Conference abstract

Village health team functionality and adherence to reporting requirements for community-based surveillance in Kasese, Uganda, 2016

Pan African Medical Journal - Conference Proceedings. 2017:6(11).20 Dec 2017.
doi: 10.11604/pamj-cp.2017.6.11.493

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Keywords: Village, health, functionality, reporting requirements, Uganda

Village health team functionality and adherence to reporting requirements for community-based surveillance in Kasese, Uganda, 2016

Benon Kwesiga1,&, Gerald Pande1, Alex Riolexus Ario1

1Uganda Public Health Fellowship Program, Kampala, Uganda

&Corresponding author
Benon Kwesiga, Uganda Public Health Fellowship Program, Kampala, Uganda


Introduction: Uganda and particularly Kasese District has a high number and frequency of disease outbreaks whose detection and reporting at community level is usually absent or delayed. Most outbreaks in Kasese are detected at health facility level although the earliest point of detection should be at community level, an indicator of a poorly functioning community surveillance system. According to the Community Based Disease/Event Surveillance system in Uganda, Community Health Workers (CHWs) commonly referred to as Village Health Team members (VHTs) are expected to play a key role in Community Based Surveillance so as to enable early detection and response to priority diseases/events at community level to the nearest health facility. This study aimed to assess CHW functionality and adherence to Community Based Disease/Event Surveillance (CBS) guidelines as well as factors associated with it in Kasese so as to identify ways of enabling CHWs to improve CBS.

Methods: these mixed methods of cross-sectional studies were carried out among CHWs and key health officials in Kasese District. Using multi-stage randomized cluster sampling, a total of 203 CHWs were selected and interviewed. Proportions of CHW functionality and adherence to CBS guidelines were calculated. Association between CHWs adherence to CBS guidelines and several factors derived from existing evidence was assessed.

Results: the mean age of the CHWs was 40 years (range: 24 - 70) with equal sex distribution. Only 1/3 (65%) had studied beyond secondary school. Almost all (98.5%) were currently functional while 94% owned a mobile phone and 89% owned and used a CHW book. Only 84% had received initial training upon recruitment while most had received refresher training of some sort. 73.4% had been supervised in the previous 3 months while only 59% of CHWs had been properly recruited during a village meeting. 57% felt that CHW work was too much while most (84%) walked on foot to do their work. All VHTs offered health education to families during home visits, 77% kept records of home visits, 67% referred patients, and 63% reported unusual health events while 56% possessed adequate knowledge of Community Case Definitions (CCDs). Using a composite variable we found that only 58% of VHTs were adequately adhering to CBS guidelines. After multivariate analysis, not having studied beyond primary school (OR = 1.9, CI = 1.02-3.5), not owning a CHW book (OR = 3.4, CI = 1.2 - 9.4) and not being supervised during work (OR = 2.7, CI = 1.4 - 5.2) were associated with poor adherence to CBC guidelines.

Conclusion: VHTs are not adequately adhering to MoH guidelines for CBS and several reasons for this have been identified. Proper recruitment, adequate and continuous training and sustained support supervision of CHWs would help improve CBS in Uganda and similar settings.