Kampala, 7th March 2014 -- The Director General of Health Services and Country Representatives of WHO, UNFPA, UNICEF and CDC recently held an informal high-level lunchtime discussion on strengthening the Community Health work in Uganda.

Prominent among the issues discussed was whether it is time for a paradigm shift to maximizing the performance of VHTs through predictable remuneration (e.g. employment), better integration with the health system for accessing technical support, mentoring and career development and linking them to specific deliverables in line with the minimum health care package for which they should be appropriately prepared.

The VHT is a community based (village) structure that promotes health and wellbeing of the people in their areas of residence. The VHTs were established by the Ministry of Health in 2000 to empower communities to take part in the decisions that affect their health; mobilize communities for health programs, and strengthen the delivery of health services at house-hold level. They also facilitate data collection at community level which informs health planning, implementation and monitoring. In addition, VHTs undertake event notification and reporting especially in epidemic prone areas.

The VHTs face a number of challenges such as poor motivation, lack of coordination and supervision, inadequate training, low education levels and work overload. At the same time, health authorities agree that the country needs efficient, well motivated dedicated and accountable VHTs able to deliver and communicate health issues at community and household levels for health improvement.

In Uganda, some technical programmes provide financial and non financial incentives for VHTs. Institutionalized financial remuneration of VHTs is argued as financially untenable and would just create a blotted health system structure. Investing in improving the effectiveness of the current VHTs is considered a viable alternative.

Participants at the lunchtime meeting had one clear message, that is, VHTs do tremendous work and they have proven the relevance of their existence. Therefore, motivation modalities should be explored.

At the meeting, it was noted that the Ministry of Health will soon undertake country-wide review of Village Health Teams (VHTs) to ascertain their functionality, map out coverage and training needs.

At the same time, UN agencies and other partners plan to support a Government of Uganda “Benchmark” visit to either Ethiopia or Malawi to learn about implementation of community-based health workers structures in those countries. Hopefully, these two activities will provide practical ways to help determine appropriate motivation mechanisms for VHTs among other things.

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For more information please contact :

Benjamin Sensasi, Health Promotion Advisor,
WHO Country Office Tel 256-414-335500
Email: sensasib [at] who.int