MINISTRY OF HEALTH
VHTVillage Health Team
Strategy and Operational Guidelines
VHT
Health Education and Promotion Division
March 2010
________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 3
ContentsForeword ........................................................................................... 5
Acknowledgements ............................................................................. 6
1. BACKGROUND ............................................................................. 7
2. JUSTIFICATION FOR THE VHT STRATEGY .................................... 9
3. VILLAGE HEALTH TEAM (VHT) ....................................................11
1. Criteria for selection ................................................................ 11
2. Qualities of a VHT Member ....................................................... 11
3. Composition of the VHT............................................................ 12
4. Objectives of VHT .................................................................... 12
5. The roles and responsibilities of a Village Health Team ................. 12
4. GUIDING PRINCIPLES FOR VHT STRATEGY ................................13
1. Community Ownership ............................................................. 13
2. Equity and Access ................................................................... 13
3. Community Support ................................................................ 13
5. IMPLEMENTATION STRATEGY ....................................................14
1. Advocacy, social mobilisation and communication ........................ 14
2. Networking and Partnerships .................................................... 14
3. Capacity Building ................................................................... 14
4. Resource Mobilisation .............................................................. 14
6. VHT CO-ORDINATION .................................................................15
1. National Level ......................................................................... 15
Stakeholders Forum ............................................................ 15
National Coordination Committee ......................................... 15
The Secretariat .................................................................. 16
2. District level ........................................................................... 17
3. Health Sub-District .................................................................. 17
4. Sub-County ............................................................................ 17 Cont
ents
4 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
5. Health Facility ......................................................................... 17
6. Community (Parish and LC1 Levels) ........................................... 18
7. MOTIVATION AND SUSTAINABILITY ..........................................19
1. Initial Incentives ..................................................................... 19
2. Continuous/consistent use of the VHTs ....................................... 19
3. VHTs health promotion initiatives .............................................. 19
4. Budgetary provision ................................................................ 20
5. Allowances ............................................................................. 20
6. Refresher Training of VHTs ....................................................... 20
7. Logistics and Supplies .............................................................. 20
8. Follow up, support Supervision and mentoring ............................ 20
9. Recognition and appreciation .................................................... 21
10. Preferential Treatment ............................................................. 21
11. Functional linkages between VHTs and health facilities ................. 21
12. Regular meetings .................................................................... 21
13. Study tours and exchange visits ................................................ 21
8. ROLES AND RESPONSIBILITIES OF DIFFERENT STAKEHOLDERS 22
1. Ministry of Health .................................................................... 22
2. Development Partners ............................................................. 22
3. Local Governments .................................................................. 22
4. Health Facilities ...................................................................... 23
5. Non Government Organization and Civil Society Organisations ...... 23
6. Local Council 1 Executive ......................................................... 23
7. Communities .......................................................................... 23
9. VHT IMPLEMENTATION GUIDELINES ..........................................24
10. STANDARDS FOR VHT IMPLEMENTATION ..............................38
Cont
ents
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 5
FOREWORD
Village Health Teams (VHTs) were established by the Ministry of Health to empower communities to take part in the decisions that affect their health; mobilize communities for health programs, and strengthen the delivery of health services at house-hold level.
The Primary Health Care principle recognizes that health services should be accessible, cost-effective, tailored to local needs, characterized by inter – sectoral co-operation and delivered with the participation of the people. It is envisaged that the VHT strategy will enable the realisation the Alma Ata Declaration, and the recent 2008 Ouagadougou Declaration on Primary Health Care and Health Systems in Africa to which Uganda subscribes.
According to the HSSP 2000/01 – 2005/06, the key challenge to the health care system is to extend basic health care service to the entire population especially in rural areas where access to healthcare is limited. It is in this regard that HSSP I recommended establishment of VHTs, HSSP II and HSSP III called for roll out and consolidation of the VHT strategy.
This Village Health Team (VHT) Strategy and Operational Guidelines therefore incorporates lessons learned during the nine years since the publication of the first Strategy and Plan in September 2001. It has been updated following a long consultation process with stakeholders and Partners.
This document is intended to facilitate a good understanding of the VHTs strategy. This is the official guide to individuals and organisations that plan to or are implementing community-based health activities in Uganda. The important point to note is that all health activities and interventions must be coordinated through the VHT structure. The Ministry of Health will not allow creation of parallel or competing community structures apart from the VHTs. It is our policy and guiding document which we hope all stakeholders and partners will follow and support as we strive for better health for all Ugandans.
Dr. Nathan Kenya-Mugisha
For: Director General Health Services
Fore
wor
d
6 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
ACKNOWLEDGEMENTS
The Ministry of Health would like to acknowledge with appreciation the resourceful support and facilitation received from UNICEF to review and finalise this document, together with the technical input from World Health Organization Country Office and Support to Health Sector Strategic Plan Project (SHSSPP).
Gratitude is extended to the Village Health Team Secretariat headed by Mr. Gilbert Muyambi and Mr. Samuel Ahimbisibwe which worked so hard to put this document in this current form.
The Ministry would also like to appreciate the input of various stakeholders during the preparation process who contributed information and ideas that enabled drafting of the document. In particular I want to thank my colleagues in the Ministry of Health, Officials from districts and SHSSPP, World Health Organisation and UNICEF; without their interest and willingness to share their experiences, the scope of this document would have been limited.
Particular mention is made of the following persons whose input and participation in various meetings enabled drafting to this document. Mr. Godfrey Kaggwa, Mr. Arsen Nzabakurikiza, Mr. Benjamin Sensasi, Dr. Geoffrey Bisoborwa, Mr. Collins Mwesigye, Dr. Charles Katureebe, Dr Claudia Hudspeth, Dr. Francine Kimanuka, Dr. Deo Sekimpi, Mr. Solomon Onyango and Ms. Rita Mwagale.
Dr. Paul Kagwa
Assistant Commissioner
Health Promotion and Education Division
Ack
now
ledg
emen
ts
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 7
1. BACKGROUND
Over the years, the Government of Uganda has been striving to improve the socio-economic standards of living through strategies such as the Poverty Eradication Action Plan (PEAP) and Vision 2020. These reforms, encapsulated in the Economic Recovery Program (ERP 1987) have aptly noted the significant role of health care delivery in development. Therefore, one of the fundamental missions of government has been improvement of health care for all in terms of provision, accessibility and utilization. Several studies in Uganda indicate unacceptably high morbidity and mortality rates from preventable diseases. Other studies have indicated that only about 49% of the population lives within five kilometres from a health facility.
In Uganda, over 75% of the diseases are preventable if only people changed and adopted appropriate and well known behaviors geared towards better health (MoH, 2005). Positive behaviors focusing on personal hygiene, sanitation, nutrition, sexual practices among others would improve the well being of many people and thus avert the high morbidity and mortality due to preventable diseases such as malaria, tuberculosis, upper respiratory infections, HIV/AIDS and childhood vaccine preventable diseases.
Implementation of health promotion and basic disease prevention measures at personal, family and community levels can turn the situation round and help the country make big strides toward the Millennium Development Goals and thus achieve better health and development for the people. Unfortunately, Uganda, like many African countries suffers from serious shortage of health human resources who would oversee and guide the people to implement these basic health interventions.
Community participation and empowerment is a strategy that enables communities to take responsibility for their own health and wellbeing and to participate actively in the management of their local health services. In the Uganda context, this will take the form of the Village Health Team (VHT).
The VHT will help to engender community participation in health and link the communities to the formal health service delivery system. This will also help bridge the current health human resource gap especially in rural or peripheral areas where the majority of the people live.
Establishment and utilization of VHTs demonstrates the commitment of Uganda to the aspirations and principles of the 1978 Alma Ata declaration and the 2008 Ouagadougou Declaration on Primary Health Care and Health Systems in Africa. These historic declarations emphasize fostering full community involvement in health and health care delivery in accordance with the primary health care approach. Inspiration for the VHT is also drawn from the 1986 Ottawa Charter on Health Promotion that calls for formulation of public health Se
ctio
n 1
8 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
policies, creation supportive environments, strengthening community action, developing personal skills and re-orienting health services all geared towards appropriate health care development and delivery.
According to the HSSP 2000/01 – 2005/06, the key challenge to the health care system is to extend basic health care service to the entire population especially in rural areas where almost thirty percent of the people live below the poverty line. It is in this regard that HSSP I recommended establishment of VHTs, HSSP II and HSSP III called for roll out and consolidation of the VHT strategy Village Heath Teams (VHTs) strategy was therefore conceived as a vehicle that could potentially help deliver much needed basic health care services direct to households and communities in Uganda.
Sect
ion
1
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 9
2. JUSTIFICATION FOR THE VHT STRATEGY
Health is recognised as one of the fundamental pillars of human and national development and this is not only consistent with Uganda’s development priorities but is also a commitment to achieving health related Millennium Development Goals (MoH, 2005). There is therefore a direct link between development and health outcomes at individual, community and national levels (MoFPED, 2001). Consequently, it is critical to foster an integrated approach to development tackling health from a development perspective. It is envisaged that engendering community participation and ownership through community-based structures such as VHTs will increase individual and community control over the determinants of health thereby contributing significantly to social-economic development of a country (WHO, 1986).
