Friday, March 8, 2013

Engaging the Village Health Team

One of IECM’s main objectives in Rukungiri is to address the child malnutrition knowledge and skills gap of local health providers.  One of the project activities designed to reach this objective is a training program for community-based volunteers. The first level of health care in Uganda is a Health Center I (HCI). This community-based structure was initiated in 2001 as part of Uganda’a Health Sector Strategic Plan. There is no physical building; rather this health center is built of volunteers who have been chosen by their community to promote health and well being of the village. Volunteers within a village are assigned specific households and together form the Village Health Team (VHT).

IECM nurses lead the malnutrition screening and 
nutritional education training session in Kikarara Parish.
 26 VHT members and one SCORE field officer were in attendance.
The malnutrition-training program for VHT members began in January 2012 and from its genesis has been a collaboration between IECM, Nyakibale Hospital, the District Health Office of Rukungiri and the Ministry of Health. As of this week, we have trained a total of 120 VHT members in four parishes of Bwambara Sub County, our main target area.

A MUAC (Middle Upper Arm Circumference) is a simple tool used to diagnose malnutrition for ages 6 months and above. The MUAC is similar to a tape measure with a slit on one side to accurately measure the circumference
of the subject’s arm. Diagnosis is based on age.

In January 2013, we received approval from the District Health Officer to train all VHTs within our catchment area. Kikarara parish was chosen as the next training site because of the severity of cases that come for treatment, low patient numbers in recent months and our strong collaboration with SCORE (Sustainable COmprehensive REsponse for vulnerable children and their families) a project that works with communities the same catchment area. Our goal is to provide VHT members with the skills and tools needed to identify and refer cases of malnutrition to IECM’s outreach sites as well as malnutrition knowledge to counsel families on proper feeding and prevention practices.

IECM’s outreach team chose March 4th for the training and a SCORE field officer mobilized VHT members while IECM prepared the necessary supplies, including MUACs and malnutrition education handouts for each VHT member. 

IECM nurses demonstrate the proper use of a MUAC.

Training is interactive, nurses pose questions and VHT members discuss challenges they’ve faced in the field. Above, two VHT members volunteer to teach the rest of the group what they’ve learned. Fellow trainees are attentive to detail and supportive– during the peer education they point out errors and ask for clarification. The session was closed with a round of applause for everyone involved.

IECM will return to Kikarara on March 11 to follow-up with the VHT coordinators and handout certificates. As VHT members identify cases of malnutrition, they are advised to fill out a referral form and send the patient for further screening at IECM’s closest outreach location. VHT members are a valuable resource, bridging the gap between the formal health system and the households. IECM staff cannot reach individual households themselves but through this VHT training program, we are reaching farther than ever by strengthening the first line of care; the Village Health Team. 

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