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In Uganda, over 18,000 children under five die from malaria each year. Delayed treatment is a common cause of childhood deaths, especially in rural Uganda where distance to health facilities presents a major challenge.
“Most of the children would suffer from malaria, diarrhoea, and coughs. But instead of taking the children to the health centre, mothers would often just give them paracetamol at home,” explains Lucy Irumba, a volunteer community health worker (CHW) in Hoima district, mid-western Uganda. “Sometimes, the children would die as a result. As a mother and a grandmother, this is very painful to witness, when you know it is avoidable.”
As a result, the Uganda Ministry of Health with support from partners such as Malaria Consortium, has trained over 12,500 volunteer CHWs, locally known as Village Health Team members (VHTs) to conduct extensive health education and prevention activities. This includes diagnosing and treating malaria, pneumonia and diarrhoea in children under 5 years at community level, as well as referring severe cases and sick newborns to the nearest health facility. This strategy is known as integrated community case management (iCCM).
iCCM has the potential to significantly reduce childhood mortality and, if implemented appropriately, can act as a health system strengthening tool, allowing essential care to reach remote villages while lessening the strain on overburdened rural health facilities.
“I became a VHT in 2009 because I wanted to help the children in the village suffering from diseases,” says Lucy. “There was a mass distribution of long lasting insecticide treated nets back then and I helped educating people on the correct use of the nets.”
In the neighbouring district of Kiboga, more than 98% of VHTs trained in iCCM remain active.
“People have increased knowledge and awareness of prevention and treatment of childhood diseases,” explains Catherine Nassiwa, Malaria Focal Person for Kiboga district. “iCCM has resulted in a reduction of almost half in outpatient attendance. We know this can be attributed to the VHTs because when they have medicine stock outs, the outpatient numbers shoot up immediately.”
As volunteers, VHTs spend their days working to support their families and try to balance providing care for the children in their communities with their own responsibilities. It is often asked how these volunteer community health workers remain motivated and committed. According to Catherine “They are our key entry persons in to the communities; they mobilise for health programmes and follow up after, they provide health education, and they detect and inform on trends in diseases. So we involve them in any relevant workshops and seminars, we show our appreciation at political functions, and we keep motivating them through quarterly support supervision visits. The VHTs are our colleagues, and we make sure they feel their importance.”
Malaria Consortium is committed to the sustainability and scale up of iCCM and CHW programmes in Uganda and in many other sub-Saharan African countries including Ethiopia, Mozambique, Nigeria, and South Sudan. The organisation’s work focuses on providing the highest quality of care through these programmes while ensuring they are used as a strategy for wider health system strengthening.
Murema Ed, a VHT in Kiboga concludes, “I feel good. This was my goal, to reduce the number of people dying, so I feel happy and proud. If all the VHTs stopped working, the situation would be very bad. We would go back to children dying.”
Watch our newest film on the impact iCCM is having on communities in Uganda
For more information on Malaria Consortium’s work in community based health delivery systems please visit the http://www.malariaconsortium.org/inscale
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Malaria Consortium is one of the world’s leading non-profit organisations specialising in the comprehensive control of malaria and other infectious diseases – particularly those affecting children. Established in 2003, Malaria Consortium works in Africa and Southeast Asia with communities, government and non-government agencies, academic institutions, and local and international organisations, to ensure good evidence supports delivery of effective services for disease control.
Cover photo credit: Tine Frank for Malaria Consortium
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