Abstract
BackgroundCommunity health workers are essential personnel in resource-limited settings. In Uganda, they are organized into Village Health Teams (VHTs) and are focused on infectious diseases and maternal-child health; however, their skills could potentially be utilized in national efforts to reduce the growing burden of non-communicable diseases (NCDs). We sought to assess the knowledge of, and attitudes toward NCDs and NCD care among VHTs in Uganda as a step toward identifying their potential role in community NCD prevention and management.MethodsWe administered a knowledge, attitudes and practices questionnaire to 68 VHT members from Iganga and Mayuge districts in Eastern Uganda. In addition, we conducted four focus group discussions with 33 VHT members. Discussions focused on NCD knowledge and facilitators of and barriers to incorporating NCD prevention and care into their role. A thematic qualitative analysis was conducted to identify salient themes in the data.ResultsVHT members possessed some knowledge and awareness of NCDs but identified a lack of knowledge about NCDs in the communities they served. They were enthusiastic about incorporating NCD care into their role and thought that they could serve as effective conduits of knowledge about NCDs to their communities if empowered through NCD education, the availability of proper reporting and referral tools, and visible collaborations with medical personnel. The lack of financial remuneration for their role did not emerge as a major barrier to providing NCD services.ConclusionsUgandan VHTs saw themselves as having the potential to play an important role in improving community awareness of NCDs as well as monitoring and referral of community members for NCD-related health issues. In order to accomplish this, they anticipated requiring context-specific and culturally adapted training as well as strong partnerships with facility-based medical personnel. A lack of financial incentivization was not identified to be a major barrier to such role expansion. Developing a role for VHTs in NCD prevention and management should be a key consideration as local and national NCD initiatives are developed.
Highlights
Community health workers are essential personnel in resource-limited settings
Our findings reveal that Ugandan Village Health Teams (VHTs) members possess some knowledge and awareness of non-communicable diseases (NCDs) and associated risk factors but identify a lack of NCD knowledge in their communities
In this study we have shown that Ugandan VHT members already possess some knowledge and understanding of NCDs, especially around the mode of transmission, diet-related risk factors, and the late manifestation of NCD symptoms, gaps remain
Summary
Community health workers are essential personnel in resource-limited settings. In Uganda, they are organized into Village Health Teams (VHTs) and are focused on infectious diseases and maternal-child health; their skills could potentially be utilized in national efforts to reduce the growing burden of non-communicable diseases (NCDs). Uganda is an example of an LMIC experiencing a growing burden of NCDs. The first nationally representative study of NCDs and their associated risk factors, completed in 2014 using the WHO STEPwise approach (STEPS), revealed that 25.8% of Ugandan men and 22.9% of women had hypertension; 9.5% of men and 19.5% of women were overweight (BMI ≥ 25 kg/m2); 4.6% of participants were obese (BMI ≥ 30 kg/m2); 3.3% had raised fasting glucose including diabetes; 6.7% had raised total cholesterol levels and 11% were current smokers [7,8,9]. A nationwide needs assessment of health facilities’ readiness to deliver NCD care, revealed large gaps in human resource readiness to treat NCDs [11]
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