In Manyatta Village, Upper Kiandani Sub-Location of Machakos County, Joyce Veronica Kioko is a trusted face in more than one hundred households she visits every month. As a Community Health Promoter (CHP), Joyce works at the frontline of disease prevention ensuring families are healthy, informed, and connected to lifesaving care.
Joyce’s work goes far beyond routine household visits. She screens children for missed immunizations, checks adults for hypertension and diabetes, and refers anyone in need of care to a health facility. With support from CMMB’s TB Program, her impact has been most profound.
When a TB case is identified at the facility, Joyce is called upon to conduct contact tracing and defaulter tracing tasks that require skill, patience, and deep community trust. CMMB-supported training equipped her on how to use digital tools like the iMonitor digital screening tool which she now puts to work independently in her community. She carefully prepares each visit, first educating families about TB: that it is treatable, curable, and patients can access free TB medication at public health facilities. Also, patients on treatment do not pose a risk to their loved ones.
Joyce during a house visit in Machakos County during a brief health education session.
Her approach helps dismantle deeply rooted stigma. In her household visits, Joyce encounters families who isolate TB patients, separate utensils, or believe TB is caused by witchcraft. Through education and dialogue, she restores dignity, encouraging families to support patients through the long treatment journey.
One household stands as a powerful example of Joyce’s impact. First visited in 2020, the family had repeated TB cases across family members. Over several years, Joyce persistently visited the family—screening contacts, referring children for TB Preventive Therapy (TPT), and reinforcing health education. In 2023, she conducted a comprehensive screening of fifty-eight household contacts. The results were decisive: forty-two people were enrolled on TPT, three were diagnosed and started on TB treatment, and gaps in care were addressed promptly. Since that intervention, no new TB cases have been reported in the households.
Joyce’s work is not without challenges. Distance, transport costs, food insecurity, and patient reluctance often stand in the way of care. At times, she has used her own resources to ensure patients can eat before taking medication or reach the facility for screening. Yet she remains committed.
Joyce Conducts oral screening in a household
“I do this work because I want a healthy community,” Joyce says. “I started even before stipends were introduced, because people need health education and early care.”
Through CMMB’s support, which includes stipends for contact tracing, free X-ray services for children, nutrition and psychosocial support for TB patients, and continuous training, Joyce is empowered. Her story reflects the strength of community-based TB programming: where knowledge replaces fear, prevention stops transmission, and one dedicated CHP can change the health trajectory of an entire family.
In Joyce, CMMB’s TB program is not just implemented; it is lived, one household at a time.
By: Roy Mwangi