Village health teams and primary healthcare service delivery in Mpigi District, Uganda

Abstract

The Village Health Teams (VHTs) have been considered by the Government of Uganda (GoU) as an effective way to bring primary healthcare services closer to the people. Consequently, the VHT programme was introduced within the broader framework of health policy under the decentralization system. This study was set to assess the role of VHTs in the delivery of primary healthcare services in Mpigi District. It aimed at establishing whether VHTs involvement translated to genuine community participation and ownership of primary healthcare programs. It examined the mechanisms used by the VHTs to deliver primary healthcare services. It also assessed the capacity of VHTs in delivering primary healthcare services and; identified challenges faced by VHTs in delivering primary healthcare services in Mpigi District. The study predominantly employed a qualitative approach. It consisted of a sample of 83 participants who were selected using simple and purposive sampling techniques. The study employed qualitative data collection methods of key informants’ interviews and focus group discussions. The study employed content analysis where themes and sub themes were developed in line with study objectives. Key findings revealed that VHT involvement in the provision of primary healthcare services raised community participation in primary healthcare services in terms of improved health seeking behavior but did not translate into ownership of primary healthcare programs. The VHTs were using a number of mechanisms to deliver primary healthcare services and these included dramatization, home visits, demonstrations, posters, village meetings and Talk Shows. Also, VHTs did not possess enough capacity to deliver primary healthcare services because of their low levels of training, insufficient timely reporting and lifesaving referrals. More to that, VHTs faced a number of challenges including inadequate VHT support, flawed healthcare system, lack of support and recognition from formal healthcare providers, shortages in medical supplies, VHTs‟ workload, the traditional culture and beliefs and VHTs insufficient Training. The study recommends that the government should recruit more educated and younger VHT members, revise the duration, content, and methodology of VHT training, revise the training curriculum for supervisors, build and encourage stronger partnerships between VHTs and other health workers, and lastly empower the social and economic status of the VHTs in the delivery of healthcare services.