School of Medicine and Health Sciences Poster Presentations
Pursuing Meaningful Support of Uganda's Village Health Teams: Priorities, Barriers, and Opportunities
Poster Number
225
Document Type
Poster
Publication Date
3-2016
Abstract
Uganda’s Ministry of Health leads a community health worker program in which Village Health Teams (VHTs) volunteer to deliver basic health services and education to their communities. VHTs have a positive impact on health outcomes, but they are not optimally supported and there has been notable VHT attrition. This study evaluates the experience and perspective of VHTs and key VHT stakeholders in an effort to expand understanding of existing challenges facing VHTs and potential opportunities for meaningful support. A mixed-methods approach was employed through a self-administered survey of 134 VHTs across the Mukono and Wakiso districts in central Uganda. A key outcome is “predicted longevity,” which is determined by whether the subject is confident that he or she can continue working as a VHT for ≥10 years if their existing support remains unchanged. In-depth interviews were held with 6 key informants, including civil servants and non-governmental organization (NGO) program managers. VHTs’ greatest challenges include insufficient supplies and transportation. 89% receive “none” or “a little” transportation tools (e.g. bicycles), while 70% receive “enough” or “almost enough” distributable health supplies (e.g. deworming tablets). The majority of respondents receive at least some ongoing training, supervision, and meetings. In terms of desired additional support, key themes were money (e.g. transportation allowance), material supplies (e.g. rubber boots), and enhancing status and respect as health workers. Regarding predicted longevity, 57% felt able to continue working as VHTs for ≥10 years if existing support remains unchanged. Bivariate analysis found that predicted longevity was positively correlated with working in the Wakiso district (P=0.043). Across both districts, predicted longevity is positively correlated with experiencing less difficulty in home visiting (P=0.003), receiving more partnership with local health center staff (P=0.001), and cleaning the health center (P=0.003). Key informants view VHTs as having an important impact on health in Uganda and facing a number of systems-level challenges, predominantly stemming from lack of domestic resources and governance authority along with dependence on outside implementing partner NGOs. Despite facing significant challenges, most VHTs are motivated to fulfill their role as health workers. Opportunities for meaningful support include practical interventions and systems-level changes, all of which could significantly improve the sustainability and impact of Uganda’s VHT program.
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Open Access
1
Pursuing Meaningful Support of Uganda's Village Health Teams: Priorities, Barriers, and Opportunities
Uganda’s Ministry of Health leads a community health worker program in which Village Health Teams (VHTs) volunteer to deliver basic health services and education to their communities. VHTs have a positive impact on health outcomes, but they are not optimally supported and there has been notable VHT attrition. This study evaluates the experience and perspective of VHTs and key VHT stakeholders in an effort to expand understanding of existing challenges facing VHTs and potential opportunities for meaningful support. A mixed-methods approach was employed through a self-administered survey of 134 VHTs across the Mukono and Wakiso districts in central Uganda. A key outcome is “predicted longevity,” which is determined by whether the subject is confident that he or she can continue working as a VHT for ≥10 years if their existing support remains unchanged. In-depth interviews were held with 6 key informants, including civil servants and non-governmental organization (NGO) program managers. VHTs’ greatest challenges include insufficient supplies and transportation. 89% receive “none” or “a little” transportation tools (e.g. bicycles), while 70% receive “enough” or “almost enough” distributable health supplies (e.g. deworming tablets). The majority of respondents receive at least some ongoing training, supervision, and meetings. In terms of desired additional support, key themes were money (e.g. transportation allowance), material supplies (e.g. rubber boots), and enhancing status and respect as health workers. Regarding predicted longevity, 57% felt able to continue working as VHTs for ≥10 years if existing support remains unchanged. Bivariate analysis found that predicted longevity was positively correlated with working in the Wakiso district (P=0.043). Across both districts, predicted longevity is positively correlated with experiencing less difficulty in home visiting (P=0.003), receiving more partnership with local health center staff (P=0.001), and cleaning the health center (P=0.003). Key informants view VHTs as having an important impact on health in Uganda and facing a number of systems-level challenges, predominantly stemming from lack of domestic resources and governance authority along with dependence on outside implementing partner NGOs. Despite facing significant challenges, most VHTs are motivated to fulfill their role as health workers. Opportunities for meaningful support include practical interventions and systems-level changes, all of which could significantly improve the sustainability and impact of Uganda’s VHT program.
Comments
Presented at: GW Research Days 2016