I’m a health volunteer in Kenya – the impacts of the UK decision to cut aid are only growing

HEA year ago, the UK government announced cuts to its aid budget. For many, this may seem like a distant financial arrangement. For those working in community health in Kenya’s Kakamega County, this marked the beginning of a change felt in villages, homes 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 struggling with chronic diseases, and families also struggling with poverty and disease. Public health is not theoretical here. This is personal.

I remember visiting a young mother in a remote village earlier this year. During her first pregnancy, outreach clinics helped her regularly. Paramedics were approaching his home and follow-ups were consistent. Someone checked in on him when he had questions or concerns.

This time was different.

Outreach activities have diminished and regular follow-ups have become less predictable. She walked a much longer distance for prenatal care. When transportation money was scarce, he postponed appointments. When I visited him at home, he had missed a scheduled checkup. Fortunately, we were able to get him back into care before complications arose. But I couldn’t ignore the difference: The safety net was thinner.

These are the kinds of changes that don’t make headlines. These appear as small delays, fewer visits, longer walks, heavier workloads. However, over time, these small gaps widen.

Much of the structure that strengthens community health systems (training, auditing, coordination and facilitation) has been supported through partnerships, including those supported in the past by agencies such as the UK Foreign, Commonwealth and Development Office (FCDO). When funds are tight, these structures are often the first to feel the tension.

Over the past year, I have observed reduced access to hard-to-reach areas, relaxed control systems and increased pressure on volunteers. Community Health Volunteers are not salaried employees. We serve because we believe in protecting our communities. But faith does not pay for transportation. Commitment does not replace structured support.

The emotional impact on volunteers is real. Many of us are balancing 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 is on the rise.

However, commitment remains strong.

In Kakamega, CHVs still walk long distances to check on patients. We use our own phones to keep track of mothers. We respond to emergencies at night. We coordinate referrals. The resilience of CHWs is extraordinary, but resilience should not be confused with sustainability.

Public health is the basis of prevention. It enables early detection of disease, supports adherence to treatment, strengthens vaccination coverage and protects vulnerable households. Strong social systems reduce pressure on hospitals and prevent minor health problems from turning into crises.

In an interconnected world, local health resilience contributes to global health security.

This thought is not about blame. The UK has historically made significant contributions to global health progress, and this support has helped create tangible improvements in communities like mine. The decrease is felt precisely because this partnership is important.

We continue to serve one year after aid cuts. We continue to show. 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, continued investment in community-level health systems must remain central, not peripheral.

The message from Kakamega’s trails is clear: public health saves lives. Partnership makes it stronger. And when that partnership weakens, communities feel it first.

Kristine Yakhama, Community Health Volunteer in Kakamega County, Kenya Action for Global HealthSteering Committee advocating for equitable access to healthcare.

This article was produced as part of The Independent. Rethinking Global Aid project