Panacea or pitfall? The introduction of Community Health Extension Workers in Uganda

31 August, 2020

- The Uganda Ministry of Health is planning to introduce new Community Health Extension Workers (CHEWs) who would be institutionalised, paid a monthly allowance, and work closely with existing Village Health Teams (VHTs) who are community volunteers.

- The introduction of CHEWs is likely to have several benefits to the country’s health system, including availability of another health cadre offering majorly preventive and selected curative services, and supporting the work of VHTs including supervision.

- But there are foreseeable concerns that could affect the CHEW programme. Just like VHTs, CHEWs would require support systems: performance management, regular refresher trainings, supervision from health practitioners, and availability of necessities and supplies.

- Given that two CHEWs would be employed per parish (the sub-counties of Uganda are divided into parishes, which are further divided into villages) in comparison with four VHTs per village, VHTs would remain crucial in supporting the community health system.

- However, there is a likelihood that with the introduction of CHEWs, VHTs would be further neglected hence affecting community health outcomes. Hence, there is need for a holistic approach to introduce and adequately support the CHEWs.

- Even with the introduction of CHEWs, deliberate effort to strengthen the existing VHT programme is necessary to improve community health.

https://gh.bmj.com/content/5/8/e002445

HIFA profile: David Musoke is a Lecturer at the Makerere University School of Public Health, Uganda. Professional interests: Malaria prevention, community health workers, environmental health, public health, disadvantaged populations. He is a member of the HIFA working group on CHWs. www.hifa.org/projects/community-health-workers www.hifa.org/support/members/david-0 dmusoke AT musph.ac.ug