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C Cu ur rr re en nt t S St ta at tu us s
A Ac ct ti iv vi it ti ie es s
A Ac ct ti io on ns s t to o I Im mp pr ro ov ve e H He ea al lt th h a an nd d S Su ur rv vi iv va al l


M Mi in ni is st tr ry y o of f H He ea al lt th h U Ug ga an nd da a
TABLE OF CONTENTS
VHT COMMENTS 3
ACKNOWLEDGMENTS 3
ACRONYMS 6
VILLAGE HEALTH TEAMS AT A GLANCE
EXECUTIVE SUMMARY 7

Section 1: Background and Methodology 9
Section 2: Current status of VHT in Uganda 11
Section 3: Coordination 14
Section 4: Selection criteria for VHTs and relationship to existing
community health workers 16
Section 5: Training of Village Health Teams 17
Section 6: Motivation of Village Health Teams 20
Section 7: Village Health Team Activities 22
a. Social Mobilization and Health Education 22
b. Activities with Health Workers 22
c. Disease Surveillance and Control 23
d. Case Management and Referrals 26
e. Nutrition 28
f. Reproductive Health 29
g. Water and Sanitation 34
h. Record Keeping and Reporting 34
Section 8: Impact of VHT good practices and innovations 35
Section 9: Supervision of VHTs 39
Section 10: VHT Documentation and Reporting 42
Section 11: Linkages and bridging gaps 47
Section 12: Information, Education and Communication 53
Section 13: Conclusions, Challenges and Actions 56
REFERENCES 58
APPENDICES
Appendix 1: Partner Mapping: Who Where and What for 60
Community Health
Appendix 2: Evidence for Community Interventions 70
Appendix 3: Health Policies, Strategies and Programmes 73
supporting VHT implementation
Appendix 4: Community Radio 76
Appendix 5: District Profles 86-245
"Something else I see in our village is that we no longer spend a lot of money on treatment for our sick children like before. This is because we
feed them well and look after them. Instead, we divert this money to income generating activities at home, like you are now able to buy a goat
or chicken, instead of spending it on treating family members who are ill."
"VHT/CORPs started with their own homes. When you visit their homes, you get overwhelmed. Their homes are respectable, latrines are well
kept, kitchens are clean and they have small vegetable gardens and so forth. When they were done with their homes, they came to us and
starting teaching us. They made themselves good examples first...."
You find that everyone tries to get involved in sanitation around their homes. Now if you find that each home has fruits in the garden, safe,
protected drinking water, they sleep well, have mosquito nets, then you wont have children who fall sick all the time. You find yourself saving
this money and using it for the development of your home and you are able to put children in school.
When you pass peoples homes now, they have good vegetable gardens. Its like they are on sale. Because of the VHT/CORPs numerous
inspections, it prompts us to have most of the things that they want. You do not want to get embarrassed when they come and find your
latrine almost collapsing, no kitchen, dirty compound, no drinking water, or a clean container. We are always concerned about these things
before and after inspections. When you are to inspect places VHT/CORPs have been to, out of like 50 homes, you find only 3 people without
these facilities.
Acknowledgements
This Report is dedicated to all volunteers who dedicate time and devotion to their communities, to improve lives and well being,
and to those who support, teach and mentor the Village Health Teams.
Village Health Teams with adequate knowledge, skills and support save many Lives, but Village Health Teams cannot replace a
functional Health System, they are an adjunct and integral part, and need constant effective support from the health system.
Special thanks to:
UNICEF for financially supporting this work, and all partners who support implementation of VHT Strategy and the translation of
evidence of all those simple interventions that we know that save lives into life saving actions, and yet many seem reluctant to
implement.
To all Departments and Divisions at the Ministry of Health, all District Health Teams, All Organisations, NGOs CBOs, CSOs who
took time to share their knowledge and experience and to propose ideas and solutions to make the Village Health Team Strategy
work.
To those pioneering Districts and Organisations, which have supported the Strategy since its inception.
Ms Jacqueline Mpanga for tireless and meticulous collation of data
Uganda Bureau of Statistics for up to the minute information and District Maps
Mr Didas Namanya, for production of many of the HMIS Maps
MoH Data Centre who supplied original copies of raw data to compile maps and District profiles (Connie Nangobi and Mr Ande )
Ms Robina Kijjambu for community radio information, Mr Solomon Ochwo for collating references.
Healthy Child Uganda for quotations and mortality data
Dr Kenya Mugisha father of the VHT Strategy
Photos : Cover photo Dr Joanna Nikulin, NTDs Department of Neglected Tropical Diseases, EPI and sanitation Dr Philip DHO
Kotido , VHT training and IEC Ms Jacqueline Mpanga, Healthy Child Uganda, all other photos Dr Helenlouise Taylor
Citations:
Village Health Teams Uganda 2009,
Ministry of Health Uganda
Author: Dr Helenlouise Taylor
ACKNOWLEDGMENTS
VHT COMMENTS
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ACT Artemesinin Combination Therapy
AIDS Acquired Immune Deficiency Syndrome
ANC Antenatal Care
ARV Antiretroviral drugs
BCG Bacille Calmette-Gurin vaccine (Tuberculosis)
CCA Community Counselling Aids
CDD Community Drug Distributor
CHW Community Health Worker
CMD Community Medicine Distributor
CORPS Community Owned Resource Person
DHS Demographic and Health Survey
DHT District Health Team
DPT Diphtheria, Pertussis and Tetanus vaccine
EmOC Emergency Obstetric Care
ENNMR Early Neonatal Mortality Rate
FGD Focus Group Discussion
HC Health Centre
HCT HIV Counselling and Testing
HMIS Health Management Information System
HIV Human Immunodeficiency Virus
HSD Health Sub District
HSSP Health Sector Strategic Plan
IMR Infant Mortality Rate
IPTp Intermittent Preventive Treatment for malaria (pregnancy)
ITN Insecticide Treated Net
KMC Kangaroo Mother Care
LBW Low Birth Weight
LLIN Long life Impregnated Net
MDG Millennium Development Goal
MMR Maternal Mortality Ratio
MNCH Maternal, Newborn and Child Health
MoH Ministry of Health
MUAC Mid Upper Arm Circumference
NGO Non Governmental Organization
NMR Neonatal Mortality Rate
NTD Neglected Tropical Diseases
ORS Oral Rehydration Solution
PDC Parish Development Committee
PEAP Poverty Eradication Action Plan
PMNCH Partnership for Maternal, Newborn and Child Health
PMTCT Prevention of Mother to Child Transmission
PNC Post Natal Care
TB Tuberculosis
TBA Traditional Birth Attendant
TT Tetanus Toxoid vaccine
U5MR Under Five-Mortality Rate
UBOS Uganda Bureau of Statistics
UDHS Uganda Demographic Health Survey
UNDP United Nations Development Programme
UNEPI Uganda National Expanded Programme for Immunization
UNICEF United Nations Children Fund
USAID United States Agency for International Development
VCT Voluntary Counselling and Testing
VHT Village Health Team
WHO World Health Organization
ACRONYMS
Executive Summary
Introduction This situation analysis was carried out to document the current situation of Village Health
Teams in Uganda, their numbers, functionality and activities. It is intended to serve as a
surrogate baseline for Districts, many of which have little or no documentation of VHT
implementation.

Background Village Health Teams are community health workers and volunteers, who serve their
communities and carry out health promotion and social mobilisation activities. They also carry
out a range of health interventions across the spectrum of health, water and sanitation, disease
surveillance and they also carry out simple treatment.

Methodology A desk review of all recent information, reports and publications relating to Village Health
Teams, and Community Health interventions in Uganda was carried out. A Partner mapping
exercise was done with Organisations implementing at community level documented and
contacted. A small team visited every District in Uganda (80), using standardised tools and
methodology from June to October 2009. The team also collated data from HMIS and other
sources into District profiles, which are available as excel data sheets which Districts can update
annually, document progress, and calculate lives saved.
Findings Findings from the District visits are documented in both District profiles, and in separate
sections within the analysis. 62 Districts have trained Village Health Teams. The coverage of
villages varies, as do the activities carried out by teams. The quality and duration of training for
VHTs varies considerably.

Supervision is highly valued by VHTs and yet is infrequently carried out by Districts. The quality
and added value of the supervision carried out is dependent on the skills and previous
experience of the supervisors. Few Districts train supervisors how and what to supervise.

VHTs when trained in disease surveillance provide a vital link with the health system to control
and prevent outbreaks of infectious diseases, and many examples of VHT actions are
documented in the District profiles.

Data collation and usage is minimal although VHTs collate important community data such as
mortality which is not captured by the Vital Registration System. The opportunity to document
impact is also lost.
Some areas of intervention which have the potential to have very high impact and substantially
reduce mortality such as encouraging post natal checks for pregnant women and newborns by
trained heath workers, and post natal home visits by VHTs are rarely carried out.

Conclusions Village Health Teams can and do save lives. Their Impact could be more dramatic if activities
were better planned and focussed on evidence based high impact interventions, and the
epidemiological situation of each District.

Effective implementation requires strong links and mentoring by health workers from the
linked health facility.

Effective Districts have good coordination mechanisms and strong links with the local political
system and with other sectors.

Partners need to support the Village Health Team Strategy and not to set up parallel and
conflicting structures of short duration. They should also support Districts by planning together
with all other community actors to ensure no duplication and the effective coverage of gaps.

VHTs are motivated by both non monetary and monetary factors, especially recognition and
EXECUTIVE SUMMARY
appreciation. The investment for providing, lunch and travel to the linked health facility for
mentoring/supervision for VHTs is small, and yet has considerable impact.

Some Districts have NO support from partners and donors to support VHT activities; however
it should be noted that some Districts successfully implement the VHT Strategy with relatively
small budgets, but by using innovative methods to motivate VHTs and keep them active.

VHTs are not the low cost answer to all Ugandas health problems. To maximise lives saved, the
VHTs must be linked to, and appropriately refer sick patients to the health service. Health
facilities in turn MUST provide at least the minimum standards of care.

