VHTs Stemming Child Deaths in Pader

Seeing it from afar, you do not expect it to house much more than a laboratory and an examination room. But it boasts of a laboratory, examination room, store and an antenatal and labour ward. The health workers at the centre provide a good service, according to some of the residents here.

Farmer Richard Okello, 42, says that other than having to occasionally queue for services, he has no complaints He describes the treatment as “effective” and the staff as “receptive”.

Little wonder, then, that when thirty-year-old Milda Atuu started experiencing labour pains at midnight on June 19, she prepared herself for the journey to Ogom. At 4am, escorted by Kevina Oryema, her elderly mother-in-law, she began the three-kilometre walk from her village to the health centre. She arrived at 7am and two hours later, she gave birth to her seventh child, a boy.

Her baby is one of the few children at the health centre, an unexpected occurrence, seeing as children are known to need more hospital visits than adults. Their weaker immune systems mean they are more likely to fall ill.

Paul Oola Komakech, a senior clinical officer and Pader district health educator, says that for three years now, the scenario of health centres receiving fewer children than adults has been seen at a number of health facilities across a number of sub-counties in Pader.

He says this has happened as a result of the implementation of the Integrated Community Case Management (ICCM) programme, a system that involves members of village health teams (VHTs) treating children under age five from their communities.

Komakech says that with VHTs working, health centre resources, including health workers, are less stretched. More children aged five years and below are also receiving timely intervention which has resulted in better treatment outcomes and fewer deaths, Komakech says.

“Since ICCM started in March 2011, some 14,000 children have fully recovered and only 58 have died. More than 150 children used to die per year. These VHTs are doing a good job,” Komakech says.

How ICCM works:

The ICCM programme involves the training of VHTs in recognising symptoms of childhood illness such as malaria, diarrhea and pneumonia and giving them diagnostic tools such as timers (for pneumonia) and rapid diagnostic tools (for malaria) for disease diagnosis. They are also given medicine to treat childhood illnesses where they are found.

About 1,300 VHTs in five sub-counties in Pader have been trained to treat children by Save the Children.


During a June 19 ceremony to commission 140 trained VHTs at Ogom health centre III, the VHTs were given bicycles, in addition to the VHT kit that contains the “bible” that guides VHTs on diseases and their symptoms, diagnostic tools and medicine.

Godfrey Ayena, the manager of the Dutch Consortium for Rehabilitation (DCR), which funds Save the Children to train VHTs in Pader, says that the DCR funding is expected to stop in 2015.

“How are you looking to sustain ICCM?” he asked the district leadership at the June 19 ceremony.

It is hoped that government will step in and sustain ICCM. The importance of VHTs has been ably demonstrated in Uganda and other countries in Africa – such as Ethiopia.

However, the key challenge remains how to sustain them. Several African governments have been happy to benefit from the voluntary spirit that initially underpins VHT work. But as communities develop and the capitalist economic system takes root even in remote villages, VHTs are learning to put a value to the time spending voluntary work.

It has meant that without some form of motivation from an NGO or the government, the VHT model faces serious sustainability challenges. Last year, the minister of state for Primary Health Care, Sarah Achieng Opendi, suggested that the government planned to remunerate VHTs, but nothing concrete has been done.

The programme is being implemented in eight districts in Uganda, by organisations such as Save the Children and Malaria Consortium in these districts, fewer hospital visits and deaths in children under the age of five have been reported. This gives mothers more time to engage in productive activities.

It also gives women such as Atuu ample space to recuperate.

Source : The Observer

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