Partnership and Dignity: a Mixed-methods Survey on Supporting and Retaining Uganda's Village Health Teams

George Washington University143 enrolled

Overview

For more than a decade, Uganda's Ministry of Health has led a community health worker program model in which Village Health Teams (VHTs), cadres of unpaid volunteers, are assigned the task of delivering preventative health services and education to their local communities. Studies have demonstrated the effectiveness of Uganda's VHTs in improving certain health outcomes; however it is known that VHTs are not optimally supported, and there has been VHT attrition in recent years. The Ministry of Health has recognized the inadequate support of VHTs thus far and is aiming to "expand VHTs to all local governments and explore ways of sustaining VHTs." The objective of this study is to evaluate the extent to which material support is a deciding factor in the efficiency and durability of Uganda's VHT initiative. Material support may take the form of monetary stipends, regular payment, transportation assistance, or nonfinancial materials such as bicycles or mobile phone airtime. This study will review existing literature and gather novel data through surveys of VHT members and VHT stakeholders. The quantitative and qualitative survey data will be analyzed for trends that may point to a conclusion in the context of existing health policy discourse on community health worker remuneration. The purpose of this study is to strengthen the knowledge base on whether or not the current absence of material support significantly limits the potential for Uganda's VHTs to be sustained and expanded. This information can be used by governmental and non-governmental organizations in their work to strengthen and sustain VHTs throughout the country.

Study Type

OBSERVATIONAL

Enrollment

143

Conditions

Malaria Diarrhea Pneumonia

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: VHT subjects must have been actively working as a VHT member for at least 6 months. Stakeholders, that is, program managers, health administrators and policy makers, must be involved in managing, administrating, or guiding policy for VHT programs as part of their official job description. These persons must also have been acting in those roles for at least 6 months. All study subjects will be 18 years of age or older. All study subjects will be literate and able to be informed to give or withhold consent of participation. Exclusion Criteria: There will be no exclusion or inclusion based on gender, race, tribal or ethnic affiliation, religion, or health status.

Outcomes

Primary Outcomes

Predicted longevity related to support sufficiency

This outcome will be measured by asking VHTs to rate aspects of their current support. We will follow up those questions by asking how long they expect to be able to continue in their position as VHTs. The two results will be evaluated for possible trends connecting sufficiency of existing support with predicted longevity.

Time frame: Up to 5 months

Secondary Outcomes

Predicted longevity of minimum 10 years if current support does not increase

This outcome will be measured by asking the VHTs if they predict being able to continue in their positions for at least 10 more years if their current support does not increase.