I have seen that the fields are not always level between women and men. Often, male farmers have the power to take out loans or benefit from agricultural extension services, while women provide the labor on small farms with little voice in decision-making. From this experience, I have learned that to overcome exclusion women need to come together to have their voices heard.

Often, health services are not a level playing field, either. For years I saw many women in my community die from preventable complications during childbirth. Over time, I convinced my local hospital to work with birth attendants and facilitate mobile childbirth clinics in our villages. Since many of the attendants were illiterate, I agreed to be their secretary.

This was the first step on my journey to form the Shibuye Community Health Workers. Since the group’s inception, our work has expanded to include other health issues such as measles outbreaks, diarrhea, sanitation, good nutrition and family planning.

When people become ill, sometimes they need medicine or certain supplies. Sometimes they need a hospital stay or an operation. Other times they simply need bed rest. But there’s one thing that’s needed by everyone, everywhere: good care. In my home country of Kenya, where approximately 1.5 million people live with HIV, many are in need of a caring presence, who understands how the virus changes their entire lives.

In 1999, HIV and AIDS was declared a national disaster and a public health emergency in Kenya. Since the beginning of the crisis, our country’s caregivers have served as a first line of defense – treating long-term patients directly in their communities and homes. Caregivers often filled the gaps where formal health care facilities were lacking or unable to respond.

Beyond that, caregivers maintained social ties for those affected by AIDS and HIV. They tended fields and defended the land rights for friends, relatives and neighbours. Caregivers tackled complex social stigma and told the true story of how many came to be afflicted. As Kenya’s AIDS pandemic spread, caregivers also found themselves increasingly in demand.

Yet, initially, caregivers efforts received little or no recognition for the critical role they played. Whenever government and other leaders came together to discuss policy around HIV, caregivers were excluded. After a while, I realized that this was because so many caregivers worked in small groups or even in isolation. We needed a platform to come together and define our goals.

In short: caregivers needed to organize. That’s why I founded Kenya’s branch of the Home-Based Care Alliance – an organization that brings together around 30,000 caregivers across 11 African countries. Our main goal is to raise a collective voice to lobby for recognition of caregivers as key players in health care.

As caregivers, we understand all of the subtle social dimensions of HIV/AIDS. Workers can’t work; students can’t learn; and parents can’t tend to their children if they are sick. This is a comprehensive, holistic way of providing health care. The fact that our caregivers remain rooted in their communities is key to their success.

Today, our local chapter of the Home-Based Care Alliance has around 3,200 members. We’ve started talking to the authorities about how to refine policy around HIV and AIDS. One of our first meetings was with the Constituency AIDS Control Committee, part of the National AIDS Control Council. I think people are realizing the tremendous value that caregivers bring in these leadership roles. And caregivers feel a strong sense of responsibility, because they were not just handpicked to sit on a committee.

The story of Kenyan caregivers could serve as a parable for women’s rights around the world. If you want to make a change – you have to come together. Organize, establish your priorities, and then fight for a seat at the table. If caregivers can do it, anyone can.

View the full report: "Progress of the World’s Women 2015-2016: Transforming Economies, Realizing Rights" here

"Making Progress - Stories of Change" here.

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  • Nwedobong Okon
    Thank you violet. Caregivers are often overlooked and their inputs in the health sector undermined. I find your story useful to my current work.
  • Sasha Byers
    Violet, Thank you for this inspirational story of how caregivers united and became a strong collective. I agree, when we work alone or in small groups, not much can get done. But organizing into a collective multiplies the effect and movements are begun! I quoted you and am saving it to me inspirational quotes page. Thank you and God Bless You and yours! Sasha Byers
  • Evelyn Bisona Fonkem
    Thanks Violet for creating social impacts in the lives of these women
  • Evelyn Bisona Fonkem
    Thanks Violet for creating social impacts in the lives of these people
  • Olipa Phiri
    Great piece Violet! The feeling is mutual for the rest of African countries. I believe agency is a key here.
  • Renu Ghimire
    Thank you Violet for sharing this. It has truly been an inspiration. Countries like Nepal can learn from your efforts where similar intervention is quite needed..
  • Mary Mkoji
    Thumbs Up Violet.... for the good work. THANKS for being bold enough to see the issues that caregivers face and come up with a contextual, sustainable and realistic solution. Your reach -Home-Based Care Alliance has around 30,000 caregivers across 11 African countries; In Kenya 3200 member - is a clear indication of the drive that caregivers have to provide proper health care to their loved ones and society. It is therefore important for more to be done to equip and train care givers so that they are more effective. Lets continue to voice out and advocate for the recognition of caregivers as key players in health care....I believe we will eventually see a change
  • Catherine wachu
    Hello Violet, Your article holds truth, I am a Kenyan and I have worked as a caregiver at some point. More professional caregivers are needed, the amount of work done by this group can not be quantified, I agree there is need to invest in caregivers through an education and good compensation. Yes, with mobilization they can serve as our voice, to bring the change we want to see. Thank you.
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