Lived experiences of community health strategy coordinators during the COVID-19 pandemic response: An explorative qualitative study in Kiambu County, Kenya

Introduction: The COVID-19 pandemic severely strained health systems worldwide, particularly in low-resource settings. In Kenya, community engagement led by Community Health Strategy Coordinators (CHSCs) was central to the national response. However, little is known about CHSCs’ own experiences navigating these responsibilities. This study explored the lived experiences of all CHSCs in Kiambu County, Kenya, during the pandemic’s peak. Methods: We conducted a 90-minute focus group discussion (FGD) with all twelve sub-county CHSCs in Kiambu County. The discussion was audio-recorded, transcribed verbatim, translated into English, and analyzed using reflexive thematic analysis to identify key experiences, perceptions of community responses, and system-level gaps. Results: The FGD revealed four inter-related challenges: inadequate resources (particularly transport and personal protective equipment) that impeded service coverage; psychological distress and stigma, including trauma from handling COVID-19 deaths and rejection by community members and even family; feelings of neglect and inequity stemming from perceived exclusion from government support and allowances; and community distrust, where inconsistent political role-modelling eroded adherence to guidelines and discouraged health-seeking. Fear of health facilities as COVID-19 hotspots further disrupted routine healthcare services. Conclusion: CHSCs sustained critical community response functions under extreme strain but felt under-resourced, stigmatized, and undervalued. Strengthening county-level preparedness requires equitable provision of PPE and transport support, routine psychosocial care for community health teams, and community co-designed communication strategies to rebuild trust. These findings underscore the pivotal role and vulnerability of CHSCs as the bridge between policy and household-level health action during crises.