The Ministry of Health needs to guide partners to work in Districts and areas least supported
with greatest need

Recommendations A full time coordinator who can work with all departments in the Ministry, and can support
Districts in all aspects of implementation, is necessary to ensure sustainable implementation of
the VHT Strategy.

Districts need to review the epidemiological situation , prioritise activities and plan to
implement activities within the District systematically according to needs (mortality and
morbidity)

Districts need to document VHT implementation, their Village Health Teams, good practices
and lessons learned. This information should be widely disseminated.

Districts should use the documented situation analysis for advocacy and eliciting support from
relevant partners.

Districts must plan jointly with all partners to avoid duplication, gaps and effective use of
resources.

All community health and related interventions must be implemented via the village health
teams
All VHTs should be trained to recognise at community level diseases of epidemic potential, and
how to report them.

Care during and after delivery for mothers and newborns should be prioritised during 2010 if
we are serious about saving mothers and newborn lives. All Mothers and newborns no matter
where delivered should receive 3 postnatal checks from a skilled health worker. ( within 6
hours, within 6 days and at 6 weeks)

All VHTs must know danger signs for newborns, children, pregnant and post partum women
and why it is important to refer immediately.


Section 1: Background and Methodology
Purpose
The purpose of the situational analysis of Village Health Teams and other community actors is to document the
coverage, functionality and best practices relating to implementation of Village Health Teams in Uganda. The
information collated has informed updating of the VHT Strategy Document and VHT Operational Guidelines and for
guidance and examples for partners and programs when introducing interventions via the Village Health Teams.
Methodology
A desk review of all recent information, reports and publications relating to Village Health Teams, and Community
Health interventions in Uganda was carried out.
A Partner mapping exercise was done with Organisations implementing at community level documented and
contacted.
All 80 Districts in Uganda were visited by a small team using a standard data collection tool which was developed and
refined during field visits to the North East Region. The field visits took place between June and October 2009.
At District level, the District Health Medical Team, Key members of Local Political Structures, the Chief Administrative
Office, Key Community Partners, VHTs, their Supervisors and Health Facilities were visited. VHTs were observed in
action, and during training when this coincided with the District Visit.
The standard data collection gathered information on the status of VHT Implementation, Coordination, Training,
Supervision, Data Collection and Reporting, Activities of VHTs, and linkages with health facilities and other sectors.
Standardised focussed discussion explored qualitative issues such as factors affecting effective VHT implementation,
Lessons learned, Evidence for Impact, and Actions needed to save lives in the District. Health Centre visits were
structured and looked at linkages with VHTs and the local community, IEC materials, and minimum standards of care.
More than 130 Health centres were visited.
VHTs were asked about their activities, why they volunteered, what motivates them and about the training they had
received.
District profiles have been elaborated; they comprise the situation relating to VHT implementation, and maternal
newborn and child health indicators. This data was extracted directly from the District Annual Reports 2008-9.
The Situational Analysis provides an overview and a snapshot of how functional the VHT Strategy Implementation is in
each District. It is not a scientific study. The quality of the information is wholly dependent on the information given on
the day of the visit, the observations of the team at the health facilities visited, and observations of and discussions
with VHTs and staff available.
Some Districts have small numbers of very effective active VHTs whilst others have large numbers of VHTs who are
largely dormant, unless called upon for specific activities such as child health days. The quality of all inputs from
selection, training implementation supervision and monitoring varies from District to District.
When the exercise was started there were only 80 Districts in Uganda. This has now been increased to 94. The number
of sub counties and villages within Districts may also change.
All Information, Policy documents , literature, partner mapping, and the Situation Analysis and District Profiles will be
made available to Ministry of Health Departments Districts and Partners.
How to Use the
Situation Analysis
Village Health Teams at a glance gives an overview of VHT implementation for
Uganda. These tables cover coverage, coordination, training, VHT activities,
supervision, data collection and reporting.
The Sections following this capture; activities, Impact, Gaps and Actions ,all of which
are linked to the tasks of the VHT, National Policy, and the Simple Evidence Based
interventions known to save lives and reduce morbidity. A profile of each District
follows which includes key HMIS data for the District for the year 2008-9. Partners
operating at the time of the District Visits are also listed.
Districts are recommended to update the information annually as the VHT situation
changes, and also to use the information to plan community activities based on
needs, prioritising those activities which will have maximum impact within the
District and related to the current local health situation. The background information
from the Districts identifies unmet needs.
What is a Village
Health Team?
Village Health Teams are volunteers chosen by their own communities to promote the
health and well being of all village members. They are Community health Workers. All
community health activities should be implemented by the Village Health Team. Other
existing community volunteers and health implementers should be integrated into the VHT
if they are selected by the community.
What do they do?
Village Health teams are role models for their communities, they mobilise their communities
for health and environmental action and activities. They give health promotion messages to
prevent disease and promote healthy growth and development. They treat simple illness at
home, and refer community members for treatment. They play an important role in
community based disease surveillance and early warning. They keep village records up to
date, and send reports regularly to the appropriate health facility or authorities. VHTs are a
crucial link between their communities and the formal health system, assisting at Health
Campaigns, Outreach activities, Health Centres and carrying out home visits to observe
treatment, or to follow up community members discharged from care. Activities cut across
all health programs from Malaria and Neglected Tropical Diseases to Newborn Care. The
VHTs are very active in Water and Sanitation activities.
Historical
Background
The Village Health Team Strategy represents the commitment of Uganda to the 1978 Alma
Ata declaration and the 2008 WHO Ouagadougou Declaration on Primary Health Care and
Health Systems in Africa. These declarations emphasise community involvement in their
own health. Village Health Committees were established and included in the Health Sector
Strategic Plan (HSSP) 2001 2005 as a vehicle to deliver basic health care services to the
households.
VHT Basic
Functions
(MoH 2009)
Community Information management,
Health Promotion and Education
Mobilization of communities for utilization of health services and
health action
Simple community case management and follow up of major killer
diseases (Malaria, Diarrhoea, Pneumonia) and emergencies
Care of the newborn
Distribution of health commodities

Section 2: Current Status of Village Health Team
Implementation in Uganda
Districts with VHTs Percentage of Subcounties with VHTs Percentage of Villages with VHTs



VHTs
No VHTs

Less than 20%
20-49%
50-79%
80%

Less than 20%
20-49%
50-79%
80%
More than three quarters of all Districts have Village Health Teams,
and more than 83396 VHTs have been trained since 2002
Only 18 Districts have no Village Health Teams, but they do have
other active Community Health Workers including Peer Counsellors
for HIV, Community Medicine Distributors, Condom Distributors,
Community Vaccinators, Community Counselling Aides, Nutrition
Scouts, Sengas and Kojas ( Aunties and Uncles), Parish Development
Committee members ,Uganda Red Cross Volunteers, Parish
Mobilisers, Network support Agents (HIV) and Community Owned
Resource Persons. It is envisaged that All of these valuable
community volunteers and workers will be integrated into the
Village Health Teams if Selected by their peers.
Two Districts have selected some VHTs, but not yet trained
any.
Districts have taken differing approaches to implementation,
some selecting a few VHTs from each village, whilst others have
covered complete Parishes and Sub Counties for training.
The numbers of VHT selected for training has varied from District to
District with an average of 4 per Village.
During early implementation of the VHT Strategy some Districts
selected and trained up to 10 VHTs. However many Districts found
the numbers unmanageable, and financially unsustainable. Large
numbers selected has had impact on retention of volunteers and
the quality of their training and supervision.
77%
23%
Districts with VHTs
(N=80)
yes no

18
20
5
6
5
26
0 5 10 15 20 25
0%
<25%
25-50%
50-75%
75-99%
100%
% Village Coverage by District (n = 80)
0% <25% 25-50% 50-75% 75-99% 100%

Active Village Health
Teams
At District level only Districts with good coordination and either Lists or registers of
VHT s were able to estimate the number of active VHTs and to estimate the attrition
rates for VHTs. Most Districts were only able to give information on VHTs ever
trained. Only 30 Districts kept a list or register of active trained VHTs.
Functional Team Size was difficult to ascertain in many districts, an estimate has
been made by calculating the VHT ratio ( VHTs trained in the District to number of
Villages ) The mean team size is less than 2 VHTs per village.
Attrition Rates
Estimates of attrition rates made by Districts ranged from 0- 50%. Districts
with active VHTs, who are kept interested, have regular refreshers and
supportive supervision, and motivate their VHTs by many methods including
non- monetary, had some of the lowest attrition rates. The lowest
calculated rate was for VHTs who are former CORPs in Bushenyi and
Mbarara with a rate of 12% over 5 years. Attrition rates can only be
calculated where Districts keep an updated register of their VHTs and their
status. This information is important for planning
89%
Reasons for VHT Attrition
Active VHT/Corps
Died
Fired
Moved House
Unknown
Work
Illness/Care Taking
Studies
Separation/Divorce
Stopped by husband
Too Busy

Mechanism of Implementation
All Districts visited reported using the recommended cascade for implementation as outlined in the Ministry of
Health Guidelines. This starts with National Officers sensitising the District who then with assistance of the DHT,
conduct a sensitisation meeting with all health stakeholders in the District This is followed by orientation and
consensus building at Sub-county level followed by Parish level and then Village level, the sub-county trainers
sensitize the village/Local Council and discusses, local health and environment problems ,the need to organize
themselves to solve the prevailing health problems ,What is a village Health team, and how they function, and how to
select team members
A Number of District Medical Officers found this methodology laborious and would like to skip the Parish level
meetings, however others found the process very useful and necessary for consensus building.
Support for
Implementation
Some Districts have large numbers of NGO, CBO and CSO partners. Others have
almost none. Partners in the District at the time of visit have been documented, and
can be found on the District profile pages.
There is inequitable distribution of NGO partners and the presence of partners in a
District does not necessarily reflect need as reflected in mortality , or morbidity nor
access to health care.
It is clear that some Districts will NOT be either able to start implementation NOR
expand VHT Implementation without increased support and funding from partners.