In Uganda as in other African countries, there is an acute shortage of health workers especially in rural and peripheral areas due to attrition, HIV/AIDS, migration or search for greener pastures (Lehmann and Sanders, 2007). This realisation makes initiation and widespread implementation of VHTs even more critical in order to reduce the workload on the few health workers or as a stop-gap measure in places where there is none.
Besides, in Uganda, more than 75% of the diseases are preventable (MoH, 2000) which can only be achieved through increased awareness, behavioural change and adoption of positive health practices. According to the National Health Policy, Health Sector Plans I, II and III the most effective way to achieve this is through interpersonal and group communication that VHTs can effectively perform in the villages where they live and are well known.
In addition, Uganda’s poor health indicators such as, low latrine coverage, falling immunization coverage, inadequate and inappropriate ITN use, malnutrition or the high total fertility rate can be partly tackled through constant dialogue with the community members using VHTs. Moreover, in Uganda geographical access to health care facilities is limited to only 49% of households due to long distance or other natural features such as marshes, rivers, hills, forests or mountains (MoH, 2000). VHTs will help bridge the gap that exists between the un-served households and the formal health system. In that sense, VHTs will be the first contact with the health system or indeed as health centre I and this is consistent with the “task-shifting” approach.
Sect
ion
2
10 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
In the past, MoH programmes undertook community activities in a vertical manner leading to fragmentation, duplication, wastage of resources and dissemination of conflicting messages. The table below shows some examples of the community based interventions that have been implemented vertically by MoH programmes vertically.
Programme Resource persons trained for community work
UCBHCA District and sub-county trainersParish Development committeesCommunity Health Workers
IMCICommunity Owned Resource PersonsCommunity Based Growth Promoters
MCPDistrict and sub-county trainersParish MobilisersDrug distributors
UNEPI Parish Mobilisers
RHCommunity Based Distributors for OCPTBAs
ACPCounselling AidesHome care providersCondom Distributors
EH&SWater Source CommitteesSanitation Aides (civil servants)
The VHT strategy is therefore meant to harmonise this arrangement so that MoH and partners approach the communities in an organised fashion that will increase efficiency and effectiveness of our programmes thus making them relevant to the communities.
The VHTs will also facilitate data collection at community level which will greatly assist in health planning and response in addition to undertaking disease surveillance and reporting especially in epidemic prone areas. There are also community resources that the VHTs can identify and harmonise to supplement the meagre district resources available for community activities.
Sect
ion
2
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 11
3. VILLAGE HEALTH TEAM (VHT)
The Village Health Team is a community based (village) structure whose members are selected by the people themselves to promote health and wellbeing of the people in their areas of residence/jurisdiction. It is the lowest health delivery structure and serves as a Health Centre I.
Criteria for selection1.
At the end of the village sensitisation meetings, the Village/Local Council I with the help of the trainer maps all households in the village and from every 25-30 households they select one member of the VHT, through a popular vote. VHTs must be selected by the community itself and not imposed by political structures. The number should on average be five members per team. Selection should be gender sensitive. Political leaders such as the LC I chairperson, vice chairperson and secretary are not be eligible for membership for purposes of ensuring checks and balances.
Potential VHT members may already be Community Health Workers, Traditional Birth Attendants, Drug distributors or similar if acceptable to the community. If a VHT member drops out, a new member will be identified from the community during the quarterly review meetings. The new member will acquire knowledge and skills from on-job training.
Qualities of a VHT Member2.
After successful sensitization of the community leaders, community members and other key stake holders on the importance of VHTs, the following criteria shall be used for selection:
Should be exemplary, honest, trustworthy and respected Y
Should be willing to serve as a volunteer Y
Must be a resident of the village Y
Should be available to perform specified VHT tasks Y
Should be interested in health and development matters Y
Should be a good mobilizer and communicator Y
Ideally should be able to read and write at least the local language Y
Should be dependable and approachable Y
Should be a good listener Y
Should be 18 years and above Y Sect
ion
3
12 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
Composition of the VHT 3.
The size of the team depends on the number of households in a given village. On average it should be one team member per 25-30 households. The more sparsely populated area is, the less the number of households per member. However in areas where people live in close proximity, the number of households per VHT member can be more than 30. The team selected per village must be gender balanced with at least a third of the members women. Each Village should have an average of five VHT members.
Objectives of VHT4.
The overall objective of the VHT strategy is to promote health at individual, family and community levels. Specific Objectives are:
To promote community participation and involvement in health1.
To promote positive health behaviour and practices 2.
To promote health care seeking behaviour3.
To strengthen timely health service delivery at community and 4. household levels
To promote community based health information system5.
To foster coordinated delivery of integrated services at community 6. level
The major roles and responsibilities of a Village Health Team5.
These shall include the following:
Home visiting Y
Mobilization of communities for utilization of health services Y
Health Promotion and Education Y
Community based case management of common ill health conditions Y
Follow up of the mothers during pregnancy and afterbirth and the Ynewborns for provision of advice, recognition of danger signs and referral
Follow up of people who have been discharged from health facility and Ythose on long term treatment
Distribution of health commodities Y
Community information management Y
Disease surveillance YSect
ion
3
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 13
4. GUIDING PRINCIPLES FOR VHT STRATEGY
The guiding principles for the VHT strategy will be the following:
Community Ownership1. The community is responsible for selection, supervision and support of the VHT. The VHTs are fully accountable to the communities in which they operate and their services/ responsibilities are community driven.
Equity and Access2. VHT services are meant to o benefit all members of the community especially those in rural peripheral areas or marginalised communities.
Community Support3. While performing their roles and responsibilities, the VHTs shall be supported by their own communities, local health facilities and local political structures.
Sect
ion
4
14 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
5. IMPLEMENTATION STRATEGIES
The following Strategies are recommended to facilitate implementation of VHT strategy:
Advocacy, social mobilisation and communication 1. This aims at creating awareness, building consensus, and gaining political commitment and support (e.g. resource allocation). Standardized communication strategies and materials for advocacy, and social mobilisation and communication coordinated by the Ministry of Health will be used for different target groups.
Networking and Partnerships 2. This will be between households, communities, VHTs, the health system, the political structure, community based organisations, development partners, community structures such as churches, schools and extension workers.
Capacity Building3. Training sessions will be conducted guided by the Ministry of Health for district facilitators and DHT members. The Ministry of Health and district health teams will ensure provision of Health Promotion materials, HMIS data collection tools and availability of basic VHT Kits. They will also build supervisory capacity at all levels in addition to improving the logistical distribution system to reach the VHTs.
Resource Mobilisation4. Functioning of VHTs requires continuous, harmonised pooled financial support, planning, and monitoring and well coordinated resource allocation. At all levels, there should a clear allocation of funds for integrated community level interventions through the VHT.
Sect
ion
5
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 15
6. VHT CO-ORDINATION
The Ministry of Health is the central player, leader and driving force of the Village Health Team Strategy. The Ministry shall coordinate advocacy and fund raising activities and also ensure that effective interventions are selected at district and local levels according to local needs but in conformity with national policy. All actors shall work within a common framework with standardised key messages, harmonised training and communication materials, and using the VHT as conduit for service delivery. Below is how the VHT will be coordinated at different levels.
National level1. Stakeholders ForumThere shall be a Stakeholders Forum whose membership includes; key Technical and Health Development Partners, Key Implementing Partners and Key funding Partners. The forum shall be responsible for coordination, VHT consensus building and experience sharing. The Stakeholders Forum shall be convened at least once a year. The health policy advisory committee shall steer this forum.
National Coordination CommitteeThe National Coordination Committee will work through the Basic Package Working Group. It will comprise of membership from the basic package Technical Working Group and shall meet quarterly.
Some of the membership shall include among others:
Ministry of Health programmes i.e. a.
Malaria Control Programme ♦
Reproductive Health Division ♦
Child Health Division ♦
Uganda National Expanded Programme on Immunization (UNEPI) ♦
Environmental Health Division ♦
Health Management Information System ♦
Nutrition Section ♦
National Tuberculosis and Leprosy Programme ♦
Health Planning Department ♦
AIDS Control Programme ♦
Neglected Tropical Diseases ♦
Support to Health Sector Strategic Plan 11 (SHSSPP2) ♦ Sect
ion
6
16 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
Other Government Ministries and Institutionsb.
Development Partnersc.
UNICEF ♦
World Health Organisation ♦
UNFPA ♦
USAID ♦
World Bank ♦
DANIDA ♦
SIDA ♦
ADB ♦
NGOs/CSOs (International and National) ♦
The functions of the National Coordination Committee shall be:
Leadership and stewardship ♦
Policy guidance ♦
Oversee progress ♦
Technical guidance ♦
Mobilise funding for VHT implementation ♦
The SecretariatThere shall be a Secretariat headed by the Assistant Commissioner for Health Promotion and Education. Health Promotion and Education shall be responsible for overseeing and coordinating the implementation of VHT at all levels. The Health Promotion and Education Division shall be the VHT National Coordination Office. The Roles of the secretariat shall include:
Harmonising of community based interventions of different programme Yand streamlining them into the National VHT plan
Guide activities of development partners to ensure effective coverage Yand logical synchronization of community based interventions
Documenting all the VHTs operations and activities Y
Sect
ion
6
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 17
District Level2. At district level, the District Health Officer (DHO) shall be responsible for overall planning, implementation and monitoring of VHT activities. He can delegate a member of the district health team to be responsible for the VHT activities. Through the Chief Administrative Officer, all other departments will be required to utilise and support the VHT structure to implement their health related community activities.
