Enhancing performance and sustainability of community health worker programs in Uganda: lessons and experiences from stakeholders

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Musoke, D, Atusingwize, E, Ndejjo, R, Ssemugabo, C, Siebert, P ORCID: https://orcid.org/0000-0003-3817-229X and Gibson, L ORCID: https://orcid.org/0000-0002-1220-8680, 2021. Enhancing performance and sustainability of community health worker programs in Uganda: lessons and experiences from stakeholders. Global Health Science and Practice, 9 (4), pp. 855-868. ISSN 2169-575X

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Official URL: https://doi.org/10.9745/GHSP-D-21-00260

Abstract

Background: Community health worker (CHW) programs in Uganda have contributed to improved health outcomes in recent years. However, opportunities for engaging the various stakeholders supporting CHW programs have been limited. This article presents workshop findings where several stakeholders shared their lessons and experiences that can enhance performance and sustainability of CHW programs in Uganda.

Methods: We collected qualitative data from stakeholders from government, private, and community organizations, as well as CHWs, involved in CHW programs in Uganda during a 1-day workshop. The workshop involved plenary presentations and group discussions on critical aspects of CHW programs. All proceedings from the workshop were audio-recorded, transcribed, and analyzed by thematic content analysis.

Results: Four major themes emerged from the workshop: lessons learned in implementing CHW programs, challenges affecting CHW programs, performance of CHWs, and ensuring sustainability of CHW programs. Key lessons learned related to 3 main subthemes: capacity building and use of technology, supervision and motivation, and stakeholder engagement and collaboration. Challenges affecting CHW programs identified included poor coordination, fragmented data collection systems, high program expectations, inadequate support mechanisms, and high dropout rates. Mechanisms for improving the performance of CHWs emphasized the need to: strengthen recruitment, training, and retention strategies; improve motivation; streamline coordination mechanisms; and develop and strengthen community health policies. The sustainability of CHW programs requires institutionalization; sustainable funding; economic empowerment of CHWs; local ownership; and a strengthened research agenda.

Conclusion: To improve the performance and sustainability of CHWs programs, stakeholders such as policy makers and implementing partners need to consider CHW needs, existing structures and policies, as well as local support.

Item Type:	Journal article
Publication Title:	Global Health Science and Practice
Creators:	Musoke, D., Atusingwize, E., Ndejjo, R., Ssemugabo, C., Siebert, P. and Gibson, L.
Publisher:	Johns Hopkins Center for Communication Programs
Date:	31 December 2021
Volume:	9
Number:	4
ISSN:	2169-575X
Identifiers:	Number Type 10.9745/GHSP-D-21-00260 DOI 1516829 Other
Rights:	© Musoke et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/.
Divisions:	Schools > School of Social Sciences
Record created by:	Laura Ward
Date Added:	09 Feb 2022 09:30
Last Modified:	09 Feb 2022 09:30
URI:	https://irep.ntu.ac.uk/id/eprint/45568