A component of Uganda’s national strategy since 2001, Village Health Teams (VHTs) have been serving as an initial point of health contact for the country’s population, which is afflicted by chronic conditions. Unfortunately, the number of available VHTs and the scope of their duties are not sufficient enough to reach all those in need. Further exacerbating the problem is that Uganda is plagued by grave disparities between the number of patients requiring medical care and the number of available doctors able to provide those services (the ratio is estimated to be 1:24,000 by the World Health Organization). URC’s community support activity in Uganda under the Applying Science to Strengthen and Improve Systems (ASSIST) Project has been focused upon improving the engagement and performance of VHTs to provide quality chronic care services to people living with HIV for self-management at the community level. Our unit was focusing its efforts upon concentrating interventions where the maximum benefit could be obtained. Areas where additional attention was needed included supportive supervision and vehicles through which to measure a worker’s progress.In fact, mHealth concepts have been introduced as a part of this activity, whereby cellular phones have been integrated into existing health-related processes, in an attempt to strengthen supervision, communication, and feedback between VHTs, their supervisors, and the health facilities. Prior to the introduction of cell phones, supervision was low as a result of transportation constraints, which made it difficult for supervisors to travel to the villages to meet the VHTs. Furthermore, when VHTs interacted with patients it wasn’t uncommon for them not to know the answers to their questions, which decreased trust and credibility. In order to address these issues, the introduction of cell phones made it possible for the VHTs to quickly obtain answers to their patients’ questions, while also closing the gap between the VHTs and their supervisors. As the graph below indicates, cell phones made more frequent contact and communication between the VHTs and their supervisors a reality, while also increasing the percentage of reporting that was completed on time. As we approach World Health Worker Week, it is important to recognize the fact that Community Health Workers (CHWs) are Frontline Health Workers. As countries undertake strategies for obtaining their Millennium Health Goals and advancing towards Universal health coverage, CHWs and this cadre of health workers need to be incorporated into national strategies.
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