Factors associated with village health team members’ adherence to practice guidelines in Mella Sub County, Tororo District, Eastern Uganda

Abstract

Background: Village Health Teams (VHTs), globally known as Community Health Workers (CHWs) were introduced into Uganda’s health system by the Ministry of Health (MOH) in the year 2000. CHWs attained global recognition after the 1978 Alma Ata declaration, aimed at achieving health for all by the year 2000 through Primary Health Care (PHC).This study therefore seeks to establish the level of adherence of the VHT members to MOH guidelines and its associated factors. Methodology: The study was a cross sectional study using mixed methods. 157 VHT members were interviewed using a semi structured questionnaire. Four focus group discussions were conducted and recorded then transcribed verbatim. The transcripts were translated to English, the data coded and analysed manually to identify the themes and subthemes. Quantitative data was analyzed with stata version 12. Results: The level of adherence of VHTs to MOH guidelines in Mella subcounty, Tororo district was generally at 89.4%. Adherence to supporting ongoing treatment was highest at 100% while to life saving practices was lowest at 51%. Level of education, years of service, supervision frequency, other training and sex of the VHT were the factors associated with adherence to the guidelines. Conclusion: CHWs in Mella sub county are adhering to MOH guidelines but the life saving role is minimally practiced due to lack of drugs and other supplies. Other factors associated with adherence to MOH guidelines are; Education level, having refresher training, years of service as VHT, supervision frequency, gender , NGO support, availability of necessary supplies, relationship with the community and health workers and monetary incentives.