VHT activities shall be fully integrated into the District Health Development and Operational Plans and it will be the guiding document for community-level health interventions in the district.
All stakeholders and implementers are coordinated by the DHO and all community level health interventions coordinated through VHT.
Health Sub-DistrictThe in-charge of the Health Sub-District with the assistance of the Assistant Health Education office shall be responsible for overall planning and coordination VHT activities at the Health Sub-District level. VHT activities shall be integrated into the Health Sub-District work plan which is developed from Health centre level. The in-charge shall be responsible for sensitisation of sub-county leaders and will ensure that activities of partners working at sub-county level are included in the sub-county and health facility work plans which are eventually amalgamated into a Health Sub-district work plan. The in-charge and the Assistant Health Education Office will be the custodians of supplies and commodities that are used by the VHT
Sub-CountyThe In-charge of HCIII with assistance of other sub county VHT Trainers will be responsible for planning, implementation and monitoring of VHT activities in the sub county. The In-charge may delegate some of the responsibilities to an active and competent Health worker in-charge of the sub-county. The in-charge in collaboration with the sub-county chief shall ensure that the health activities of NGO’s are implemented through the VHTs.
Health FacilityHealth facilities of all levels shall be responsible for coordination, implementation, monitoring and evaluation of VHT activities within their areas of responsibility. Health Centres shall provide technical guidance to the VHTs, replenish Se
ctio
n 6
18 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
commodities and health supplies, hold regular meetings with VHT members, encourage them to participate in health unit activities and give them support supervision.
Community (Parish and LC 1Levels)This is the implementation level of VHT activities. The Community leaders (LC1 and Parish chief) will be responsible for coordination, overseeing and administrative (non-technical) supervision of VHT activities in their areas. The VHTs will be accountable to the community leaders. For proper function VHT members will select a team leader, a secretary and treasurer from amongst themselves and coordinator at parish level.
Sect
ion
6
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 19
7. MOTIVATION AND SUSTAINABILITY
VHT Members are expected to perform their roles and responsibilities on Voluntary basis, and yet they are expected to achieve the set objectives for the VHT strategy. The Ministry of Health therefore proposes some incentive mechanisms that may be used to reward and motivate the VHT members and thereby sustain the programme.
Initial Incentives1. The following shall be provided to the VHT as incentives to accept the assignment and begin work:
Good quality training Y
Award of certificates Y
Commissioning ceremony Y
Badges, T-shirts, bags Y
Job aides Y
IEC materials Y
Registers Y
Continuous/consistent use of the VHTs2. These will be required to sustain the services of the VHT and minimize attrition hence they should be provided on a continuous basis.
VHT is a government policy and it stipulates that all health activities at community level by the government, NGOs and or Partners targeting communities shall be coordinated through VHTs. This includes health promotion activities, campaigns and other health events and functions. This will keep VHT members engaged, will feel useful and benefit from the benefits of the programs’ activities including allowances. VHTs can also be assigned tasks like distribution of IEC materials. This in turn makes the community value and continue demanding and utilising their services.
Health Promotion Activities3. VHTs will be supported to initiate and organise health promotion initiatives like drama with health messages. This will serve as entertainment or recreation as well as education for community from which VHT members earn recognition. Se
ctio
n 7
20 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
Budgetary provision4. As a priority area in health service delivery, VHT activities should be planned and budgeted for at all levels from national to the village level. Local councils should put in place innovative financing mechanisms to support VHT. Areas for budgeting include but not limited to the following:
Support supervision Y
Facilitation for regular meetings between VHT, health workers and Ytrainers
Allowances for VHTs. The Ministry of Health and District Local YGovernment shall advise on the rates from time to time to guide actors for purposes of harmonisation. A minimum monthly stipend of $5 (UGX 10000) which can be paid quarterly during the Quarterly Review and planning meetings)
Monitoring Y
Task Specific Allowances5. Government, NGO’s and Partners will facilitate VHTs in the performance of specific extraordinary tasks. Such allowances will cover items like transport and lunch.
Refresher Training of VHTs6. The VHTs shall undergo continuous refresher and update training organized by Government, NGO’s and Partners using standardized VHT materials, additional modules for specific services and other specific areas like: Malaria, Reproductive Health, Child Health and others. This will improve their knowledge and skills and also motivate them to keep serving as VHT members.
Logistics and Supplies7. There should be a constant supply of medicines and supplies and other logistical support to enable VHTs provide services to their clients including their own families all the time. Once there is shortage of these supplies the VHTs may be demeaned by the community which may lead to frustration.
Follow up, support Supervision and mentoring8. VHTs will receive regular follow up and supervision from their trainers and health workers. During supervision VHTs will be supported to improve their skills. Where necessary, VHTs will be offered apprenticeship training at the health facility to get hands on training.Se
ctio
n 7
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 21
Recognition and appreciation by health workers, leaders and 9. community
Leaders at all levels shall be oriented to recognize and show appreciation of the services of VHTs in public. This works as a marketing strategy for the services of the VHTs and also makes them feel important and that their services are valued and hence keep serving.
Preferential treatment10. Aside from the medical criteria for priority treatments, VHT shall be given preferential treatment at health facilities and other services in the community
Functional linkages between VHTs and health facilities11. VHTs will be closely linked to the health facilities. They will receive apprentiship training at health facilities. Health facilities will be oriented to honor referrals from VHTs and refer discharged patients where necessary for follow up in the community.
Regular meetings between trainers, health workers and VHTs 12. (Including community leaders)
There will be quarterly meetings between VHTs, Health facility staff including the trainers/supervisors and LC I chairpersons, Parish Chiefs and LC II Chairperson. During the meetings, VHTs will be able will share experiences, present their reports and obtain feedback. The meetings will also be used as opportunity to provide refresher trainings to VHTs. At the end of the meeting, all those attending will get a transport refund of UGX 5000. In addition, VHTs will be given their monthly stipend for the previous quarter.
Study tours and exchange visits13. Government and Partners shall from time to time organize study tours and exchange visits for VHTs. This will enable VHTs to learn through observation of best practices within and outside their own districts. Travel and its associated fun and allowances will serve as a motivation for the VHTs.
Sect
ion
7
22 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
8. ROLES AND RESPONSIBILITIES OF DIFFERENT STAKEHOLDERS
Ministry of Health1. To provide policy framework for the establishment, functioning, monitoring and evaluation of the VHTs. The Ministry will specifically:
Define minimum package of services and standards to be provided Yby VHT
Provide guidelines on recruitment, retention, facilitation and motivation Yof VHTs
Policies to link VHTs with health and health related interventions Y
To ensure availability of medicines and supplies as provided for in the Ypackage
MOH to take lead in resource mobilization for VHTs Y
To provide overall coordination and supervision in VHT implementation Y
To link up with relevant ministries to harmonise policy frameworks in Ysupport of VHTs.
Local Governments2. To integrate VHT strategy into their development and operational Yplans
To allocate and avail resources for implementation of activities Y
To formulate, pass and enforce by-laws in support of VHT functions Y
To promote intersectoral collaboration in the local government Y
To ensure harmonised and integrated implementation of health Yactivities at community level using VHTs.
To ensure that all those delivering community based health care Yinterventions do so through VHTs and avoid creating other parallel structures
Development Partners3. To contribute to policy development, monitoring and evaluation Y
To provide technical, financial and logistical support for the Yoperationalization of the VHT strategy
To support documentation and sharing of best practices Y
Sect
ion
8
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 23
Non Government Organization and Civil Society Organisations4. Participate in joint planning with Government Health planning authority Yat all levels
Facilitate functioning of VHTs in accordance with the National Strategy YGuidelines
Integrate their community based health programmes into the district YVHT plan
Promote and raise the profile of the VHT strategy Y
Sensitize communities on the roles of VHTs Y
Health Facilities5. To take overall technical responsibility for all VHT activities within Ytheir areas of responsibility
Conduct training and supervision of VHTs Y
Support management of medicines and supplies for VHTs Y
To regularly organize planning, review meetings and refresher Yprogrammes with VHTs in their catchment areas
To receive, analyze, utilize VHT data and provide feedback Y
Local Council 1 Executive 6. To advocate for VHTs Y
Sensitize communities on the roles of VHTs Y
Provide time for VHTs to talk about health issues at community Ymeetings and other public gatherings
Enforce implementation of advice based on recommendations given Yby VHTs on health issues
Initiate and implement motivation schemes for VHTs Y
Participate and also mobilise communities to participate in VHT Yinitiated activities
Communities7. Volunteer for VHT work Y
Select VHT according to the national guidelines Y
Seek and utilize and the services of the VHT Y
Recognize and appreciate the services of VHT Y
Help VHTs to collect medicines and supplies from heath centres Y
Report health incidences in the community to VHTs Y
Respond to the call for community activities initiated by VHTs Y Sect
ion
8
24 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
9. VHT IMPLEMENTATION GUIDELINES
The VHT Operation Guidelines provide a benchmark for VHT implementation at different levels and identifies roles and responsibilities for each party at the following levels:-
National Level Y
District Level Y
Health Sub-District Level Y
Sub-county Level Y
Parish Level Y
Community Level Y
The Guidelines specify in detail what activities that needs to be done at each level and how each activity will be done. It also identifies the responsible person or officer for a particular activity, source of funding and the indicators to show that that a particular activity has been accomplished.
