One year ago, the UK government announced cuts to its aid budget. For many, this may have seemed like a distant fiscal adjustment. For those of us working in community health in Kakamega County, Kenya, it marked the beginning of a shift – one felt in villages, households, and health centres.
I serve as a Community Health Volunteer (CHV). My work brings me face-to-face with pregnant mothers, children under five, elderly patients managing chronic illnesses, and families navigating poverty and illness at the same time. Community health is not theoretical here. It is personal.
I remember visiting a young mother in a remote village earlier this year. During her first pregnancy, outreach clinics were a regular help. Health teams would come closer to her home, and follow-ups were consistent. When she had questions or concerns, someone checked in.
Outreach activities had reduced, and regular follow-ups were less predictable. She walked a much longer distance for antenatal care. When transport money was scarce, she postponed appointments. By the time I visited her at home, she had missed a scheduled check-up. Thankfully, we were able to link her back to care before complications arose. But I could not ignore the difference: the safety net felt thinner.
These are the kinds of changes that do not make headlines. They appear as small delays, fewer visits, longer walks, heavier workloads. Yet over time, these small gaps widen.
Much of the structure that strengthens community health systems – training, supervision, coordination, and facilitation – has historically been supported through partnerships, including those backed by agencies such as the UK’s Foreign, Commonwealth & Development Office (FCDO). When funding tightens, those structures are often the first to feel the strain.
Over the past year, I have observed reduced outreach in hard-to-reach areas, stretched supervision systems, and increasing pressure on volunteers. Community Health Volunteers are not salaried employees. We serve because we believe in protecting our communities. But belief does not pay for transport. Commitment does not replace structured support.
The emotional impact on volunteers is real. Many of us balance household responsibilities, personal economic challenges, and demanding community work. When times and visits become inconsistent, some quietly question how long they can continue. Burnout is rarely discussed, but it is growing.
And yet, the commitment remains strong.
In Kakamega, CHVs still walk long distances to check on patients. We use our own phones to follow up on mothers. We respond to emergencies at night. We coordinate referrals. The resilience of community health workers is extraordinary – but resilience should not be confused with sustainability.
Community health is the foundation of prevention. It ensures early detection of illness, supports adherence to treatment, strengthens immunisation coverage, and protects vulnerable households. Strong community systems reduce pressure on hospitals and prevent small health issues from becoming crises.
In an interconnected world, local health resilience contributes to global health security.
This reflection is not about blame. The United Kingdom has historically contributed significantly to global health progress, and that support has helped to create tangible improvements in communities like mine. It is precisely because that partnership has mattered that its reduction is felt.
One year after the aid cuts, we continue to serve. We continue to show up. We continue to believe that every mother, every child, and every patient deserves timely care.
But if we are serious about universal health coverage and shared global resilience, then sustained investment in community-level health systems must remain central – not peripheral.
From the footpaths of Kakamega, the message is clear: community health saves lives. Partnership strengthens it. And when that partnership weakens, communities feel it first.
Kristine Yakhama is a Community Health Volunteer in Kakamega County, Kenya, and a member of Action for Global Health’s Steering Committee, advocating for equitable access to health services.
This article has been produced as part of The Independent’s Rethinking Global Aid project
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