In 2010, President Museveni launched Village Health Teams (VHTs) in what he called the Integrated Community Case Management (ICCM) programme which was aimed at curbing the then soaring numbers of poor household health care by bringing health services at one’s door step.
At the time of the launch of VHTs, Museveni supported the decision that more than 60 per cent of infants below the age of five in Uganda died due to diseases like; malaria, pneumonia and diarrhoea. These diseases, according to him, including malnutrition, had left about 89.6 per cent children sick every year.
A Uganda Bureau of Statistics (UBOS) around the same year indicated that over 180,000 children die before their fifth birthday every year, adding that 6,000 women die each year in Uganda from pregnancy-related causes while 40,000 children survive with chronic and weak health conditions.
A village health team (VHT) was meant to comprise four to five people selected in a popular vote from a village. Each member would be in charge of 25 to 30 households.
These numbers have more than doubled, according to our on-site visits to some villages in the Eastern part of the country because of the enormous need that is on ground.
They were also expected to visit homes, mobilise communities to utilise health services, promote health education and community-based management of common disease, advise mothers during pregnancy and after birth as well as follow up patients who have been discharged and those undergoing long-term treatment.
The teams would also be in charge of distributing health kits and disease surveillance.
Ms Elizabeth Nabwire, a VHT in Bulakho village, Buyanga sub-county, Bukhubalo parish Busia District says she moves more than 12 kilometres a day to make sure that she delivers the health care.
“We are volunteers and do not receive any kind of payment from the government. We survive on allowances from some non-governmental organisations that give us Shs15, 000 a month whenever they come. The NGOs only come in once in a while,” Ms Nabwire says.
It is upon that background that the Speaker of Parliament Anita Among has pledged to coordinate with the Ministry of Health to ensure that members of village health teams receive befitting allowance for the work they do in managing and extending health services to communities.
“I am going to make sure that I bring this matter to the attention of Parliament so that you are well remunerated in order to serve people better and achieve the national community health strategy,” Ms Among said.
She made the remarks during a meeting with village health team members and local council representatives from the five sub-counties of Bukedea District on Thursday last week.
Village health teams have over time been vital in increasing access and utilization of health services as well as helping the government to monitor community health, which has reduced morbidity and mortality of children under five years.
Ministry of health reports of 2022 titled, ‘Trends in maternal mortality’ indicated that Uganda’s maternal mortality rating has decreased from 336 mothers per 100,000 live births to 284 women per 100, 000 live births.
It tracked maternal deaths nationally, regionally and globally from 2000 to 2020 and shows that generally there were an estimated 287,000 maternal deaths worldwide in 2020.
These figures represent only a slight decrease from 309,000 in 2016 when the Sustainable Development Goals (SDGs) came into effect.
For Uganda for instance, the improvement has been attributed to mainly the village health teams whom several experts say have delivered the needed services at the right time.
Ms Among says that such groups have been key in extending health management services to local communities yet they continue to face funding shortages, which make their work difficult.
“You (village health teams) play a very important role of mobilising communities and bridging the gap between communities and health facilities,” she said, noting that for a long time members of village health teams have been known to offer voluntary service without pay, which “must change”.
In her remarks she asked relevant government institutions to pay attention to the support offered by village health groups in improving access to health and other essential services.
Mr Emmanuel Ainebyoona, the ministry of health spokesperson told News 24/7 in an interview that there are several interventions to improve the work environment of the VHTs across the country.
“We want to make sure that we get something befitting because there is something we are coming up with called the Community extension workers and these will be at the sub-county to supervise the VHTs. We welcome ideas like those of the speaker because when we are allocating budgets we shall have to involve several stakeholders,” Mr Ainebyoona says.
