Village Health Team Functionality in Uganda: Implications for Community System Effectiveness
Science Journal of Public Health
Volume 4, Issue 2, March 2016, Pages: 117-126
Received: Feb. 28, 2016;
Accepted: Mar. 9, 2016;
Published: Mar. 22, 2016
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Babughirana Geoffrey, World Vision, Kampala, Uganda
Muhirwe Barungi Lorna, World Vision, Kampala, Uganda
Kimurahebwe Clare, Independent Consultant, Kampala, Uganda
Community health workers have long been recognized as a critical cadre for the timely delivery of basic primary health care packages in low resource settings. In most countries, community health workers are semi-skilled workers who receive in-service training without structured curricula, mentorship approaches and clear opportunities for career advancement which affects their functionality. Several other external issues may affect community health worker functionality including availability of equipment and supplies, community involvement, country ownership and health system performance. Assessment of village health team (VHT) functionality was conducted in 24 districts in Uganda and involved 2369 village health workers. The study utilized guided self-assessments and participatory performance improvement processes based on the Community Health Worker Assessment and Improvement Matrix (CHWAIM) toolkit. Functionality assessment focused on 15 programmatic components regarded as essential for effective CHW programs. Data collection and functionality scoring was done at district level with the involvement of district leaders and VHTs themselves. Data from study districts was pooled into one national data set and aggregated to provide an aggregate representation of the national VHT functionality situation in Uganda. VHT functionality is affected by various programmatic components interacting at various levels. Our findings indicate that the four operational regions of the country are at different levels of VHT functionality with Karamoja region having the highest functionality level (52%) and Central region having the lowest functionality (38%). At an aggregate level, the national VHT functionality stood at 46%. In all the regions; supervision, individual performance evaluation and referral linkages registered a functionality score of 1 or 0 indicating either partial or non-functionality. This was the same finding for reporting and availability of equipment and supplies which obtained a score of 1 in all the regions except Karamoja. Overall program evaluation and country ownership scores were both 1 which has implications for achieving optimum VHT functionality levels in Uganda. As Uganda looks towards re-engineering its health system to meet the sustainable development goals, sufficient attention must be paid to strategies that support routine monitoring of the functionality of village health teams for overall program excellence.
Muhirwe Barungi Lorna,
Village Health Team Functionality in Uganda: Implications for Community System Effectiveness, Science Journal of Public Health.
Vol. 4, No. 2,
2016, pp. 117-126.
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