Using mHealth to Improve the Performance and Engagement of Village Health Teams
A component of Uganda’s national strategy since 2001, Village Health Teams (VHTs) serve as an initial point of health system contact for much of the country’s population. Unfortunately, the number of available VHTs and the scope of their duties are not sufficient to reach all households needing services. Further exacerbating the problem is that Uganda is plagued by grave disparities between the number of patients requiring medical care and the number of available doctors able to provide those services (the ratio is estimated to be 1:24,000 by the World Health Organization).
The ASSIST Project’s community support activity in Uganda has focused on improving the engagement and performance of VHTs to provide self-management support for people living with HIV. A major gap in current health system support for VHTs is the lack of supportive supervision and vehicles to transport facility workers to the community level.
As a part of this activity, mHealth technologies have been introduced, whereby cellular phones have been integrated into existing health-related processes, in an attempt to strengthen supervision, communication, and feedback between VHTs, their supervisors, and the health facilities. Prior to the introduction of the cell phones, supervision was limited due to transportation constraints. Furthermore, when VHTs interacted with patients, it wasn’t uncommon for them not to know the answers to their questions, which decreased trust and credibility.
In order to address these issues, the introduction of cell phones made it possible for the VHTs to quickly obtain answers to their patients’ questions, while also facilitating communication between the VHTs and their supervisors. Since beginning the intervention in June 2013, the proportion of VHTS who have reported to supervisors increased from 15% to 65%, and the proportion of VHTs who received feedback from supervisors rose from 30% to 100%. Cell phones made more frequent contact and communication between the VHTs and their supervisors a reality, while also increasing the percentage of reporting that was completed on time.
As we approach World Health Worker Week, it is important to recognize the Village Health Teams and other community health agents are Frontline Health Workers that need to be incorporated and supported within national health strategies.