Coordination and Networking
At all levels Government will be the lead and coordinating agency for VHT implementation, but all other stakeholders willing to work towards the common goal will be free to participate in a coordinated way. With Ministry of Health and District Health Offices in the lead, all stakeholders need to be brought on board, but in a coordinated way.
At national level all stakeholders supporting the VHT Strategy must do so through Ministry of Health.
At District level all stakeholders must support the VHT Strategy through the District Health Office, similarly at HSD and SC levels.
Lastly, all community level health interventions will be coordinated through the VHT.
Advocacy
Taking into account the issues in the Background to VHT strategy, advocacy will remain a key intervention for the acceptance, adequate resourcing and successful implementation of the VHT Strategy.
Sect
ion
9
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 25
Capacity Building
Capacity building shall include the clarifying of the rationale/justification of the VHT Strategy. The information and training for district level sensitisation, Training of Trainers and Initial Training of VHT shall have standard materials approved by Ministry of Health.
The VHT members should have continuous capacity building after the initial training. This should involve refresher training, hands-on work at the nearest Health Unit and regular supervision by the VHT Trainers/Supervisors.
Supervision
VHT Supervision is one of the main determinants for the SUSTAINABILITY of the VHT Strategy. The most critical supervision is that of VHT members by their VHT Trainers/ Supervisors. Adequate thought and resources need to be allocated to this.
Reporting and Feed back
Reports need to be timely so as to be useful for planning and decision making. Reports should be discussed by all key stakeholders so that they form the basis for continuous improvement of health. The Quarterly VHT Meetings should discuss reports from the previous three months.
Monitoring and Evaluation
There must be a mechanism to find out whether VHT activities are implemented according to the set guidelines, monitor the activities of the VHT and eventually evaluate the VHT impact on health.
Planning and Budgeting
The main mobiliser of financing for the VHT Strategy is Government on behalf of the people of Uganda. Partners should continue to support where necessary. Districts are also encouraged to include VHT activities in their work plans and budget for them especially supervision of VHTs.
Sect
ion
9
26
___
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
_Stra
tegy
and O
pera
tiona
l Guid
eline
s
MA
TR
IX F
OR
VH
T O
PER
ATIO
NA
L G
UID
ELIN
ES
NA
TIO
NA
L L
EV
EL
Are
a o
f fo
cus
Wh
at
wil
l b
e d
on
eH
ow
it
wil
l b
e d
on
eP
ers
on
R
esp
on
sib
leS
ou
rce o
f Fu
nd
ing
Ind
icato
rs
Coord
inat
ion
and
Net
work
ing
Est
ablis
h a
nd o
per
atio
nal
ize
nat
ional
coord
inat
ing
com
mitte
e an
d s
ecre
tariat
Dev
elop s
trat
egy,
guid
elin
es
• an
d s
tandar
ds
Hold
quar
terly
mee
tings
• D
isse
min
ate
guid
elin
es•
Dev
elop a
sca
le-u
p p
lan f
or
• VH
T im
ple
men
tation.
MO
H
• sp
ecifi
cally
D
HS (
C&
C),
Sec
reta
riat
(ACH
S-H
P&E
Offi
ce)
Min
istr
y of
• H
ealth
Part
ner
s•
Min
ute
s of
• m
eetings
Nat
ional
•
Coord
inat
ion
Com
mitte
e in
pla
ceSec
reta
riat
in
• pla
ce
Advo
cacy
Rai
se p
rofile
of VH
T d
evel
opin
g
conse
nsu
s ab
out
the
nee
d f
or
VH
T a
nd M
obili
zing s
upport
in
cludin
g fi
nan
cial
support
Lobbyi
ng f
or
reso
urc
es•
Orien
tation o
f par
tner
s,
• polit
ical
lea
der
s, lin
e m
inis
trie
s an
d d
istr
ict
auth
orities
, re
ligio
us
org
anis
atio
ns,
Tra
ditio
nal
le
ader
s an
d o
ther
nat
ional
st
akeh
old
ers.
H
ave
in p
lace
sta
ndar
dis
ed
• ad
voca
cy t
ools
The
Sec
reta
riat
Min
istr
y of
• H
ealth
Part
ner
s•
Num
ber
of tim
es
• st
akeh
old
ers’
fo
rum
has
met
Part
icip
atio
n o
f •
stak
ehold
ers
in
VH
T a
ctiv
itie
s
Cap
acity
build
ing
Dev
elop t
rain
ing p
lan,
• D
evel
op t
rain
ing m
ater
ials
• Tec
hnic
al s
upport
to d
istr
icts
•
for
VH
T c
apac
ity
build
ing
Conduct
dis
tric
t le
vel
• orien
tation for
lea
der
sConduct
dis
tric
t tr
ainin
g o
f •
trai
ner
sM
onitor
trai
nin
g a
t lo
wer
•
leve
lsD
evel
op a
nd a
vail
•
imple
men
tation g
uid
elin
es
to b
e a
dher
ed t
o b
y th
e M
OH
, Pa
rtner
s, dis
tric
ts a
nd
NG
Os
Tra
inin
g
• Sen
sitisa
tions
• Fi
eld t
rips
• Sem
inar
s •
work
shops
•
The
• Sec
reta
riat
Nat
ional
•
Tra
iner
s
Min
istr
y of
• H
ealth
Part
ner
s•
Nat
ional
•
Coord
inat
ion
Com
mitte
eA V
HT tr
ainin
g
• pla
n in p
lace
, VH
T t
rain
ing
• m
ater
ials
in p
lace
Tec
hnic
al S
upport
•
Tea
m t
o a
ssis
t dis
tric
ts w
ith V
HT
capac
ity
build
ing
Section 9
Stra
tegy
and O
pera
tiona
l Guid
eline
s_____
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
__
27
Super
visi
on
Conduct
support
super
visi
on
• to
the
dis
tric
t hea
lth t
eam
Incl
ude
VH
T s
uper
visi
on in
• th
e quar
terly
Are
a Tea
m v
isits
Rev
iew
dis
tric
t VH
T r
eport
s•
Conduct
tec
hnic
al s
upport
•
super
visi
on
Sec
reta
riat
• Tra
iner
s •
Nat
ional
Co-
• ord
inat
ing
Com
mitte
e
Min
istr
y of
• H
ealth
Part
ner
s•
Rep
ort
s of
• quar
terly
area
te
am v
isits
Support
•
super
visi
on
report
s to
dis
tric
ts
Rep
ort
ing a
nd
feed
bac
k
Dev
elop a
dis
tric
t re
port
ing
• fo
rmat
Des
ign a
com
pute
r pro
gra
m
• to
cap
ture
all
dat
aPr
oduce
quar
terly
and
• an
nual
re
port
s
Rec
eive
rep
ort
s fr
om
dis
tric
ts
• ab
out,
tra
inin
g,
activi
ties
, fu
ndin
g a
gen
cies
an
d o
ther
sCom
pile
info
rmat
ion into
a
• dat
a bas
eRec
eive
quer
ies
and inquirie
s •
about
VH
T a
nd r
espond
acco
rdin
gly
Mak
e fe
ed-b
ack
report
s to
all
• dis
tric
ts a
bout
VH
T a
ctiv
itie
s co
untr
ywid
ePr
ovi
de
a co
mpre
hen
sive
•
report
for
the
Annual
Nat
ional
H
ealth A
ssem
bly
The
• Sec
reta
riat
M
oH
Res
ourc
e •
Cen
tre
Min
istr
y of
• H
ealth
Part
ner
s•
Rep
ort
s•
NH
A r
eport
• D
atab
ase
•
Monitoring
and
eval
uat
ion
Monitoring
Chec
klis
t fo
r D
evel
op a
nd
• av
ail im
ple
men
tation
guid
elin
es t
o b
e a
dher
ed
to b
y th
e M
OH
, Pa
rtner
s,
dis
tric
ts a
nd N
GO
sRev
iew
ing d
istr
ict
report
s•
Conduct
ing s
upport
•
super
visi
on
Eva
luat
ion
Conduct
a m
id-t
erm
rev
iew
•
ever
y tw
o y
ears
Conduct
a c
om
pre
hen
sive
•
eval
uat
ion e
very
five
yea
rsConduct
fiel
d r
esea
rch
•
The
• se
cret
aria
tD
evel
opm
ent
• Pa
rtner
sM
OH
•
Progra
mm
esRes
ourc
e •
Cen
tre
Univ
ersi
ties
/ •
rese
arch
in
stitutions
Min
istr
y of
• H
ealth
Part
ner
s•
Hav
e a
funct
ional
•
M&
E P
rogra
mm
e in
pla
ce(D
evel
op
• in
dic
ators
fro
m
activi
ties
)Eva
luat
ion r
eport
•
Section 9
28
