Background Community health workers (CHWs), also referred to as community health promoters, (CHPs) are a cornerstone of Kenya's primary healthcare strategy, mandated to bridge the gap between households and formal health services through home-based outreach. Despite their central role in national health policy, nationally representative data on the actual coverage of CHW household visits remain limited. The proportion of women of reproductive age who receive CHW visits and the factors that determine whether they do, is largely unknown at population scale.Methods We used data from the 2022 Kenya Demographic and Health Survey (KDHS), which included a question on whether a CHW had visited the respondent's household in the three months preceding the survey. The analytic sample comprised 32,156 women aged 15–49. Weighted prevalence of CHW visits was estimated with 95% confidence intervals. Bivariate associations were examined using F-tests with Rao-Scott corrections. Multivariable logistic regression was conducted in three sequential models incorporating individual, household, and community-level factors, with all analyses accounting for the complex survey design.Results Only 5.3% (95% CI 4.8–5.8) of women reported a CHW visit in the preceding three months. In bivariate analysis, CHW coverage was significantly associated with education, parity, marital status, wealth quintile, household electricity and sanitation, residence, region, and travel time to facility. In the fully adjusted model, the strongest predictors of receiving a CHW visit were higher parity (aOR 2.06 for 5 + children versus none), rural residence (aOR 1.40), and hesitation about going to a facility alone (aOR 1.43). Counterintuitively, higher education was independently associated with greater odds of a CHW visit in the fully adjusted model, a pattern explained by regional confounding. Marked regional variation was observed, with coverage in Central region and Nairobi less than a third of that in the Coast reference region.Conclusions CHW visit coverage in Kenya is extremely low, reaching fewer than one in twenty women of reproductive age over a three-month period. Coverage is somewhat better targeted toward disadvantaged households, but the absolute levels are insufficient to constitute a meaningful outreach system. The strong regional variation suggests that CHW deployment and retention is uneven, likely reflecting county-level differences in financing, supervision, and political prioritisation of community health. Strategies to improve CHW coverage must address workforce remuneration, supply chains, and supervision structures rather than training alone.