Uganda’s Village Health Teams Program

By: David Musoke, Joviah Gonza, Rawlance Ndejjo, Amanda Ottosson, Elizabeth Ekirapa-Kiracho

Four-member Community Health Worker teams in Uganda provide home visits and health management services for local communities. Limited funding prevents these workers from receiving regular and consistent supervision. However limited their supervision, the impact of each team has enabled the country to achieve reductions in morbidity and mortality among children.

Background 

Community Health Workers in Uganda work as members of Village Health Teams (VHTs). The  VHTs Program was established in 2001 as a cost-effective way to link communities with health  services. VHTs support the Ministry of Health (MOH) to bring health services closer to the  population.  

Implementation 

In Uganda, each village is mandated to have four VHT members, at least two of whom provide  integrated community case management (iCCM) of childhood illnesses.  

Roles/responsibilities 

The main role of VHTs is to mobilize communities for better health services, hence bridging the  gap between communities and health facilities. Other specific roles of VHTs include: conducting  home visits, managing malaria, diarrhea and pneumonia among children under five years,  distributing health commodities, and conducting referrals to health facilities. 

Training 

All VHT members must be above 18 years and able to read and write, preferably in the local  language. Initial training is provided to all VHT members, with those involved in the provision  of iCCM receiving additional training. Refresher trainings are conducted by the MOH and  implementing partners as needed although on an irregular and non-standardized basis. 

Supervision 

VHTs are supposed to report to a health facility within their community where a health worker  supervises them. A parish coordinator often offers support to all VHTs within a parish, and the  District Health Educator is mandated to oversee the work of all VHTs in the district. However,  due to limited funding and human resource capacity, supervision of VHTs is often irregular and inconsistent. 

Incentives and remuneration 

According to the MOH VHT strategy, VHT members are community-selected volunteers who do  not receive financial payment for their services. However, they may receive non-monetary and  sometimes ad hoc monetary incentives from the MOH or from their implementing partners that  work with them in communities. These incentives are not standardized and vary throughout the  country, and mainly depend on the implementing partner that is supporting the VHTs. 

Impact 

VHTs have made a significant contribution to increasing access and utilization of health services  as well as improving health outcomes in communities, including reduction of morbidity and  mortality of children younger than five years of age.