___
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
_Stra
tegy
and O
pera
tiona
l Guid
eline
s
Plan
nin
g a
nd
budget
ing
Ensu
re t
her
e is
a V
HT
• Budget
lin
e su
pport
ed b
y M
OFP
ED
at
nat
ional
and
dis
tric
t le
vels
Dev
elop b
udget
s an
d
• pro
posa
ls
Proje
ct fi
nan
cial
req
uirem
ents
•
for
VH
TM
obili
se f
undin
g t
o s
upport
•
VH
TAdvo
cate
for
funds
•
Plan
nin
g
• Sec
reta
riat
Min
istr
y of
• H
ealth
Part
ner
s•
Sta
kehold
ers
foru
m
Section 9
Stra
tegy
and O
pera
tiona
l Guid
eline
s_____
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
__
29
DIS
TR
ICT
LEV
EL
Are
a o
f fo
cus
Wh
at
wil
l b
e d
on
eH
ow
it
wil
l b
e d
on
eP
ers
on
R
esp
on
sib
leS
ou
rce o
f Fu
nd
ing
Ind
icato
rs
Coord
inat
ion/
Linka
ges
Build
Multis
ecto
ral
• par
tner
ship
s an
d lin
kages
in
support
of th
e VH
T S
trat
egy
in t
he
Dis
tric
tBuild
Multis
ecto
ral
• par
tner
ship
s an
d lin
kages
in
support
of th
e VH
T S
trat
egy
in t
he
Dis
tric
t
Orien
tation lea
der
s an
d
• par
tner
s in
key
sta
kehold
ers
im
ple
men
ting a
ctiv
itie
s at
co
mm
unity
leve
l M
ainta
in D
HT c
ohes
ion
• on iss
ues
of
VH
T S
trat
egy
imple
men
tation
Defi
ne
and m
ainta
in
• lin
kages
with o
ther
Dis
tric
t D
epar
tmen
ts,
DPs
, N
GO
s,
CBO
s an
d a
ny
oth
er d
efined
st
akeh
old
ers
Defi
ne
and m
ainta
in lin
kages
•
with H
SD
s an
d S
Cs
on V
HT
issu
esO
rien
tation
lead
ers
and
• par
tner
s in
key
sta
kehold
ers
im
ple
men
ting a
ctiv
itie
s at
co
mm
unity
leve
l M
ainta
in D
HT c
ohes
ion
• on iss
ues
of
VH
T S
trat
egy
imple
men
tation
Defi
ne
and m
ainta
in
• lin
kages
with o
ther
Dis
tric
t D
epar
tmen
ts,
DPs
, N
GO
s,
CBO
s an
d a
ny
oth
er d
efined
st
akeh
old
ers
Defi
ne
and m
ainta
in lin
kages
•
with H
SD
s an
d S
Cs
on V
HT
issu
es
DH
O a
ssis
ted
• by
the
DH
E o
r oth
er n
amed
per
son in t
he
Dis
tric
t •
serv
ing
as V
HT
Coord
inat
or
CAO
to
• ch
air
the
D
istr
ict
VH
T
Coord
inat
ion
mee
ting
Min
istr
y of
• H
ealth
Min
istr
y •
of Lo
cal
Gove
rnm
ent,
Oth
er
• Pa
rtner
s
Inte
r-se
ctora
lD
istr
ict
VH
T
Coord
inat
ion
Com
mitte
eM
inute
s an
dre
port
s of m
eetings
Section 9
30
___
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
_Stra
tegy
and O
pera
tiona
l Guid
eline
s
Advo
cacy
Rai
se p
rofile
of VH
T•
Dev
elopin
g c
onse
nsu
s •
about
the
nee
d for
VH
T a
nd
Mobili
zing s
upport
in
cludin
g
finan
cial
for
VH
T
Enlis
t co
llabora
tion a
nd
• su
pport
of par
tner
s Id
entify
the
stak
ehold
ers
•
Org
anis
e D
istr
ict
VH
T
• Advo
cacy
foru
ms
Use
and d
isse
min
ate
VH
T
• ad
voca
cy t
ools
Sen
sitisi
ng a
nd lobbyi
ng
• dis
tric
t polit
ical
lea
der
s,
dis
tric
t dep
artm
ents
and
const
ituen
cy a
nd s
ub-c
ounty
le
ader
s, r
elig
ious
lead
ers,
tr
aditio
nal
lea
der
s an
d o
ther
dis
tric
t st
akeh
old
ers.
Tra
nsl
ate
sta
ndar
dis
ed
• ad
voca
cy t
ools
into
loca
l la
nguag
e(s)
Map
the
VH
T p
artn
ers
and
• th
eir
VH
T a
ctiv
itie
s in
the
dis
tric
tCoord
inat
e th
e dis
sem
inat
ion
• of
VH
T m
ater
ials
Lo
bby
stak
ehold
ers/
par
tner
s •
to b
uy
in a
ll ke
y ar
eas
of
colla
bora
tions
Dev
elop a
thre
e to
five
yea
r
• D
istr
ict
VH
T m
aste
r pla
nEnsu
re t
hat
all
VH
Ts
mat
eria
ls
• ar
e co
llect
ed f
rom
Min
istr
y of
Hea
lth a
nd a
re d
istr
ibute
d t
o
all H
ealth S
ub-D
istr
icts
and
Sub-C
ounties
.D
istr
ict
Tec
hnic
al P
lannin
g
• co
mm
itte
eThro
ugh b
udget
confe
rence
•
mee
ting
Dis
tric
t H
ealth
• O
ffice
r
Min
istr
y of
• H
ealth /
M
inis
try
• of Lo
cal
Gove
rnm
ent
Oth
er
• Pa
rtner
s
VH
T in
corp
ora
ted
in d
istr
ict
pla
n a
nd
budget
pla
n
Section 9
Stra
tegy
and O
pera
tiona
l Guid
eline
s_____
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
__
31
Cap
acity
build
ing
Conduct
HSD
/SC lev
el V
HT
• se
nsi
tisa
tion
Car
ry o
ut
Dis
tric
t Tra
inin
g o
f •
VH
T T
rain
ers
with b
ack
up
of M
OH
Super
vise
, bac
k up a
nd
• M
onitor
trai
nin
g o
f VH
Ts
at
low
er lev
els
(HSD
/SC)
Tec
hnic
al s
upport
to H
SD
s/•
SCs
for
continuous
VH
T
capac
ity
build
ing
Tra
in H
SD
/SC T
rain
ers
for
• su
per
visi
on o
f VH
T a
ctiv
itie
s
A
Dis
tric
t VH
T t
rain
ing p
lan,
• Colle
ct f
rom
MO
H V
HT
• tr
ainin
g m
ater
ials
and if
nec
essa
ry t
ransl
ate
them
into
th
e lo
cal la
nguag
e(s)
Provi
de
tech
nic
al s
upport
to
• H
SD
s an
d S
ub-C
ounties
for
VH
T c
apac
ity
build
ing
Dev
elop D
istr
ict
VH
T
• su
per
visi
on P
lan
Dev
elop D
istr
ict
VH
T M
& E
•
Plan
DH
T•
MoH
• D
istr
ict
Loca
l •
Gove
rnm
ent
Oth
er
• Pa
rtner
s
Inte
r-se
ctora
lD
istr
ict
VH
T
Coord
inat
ion
Com
mitte
eTra
inin
g p
lan
Tra
inin
g r
eport
s
Super
visi
on
Monitor
super
visi
on c
arried
•
out
by
HSD
s an
d S
Cs
Colla
te s
uper
visi
on r
eport
s•
Incl
ude
VH
T s
uper
visi
on in
• al
l D
HT fi
eld/s
uper
visi
on
visi
tsD
HT m
ember
s to
att
end
• a
spec
ified
num
ber
of
Quar
terly
Sub-C
ounty
VH
T
Mee
tings
in d
iffe
rent
HSD
s/SCs
ever
y quar
ter
Use
sta
ndar
d c
hec
k lis
t an
d
• or
super
visi
on form
sThe
secr
etar
iat
mem
ber
s to
•
atte
nd a
spec
ified
num
ber
of Q
uar
terly
Sub-C
ounty
VH
T M
eetings
in d
iffe
rent
dis
tric
ts e
very
quar
ter
Use
sta
ndar
d c
hec
k lis
t •
and o
r su
per
visi
on form
s•
Provi
de
a ch
eck
list
and o
r •
super
visi
on form
s to
HSD
an
d S
C V
HT T
rain
ers
Conduct
support
super
visi
on t
o
the
HSD
s an
d s
ub c
ounty
lev
els
DH
E o
r •
oth
er n
amed
D
istr
ict
VH
T
Coord
inat
or
Min
istr
y of
• H
ealth /
M
OLG
/Oth
er
Part
ner
s
Inte
r-se
ctora
lD
istr
ict
VH
T
Coord
inat
ion
Com
mitte
e
Section 9
32
___
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
_Stra
tegy
and O
pera
tiona
l Guid
eline
s
Rep
ort
ing a
nd
feed
bac
k
Adopt
nat
ional
form
at a
nd
• co
nte
nt
of VH
T R
eport
s fr
om
H
SD
s an
d S
Cs
Ensu
re r
eport
ing c
om
pat
ible
•
with H
MIS
Rec
eive
VH
T r
eport
s fr
om
•
HSD
s an
d S
Cs
about
all VH
T t
rain
ing a
nd
• fiel
d,
activi
ties
Com
pile
info
rmat
ion into
a
• D
istr
ict
VH
T d
ata
bas
ePr
ovi
de
a co
mpre
hen
sive
•
report
for
MO
H R
esourc
e Cen
tre
and l V
HT S
ecre
tariat
Com
pile
an A
nnual
VH
T
• Rep
ort
for
the
Dis
tric
t Tec
hnic
al a
nd P
lannin
g
Com
mitte
e Pr
ovi
de
fee
d-b
ack
of
all
• ag
gre
gat
ed r
eport
s to
all
HSD
s an
d S
Cs
about
VH
T
activi
ties
and C
om
munity
Bas
ed H
ealth I
ndic
ators
Dev
elop a
dis
tric
t re
port
ing
• fo
rmat
com
pat
ible
with H
MIS
Est
ablis
h a
Dis
tric
t D
ata
bas
e •
for
VH
T a
ctiv
itie
s Pr
oduce
quar
terly
report
s
• docu
men
ting z
ero r
eport
ing
Produce
annual
rep
ort
•
DH
O•
Min
istr
y of
• H
ealth
Dis
tric
t•
LG/O
ther
• Pa
rtner
s•
Inte
r-se
ctora
lD
istr
ict
VH
TCoord
inat
ion
Com
mitte
eD
istr
ict
VH
T
dat
abas
e in
pla
ce
Monitoring
and
eval
uat
ion
Adopt
and u
se t
he
nat
ional
•
monitoring a
nd e
valu
atio
n
chec
klis
t.