Involvement of Key
stakeholders
x All Districts when starting implementation involved the Political Structures,
Village and religious leaders.
x In some Districts some Health staff, traditional healers , informal health
providers and private health Practitioners were excluded
x In some Districts Sectors outside health were not implicated.
x Some Districts have effectively included Church Based Organisations.
Lessons learned from implementation of the VHT Strategy.
The Road to Success
x The Village Health Team Strategy works effectively in some Districts The Impact of VHTs can be measured
and cuts across a many interventions programs.
x Successful implementation is linked to prioritisation of the health needs as seen by both the health system
(epidemiology) AND the communities they serve
x Successful Districts have strong leadership and ALL community based health interventions are channelled via
the District Health Team
x There is one District Plan for Community Health Interventions These plans are included in the District Plans
x Pooling of funding from multiple donors and channels.
x Establishment of strong links with other sectors: water and sanitation, Supplementary Feeding
Programs, Development , Education, Microfinance and Income Generating schemes, Forestry
x Health Worker acceptance and understanding of the VHT implementation process, their knowledge
of VHT roles and responsibilities and their own roles towards the VHTs.
x Strong linkage between the VHT and their nearest Health facility, with monthly visits and strong
mentoring/coaching.
x Strong outreach component with VHT involvement
x Broad-based community involvement in the selection of VHTs and respect for community decisions
x Integration of other community health workers into the Village Health Teams.
x The quality and nature of the training received linked to the roles and responsibilities of the VHTs
and the knowledge and skills to address their prioritized health issues
x Motivation packages and Imaginative non monetary motivations including recognition, competitions
and prizes
x Building links between the communities and the health workers using the VHT as go-between or mediator
increases the communitys trust and confidence in the health care system, BUT interventions or services must
be available when needed.
x Regular Systematic home visits
x Effective supportive Supervision using innovative sustainable models
x Avoidance of stock-outs and lack of necessary means and necessary equipment
VHT Ratio ( Number of VHTs in District : Number of Villages in District)
Ratio
0 1 2 3 4 5 6
# Districts 18 25 7 12 7 3 4 4
% 23% 31% 9% 15% 11% 4% 5% 5%

Implementation Strategies are recommended by the Ministry of Health 2009
Advocacy and Sensitisation of stakeholders in the health and related sectors at all levels to promote
political will and social commitment, legitimise the structure, mobilise resources.
Resource Mobilisation and Pooling
Resource allocation needs to be adequate, and well coordinated
Effective communication Strategies which are relevant to specific communities and culturally and
educationally appropriate.
Strengthening linkages between households and VHTs and VHTs and political, and health system and
communities.
Effective Monitoring and Evaluation with regular follow up and reviews
Effective District Planning: Plans and budgets for VHT implementation in the Districts must be included in the
District annual Plans.
Strengthening of the Health System: At the same time as improving health at community level efforts MUST
be made to ensure that referral health care achieves acceptable minimum standards
Volunteerism Support of volunteerism is absolutely vital, and this should include: the basic package of benefits as
defined by the Ministry of Health
ACTIONS
x Districts and all partners should review and implement the Updated
VHT Strategy Document 2009
x Districts and partners should follow VHT Operational Guidelines 2009
x Districts should keep a register of partners their activities , geographic
coverage and duration of their projects
x Districts need to document VHT Implementation
x VHT training Registers should be kept and updated regularly
x Inactive VHTs should be replaced
x Partners should be encouraged to support Districts and Sub Counties
with the greatest need based on current Morbidity and Mortality data.


Section 3: Coordination
At National Level
In order to strengthen VHT implementation a National Coordinating Committee was
founded in June 2009. Membership includes Commissioners from the Ministry of Health,
Representatives of Key line Ministries, and Key technical Partners. The former VHT
secretariat which sits in the Division of Health Promotion has been strengthened with two
full time members of dedicated to VHT support. The coordinating body in the Ministry of
Health is known as the VHT Technical Steering Committee, and has been strengthened by
co-opting program managers from key programs, it is lead by the Assistant Commissioner
for Health Promotion and Health Education.
The decision to form a VHT Partners Forum has recently been adopted.
Effective National level coordination is crucial for effective implementation of the VHT
Strategy. Support to and documentation of all Activities throughout the Country, collation,
analysis and dissemination of data relating to implementation and impact are essential
functions of the VHT Technical Steering Group. These functions have been weak in the
past, but new Policy, Strategy and Operational Guidelines and having dedicated staff,
should strengthen and support their function.
At District Level
At District level the District Health Team should coordinate activities, in collaboration with
partners. Activities should include joint planning, joint review meetings, supervision, and
evaluation, collation analysis and dissemination of data. The analysis showed that for
effective VHT implementation, strong coordination is necessary at District and lower
levels, however some Districts were unable to effectively coordinate.
Districts where VHTs are performing well are more likely to have effective partnerships
and coordinate with other sectors and Organisations such as Womens Groups, Uganda
Red Cross Society, Functional Adult Literacy, Agriculture, Forestry, Water and Sanitation,
Microfinance, Food Security.
40%
46%
14%
List or Register of Partners
at District Health Office
Yes (All Partners) No Some

In most Districts all Organisations (NGOs CBOs and CSOs) are registered at the Community
Development Office, these lists however were not always up to date. Only 40 % of
Districts had a complete list of CBOs, CSOs and NGOs available at the District Health
Office. This created problems in some District when staff changed. It also affects
coordinated planning and implementation.
Districts have M O Us (Memoranda of Understanding) were only with larger NGOs and
International NGOs.
Planning for VHT activity needs strengthening and activities need to be linked to the
Epidemiological situation in the District.
Planning for VHTs activities monthly by health workers with VHTs ,is rare, although many
NGOs do so.


Districts which have experienced Emergencies and those having IDPs such
as Districts in the North, Teso and Karamoja have joint planning, and Joint
Review with Partners regularly. However, in most other Districts few CSOs
and CBOs take part in joint planning or review

Reporting to the District Medical Office and
team is not always systematic or regular.
Some Community Based Organisations have
never reported their activities.

20%
30%
50%
Joint Planning with
Community Partners?
Yes (All Partners) No Some

18%
29%
54%
Joint Review with Community
Partners?
Yes (All Partners)
No
Some

24%
30%
46%
Regular reporting from
Community Partners?
Yes (All Partners) No Some


ACTIONS
x All Districts should keep a simple register of Partners Operating in the District,
their area/s of intervention, geographic coverage in the District and duration of
project activities.
x All partners should attend planning and review meetings, and report activities in a
standardised simple format at least quarterly.
x The Ministry of Health Circular on VHT implementation should be shared with all
organisations operating in the Districts
x Districts should plan community activities according to the local health and
environmental situation.
x Supervisors should agree activities for the month with their Village Health Teams,
support and supervise them.
x The MoH needs to show leadership and effectively coordinate.

Section 4: Selection criteria for VHT
Selection Criteria Village Health Teams (Ministry of Health 2009)
Current Situation
x Must be selected by the community itself and not imposed by
political structures
x Should be exemplary, honest and trustworthy and respected
x Want to serve as a volunteer
x Must be a resident of the village
x Should be available to perform specified VHT tasks
x Should be interested in health and development matters
x Should be a good mobiliser and communicator
x May already be a CHW TBA, drug distributor or similar
x Ideally should be able to read and write at least the local language
x Political leaders cannot be selected
x Selection should be gender sensitive

Village Health teams should be and usually are
selected by their own communities. As a result of
experience and feedback from Districts the
selection criteria have been updated.
As most Districts do not hold a register of VHTs,
they could only estimate the sex ratios.
Information on Literacy of VHTs was difficult to
find or not available at Districts.
In Mbara they keep VHT profiles including
education level, number of Children under 5
years, and sex.

34%
2%
58%
6%
CHWs Community Medicine
Distributors and TBAS incorporated
into Village HealthTeam
Yes all No/None Some No Information

35%
65%
VHTs Women (n=62)
Data No Data

Most Districts included some former community
Health Workers, Traditional Birth Attendants,
Community Medicine Distributors. However,
other Traditional Practitioners were usually
excluded.
Many HIV projects use volunteers outside the VHT
system.


Team Composition
% VHTs Women N = 22
<25% 25-50% 50-75%,


Feedback from Districts
x Although following the MoH Protocol we found political pressure for selection of members of the community and their family
members. It is not easy.
x We selected students because the criteria said must be able to read and write. Most of them left at the beginning of the
school year so we had to reselect.
x We had to exclude many respected members f the community like the TBAs and some people who worked on the Guinea
Worm program because they cannot read. The communities were not happy.
x More women were selected because they stay and are often more reliable
x We selected all the Community Medicine Distributors as VHTs, but some of these have a bad attitude. It is better if the
community selects themselves.
Feedback from Community members and VHTs
x The LC1s did not tell us about the selection meeting so we missed it and only his relatives were selected, but we have been
helping our communities for many years. The meeting had to be held again and this time most of us were selected.
x I have been a TBA for more than 50 years and have delivered Ministers. I would have liked to be part on my village health
team, but because I cannot read and write I was left out.
Feedback from NGOs
x We usually select our own Community health Workers, but it may be good if we all use VHTs, especially if they have already
had some training.
Good Practices and Innovations x Districts with low literacy rates paired up literate and non literate, or had a
supervisor or coordinator assist with filling in records and reporting.
Actions x The updated selection criteria should be widely circulated and be used when
selection or reselection taking in Districts. Districts should endeavour to prevent
political orchestration of the process.

