The history and context of village health teams in
Uganda
Since the Alma-Ata declaration, successive Ugandan
governments have acknowledged the relationship between
health and poverty, but unfortunately, political
turmoil made interventions impossible until the 1990s,
when fragmented community-based interventions by
development partners began to be implemented [45].
The 1999 national health policy included community
empowerment and mobilization for health as key elements
of the national minimum health care package. A
programme designed to improve the home-based management
of fevers, implemented after the Abuja Declaration
of 2000, demonstrated the benefits of community-based
interventions and opened up the way for a strategy based
on village health teams (VHTs) [46,47].
The selection of VHTs followed a process of building
consensus in the community. First, during face-to-face
sensitization sessions, community members were educated
about the programme and its need for volunteers.
The meeting’s facilitator, often a technical person from
the district’s health team or the nearest health centre,
described the kind of people best suited for selection as
VHTs. After sensitization and consensus building among
all stakeholders and all households in the village have
occurred, a popular vote is held. According to Uganda’s
Ministry of Health guidelines, to be selected as a VHT
member, a person must meet several criteria: he or she
must be above 18 years of age, a village resident, able to
read and write in the local language, a good community
mobilizer and communicator, a dependable and trustworthy
person, someone interested in health and development
and someone willing to work for the community.
Preference is given to people already serving as CHWs
especially if they have served well [48].
Nationally, VHTs are expected to carry out general
tasks in all PHC core areas which include home visiting,
mobilization of communities for utilization of health services,
health promotion and education, management of
common illnesses, follow-up of pregnant mothers and
newborns, follow-up of discharged patients and those on
long-term treatment and community information management
[49]. This necessitated generalist training on a
range of subjects including interpersonal communication,
community mobilization and empowerment, child
growth and development, control of communicable diseases,
sexual and reproductive health, environmental