Malnutrition, including stunting, wasting, and micronutrient deficiencies, continues to be a major challenge in Uganda’s Kabarole district and Fort Portal City. Despite the presence of Village Health Teams (VHTs) as community health extension workers, gaps in functionality, irregular training, and limited supervision hinder their ability to effectively tackle these issues. This creates missed opportunities to strengthen community health systems, improve access to nutrition services, and enhance the health outcomes of vulnerable populations, including children under five years old and pregnant women.
The Healthy Food Africa project has strengthened VHT structures and equipped VHTs with the necessary tools, training, and methodologies to conduct effective nutrition assessments, provide counseling, and support community health interventions.
Key Findings
The Village Health Team (VHT) program, established in 2001, serves as a bridge between communities and health services. To enhance its impact, the Healthy Food Africa project has strengthened VHT structures in partnership with the Kabarole Research and Resource Center (KRC-Uganda). The project focuses on equipping VHTs with the necessary tools, training, and methodologies to conduct effective nutrition assessments, provide counseling, and support community health interventions.
Training and mentorship programs emphasize skills such as using anthropometric methods (e.g., weight, height, and Mid Upper Arm Circumference measurements) and the ASPIRE methodology (Ask, Show, Probe, Inform, Reassure, Examine) to improve engagement during community conversations. The integration of Maternal, Infant, Young Child, and Adolescent Nutrition (MIYCAN) guidelines ensures that VHTs address the full spectrum of nutrition needs.
VHTs play a critical role in active case finding and referrals for malnutrition, promoting kitchen gardens for household food security, and conducting sanitation and hygiene campaigns. They also register and follow up on pregnant women and children under five to prevent malnutrition relapse and support consistent health monitoring.
Benefits and Impact
The enhanced engagement of VHTs has led to significant improvements in community health and nutrition outcomes. Key results include:
- Increased Access to Health Services: VHTs have improved health-seeking behaviors among community members and contributed to reducing morbidity and mortality in children under five years.
- Promotion of Household Food Security: The adoption of kitchen gardens has grown, with VHTs distributing vegetable seedlings to households with vulnerable members, including pregnant women, lactating mothers, and HIV/AIDS patients.
- Improved Sanitation: Hygiene and sanitation campaigns led by VHTs have resulted in areas like Kicwamba sub-county achieving Open Defecation Free status.
- Strengthened Referral Systems: Active malnutrition case finding has increased referrals, improving access to timely care.
- Sustainable Practices: VHTs have promoted agroecological approaches, food safety, and community health education.
The experience in Kabarole highlights the vital role VHTs play in bridging health gaps at the community level. Strengthening this model can address malnutrition, promote preventive health behaviors, and build resilient community health systems. However, challenges such as limited resources, irregular supervision, and community indifference must be addressed collaboratively by government and partners.
Practical Recommendations
- Strengthen Training and Mentorship: Regular and standardized training programs are essential to keep VHTs updated on health and nutrition practices. On-the-job mentorship fosters continuous skill development.
- Improve Incentives and Support: Address the current stipend of 10,000 UGX/month to improve motivation and retain skilled VHT members.
- Enhance Supervision and Reporting: Increase routine follow-ups and strengthen documentation to ensure accurate tracking of VHT activities and community outcomes.
- Community Engagement Plans: Encourage VHTs to develop home visit plans to cover households systematically, even in challenging contexts.
Contact Information
Eric Oteba
Food System Lab Fort Portal, Uganda