Section 5: Training of Village Health Teams
Training in Health
Promotion
The Ministry of Health Division of Health Promotion and Education has a standardised
cascade system of Training for Health Promotion, at District level which uses a
standard training manual. The training is for 5 days with 3 facilitators and a
recommendation for 25 participants per class. The VHT Strategy document
recommends that all village health teams should be trained in Health Promotion and
then should receive further modular training for other interventions and duties.
Materials Used
Of the 62 Districts Implementing the VHT Strategy, 75% used the Ministry of Health
Promotion training manual. Others adapted their own such as the CORPS training
manual/s (UNICEF, Healthy Child Uganda etc).CORPs have additional knowledge and
skills in community case management and first aid.
Other programs and organisations only trained VHTs in the area of program to be
implemented, such as contraceptive distribution, treatment for malaria, using their
own training materials.
The result is that key messages, knowledge and skills vary between Districts and
between VHTs.
0 5 10 15 20 25 30 35 40
1
2
3
4
5
>5
10
>10
No Info
Duration of VHT Basic Health
Promotion Training (days)
Number of Districts

The mean duration for VHT health Promotion was 5
days however the range is from 2- 10 days.
Availability of funding was cited as the reason for
curtailing the planned number of sessions and
increasing the number of participants per class.
Number of participants The mean number of participants per class was 50 with a range of 25-102
Facilitator to participant
ratio
This ranged from 1:20 to 1:51 with a mean of 1:25
Methodology Those training sessions observed used lecture methodology. The classes were
very large and the VHTs had no manual or materials for making notes.
Participants were far from their teachers who made notes on a flip chart. The
number of subjects covered each day was large, and there was little or no time
for the VHTs to acquire or practise any skills.
The VHTs interviewed enjoyed the experience and learning new knowledge.
Involvement of Health
Workers and Supervisors
Districts which included health workers and supervisors in the training of their
VHTs have better linkages between the VHT and the health facilities.
Districts where there are not good linkages between the health Centres and the
VHTs in general did not include health workers in the training of VHTs, nor
inform them of the roles and responsibilities of VHTs and their own role towards
them. In these Districts health workers use VHTs like a sleeping army of
reservists who can be called upon only when a specific activity is due to take
place, such as Child Health Days, a vaccination or sanitation campaign. These
health workers tended to value less the VHTs than those Health workers who
are actively involved in the training supervision and mentoring of the VHTs.
Quality Control Most Districts have no quality control of VHT training. The quality of training
depends on the skills and experience of the trainers.
Feed back from District teams partners and health workers
The curriculum for VHTs is too long to complete during 5 days. If the entire course is to be completed, then
interaction and practice has to be sacrificed.
Districts should be allowed to prioritise topics
We dont have enough funding to train the VHTs properly
Section 5: Training of Village Health Teams
Feed Back from VHTs
x All VHTs enjoyed their training
x We learned many things which help our communities and we know when to refer to the health
centre
x I liked learning about what foods to eat and about malnutrition
x I would have liked to practice how to fill in my register. I am not sure if I am doing it correctly
x There was so much information to remember
x The class was very large and so we could not see what the teacher was writing
x We had nothing to make notes
x We would like a book to take away so that we remember what we learned
x The training for VHTs is not good like the training we had as CORPS. We practised a lot and how to be
a good CORPs, doing theatre and songs and making pictures and talks we also learned about
reporting.
Photo Jacquie Mpanga
Knowledge
All VHTs met were asked if they remembered any
danger signs, and if they learned when and how to
refer patients:
x Almost all VHTs know the danger signs for
malaria, which reflects the additional
training many received as community
medicine distributors.
x Women and especially the former TBAs
knew some danger signs in pregnancy. The
male VHTs had less knowledge.
x Fewer knew danger signs postpartum, and
almost none knew danger signs in the
newborn.
x Referral for Malaria was clearly understood,
however how the referral should be done
and whether the VHTs have been trained to
use a standardised referral slip varies from
District to District.
Gaps
Those identified in focus group discussions include:
x How to use the register and when and what to report
x Community Disease surveillance and reporting
x New born Care
x Post partum care for mother and newborn
x Who and how to refer
x First aid and actions for burns, choking, bleeding, unconscious
x How to read a MUAC tape
A major gap is that many Districts do not have a training record of which VHTs have
been trained, and in what.
Good practices
Some Districts have had additional on the job trainings and refreshers to address the
gaps identified from the basic VHT training, at health Centre and outreach visits, at
monthly and quarterly meetings. Some training was very practical teaching how to
do:- theatre, puppet shows, how to fill in register, how to report activities and deaths,
First Aid training.
In the past VHT/CHW/TBAs have been trained on safe motherhood and danger signs
during pregnancy and delivery.
8 Districts are starting to teach their VHTs about newborn care and home visiting.

Opportunities
x Refresher sessions for new knowledge at monthly and quarterly meetings to
address gaps.
x Coaching and Refresher sessions at monthly visit to health facility or outreach
to improve skills and impart new skills and knowledge.
x Radio programs to update and plug gaps in knowledge
x SMS messages to update knowledge and remind VHTs of actions
Actions
The updating of training manuals and Training of trainers materials must be expedited taking into account
information from Trainers, VHTs District Teams and Programs. The updated materials must use adult training
methodology with plenty of practice, and focus on the core lifesaving activities of VHTs. Gaps identified such
as disease surveillance, reporting, danger signs and referrals must be addressed.

The Districts and donors should monitor the quality of VHT training, and ensure that all training meets
minimum standards (content, duration, participant to facilitator ratio, methodology) and the VHTs acquire
the knowledge and skills necessary for their function.
Every District should keep a training register of VHTs trained in Health Promotion and additional modules.
This information is important for planning.

VHTs need regular refreshers, exposure, and reinforcement of knowledge and skills. This can be achieved by
a mixture of supportive supervision, coacjing/mentoring, refresher training, and monthly meetings.

8%
67%
25%
VHTs Trained to Measure Mid
Upper Arm Circumference?
Yes All
No
Some

Yes All
No
Some
45%
27%
28%
VHTs Trained in How to Refer
Yes All No Some

0% 20% 40% 60%
Yes all
No
Some
No Info
VHTs Trained Early Warning and
Surveillance
VHTs Trained in Surveillance/ Early Warning


Section 6: Motivation of Village Health Teams
Village Health teams are volunteers .Motivation entails instituting and reinforcing mechanisms that recognise and
appreciate the contribution of VHTs to their communities and to the health system. For this reason the Ministry of Health
has defined a minimum motivation package for purposes of enabling the VHTs to function and identity and cultivating a
sense of achievement with certificates/awards, letters of recognition,.)
Motivation and enabling incentives MoH 2009
x Basic requirements to carry out VHT function (Standardised VHT uniform, ID)
x Standardised bag and kit using Standard VHT logo.
x IEC materials Register and Summary report Forms
x Soap
x Lunch and travel allowance (whilst carrying out outreach and visits to health centre).
x Health worker supervision and mentoring technical support
x Activity and performance related incentives
x Recognition by Authorities and their own communities-
x Advocacy and support for VHT to access Government programs, income generating schemes and other
microfinance and credit schemes
x Community reward such as community digging, seeds, livestock

5
18
5
3
0
0
3
2
6
6
11
14
6
1
3
3
2
3
0 2 4 6 8 10 12 14 16 18 20
Taking part Community Activities
Appreciation/Recognition/Status/Trust/Repect
Uniform
Rainwear
Soap
Mosquito nets
Bicycle
Registers/ Forms
Certificates
Training
Supervision & Support
Meetings
Money
Snacks/Lunch
Having medicines
Saving lives/ Doing a good job
Learning new things
Competitions
What motivates VHTs ?

6%
26%
29%
29%
9%
6%
Gain New Skills and Knowlege
Help My Neighbours
To Improve Health / Save lives
Voluntary Spirit /Need to Serve
For Recognition
Financial reward
0% 5% 10% 15% 20% 25% 30% 3
Why VHTs Volunteer


The reasons Village Health Teams volunteer were mostly altruistic and based on service for the community, family and
neighbours. No one .answered, because I was selected by my community. Few mentioned financial reward, and the y
tended to be male and volunteers for a number of vertical programs and NGOs.
VHTs are motivated by being appreciated, and recognised by the authorities and health workers and their communities,
gaining the respect and trust of their neighbours. Attending meetings with colleagues and the health workers and being
supervised were seen as very important by the VHTs. Having medicines was a motivating factor , and also gained the VHT
recognition, status and respect. Those VHTs effectively linked to the nearest health facility found their visits to the HC
highly motivating, as they were seen by their fellow villages, the patients they referred were seen immediately or quicker,
and they learned new skills, all of which earned them more trust and respect.
Without exception VHTs said that having no drugs was very de motivating, many of them talked about losing face. VHTs
were very vocal about wanting certificates, or never receiving the certificates promised to them by the District. The
certificates add to their status and also enable them to enter the job market and seek and find work.
Other de-motivating factors were no longer having a VHT register, or no longer being called to meetings. These issues
were most acute where projects funding had ended. The most common motivations received from Districts and partners
is being monetary and being selected for community activities. A number of Districts provided long Life Insecticide
treated nets, and soap, but these are not valued by VHTs, but seen as part of the job and to be a role model for their
communities. The Districts do not give the VHTs the supervision and support that they value as motivating factors.
A number of NGOs have introduced Income Generating Schemes for VHTs ( See District Profiles)
25
16
4
24
5
3
4
21
4
2
8
1
23
28
13
0 5 10 15 20 25
Selection for Community Activities
Recognition Status
community reward including livestock t
Uniform
Rainwear
Soap
LLINs ( Mosquito nets)
Bicycle
Stationery Registers Forms
Certificate
Training or Refreshers
Supervision
Meetings
Monetary
Refreshments
Motivation from Districts
Number of Districts