Monitor
to e
nsu
re t
hat
•
guid
elin
es a
re a
dher
ed t
o b
y th
e dis
tric
ts a
nd N
GO
s during
imple
men
tation
Conduct
a m
id-t
erm
rev
iew
•
com
pre
hen
sive
ev
aluat
ion
of
all D
istr
ict
VH
T a
ctiv
itie
sRev
iew
ing H
SD
/SC V
HT
• re
port
sConduct
oper
atio
nal
fiel
d
• re
sear
ch
DH
O•
Min
istr
y of
• H
ealth
Dis
tric
t•
LG/O
ther
• Pa
rtner
s•
Chec
klis
t ad
opte
dM
id-t
erm
rev
iew
Rep
ort
s av
aila
ble
Section 9
Stra
tegy
and O
pera
tiona
l Guid
eline
s_____
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
__
33
Plan
nin
g a
nd
budget
ing
Budget
and m
obili
se f
unds
• Rat
ional
allo
cation o
f fu
nds
• fo
r VH
T a
ctiv
itie
s in
the
Dis
tric
t
Dev
elop p
lans
and b
udget
s
• bas
ed o
n d
efined
VH
T
activi
ties
in t
he
dis
tric
tAdvo
cacy
and lobbyi
ng f
or
• VH
T f
undin
gEnsu
re t
her
e is
a V
HT B
udget
•
line
at D
istr
ict,
HSD
and S
C
leve
lsM
obili
se f
unds
for
VH
T f
rom
•
MO
H,
oth
er G
OU
Min
istr
ies
and A
gen
cies
, D
evel
opm
ent
Part
ner
s, p
riva
te s
ecto
r,
NG
Os
and o
ther
leg
itim
ate
sourc
es
DH
O’s
Offi
ce•
Min
istr
y of
• H
ealth
MO
LG/O
ther
•
Part
ner
s
Plan
s Budget
allo
cation
Section 9
34
___
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
_Stra
tegy
and O
pera
tiona
l Guid
eline
s
HEA
LTH
SU
B D
ISTR
ICT
Are
a o
f fo
cus
Wh
at
will b
e d
on
eH
ow
it
will b
e d
on
eP
ers
on
R
esp
on
sib
leS
ou
rce o
f Fu
nd
ing
Ind
icato
rs
Coord
inat
ion
Inco
rpora
te a
ll VH
T
• ac
tivi
ties
in t
he
HSD
pla
n
Dev
elop H
SD
VH
T
• Im
ple
men
tation P
lan
Coord
inat
e a
ll H
SD
•
and S
C e
ffort
s to
war
ds
imple
men
ting th
e VH
T
Str
ateg
y in
the
HSD
Iden
tify
ing a
ll VH
T
• st
akeh
old
ers
in t
he
HSD
Org
anis
ing q
uar
terly
VH
T
• Coord
inat
ion m
eetings
in t
he
HSD
HSD
in
-•
char
ge
Min
istr
y of
• H
ealth/D
LG/
DPs
/NG
Os/
CBO
sO
ther
•
par
tner
s
Min
ute
s Q
uar
terly
Rep
ort
s
Super
visi
on
Dev
elop V
HT T
rain
ing
• su
per
visi
on P
lan
Orien
t Sub-C
ounty
VH
T
• tr
ainer
s on s
uper
visi
on
skill
s fo
r VH
Ts
Conduct
support
•
super
visi
on t
o t
he
Sub-
Counties
, Pa
rish
es a
nd
Vill
age
in t
he
HSD
Car
ry o
ut
support
•
super
visi
on t
o low
er h
ealth
units
Monitor
VH
T im
ple
men
tation
• ac
tivi
ties
M
onitor
super
visi
on c
arried
•
out
by
Sub-C
ounty
VH
T
Tra
iner
sConduct
Sub-C
ounty
lev
el
• se
nsi
tisa
tion t
oget
her
with
Sub-C
ounty
VH
T T
rain
ers
Part
icip
ate
in
dis
tric
t •
trai
nin
g o
f Sub-C
ounty
VH
T
trai
ner
sSuper
vise
and M
onitor
• tr
ainin
g a
t Sub-C
ounty
and
Parish
lev
els
Tec
hnic
al s
upport
to S
ub-
• County
VH
T t
rain
ers
for
VH
T
capac
ity
build
ing
Ass
ista
nt
• H
ealth
Educa
tor
or
nam
ed
HSD
VH
T
Coord
inat
or
Min
istr
y of
• H
ealth/D
LG/
DPs
/NG
Os/
CBO
sO
ther
•
par
tner
s
Super
visi
on
report
s
Section 9
Stra
tegy
and O
pera
tiona
l Guid
eline
s_____
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
__
35
Rep
ort
ing
and f
eedbac
k
Updat
e th
e ar
ea M
P on V
HT
• im
ple
men
tation
Ensu
re V
HT r
eport
ing f
rom
•
all VH
T m
ember
s an
d S
C
VH
T T
rain
ers
in t
he
HSD
is
co
mpat
ible
with M
OH
HM
IS
form
at
Colla
te S
C V
HT s
uper
visi
on
• re
port
s in
to H
SD
super
visi
on
report
Adopt
an H
SD
VH
T
• re
port
ing f
orm
at c
om
pat
ible
w
ith
MO
H H
MIS
Rec
eive
month
ly/q
uar
terly
• VH
T r
eport
s fr
om
SC V
HT
Tra
iner
s ab
out
all VH
T
activi
ties
in t
he
HSD
Com
pile
info
rmat
ion into
•
a m
onth
ly/q
uar
terly
and
annual
H
SD
VH
T r
eport
,
accu
mula
ted t
o a
com
pute
r bas
ed
HSD
VH
T d
ata
bas
eM
ake
feed
-bac
k re
port
s to
•
all SCs
about
aggre
gat
ed
VH
T a
ctiv
itie
s in
the
HSD
Provi
de
a co
mpre
hen
sive
•
HSD
VH
T r
eport
to D
HO
HSD
In-
• ch
arge
Min
istr
y of
• H
ealth/D
LG/
DPs
/NG
Os/
CBO
sO
ther
•
par
tner
s
Rep
ort
s
Monitoring
and
eval
uat
ion
Dev
elop a
nd im
ple
men
t •
HSD
VH
T M
onitoring a
nd
Eva
luat
ion P
lan M
ake
sure
im
ple
men
tation g
uid
elin
es
are
adher
ed t
o b
y th
e su
b-
counties
Conduct
ing M
onitoring
• vi
sits
Part
icip
ate
in m
idte
rm
• re
view
s an
d 5
yea
r ev
aluat
ion
Rev
iew
SC V
HT r
eport
s•
Conduct
oper
atio
nal
fiel
d
• re
sear
ch
Acq
uire
and u
se V
HT
• im
ple
men
tation g
uid
elin
es
and s
tandar
ds
dev
eloped
by
MO
H
HSD
In-
• ch
arge
Min
istr
y of
• H
ealth/D
LG/
DPs
/NG
Os/
CBO
sO
ther
•
par
tner
s
Monitoring r
eport
sRes
earc
h r
eport
s
Plan
nin
g
and
budget
ing
Inco
rpora
te V
HT a
ctiv
itie
s •
in H
SD
pla
nConduct
pla
nnin
g m
eetings
• H
SD
In-
• ch
arge
Min
istr
y of
• H
ealth/D
LG/
DPs
/NG
Os/
CBO
sO
ther
•
par
tner
s
VH
T a
ctiv
itie
s in
cluded
in H
SD
pla
ns
Section 9
36
___
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
_Stra
tegy
and O
pera
tiona
l Guid
eline
s
SU
B C
OU
NTY
Are
a o
f fo
cus
Wh
at
will b
e d
on
eH
ow
it
will b
e d
on
eP
ers
on
R
esp
on
sib
leS
ou
rce o
f Fu
nd
ing
Ind
icato
rs
Coord
inat
ion
Coord
inat
e al
l VH
T
• ac
tivi
ties
in t
he
sub
county
and m
ake
sure
th
at a
ll co
mm
unity
leve
l hea
lth inte
rven
tions
are
imple
men
ted t
hro
ugh t
he
VH
Ts
Linki
ng V
HTs
to t
he
hea
lth
• fa
cilit
ies
Pass
