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Despite many challenges, Uganda’s village health teams deliver care to some of the nearly 85 percent of Ugandans who live in remote, hard-to-reach corners of the country, or the “last mile.” During some months, these committed volunteers know that they will have the medicines necessary to treat children dying of pneumonia, malaria, and diarrhea. But during others, the teams are less sure. They’ve also come to expect inconsistent supervision and training.
The situation in Uganda is not unique—community health worker (CHW) programs throughout the world struggle from limited resources and sub-optimal design, often devolving from a national strategy into a patchwork of nonprofit programs and activity.
Why is this? The global health community understands that these same programs are important for reaching Millennium Development Goal 4 (MDG 4)—to reduce mortality among children under five from the current level of 6.6 million deaths per year to 4.3 million by the end of 2015. Yet many perceive CHWs as inadequate replacements for trained health professionals such as doctors and nurses.
For full text of this article go to Stanford Social Innovation Review’s website.

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