Section 7: Village Health Team Activities
What do VHTs do?
Social Mobilisation and Health Education
Social Mobilisation and Health Education are the mainstay of the VHTs activities.
All VHTs are active in mobilising for health programs, from Immunisation to HIV
Counselling and HIV Testing, from Antenatal care to Facility based Delivery. In
some Districts, this is the sole activity of the VHTs whereby they mobilise for Child
Health Days and Immunisation Campaigns.
VHTs are particularly active in some Districts in mobilising for water and sanitation
( see District profiles)
IMPACT
The Impacts of VHT Social Mobilisation activities are captured in Section 8. Of
Note the uptake of vaccination, the use of insecticide treated bed nets, and facility
based deliveries has increased.
Hand washing and latrine coverage has also increased in many Districts
GAP
VHTs few carry out health education on reducing delays in seeking care or using
danger signs for Mothers, and Newborns.
The Importance Post natal Checks and post natal care for both mothers and
infants is a SERIOUS GAP in ALL Districts
ACTIONS
Include missing topics in VHT training, Refreshers and Supervision.
Encourage VHTs to come to health facility on a roster/ rota
Health Workers and supervisors to assist VHTs to make a plan/program of
activities related to the health situation of the VHTs home community.
What do VHTs
do?
Activities with Health workers
VHTs in many Districts visited assist at monthly outreach programs for Immunisation.
In other Districts, they assist at outpatients, weighing patients, recording, measuring
MUACs and assisting at HCT and PMTCT clinics in their role as peer counsellors,
organising queues and giving health talks.
IMPACT

Where VHTs work with health workers, the VHTs are more likely to be supervised and
mentored. The VHTs are often more motivated and enthusiastic, have improved
knowledge and skills, and the relationship and links between the community and the
health workers is often improved. They are more likely to refer early, and the
patients referred do not wait to see the health worker ( See sections Motivation and
Building links)

Where VHTs assist in organising queues sick patients are triaged and immediately
seen and less likely to die in the queue whilst waiting.
Health workers are freed up to attend to the sick or carry out medical procedures
whilst VHTs help with the menial tasks.(Task Shifting)
GAP
Some Districts have not yet attached VHTs to Health facilities and Health workers are
not clear on their roles and responsibilities towards VHTs.
Health workers have not forged the effective relationships which would result in
effective active VHTs
ACTIONS
Ensure that VHTs are effectively linked to the nearest Health facility and that the HW
keep updated list of active VHTs
Include VHTs in outreach activities.
Roster each VHT to attend health facility once per month for supervision mentoring
and on the job training
Ensure in pre-service training that roles and responsibilities of VHT and health worker
are included in the curriculum.
a. Social Mobilization and Health Education
b. Activities with Health Workers
Disease Surveillance and Control


VHTs play a crucial role in informing the Authorities and Health
workers about the presence of disease and unusual
occurrences in their communities. Examples of good practice
and impact have been documented in the District VHT Profiles.
Those districts subject to regular outbreaks of diseases such as
Cholera, Ebola Haemorrhagic diseases, and Plague have
specifically trained their VHTs.
Most VHTs however have not received formal training.
Yes all
No
Some
No Info
21
29
11
3
VHTs Trained
Surveillance/Early Warning
Number of Districts

What do VHTs
do?
In 5 Districts VHTs or Community Health workers have been trained in active surveillance
(Integrated Community Based Surveillance) These include Kabarole, Pallisa, Apac,
Nakapiripirit and Luwero.
In All other Districts VHTs are reminded of the cases to report when they are being
trained for Child Health Days and Campaigns. These include sudden onset paralysis in a
child less than 15 years of age, cases of Measles and Neonatal Tetanus.
VHTs also mobilise and give information to their communities. They are active in Latrine
digging, hand-washing campaigns and spraying to kill mosquitos and fleas, the vectors
for some of these diseases.
IMPACT
In a number of Districts (see District Profiles) it is the VHTs who have notified cases
(Hepatitis E, Cholera and Ebola) and have been very active and instrumental in control
and prevention.
GAP
In current training active community surveillance and reporting is not included. There is
no place in the current VHT Register to record neither cases of disease of epidemic
potential nor vaccine preventable diseases.
ACTIONS
Train all VHTs in active surveillance of Vaccine preventable diseases and how to fill out
their register and report to the Health Centre to which they are attached..
Include surveillance in the new updated VHT Register
Opportunities
Use of Mobile phones for SMS reporting, and giving information to VHTs especially for
outbreaks of epidemic potential.

Diseases VHTs should Report:
DISEASE/ CONDITION COMMUNITY CASE DEFINITION
Acute Flaccid Paralysis (AFP) Any sudden weakness in a limb of a child less than 15 years
Guinea Worm Disease
(Dracunculiasis)
Any person with swelling and blisters and eventual emerging long worm from
his/ her skin/ body
Leprosy Any person with skin patches that have lost sensation or loss of sensation in
hands/ feet
Neonatal Tetanus (NNT) Any newborn who is normal at birth but becomes unable to suck or feed after 2
days
Bacillary Dysentery (Acute
Bloody Diarrhoea)
Any person with diarrhoea with visible blood in stools
Cholera Any person with lots of watery stools
Measles Any person with fever and a rash
Meningitis Any person with fever and neck stiffness (for children below 1 year bulging
fontanelle/ soft spot)
Plague Any case of fever with painful swelling in the armpits or in the groin, or with
cough and chest pain in an area known to have plague
Rabies Any person bitten by a mad or abnormally behaving animal
Viral Hemorrhagic Fever
(VHF) Ebola, Marburg
Any case of sudden death or high fever, with bleeding from the nose or mouth, a
large amount of bloody vomits and others diarrhoea, red urine, or blood spots on
the skin
Yellow fever Any person with fever and yellowing of the eyes or yellow skin not responding to
antimalarial
What do VHTs do?
Neglected Tropical Diseases
VHTs carry out social mobilisation for NTDs and for mass
treatment.
In 63 Districts CMDs who have recently been incorporated
into the VHTs have been trained in surveillance and
treatment of Lymphatic Filariasis, Schistosomiasis,
Onchocerciasis ( River Blindness), Trachoma and Soil
Transmitted Helminths (Intestinal worms).The VHTs
support regular Community Drug Distribution and twice
yearly mass treatment
In West Nile Region and other endemic Districts
approximately 40 VHTs in total have been trained in
active surveillance and referral of Sleeping sickness. By
the end of 2009, 120 VHTs will have been trained

Neglected
Tropical
Disease
Lymphati
c
filariasis
Onchoce
rciasis
Schistoso
miasis
Soil
Transmit
ted
Helminth
s
Trachoma
Districts
Endemic
44 27 44 80 24
Est. infected
population
( millions)
4.8 1.5 4.0 11.0 0.7

Florence Muhumuza MoH

% Villages in Each District Endemic
for Neglected Tropical Diseases


<20%
20-49%
50-79%




Good Practices
VHTs selected for Community drug distribution are victims of NTDs and so they are sharing real life testimonies
Supervision takes place regularly twice per year using standard tools and no shortages or stock outs of drugs as they are all
donated and free of charge.
Good IEC present in almost all Health Centres,
Ownership of interventions by the communities, and the trained VHTs are highly respected and committed to their work.
Impact
Guinea Worm has been Eliminated from Uganda
since VHTs/Community Drug Distributors involved in mass campaigns and
surveillance
Severe clinical signs of onchocerciasis are no longer seen in those Districts with high coverage using
Village Health Teams.
GAP
30 Districts are endemic for Sleeping Sickness. However the numbers of VHTs trained are very few.
IEC materials in pictures are not included in flip charts for VHTs.
VHTs keep separate registers for NTDs
ACTIONS
All VHTs must know signs of NTDs endemic in their Districts. Active surveillance and
reporting needs to be implemented in ALL Districts. Case surveillance should be added to
VHT training and Village Register.


Malaria
What do VHTs do?
VHTs give information to their communities on prevention treatment and control of malaria; the use of LLINs; in some
Districts they ensure LLIN use by the hang up and keep up programs. They assist in the distribution of bed nets especially
campaigns
Elsewhere VHTs use rapid diagnostic tests to diagnose malaria, they treat under 5 s with fever with ACTs ( when they have
supplies); they are involved in indoor residual spraying in some Districts, and elsewhere they destroy mosquito breeding
sites.
Achievements
VHTs have assisted in the distribution of a significant proportion of the 6 million ITNs that have been distributed
Nationally.
ACTs have been declassified from prescription only drug to over the counter drugs. During 2008 43,945 CMDs/VHTs in 38
districts were trained in distributing ACTs. During the visits it was found that VHTs in 25 of these Districts are treating
Malaria.
Good Examples
Model home competitions
emphasize clearing bushy areas &
stagnant water.
Malaria focused education using
puppets, health talks, school talks
Job Aids and IEC. Algorithms for
case management



Photo AFFORD 2009


Materials for Free Net
Distribution
In 6 local languages
A4 ANC Flipchart
Laminated A4 job aid
for Health Workers
Laminated A4 job aid
for Community
Volunteers
A2 Community poster
A5 Net insert for users
Flipchart
Job aid for health workers
Job aid for community volunteers
Community Poster

IMPACT
A base line community survey in Mbara showed that 32% of children reported to
have had fever/malaria during the previous 2 weeks
36% of <5 deaths in the past were attributed to malaria/fever
14% of the households were seen to have mosquito nets hanging
4% of children age 0-23 months had slept under a mosquito net the previous night
Findings after one year of VHT/CORPs monthly monitoring
91% of homes checked had nets hanging
97% of homes with nets hanging report that pregnant mothers or under fives are
sleeping under the nets
GAP
Recent Coverage data for LLIN use was not available at the time of visit in any District.
Data if available was only the cumulative number of ITNs/LLINs distributed.
Few Health centres visited had any nets available for distribution to pregnant women or children.
90% of Health facilities visited with pregnant women and under 5 s in patient with Malaria or Severe Malaria
had NO LLINs hanging
Many Health Centres had rupture of stock of ACTs during visits in June-September2009.
Only during the latter part of 2009 did some VHTs/CMDs have ACTs for treatment at community level during
the Teams Visit. Many NGOs use Community Health Workers, and Peer educators, who have not yet been
integrated into the Village Health teams.



