Abstract
Primary health care provision through innovative community level interventions such as the Village Health Team (VHT) concept in Uganda can be a rational way of achieving universal access to healthcare. This cross-sectional study interviewed 150 VHT members and 16 key informants in three districts in Northern Uganda to establish the roles of VHTs, the service gaps encountered and the measures in place to address these gaps. Quantitative data were analyzed using SPSS 16.0. Direct content analysis of themes of transcribed qualitative data was conducted manually for common codes. The majority of the respondents 64.29% (n = 72) reported to have been VHT volunteers for more than 5 years. Among the roles were community mobilization reported by 99.1% (n = 111) and home visiting of individuals reported by 97.3% (n = 109). Lack of transport, motivation, adequate skills and community appreciation with nearly no measures in place to counteract the challenges was reported by almost all respondents. Although the VHT concept can be a significant means of achieving universal access to primary health care, extensive community involvement and motivation of the volunteers are highly needed for a maximum benefit.
Highlights
The Village Health Team (VHT) concept that serves as a community’s initial point of contact for health care became part of Uganda’s National Health Strategy in 2001 [1]
The very nature of Primary Health Care (PHC) necessitates community participation [5] and the origin of the VHT concept can be traced to the 1978 Alma Ata declaration, where health was entrenched as a basic human right [6] and member countries agreed that PHC through concepts like the VHTs was a means through which universal health care would be achieved and Governments were responsible for developing measures and strategies that were relevant to their unique social, economic, political and cultural conditions [7]
Gulu and Pader districts in Northern Uganda being among the districts which were mostly affected by the Lord’s Resistance Army insurgence led by Joseph Kony that ravaged the area for over two decades, implementation of the VHT concept in these areas has encountered outstanding challenges compared to other peaceful areas of the country
Summary
The Village Health Team (VHT) concept that serves as a community’s initial point of contact for health care became part of Uganda’s National Health Strategy in 2001 [1]. The very nature of Primary Health Care (PHC) necessitates community participation [5] and the origin of the VHT concept can be traced to the 1978 Alma Ata declaration, where health was entrenched as a basic human right [6] and member countries agreed that PHC through concepts like the VHTs was a means through which universal health care would be achieved and Governments were responsible for developing measures and strategies that were relevant to their unique social, economic, political and cultural conditions [7]. A situation analysis by UNICEF (2009) concluded that VHTs can and do save lives, but their impact could be more dramatic if activities were better planned and focused on evidence-based high impact interventions [15] and the need for this study
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