enab
ling b
y-la
ws
• O
rgan
ise
a hea
lth f
oru
m f
or
• al
l st
akeh
old
ers
in t
he
sub
county
HC I
II I
n-
• ch
arge
is t
he
coord
inat
or
Sub c
ounty
•
chie
f ch
airs
th
e m
eeting
MO
H•
Dis
tric
t•
Sub c
ounty
• Pa
rtner
s•
By-
law
s in
pla
ceM
inute
s fr
om
th
e Sta
kehold
ers
foru
m
Advo
cacy
Sen
sitisa
tion o
f su
b-
• co
unty
lea
der
s on V
HT
imple
men
tation
Hold
sen
sitisa
tion m
eetings
• Sub c
ounty
counci
l m
eetings
•
HC I
II I
n-
• ch
arge
is t
he
coord
inat
or
MO
H•
Dis
tric
t•
Sub c
ounty
• Pa
rtner
s•
Mee
ting r
eport
s
Cap
acity
build
ing
Plan
for
VH
T t
rain
ing
• Conduct
VH
T t
rain
ing
• Pr
ovi
de
logis
tics
•
Orien
tation o
f hea
lth
• w
ork
ers
on V
HT s
trat
egy
Org
anis
e se
lect
ion m
eetings
• O
rder
, st
ore
and d
istr
ibute
•
com
moditie
s an
d s
upplie
sM
eetings
/work
shops
•
HC I
II I
n-
• ch
arge
, CD
O,
HA
MO
H•
Dis
tric
t•
Sub c
ounty
• Pa
rtner
s•
Rep
ort
s of
VH
T
sele
ctio
n m
eetings
Inve
nto
ry o
f lo
gis
tics
Dat
abas
e of
VH
Ts
in t
he
Sub c
ounty
Tra
inin
g r
eport
s
Super
visi
on
Follo
w u
p V
HT m
ember
s in
•
thei
r co
mm
unitie
s.Conduct
month
ly V
HT
• m
eetings
Conduct
quar
terly
VH
T
• m
eetings
Conduct
Support
super
visi
on
• Sch
edule
mee
tings
• Sub C
ounty
•
VH
T t
rain
ers
MO
H•
Dis
tric
t•
Sub-c
ounty
• Pa
rtner
s•
Rep
ort
s of
VH
T
sele
ctio
n m
eetings
Rec
eivi
ng m
onth
ly
report
s
Section 9
Stra
tegy
and O
pera
tiona
l Guid
eline
s_____
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
__
37
Rep
ort
ing
and f
eedbac
k
Subm
it V
HT a
ctiv
ity
report
s •
to H
SD
Hav
e a
VH
T p
erfo
rman
ce
• m
onitoring
Rec
eive
rep
ort
s fr
om
VH
TS
• M
ake
conso
lidat
ed V
HT
• re
port
to t
he
HSD
G
ive
VH
Ts
com
men
ts o
n
• th
e re
port
s th
ey s
ubm
itte
d
Mee
tings
with V
HT m
ember
s•
Sub C
ounty
•
VH
T t
rain
ers
MO
H•
Dis
tric
t•
Sub-c
ounty
• Pa
rtner
s•
Rep
ort
s of
VH
T
sele
ctio
n m
eetings
Monitoring
and
eval
uat
ion
Monitoring V
HT m
ember
•
activi
ties
Fo
llow
ing u
p V
HT m
ember
s •
in t
hei
r co
mm
unitie
s
Hea
lth
• Ass
ista
nt
Com
munity
• D
evel
opm
ent
offi
cer
MO
H•
Dis
tric
t•
Sub-c
ounty
• Pa
rtner
s•
Rep
ort
s
Plan
nin
g
and
budget
ing
Prep
are
a pla
n a
nd b
udget
•
for
VH
T a
ctiv
itie
s an
d
Inco
rpora
te it
in s
ub-
county
hea
lth p
lans
Sub-c
ounty
tec
hnic
al
• pla
nnin
g m
eetings
In-
Char
ge
• H
ealth
• Ass
ista
nt
CD
O•
MO
H•
Dis
tric
t•
Sub-c
ounty
• Pa
rtner
s•
Ava
ilabili
ty o
f
work
pla
n
VH
T a
ctiv
itie
s in
corp
ora
ted into
su
b c
ounty
hea
lth
pla
n
Section 9
38
___
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
_Stra
tegy
and O
pera
tiona
l Guid
eline
s
HEA
LTH
CEN
TR
E I
I LEV
EL
Are
a o
f fo
cus
Wh
at
will b
e d
on
eH
ow
will it
be d
on
eP
ers
on
R
esp
on
sib
leS
ou
rce o
f Fu
nd
ing
Ind
icato
rs
Coord
inat
ion
and r
eport
ing
Org
anis
e Q
uar
terly
• m
eetings
with V
HTs
Rec
eivi
ng n
ew info
rmat
ion
• Shar
ing e
xper
ience
s •
Rev
iew
of re
port
s•
Rev
iew
and u
pdat
e of
key
• m
essa
ges
Re
pla
nnin
g
•
Quar
terly
mee
tings
•
In c
har
ge
• H
C11
VH
T f
oca
l •
per
son
Hea
lth
• Ass
ista
nts
Min
istr
y of
• H
ealth
DLG
• SCLG
, •
Com
munitie
s an
dPa
rtner
s•
Quar
terly
mee
ting
report
s an
d
regis
ters
ava
ilable
Logis
tics
and
Supplie
s
Rec
eivi
ng an
d a
ccounting
• fo
r m
edic
ines
, su
pplie
s an
d
com
moditie
s
Use
Sto
ck c
ards
to
acco
unt
• an
d r
equis
itio
n f
or
more
su
pplie
s
In c
har
ge
• H
C11
Parish
chie
f•
N/A
• Lo
gis
tica
l re
port
s
Super
visi
on
and
men
toring o
f VH
Ts
Follo
w u
p a
nd s
upport
VH
T
• m
ember
s in
the
fiel
d o
n a
m
onth
ly b
asis
Com
munity
visi
ts•
Hom
e vi
sits
•
Hea
lth
• Ass
ista
nt
VH
T t
rain
ers
•
DLG
• SCLG
•
Act
ivity
report
s
Section 9
Stra
tegy
and O
pera
tiona
l Guid
eline
s_____
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
__
39
VIL
LA
GE L
EV
EL
Are
a o
f fo
cus
Wh
at
wil
l b
e d
on
eH
ow
wil
l it
be d
on
eP
ers
on
R
esp
on
sib
leS
ou
rce o
f Fu
nd
ing
Ind
icato
rs
Coord
inat
ion
and r
eport
ing
Est
ablis
h a
VH
T lea
der
ship
•
to c
oord
inat
e VH
T m
ember
sM
onth
ly v
illag
e hea
lth t
eam
•
mee
tings
chai
red b
y th
e LC
IVill
age
leve
l D
ata
colle
ctio
n,
• use
and r
eport
ing o
f
findin
gs
Subm
it s
um
mar
y re
port
s to
•
hea
lth fac
ility
In e
ach v
illag
e, t
he
VH
T
• m
ember
s se
lect
am
ongst
th
emse
lves
a T
eam
lea
der
,
Sec
reta
ry a
nd T
reas
ure
r U
se o
f VH
T h
ouse
hold
reg
iste
r •
and s
um
mar
y fo
rms
Org
anis
ing V
HT m
eetings
with
• LC
I ch
airp
erso
n
VH
T
• Le
ader
ship
an
d
LCI
• ch
airp
erso
n
VH
T t
eam
le
ader
ship
ava
ilable
Rep
ort
s av
aila
ble
Mee
tings
take
pla
ce
Cap
acity
build
ing
Build
the
hea
lth a
nd
• dev
elopm
ent
capac
ity
of
com
munity
mem
ber
sCom
munity
empow
erm
ent
• D
istr
ibution o
f hea
lth
• co
mm
oditie
s an
d m
edic
ines
Educa
te p
eople
about
life
• sk
ills
and c
om
munity
hea
lth
pra
ctic
es
Reg
ula
r co
nta
ct w
ith
• house
hold
mem
ber
s Com
munity
dia
logues
at
• fo
rmal
or
info
rmal
mee
tings
Inte
rper
sonal
com
munic
atio
n•
Hom
e vi
sits
• Com
munity
funct
ions
e.g.