Vaccine Preventable Diseases
What do VHTs do?
Measles Cases 2008
Map MoH UNEPI 2009
Neonatal Tetanus Cases 2008
Map MoH UNEPI 2009
VHTs register pregnant women, newborns and
children in their Village register/record book.
They mobilise their communities for routine
immunisation, for outreach, for vaccination
campaigns and Child Health Days.
In some Districts VHTs are trained Vaccinators,
assisting health workers at the health facility
and at outreach





Good Practices and Impact

Use of VHTs for mobilisation has shown documented increase in
vaccination coverage in many Districts.(See Impact Section)
VHTs check immunisation status of inpatients in some HC III and IVs and
Hospitals and immunisation opportunities are not missed. In some
Districts trained VHTs are vaccinators
Since June 2009 in Kotido non pregnant and pregnant women are
mobilised at church by VHTs, and then health workers immunise against
tetanus. This has enabled the District to drastically improve coverage
from 33.5% to 68.6%.
GAP
Despite widespread involvement of VHTs, routine vaccination coverage is insufficient to prevent outbreaks. This is
illustrated in the maps above for measles and neonatal tetanus outbreaks 2008.
Few VHTs have been trained in active surveillance of vaccine preventable diseases.

Action
Ensure that VHTs working in low coverage hard to reach areas are
especially active and adequately supported, and their activities
focus on improving Routine Immunisation Coverage..
Ensure ALL children are fully Immunised via Routine Immunisation
Services.
Ensure that all VHTs know diseases to report and how to report
them

Home Visits; Referrals; Case Management and Observation of
Treatment
Home Visits
All VHTs carry out home visits to fill out their house hold register in their VHT record book, for documentation of latrine and
water sources, to document children under five years, and pregnant women.
VHTs carry out home visits at other times, however the when why and what is done at a home visit varies between Districts and
between VHTs.In 8 Districts some VHTs have been trained to conduct postnatal home visits to check on the mother and new-
born.



d. Case Management and Referrals
Referrals
Approximately half of VHTs have been trained how to refer, however
training was not standardised, who is referred varies amongst VHTs and
between Districts. Referrals are usually verbal.

Counter referral from the health facility to the VHT were rare except in the
context of NGO projects, but are well developed in some HIV projects.
67%
20%
13%
Verbal
Standard letter
No Info
If VHTs Referring How?

Observation of Treatment:

Tuberculosis

Ante Retroviral Treatment
The TB program formerly had community volunteers covering 100% of
Districts, carrying out Direct Observation of Treatment. It is estimated that
30-40% of TB cases are under TB Dots. However very few Districts have
included VHTs for this activity. There is an opportunity to Implicate VHTs
and for Districts to ensure that former DOTS Community Volunteers are
incorporated into the VHTs
Some NGO projects use Community Health Workers to observe ARV
compliance, however no examples of VHTs carrying out this task were
seen during field visits

Case Management
VHTs/Community Medicine Distributors throughout
the country previously treated children less than 5
years with Homapak for fever (Home Based
Management of Fever).
Recently more than 43000 VHT/CMDs have been
trained for 1-2 days on how to treat with ACTs
(Artemesinin Combination Therapies). Many of them
however do not have drugs.
In 7 Districts VHTs have been treating paediatric
pneumonia, and in 18 Diarrhoea with ORS. Recently
VHTs have been trained to give a 10 day treatment of
oral zinc, for diarrhoea, which is nowNational Policy.
VHTs treat Neglected Tropical diseases in 64 Districts.
25
18
5
7
7
64
11
1
36
0 10 20 30 40 50 60 70
Malaria
Diarrhoea ORS
Diarrhoea Zinc
Pneumonia
First Aid
NTDs
DOTs TB
ART
Contraceptives
Districts VHTs CHWs currently carrying out Treatment and
Commodity distribution at Community Level N=80

The Ministry of Health will be introducing
case management of sick children into a
number of Districts during 2009-11 This will
include treatment of malaria, pneumonia,
diarrhoea and screening for malnutrition
using MUAC by VHTs .
Few VHTs know simple basic first aid, and
this is an area that many Districts would like
to address. Some Districts have close
working relationships with the Uganda Red
Cross who carry out basic first aid training
Pilot Districts Community Case
management 2009-2011
Pilot Districts






Nutrition
What do VHTs do?
The VHTs and other community volunteers carry out the following interventions at community level
Nutrition assessment of all age categories using the Mid-Upper Arm Circumference (MUAC)
Carry out the Growth Monitoring Promotion (GMP)
Carry out nutrition education and counselling at the community level
Referral of individuals needing medical attention, RUTF and follow them up
Register the community members seen and send reports to the health centres
Some VHTs assist at therapeutic feeding centres at Health facilities and screening programs including outreach.
Nu-Life are supporting Community interventions via Community Health Workers and VHTs in 38 Districts.
8%
67%
25%
Districts Where VHTs Trained to
Measure Mid Upper Arm
Circumference
Yes All
No
Some

0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Yes All No Some
3%
81%
16%
VHTs have MUAC Tape?
District VHTs
have MUAC
Tape


Improving Child Feeding / Nutrition Practices
We know how to feed our children appropriately with the right foods. We know how often to feed them. We did not know before, we were
ignorant to this information.
"Those who breastfeed have to do it at least 6 times per day. For the children who eat, they need to eat at least 3 times per day with fruits and
vegetables at every meal. You don't wait for them to cry to figure out if they are hungry. We have learned to know what their needs are."
Each home in our area has its own gardens and in times of starvation/dry season, we learned to keep extra foods so that we do not have to
go to other villages to beg for food. We have enough, and this is because of the VHT/CORPs lessons.
Health Child Uganda 2009 Project Evaluation
Linkages
VHTs and Community Health Workers are also implicated in food security and communal and Kitchen Garden Programs,
Food distribution, and there are linkages with PMTC and Water and sanitation programs in many Districts.
GAPs
x There are many different non standardised MUACS
with differing cut offs for classification of
malnutrition and referral.
x Few VHTs have been trained Nationwide to read a
MUAC tape.
x Many Health workers are also unfamiliar with
measuring MUAC
x Few VHTs follow up after discharge resulting in
repeated admissions..
ACTION
There needs to be clear standardisation of referral criteria and MUAC tapes
Withdrawal of all non standard MUACs and replacement with the MoH 2009 Standard MUAC in
every District
Ensure Strong Effective links between Health Centres and VHTs implementing Nutritional activities.
All VHTs should be trained how to read MUAC, how to refer and how to follow-up after discharge
Train Health Workers in how to read MUAC and the management of Malnutrition, so that all
Children Referred by VHTs are correctly cared for.
Ensure that ALL children admitted to health facility have their nutritional status assessed no matter
what the diagnosis.
Ensure that children discharged from Therapeutic feeding centres are followed up at home by the
VHT


e. Nutrition
1
Methods for Assessing Severe Malnutrition at Community Level (UN Standing Committee on Nutrition)

Reproductive Health
Family Planning VHTs are trained in IEC for family planning, and they distribute condoms
and oral contraceptives VHTs are also involved in operational research
in providing depot contraceptive preparations
What do VHTs do?
GAP
Despite VHT involvement, the population growth is currently one of the
highest in the world at 6.3%. Over 41% of women do not have access to
FP services.
The actual number of contraceptives distributed as registered in HMIS
is minimal. Spacing births can reduce maternal mortality by more than a
third, and also reduce newborn deaths
ACTIONS
Ensure that those VHTs distributing contraceptive have sufficient and
uninterrupted supplies. Ensure health workers provide regular quality
services for those referred to Family Planning Services by VHTs
Pregnancy
Pregnant Women Malaria
Prevention
IPT2 (2008-9)
4 Antenatal Clinic Visits (2008-9)
What do VHTs do?
VHTs register pregnant women in their villages,
they encourage women to attend antenatal care,
to prepare for delivery and to deliver at the
health centres They mobilise pregnant women
for outreach for tetanus immunisation for IPT2
and also ensure that they sleep under an
insecticide treated bed net ( ITN or LLIN)


GAP
Recent coverage data for ITN /LLIN / mosquito
net usage by pregnant women was not
available at any District visited.
IPT2 should exceed ANC4, the fact that it
does not implies that even if VHTs encourage
attendance at clinics and outreach, the
women are not receiving comprehensive
antenatal care. Although in the past many
health centres reported distributing ITN/LLIN
at Antenatal clinics, only 5 health centres out
of the 130 visited had nets in stock on the
day of visit.
Antenatal HIV testing of pregnant women
could be improved in some Districts.(Profiles)

<20%
20-39%
40-59%


<20%
20-39%
40-59%

Good Practices
VHTs in many Districts have increased Antenatal clinic
attendance. However, ANC4 drops off dramatically.(See Profiles)
Actions VHTs to ensure that all pregnant women to attend 4
Antenatal Clinic Visits
Districts and In charges to ensure that women who attend ANC
are assessed and examined correctly including blood pressure
measurement and women given preventive drugs and
Counselling for HIV testing as part of comprehensive ANC.
ANC Visits should be supervised regularly. The necessary
equipment if absent or not functional, must be ordered.

1
SCN Nutrition Policy Paper No. 21
WHO, UNICEF, and SCN Informal Consultation on Community-Based
Management of Severe Malnutrition in ChildrenFood and Nutrition Bulletin, vol. 27, no. 3 (supplement)M. Myatt, T. Khara, and S. Collin
f. Reproductive Health
Intra-partum
Percentage of Women Delivering
in a Health Unit 2008-9
What do VHTs do?
VHTs encourage mothers to deliver in health facilities. VHTs members who
are former trained TBAs encourage mothers to seek care for themselves if
any danger signs.
In some Districts Many TBAs still conduct deliveries at home, and in Districts
where few midwives TBAs also deliver in the health centres. Some trained
VHT/TBAs can resuscitate using ambubag, and do so if the singlehanded
midwife is away from the health facility.
Some VHTs are rewarded for accompanying pregnant women to deliver at
the health facility.

