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"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Tine Frank, Karin Källander, and Sarah Marks

Malaria Consortium’s inSCALE project has been working in Uganda to help scale up quality integrated community case management programmes to improve child health. This Learning Paper details the process of establishing Village Health Clubs with the aim of improving the motivation and performance of community health workers – known as village health team members (VHTs) in Uganda.

Formative research from inSCALE has shown that status and community standing are important to VHTs in Uganda, yet many feel the purpose of their work is not well understood
in their communities. The Village Health Clubs were designed as a participatory community engagement approach to promote the VHTs as key village health assets.

The Village Health Clubs were implemented through a series of processes, which included stakeholder discussions, developing and pre-testing job aids and sensitisation plans and training 880 iCCM VHTs using a training- of-trainers approach.

VHTs received initial support and supervision in setting up and running the clubs. Ongoing progress reviews and process evaluations, have found that 59 percent of the clubs were still active nine months after training. A majority of VHTs reported a positive impact on their status and standing in the community; community support; a feeling of connectedness to the community; improved performance and motivation; and increased access to and use of appropriate treatment for children under five.

Some of the main challenges reported for Village Health Clubs were in relation to drug stock outs, which reduced club attendance as well as a lack of supervision of the Village Health Club facilitators. The key recommendations include linking the Village Health Clubs to income-generating activities for improved sustainability, as well as facilitating regular supervision by health facility supervisors. Due to the popularity of the Village Health Clubs, Malaria Consortium will continue to introduce this concept in and beyond Uganda, as well as incorporate the lessons learnt into the development and implementation of other social mobilisation activities. 

Citation: Frank, T., Källander, K., Marks S. (2015). Establishing Village Health Clubs to improve community health worker motivation and performance. Learning Paper series. London, Malaria Consortium. 

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