Community Health Worker Program
BACKGROUND: Uganda has had a Village Health Team (VHT) model for many years, made up of 4 to 5 volunteers from every village in the country selected to serve as their Community Health Workers (CHW), focused primarily on education around hygiene, sanitation and nutrition. In 2013, the government trained two of these CHWs from each community in the Maliba Sub-county according to the Ugandan Ministry of Health & WHO guidelines on Integrated Community Case Management (iCCM) to treat the three leading causes of death and illness among children under 5 years of age: malaria, pneumonia, and diarrhea. As the national health system is overburdened and under-resourced, however, consistent training, supervision, support, and medication stock supplied to these CHWs has been challenging to sustain.
The Maliba Community Health Initiative: MaCHI
IMPACT: The impact of MaCHI has been felt by all members of the community. Caregivers report needing to make fewer trips to the clinics and clinic staff indicate they are no longer overburdened with children under 5 years presenting with iCCM conditions (malaria, pneumonia, diarrhea) from the villages where P-HEALED is active as they are being well managed in the community. As part of our program assessment, we studied this impact and found a greater than 85% reduction in health center visits from patients under 5 years living in P-HEALED supported communities over the first year of operations (p < 0.0001).
Given the success of this program, adjacent villages and the local government are requesting expansion of the program and we are actively seeking funds to broaden our scope to include more communities under MaCHI.
INTERVENTION: In 2020, we partnered with the communities and local government in the Maliba Sub-County to launch the Maliba Community Health Initiative (MaCHI). Through this initiative, we trained a new cadre of 20 CHWs in 10 villages to treat children under 5 years according to the iCCM guidelines. Through MaCHI, we manage our own supply chain to ensure our CHWs do not stock out of medicines, while also providing regular trainings and supervision.
Augustine Bwambale, MaCHI Field Administrator : En route to CHWs for supervision visits and to deliver medications