Postpartum Care


Less than 15%
15-29%
30-49%

All District Health Teams recognized their lack of action in post partum
care at health facility and in the community as a problem. This gap
leads to avoidable death in women and their newborn infants.
Many Health workers are unaware of When and Why Postnatal are
necessary, and what needs checking at Postnatal Visits. Post natal care
is often seen as something just for HIV positive women and their
infants Analysis of HMIS data 2008-9 shows that only 18% of women
receive ANY postnatal Check.In 52/80 of Districts this visit is at 6 weeks. .
33%
30%
16%
9%
4%
4%
4%
Causes of Maternal Deaths
Source: Khan, Khalid S., et al, Lancet 2006:367:1066-74
Haemorrhage
Other Causes
Sepsis Infections & AIDS
HypertensiveDisorders
Anaemia
Obstructed labour
Abortion

Any Post Natal Visit %
HMIS 2008-9
Why Mothers and babies need Post Natal Check with trained Health
Worker:
An estimated 42% of maternal deaths are during birth or the first day after birth
Most neonatal deaths occur: in the first 48 hours of life and almost all within
the first week of life



5%
5-9%
10-19%

Timing of intrapartum-related deaths in a community setting in rural Sarlahi,Nepal. Source: Nepal Newborn Washing Study, SarlahiNepal of 23 662 live
births in the community A total of 759 newborns died in theneonatal period (NMR 32), of which there were 180 intrapartum-related neonatal deaths of
babies N34 weeks of gestational age. Almost all intrapartum-related neonataldeaths occurred in the early neonatal period: 67% in the first day of life, 86% in
the first2 days, and 99% within the first week of life
0
0
0
52
28
24 Hours
24 Hours & <1 Week
24 Hours & 1 Week & 6 Weeks
24Hours & 6 Weeks
At 6 Weeks only
Timing of Postnatal Check with Health
worker in Districts (N=80)
Postnatal Check with Health worker



GAP
Only women delivering at a health facility are likely to
receive a post natal check within the first 24 hours after
delivery, from a skilled health worker, however many
are never properly checked. During the District visits a
young healthy woman gave birth in a health facility.
The pregnancy and delivery were normal, the delivery
was normal and the newborn was normal. The midwife
did not recheck the mother and infant after delivery,
and the mother haemorrhaged to death, 6 hours later.

Almost NO VHTS are currently referring mothers and
infants for routine postnatal checks or care.
Some VHTs trained in safe motherhood and former
TBAs trained as VHTs refer mothers with danger signs
but this is not systematic.

What do VHTs do?
160 VHTs have recently been trained in 8 districts on home visiting
and post natal care.
In Kisoro District community based transport systems linked to
traditional burial groups, transport sick mothers and infants for
health care.(See District Profile)
A few ex TBA VHT members were found to be referring mothers
and newborns for routine postnatal checks with a health worker
soon after delivery, but this was a rare practice.
A precious opportunity to save lives of mothers and
infants is lost

Any post natal care or review is at 6 weeks. All
women and all newborns whose lives may have been
saved, have already died.
Innovations:
In Kotido the lessons learned from institutionalising antenatal care, by linking ANC with food distribution and bednet
distribution will be applied to institutionalise postnatal checks in the face of very high home deliveries. Soap and Isuka
(lightweight blanket) will be given to women attending for checks for themselves and their newborns in the 24hours after
birth.
ACTIONS
M o H Department of Reproductive Health and Districts must inform ALL health workers of the importance of skilled post
natal checks for both Mother and the Newborn.
Health Workers should know Why Post Natal Checks are carried out, When they should be carried out and What they should
do for the mother and her newborn at each of these visits.
VHTs MUST be trained to encourage women to attend for 3 post natal checks with a skilled trained health worker even if
born at home.
All VHTs must know that immediately drying a newborn and keeping warm can save up to 10% of early neonatal deaths.
Districts should train VHTs with access to mothers and their newborns to carry out at least 2 home visits, the first should be
within 24hours of birth, the second on day 3 and if possible a third before the end of the first week of life.
2

New born care Evidence
3

What do VHTs
do?
Home Visits for the Newborn
Child have started in 8
Districts, but only 120 VHTs
have so far been trained in
newborn care.
An estimated 10 oI intrapartum-related neonatal deaths could be averted by the immediate steps of drying and stimulating a
baby who is not breathing
Community and outreach care have been estimated to reduce neonatal deaths by around a third
Studies oI community cadres (CHWs) have demonstrated that with adequate training, danger signs can be identified
There is convincing evidence from cRCTs demonstrating that CHW interventions may mobilize communities to increase rates
of care seeking and skilled birth attendance
In high mortality regions with low skilled birth attendance rates, increasing coverage oI both community and Iacility-based
care to 90% could avert up to 67% of all neonatal deaths
CHW packages may result in 36% reduction in ENMR
Evidence from several observational studies shows that facility-based basic neonatal resuscitation may avert 30% of
intrapartum related neonatal deaths.
Innovative community-based strategies combined with health systems strengthening may improve childbirth care for the rural
poor, help reduce gross inequities in maternal and newborn survival and stillbirth rates, and provide an effective transition to
higher coverage for facility births
Good Practices


In 5 health Centres visited staff had good knowledge and skills in relation to the sick
newborn, and low birth-weight infants. In one health facility a VHT demonstrated
perfectly how to resuscitate a non breathing baby, which she had been taught during
training. Her skills outclassed those of many health workers.
Challenges
In those cultures and communities where the traditional postpartum period of
seclusion is practiced ,and in those villages where all VHTs are male, it is difficult to
access mothers and newborns, and this is why trusted respected former trained TBAs
should be included into the Village Health Team.
Even if VHTs systematically referred newborns born at home and all those with
danger signs, the health system is un prepared and the necessary knowledge, skills
and basic equipment relating to the newborn not available.
Although low-birth weight is a risk factor for mortality and an HMIS indicator , only
55% of health facilities in the Uganda Service Provision Assessment Survey had
functional Infant scales.
Only one third of health facilities visited had functional neonatal ambu- bags, and yet
this is not on the inventory of essential equipment, so health workers and Districts
neither check nor order this low-cost life saving piece of equipment.


2
WHO UNICEF Joint Statement Home Visits for the Newborn Child: A strategy to Improve Survival
3
International Journal of Gynecology and Obstetrics 107 (2009) S89S112
GAPS
VHTs in general do NOT have a good knowledge base in relation to the new-born. They do not know danger signs for the
newborn baby. They are unaware that small or Low birth weight babies are at high risk of death and need special care.
VHT home Visits for the newborn just being introduced in 8 Districts, but the knowledge and skill base of many low- level
health workers is insufficient to manage newborn problems if they were referred by VHTs with complications or danger
signs.
Knowledge of management of low birth-weight infants was poor in all levels of health facilities visited. Health workers did
not know that low birth weight infants have a higher risk of death. Few had heard of kangaroo mother care, and 90% did not
know that low-birth weight infants, need feeding more frequently( 2 hourly)
90% of health-workers questioned carrying out deliveries in the health facilities visited did not know how to manage a non-
breathing newborn yet this could avert up to 30% of deaths.
In Health facilities visited (50%.) did not have neonatal ambu-bag and masks for the newborn, and only 3 had algorithms for
management of the neonate.
ACTIONS
All VHTs and Health workers should know that if both the mother and whoever helps her deliver the newborn , wash their
hands before delivery and before handling the baby,then early neonatal mortality can be reduced by over 41%
4
.
All VHTs should know and share knowledge that newborns should be dried immediately and kept warm,(mortality reduction
10%)
All VHTs need to refer newborns for postnatal check, immunisation, weighing and birth registration as soon as possible after
birth.
VHTs should be taught to recognise danger signs in the community and to refer immediately.
All health workers carrying out deliveries should have knowledge and skills to manage the non breathing baby, and a low-
birth weight infant.(<2.5kgs)
All health centres delivering pregnancies should have algorithms for management of newborn problems, and the minimum
equipment required for basic resuscitation.
VHTs with access to the newborn should be trained in home visits and newborn care
HIV and PMTCT
HIV Prevalence (Source STD/AIDS
Control Program,
Kampala
8.5%
2.3%
3.5%
5.9%
6.9%
8.2%
5.3%
8.5%
6.5%
Uganda total: 6.4%
Ministry of Health 2009) percent of Men
and Women 15-49 HIV positive
What do VHTs do?
Some VHTs are Peer Counsellors and persuade community members to attend HIV
Counselling and Testing.
VHTs carry out home visits ,when pregnant women are encouraged to attend ANC and
HCT
Pregnant women who are HIV positive are linked to PMTCT.
VHTs Educate caretakers of AIDS ill patients on how to protect themselves from
infection and Home Care
GAPS
There are many Good HIV programs in the Districts and their activities are well
coordinated and supervised at District level, however many of the community health
workers involved in activities are outside the VHT system.
Even if women are tested for HIV and deliver in the health facility they are not always
given antiretroviral treatment to protect the new born (PMTCT). Newborns delivered in
the unit are also not guaranteed antiretroviral treatment.
Pregnant Women Tested HIV Positive
MoH HMIS 2008-9
Reproductive Health & PMTCT MoH HMIS 2008-9



4-7%
8-11%

0 20 40 60 80 100
% Women given Malaria Prophylaxis (IP2)
% 4 Antenatal Clinic Visits
% HIV positive given PMTCT
% Women delivering in UNIT
% HIV Positive Women delivering in UNIT
% Exposed newborns born in UNIT given
ARVs*
Any Post Natal Visit
61
63
35
65
53
15
82
39
37
65
35
47
85
18
Unreached % Coverage %


4
Victor Rhee, MHS; Luke C. Mullany, PhD; Subarna K. Khatry, MBBS; Joanne Katz, ScD;
Steven C. LeClerq, MPH; Gary L. Darmstadt, MD; James M. Tielsch, PhD ARCH PEDIATR ADOLESC MED/VOL 162 (NO. 7), JULY 2008

