Partnership and Dignity: a Mixed-methods Survey on Supporting and Retaining Uganda's Village Health Teams

Malaria Clinical Trial

Official title:

Partnership and Dignity: a Mixed-methods Survey on Supporting and Retaining Uganda's Village Health Teams

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02374580
• Other study ID #: VHT_041406
• Status: Completed
• Phase: N/A
• First received: December 4, 2014
• Last updated: June 15, 2016
• Start date: February 2015
• Est. completion date: May 2015

Study information

• Verified date: August 2015
• Source: George Washington University
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review BoardUganda: National Council for Science and Technology
• Study type: Observational

Clinical Trial Summary

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 143
• Est. completion date: May 2015
• Est. primary completion date: May 2015
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

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.

Exclusion Criteria:

There will be no exclusion or inclusion based on gender, race, tribal or ethnic affiliation, religion, or health status.

Study Design

Time Perspective: Cross-Sectional

Related Conditions & MeSH terms

• Diarrhea
• Malaria
• Pneumonia

Locations

Country	Name	City	State
United States	The George Washington University School of Medicine and Health Sciences	Washington	District of Columbia

Sponsors (2)

Lead Sponsor	Collaborator
George Washington University	Makerere University

Country where clinical trial is conducted

United States, 

References & Publications (9)

Brenner JL, Kabakyenga J, Kyomuhangi T, Wotton KA, Pim C, Ntaro M, Bagenda FN, Gad NR, Godel J, Kayizzi J, McMillan D, Mulogo E, Nettel-Aguirre A, Singhal N. Can volunteer community health workers decrease child morbidity and mortality in southwestern Uganda? An impact evaluation. PLoS One. 2011;6(12):e27997. doi: 10.1371/journal.pone.0027997. Epub 2011 Dec 14. — View Citation

Kalyango JN, Rutebemberwa E, Alfven T, Ssali S, Peterson S, Karamagi C. Performance of community health workers under integrated community case management of childhood illnesses in eastern Uganda. Malar J. 2012 Aug 20;11:282. doi: 10.1186/1475-2875-11-282. — View Citation

Kayemba Nalwadda C, Guwatudde D, Waiswa P, Kiguli J, Namazzi G, Namutumba S, Tomson G, Peterson S. Community health workers - a resource for identification and referral of sick newborns in rural Uganda. Trop Med Int Health. 2013 Jul;18(7):898-906. doi: 10.1111/tmi.12106. Epub 2013 Apr 2. — View Citation

Lehmann U., Sanders D. Community health workers: what do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. (2007) Geneva: World Health Organization. Available at: <http://www.who.int/hrh/documents/community_health_ workers.pdf>

Ministry of Health Uganda. Annual Health Sector Performance Report: Financial Year 2012/2013. 2013.

Ministry of Health Uganda. The second national health policy. 2010.

Ministry of Health, Uganda, Education and Promotion Division. Village health team strategy and operational guidelines. 2010.

Okello D, Floyd K, Adatu F, Odeke R, Gargioni G. Cost and cost-effectiveness of community-based care for tuberculosis patients in rural Uganda. Int J Tuberc Lung Dis. 2003 Sep;7(9 Suppl 1):S72-9. — View Citation

Perry, H, et al. How effective are community health workers? an overview of current evidence with recommendations for strengthening community health worker programs to accelerate progress in achieving the health-related millennium development goals. Johns Hopkins University Bloomberg School of Public Health. 2012.

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Predicted longevity related to support sufficiency	This outcome will be measured by asking VHTs to rate aspects of their current support. We will follow up those questions by asking how long they expect to be able to continue in their position as VHTs. The two results will be evaluated for possible trends connecting sufficiency of existing support with predicted longevity.	Up to 5 months	No
Secondary	Predicted longevity of minimum 10 years if current support does not increase	This outcome will be measured by asking the VHTs if they predict being able to continue in their positions for at least 10 more years if their current support does not increase.	Up to 5 months	No