Research by the SHINE Consortium surveyed 1,236 community health promoters (CHPs) in Nairobi’s informal settlements and rural Kiambu, finding that 22.4% showed symptoms of depression and 30.6% reported anxiety.

Depression, anxiety and stress were markedly higher in Nairobi, where 26.4% of CHPs recorded moderate or higher depression versus 8.2% in Kiambu, and 33.8% reported anxiety compared with 18.9% in the rural county.

The study links these mental‑health outcomes to working conditions: between 93% and 97% of respondents said their monthly KSh5,000 stipend was inadequate, and 92%–94% regularly spent personal money on transport, airtime and patients’ medical costs.

Supervisory gaps were evident as some Community Health Assistants (CHAs) oversaw up to 100 CHPs, far exceeding the policy norm of ten, undermining supportive supervision and contributing to worker distress.

Female CHPs reported additional safety concerns, including sexual harassment during household visits, with limited mechanisms for confidential reporting.

Researchers have piloted a four‑component mental‑health and wellbeing package for 500 CHPs and 50 CHAs, aiming to integrate psychosocial support into Kenya’s universal health coverage framework.

The SHINE policy brief recommends that the Ministry of Health embed CHP wellbeing in the Community Health Strategy, improve stipend timeliness, strengthen supervision, and create confidential channels for reporting gender‑based violence.