The Village Health Teams (VHTs) in Uganda: how funders address their challenges!


In developing countries like Uganda, the poor are the majority and mostly stay in rural communities. The Ugandan health care system, has been designed in such a way that trained volunteers serve these rural communities. These are referred to as village health teams (VHTs). VHTs were introduced in Uganda’s healthcare system in 2000 to help increase the uptake of health services in communities. According to the Uganda Village project it took more than 5 years for the concept to be implemented in districts like Iganga.

According to Health Child Uganda (HCU), VHTs have made progress in providing healthcare in many different ways. Though VHTs in Uganda are faced with almost the same problems across the country – transport among others (Kimbugwe et al, 2014) – their efforts have been applauded in their increase in immunization coverage, reduction of infant mortality from malaria in 17 districts (The new vision 2015) and encouraging of male involvement in ANC and HIV testing (Kananura 2012).

Their work includes community mobilization for public health campaigns such as immunization and family planning, nutrition and immunization and home visits (Kimbugwe et al 2014). Though they have also been trained to do other primary health care activities depending on the training they have been offered, it is mostly informal yet impactful work. In some districts, they have been trained to provide services like malaria treatment, and family planning methods including injectables.

Due to availability of aid in different parts of Uganda the program has been implemented differently in different regions of the country. This way of tailoring the program to each region has been reported as successful, but the costs involved and the potential effects this tailoring has on the performance of the VHTs has not been mentioned. In some cases this has been done to suit the donors interests by policy makers.

Research shows that the VHT concept can be a significant means of achieving universal access to primary health care. On the other hand, this concept has faced challenges, which have been approached in different ways with varying impacts. Some approaches have resulted in failure, un-sustainability and/or are successful but with a comparatively high cost incurred. For instance, the Bikes Not Bombs project in Amuru District was successful however the VHTs had to provide the bicycles to improve transport.

Donors should re-think the aid given to support VHTS, and focus on working with projects and organizations that report success before implementing a new program on a large scale. Simply supporting what has been implemented elsewhere is not sustainable as this might not be associated with the same results in Uganda. For example there has been a theory that a change of title and giving VHTs a salary would improve their performance. This could work in other countries, but it might totally fail in Uganda.

 

References

  1. Kimbugwe et al; 2014. Challenges Faced by Village Health Teams (VHTs) in Amuru, Gulu and Pader Districts in Northern Uganda. Open Journal of Preventive Medicine 09/2014; 4(9):740-750. DOI:10.4236/ojpm.2014.49084
  2. Kananura R; 2012. Role of Village Health Teams (VHTs) in Public Health-Uganda. American Public Health Association. Available at https://apha.confex.com/apha/140am/webprogram/Paper268132.html  
  3. Bike not bombs available at https://bikesnotbombs.org/amuru
  4. Mungerera wants the village health teams regulated. The new vision available at http://www.newvision.co.ug/news/654589-mungherera-wants-village-health-teams-regulated.html accessed on 1/7/2015
  5. Uganda village project , Village health teams available at http://www.ugandavillageproject.org/what-we-do/healthy-villages/village-health-teams/ accessed on 30/06/2014

-Josephine Najjuma, a leading member of the Student Network Organization of The Network Towards Unity for Health from Uganda

Photo credits: https://bikesnotbombs.org/amuru