District of Columbia
For more than a decade, Uganda's Ministry of Health has led a community health worker
program model in which Village Health Teams (VHTs), cadres of unpaid volunteers, are
assigned the task of delivering preventative health services and education to their local
communities. Studies have demonstrated the effectiveness of Uganda's VHTs in improving
certain health outcomes; however it is known that VHTs are not optimally supported, and
there has been VHT attrition in recent years. The Ministry of Health has recognized the
inadequate support of VHTs thus far and is aiming to "expand VHTs to all local governments
and explore ways of sustaining VHTs." The objective of this study is to evaluate the extent
to which material support is a deciding factor in the efficiency and durability of Uganda's
VHT initiative. Material support may take the form of monetary stipends, regular payment,
transportation assistance, or nonfinancial materials such as bicycles or mobile phone
airtime. This study will review existing literature and gather novel data through surveys of
VHT members and VHT stakeholders. The quantitative and qualitative survey data will be
analyzed for trends that may point to a conclusion in the context of existing health policy
discourse on community health worker remuneration. The purpose of this study is to
strengthen the knowledge base on whether or not the current absence of material support
significantly limits the potential for Uganda's VHTs to be sustained and expanded. This
information can be used by governmental and non-governmental organizations in their work to
strengthen and sustain VHTs throughout the country.
VHT subjects must have been actively working as a VHT member for at least 6 months.
Stakeholders, that is, program managers, health administrators and policy makers, must be
involved in managing, administrating, or guiding policy for VHT programs as part of their
official job description. These persons must also have been acting in those roles for at
least 6 months. All study subjects will be 18 years of age or older. All study subjects
will be literate and able to be informed to give or withhold consent of participation.
There will be no exclusion or inclusion based on gender, race, tribal or ethnic
affiliation, religion, or health status.