• w
eddin
gs,
burial
s, f
ootb
all
mat
ches
etc
Org
anis
e dra
ma
sess
ions
• D
uring o
utr
each
es e
.g.
child
•
day
s plu
sAppre
ntice
ship
(han
ds
on
• tr
ainin
g)
VH
T m
ember
s•
Rep
ort
s of hom
e vi
sits
Num
ber
of
funct
ions
addre
ssed
Num
ber
of
com
moditie
s re
ceiv
ed a
nd
dis
trib
ute
d
Num
ber
of
com
munity
dia
logues
hel
d
Act
ivit
ies
to
be I
mp
lem
en
ted
by V
HT M
em
bers
Ind
icato
rs
Be
a ro
le m
odel
All
VH
Ts
must
kee
p a
model
•
hom
eAva
ilabili
ty o
f sa
fe d
rinki
ng
• w
ater
A C
lean
usa
ble
lat
rine
with
• han
d w
ashin
g f
acili
ty w
ith
soap
Sep
arat
e ac
com
modat
ion f
or
• an
imal
sAva
ilabili
ty a
nd u
se o
f Lo
ng
• La
stin
g I
nse
ctic
ide
Net
(s)
VH
Ts
• N
um
ber
of VH
Ts
with m
odel
hom
es
Section 9
40
___
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
_Stra
tegy
and O
pera
tiona
l Guid
eline
s
Imple
men
t Soci
al m
obili
sation a
ctiv
itie
s
Dis
trib
ute
IEC m
ater
ials
• In
ter
Pers
onal
Com
munic
atio
n•
Dra
ma
• O
rgan
ise
sport
s ac
tivi
ties
•
Use
med
ia e
.g.
radio
s•
VH
Ts
•
Num
ber
and t
ypes
of
IEC m
ater
ials
dis
sem
inat
edN
um
ber
of
reci
pie
nt
hom
es o
f IE
C
mat
eria
ls
Hom
e vi
siting
Chec
k fo
r th
e pre
sence
and
• ad
vise
on t
he
use
of sa
nitat
ion
faci
litie
s Chec
k fo
r th
e e
xist
ence
of a
•
pre
gnan
t or
new
moth
er a
nd
advi
se o
n t
he
import
ance
of
ante
nat
al /
Post
nat
alChec
k on t
he
avai
labili
ty a
nd
• ca
re o
f new
born
s an
d o
ther
vu
lner
able
child
ren
Chec
k fo
r av
aila
bili
ty o
f peo
ple
•
with d
isab
ilities
Chec
k fo
r av
aila
bili
ty o
f ch
ronic
•
illnes
ses
Chec
k fo
r th
e pre
sence
and
• utilis
atio
n o
f I
TN
sChec
k on a
nd a
dvi
se o
n a
ny
• oth
er r
elev
ant
hea
lth iss
ues
.
VH
Ts
•
Num
ber
of
hom
es
visi
ted
Num
ber
of
hom
e vi
sits
mad
e
Sav
ing liv
es
Iden
tify
dan
ger
sig
ns
espec
ially
•
among w
om
en,
child
ren a
nd
PWD
sre
fer
case
s to
hea
lth fac
ility
• M
obili
se for
imm
unis
atio
n•
Advi
se p
regnan
t w
om
en t
o
• go for
AN
C a
nd P
ost
nat
al for
moth
ers
and t
hei
r new
born
sG
ive
sim
ple
tre
atm
ent
for
• m
alar
ia,
dia
rrhoea
, pneu
monia
an
d o
ther
s
VH
T
•
No o
f ca
ses
refe
rred
No o
f ca
ses
trea
ted
No o
f im
munis
atio
n
sess
ions
support
ed
Num
ber
of
wom
en
counse
lled f
or
AN
C
and P
NC
Num
ber
of
new
born
s vi
site
d a
t hom
e
Section 9
Stra
tegy
and O
pera
tiona
l Guid
eline
s_____
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
______
__
41
Support
Support
peo
ple
on long
• te
rm t
reat
men
t an
d t
hose
in
nee
d o
f sp
ecia
l at
tention
e.g.
vict
ims
of
Gen
der
Bas
ed
Vio
lence
, H
IV,
CB-D
OTs
Advi
se o
n f
ood s
ecurity
and
• nutr
itio
n in h
om
esAdvi
se o
n e
duca
tion o
f •
child
ren e
spec
ially
the
Girl
Child
up t
o 1
8 y
ears
No o
f peo
ple
w
ith s
pec
ial
nee
ds
/ on long
term
tre
atm
ent
support
ed
No o
f hom
es
advi
sed o
n f
ood
secu
rity
and
nutr
itio
n
No o
f fa
mili
es
counse
lled o
n t
he
import
ance
of
educa
tion e
sp.
of
the
girl ch
ild
Linki
ng c
om
munity
to form
al h
ealth s
ecto
r
Ref
erra
l of
pat
ients
• Pa
rtic
ipat
e in
mee
tings
at
• th
e hea
lth c
entr
eFo
llow
ing u
p d
isch
arged
•
pat
ients
fro
m h
ealth f
acili
tyD
ata
colle
ctio
n a
nd r
eport
ing
•
No o
f re
ferr
als
No o
f m
eetings
par
tici
pat
ed in
No o
f dis
char
ged
pat
ients
follo
wed
up
Rep
ort
Dat
a co
llect
ion,
reco
rd k
eepin
g,
report
ing
and f
eedbac
k
Dra
w a
com
munity
map
• Fi
ll in
and u
pdat
e th
e VH
T
• house
hold
reg
iste
rRep
ort
notifiab
le d
isea
ses
• an
d o
ther
unusu
al h
ealth
occ
urr
ence
sColle
ct c
om
pile
, use
dat
a •
and g
ive
feed
bac
k to
co
mm
unity
Rep
ort
dat
a to
rel
evan
t •
auth
orities
Com
munity
map
Com
ple
ted V
HT
house
hold
reg
iste
r
Notifiab
le d
isea
ses
report
ed
Rep
ort
s an
d f
eed
bac
k to
auth
orities
Section 9
42 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
10. STANDARDS FOR VHT IMPLEMENTATION
Standards for VHT ( Showing a good example)
All VHTs must keep a model home
A clean usable latrine with hand washing facility with soap
Availability of safe drinking water
Separate accommodation for animals
Availability and use of Long Lasting Insecticide Net(s) (LLINs)
Standards for VHT Kit
All VHT members will be equipped with a standard Kit and certificate
ALL Partners will supply the same minimum kit
Composition of the VHT Kit: Badge, Bag , Register , VHT Participant Manual, Health Promotion Flip charts, Standardised IEC materials and Job Aids
Availability of essential drugs
Community Case Management
Medicines used at community level in accordance with national guidelines
The defined Essential drugs are available in the VHT drug Kit and Drugs are not expired and all strengths present
All any stock out will be documented and counted
Standards for ICCM Kit
The ICCM kit will include: Pre-packed medicines for malaria, pneumonia and diarrhea: Amoxicillin for non severe pneumonia, ACTs for uncomplicated malaria, Low Osmolarity ORS for diarrhea, Zinc for diarrhea, rectal Artesunate for pre-referral patients, diagnostic commodities e.g. respiratory timers, MUAC tape, user items e.g. Job Aid cards.
Standards for VHT Training
All VHTs will have 5 day standard training in health promotion, which conforms to • agreed norms and standards content, duration and ratios of VHTs to facilitators
Additional modular training will be given to every VHT member. •
Quality assurance will be applied for norms and standards of additional training•
Certificate•
Training will be conducted using standardised materials•
Quarterly meetings should include refresher trainings• VHTs will select amongst themselves two people but the selection of these members • should be guided by geographical location to ease access.
Thirty people should be trained as VHT members in a single training for a course • of five days.
Sect
ion
10
Strategy and Operational Guidelines______________________________________________________________________________________________________________________________________________________________ 43
Minimal skills required by VHTs for Core Functions
Knows roles and responsibilities
Able to fill out VHT register
Knows Key Messages (Key Family practices)
Ability to communicate effectively
Observational skills
Mobilisation skills
Knows diseases to report
Knows how to read MUAC tape
Availability of essential Equipment and work Aides
Every VHT has a Job Aid for identifying children, newborns and women with danger • signs available and immediately accessible in VHT kit.Every VHT will have a standardised colour coded MUAC tape/strap with standardised • MoH/WHO cut offs for Malnutrition and severe malnutritionEvery VHT carrying out CCM has a means of counting respiratory rate which is • immediately available (respiratory timer, watch with second hand, mobile phone with timer function)
VHT Core Activities
(refer to the VHT handbook on VHT responsibilities Pg.6)
Ability to conduct Home visits•
Ability to organise and conduct village meetings•
Ability to carry out individual counselling•
Ability to mobilise people for health service•
Ability to communicate •
REPORTING
Reporting By VHTs
Ability to report Diseases under surveillance and other unusual health events to • the health unit
Ability to give monthly reports to the health unit •
Supervision
All VHTs will be supervised by HCII at monthly meeting when registers and reports will be checked and on job training and supervision will be carried out
All VHTs will attend quarterly supervision meeting
VHTs will receive supportive supervision in the community at least once per year
Community Case Management For VHTs
Only VHTs who have completed basic health promotion training followed by Case Management training will treat members of the community.A pregnant woman, newborn or child with a danger sign has any referral treatment given and referral letter written and immediately referred.
Sect
ion
10
44 ________________________________________________________________________________________________________________________________________________________________Strategy and Operational Guidelines
NOTESN
otes
Ministry of Health Policy and Guideline on how to engage and utilize Village Health Teams in
Community-based health services delivery in Uganda
VHT