ACTIONS
VHTs can encourage women to be tested for HIV , to attend antenatal appointments with a skilled health worker,
and to deliver in a health facility. They can also facilitate referral and working with their communities, set up
community transport systems
They must also encourage ALL women no matter where they deliver to be checked by a health worker as soon as
possible after birth. The newborn also needs to be checked, weighed, immunised and the birth registered. Infants
born to HIV positive women need Antiretroviral medicine after birth.
All VHTs need to be taught the danger signs in pregnancy, Childbirth and for the newborn.
All VHTs should include inform their communities of these key messages and include these activities in their
calendars
Child Health
What do VHTs do?
VHTs learn about key family practices in their Health Promotion Training. They are active in
all health programs relating to child health including immunisation, nutrition and hygiene.
They take part in Child Health Days and Immunisation Campaigns. Some VHTs assist at
outreach and outpatient services, triaging, registering, weighing , measuring MUAC, and
giving health talks
Gaps
Few VHTs are aware of danger signs and the importance of early referral.
Few VHTs are supervised in their child health activities
Not all VHTs are trained in referral
Few are trained in nutritional screening although under-nutrition contributes significantly to child Mortality
Few VHTs are trained in treating sick children.
VHTs do not have uninterrupted supplies of the necessary drugs, and are not frequently supervised.
There is poor documentation of activities and outcomes.
54
33
25 24
19
33
25
31
45
38
26
159
129
94
128
116
177
185
145
181
200
174
0
50
100
150
200
250
Neo Natal Mortality Infant Mortality Under 5 Mortality

Mortality rates by Region (per 1000 Live births) Uganda DHS 2007
Deaths in Children Uganda

MALARIA
23%
PNEUMONIA
21%
DIARRHOEA
17%
HIV AIDS
8%
MEASLES
3%
INJURIES
2%
OTHER
2%
NEONATAL
24%
Causes of Under-five deaths

2% 2%
7% 7%
26%
31%
0%
10%
20%
30%
Causes of NEONATAL deaths

Source: Lawn JE, Cousens SN for CHERG (Nov 2006) World Health
Organisation

Health Facility deaths in children 2008-9 by cause can be found in the
District Profiles. The HMIS data do not represent the majority of
deaths in children which occur at home.
Actions
These have been captured in the relevant sections on training ,supervision, data
collection .
Water and Sanitation
Access to Latrines by District
(2008/9)
5
Safe Drinking Water Coverage
below 60%(Rural ) 2008
6
Safe Drinking Water Coverage
(Rural Population) 2008




<20%
20-39%
40-59%
60-69%



<20%
20-39%
40-60%
Urban
No Data



<20%
20-39%
40-59%
60-79%
80-95%
Urban
No Data
What do VHTs do?
VHTs are extremely active in this area In Social Mobilisation and Education, and latrine
digging.
IMPACT
For many examples see Impact section
Good Practices
" They did not stop there, they also taught us to preserve the walls of our
latrines, to get small containers of water and put them near toilets so that once
you use the facility you wash your hands, boiling water for drinking, teaching
children that when they are thirsty they should use a clean cup and showing
them where the container with clean water is stored."
GAP
Some Districts have a clear problem with out breaks of diarrhoeal diseases,(typhoid
cholera hepatitis E) and all of their VHTs should be trained in water and sanitation, and
the importance of hand washing and yet many are not ( See District Profiles)
ACTIONS
Ensure all VHTs especially those who missed standard VHT health promotion training
are trained and active in water and sanitation.

h. Record Keeping and Reporting
What do
VHTs do?
VHTs fill out their registers, record household members, births and deaths and home visits,
patients treated. Some VHTs report monthly summarising the data and reporting to the
health centre to which they are attached (See section on data and reporting)
GAP
Many VHTs do not have a register. Those who do not necessarily use them, and many do not
summarise the data and report. Many did not have training and practice on how to fill out the
register.
ACTIONS
Ensure VHTs learn how to fill out register and have practice during training
Ensure that the register is simple and collects the essential information for action and District
Planning AND Ensure that valuable birth and death data is collected and used.

5
Government of Uganda, Ministry of Water and Environment Water and Environment Sector Performance Report 2009 October 2009
6
Mapping a Healthier Future 2009 World Resources Institute, Ministry of Health Uganda, Ministry of Water and Environment Uganda


g. Water and Sanitation
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Section 9:.Supervision of Village Health Teams
Supervision of Village Health Teams is acknowledged by all
Districts and key Informants interviewed as crucial for
maintaining and sustaining VHT performance and as a motivating
factor for VHTs, however the activity has rarely been carried out
by supervisors during the past year. Districts cite lack of budget,
and low staffing as a cause.
NGO projects are more likely to supervise the VHTs supporting
their projects..
29%
63%
8%
Any Supervision of VHTs during the
past 6 Months? (N =62)
Yes No No Info

Who Supervises the VHTs?
x Health Centre Staff in charges HCII, III and IV
x The District Health Team including District Trainers
x Community Development Assistants
x Health Assistants
x District Health Inspector ,
x Health Sub District Supervisors,
x Environmental Assistants
x Peer Supervisors,
x Parish Coordinators
x Parish development Committees
x Sub County Supervisors
x VHT coordinators,
x VHT Supervisors
x NGO Staff on projects using VHTs
x The Community itself
Supervision Training
19%
78%
3%
Have supervisors had ANY training
on how to supervise VHTs?
Yes No No Info
Very few VHT supervisors have had specific
training on when what and how to supervise
VHTs.
If Health centre staff were not involved in VHT
training, and there are no effective linkages
then it was found that no VHT had ever taken
place
How are VHTs supervised?
A number of health facilities supervise VHTs when they come to help out at the Health Centre. Their registers are
reviewed, and they given new information, and skills. This method was very popular with the VHTs and the health
workers supervising. In the Health facilities carrying out this method of supervision, the VHTs and health workers had
very close ties and mutual respect, and the VHTs helped out with simple routine tasks such as organizing queues,
weighing, checking MUACs and registering patients.
Districts which had called together large numbers of VHTs to monthly meetings had been unable to review VHT
registers, but had reported important discussions with the VHTs.
Quarterly meetings were popular with health staff some VHTs, but VHTs preferred individual or smaller group
supervision.
A number of Districts started supervision at the inception of the VHT strategy, with quarterly or monthly meetings;
however lack of funding has meant that this has not taken place for a number of years.
VHTs carrying out activities for vertical programs involving Treatment and distribution of commodities are much more
likely to be supervised than those only carrying out health promotion and social mobilization. Few VHTs are supervised
in their villages, those who are are by NGO supported projects especially relating to Malaria and HIV and those carrying
out treatment
Quality of Supervision

Supervision is not standardised and depends on the personal training, Knowledge
and skills of the supervisor
Observed Supervision comprised review of VHT registers and discussions of
problems.
Few Districts and fewer Supervisors had a VHT supervision work aids or check lists.
The objective of supervision (what to supervise) is to ensure VHTs are
active and functional and to assess core competencies related to their basic
functions and build skills. These are the skills and knowledge learned during the 5
day basic training in Health Promotion and Health Education.
What is supervised over time and between VHTs will vary as skills and
competences will improve.

13%
84%
3%
Is there a VHT supervision checklist?
(N=62)
Yes No No Info

5 Steps of Supervision
Initiation of implementation (getting the VHT started)
Maintaining performance
Data Monitoring of process and progress
Documentation
Evaluation


VHT CORE COMPETENCIES
x Knows roles and responsibilities
x Knows Key Messages (Key Family practices)
x Know ALL danger signs for pregnant woman newborn and child
x Able to use and read a MUAC tape
x Knows disease to report
x Able to correctly fill out VHT register
x Able to correctly fill in standard referral letter
x After CCM or other treatment training, able to select the correct drug
x Able to treat correct dose and duration (after checking expiration date)
x Able to counsel correctly using VHT Cards and other counselling tools
x Able to give appropriate pre referral treatment (correct dose)
The supervisor should
x Review register and reporting of VHTs
x Assess and ensure that VHT have the supplies and equipment necessary to carry out their function
x Assess drug management
x Assist VHT to find solutions to problems
x Build linkages between the VHT and the community and VHT and the linked health Centre
x Build linkages between the Health Centre and the VHT and community
Feed back from
the Districts
Supervision is essential to maintain interest of the volunteers
Poor quality inspection type supervision leads to de motivation and loss of VHTs.
We dont have the time to visit all the VHTs
We dont have a vehicle to supervise
Feedback from VHTs We like it when we meet our supervisors, we chat and discuss our problems and what we
have done since we last met.
They used to give us homapak drugs at supervision but now they dont have them so we dont come
The health workers teach us new things and show us how to do things and we practice Thats why we like coming to the
health centre every month
Good practices and a Supervision Model that works
Each VHT chooses a day per month and is placed on roster at the health centre to which they are attached.
If there are 100 VHTs attached to the HC then they attend in groups of 3-4.
The supervisor checks the registers gives feed back and collates data. He or she then gives the VHTs new knowledge or
an update e.g. on an outbreak of meningitis and how to refer urgently and how to fill in register appropriately. The VHTs
if available stay and assist in clinic giving health talk, organising queues, registering patients or checking muacs This is
another opportunity to supervise and reinforce skills and knowledge. The VHTs collect any supplies and incentive before
leaving
This model was popular with VHTs and health workers carrying it out
This model appears cost effective, feasible and sustainable
In some Districts excellent rec
ords of VHT supervision and discussions with VHT were seen




5 Steps of Supervision


Gaps
x No Routine Supervision in many Districts
x Supervision model whereby health worker goes out to supervise VHTs in the
community is NOT doable or sustainable in many Districts. There are inadequate
health staff or resources.
x No Supervision training in many Districts
x No Supervision tools including registers in many Distraicts
x Inadequate staff and finance to ensure VHTs supervised at community level.
Opportunities
.Those Districts where supervision has lapsed could revisit what model of supervision may
work in their District with the resources that they have available
Districts should learn from those projects and Distrcts which are able to sustain quality
supervision. .
ACTIONS
See Supervision as Coaching , Support and an opportunity to increase knowledge
Train Supervisors
Document Supervision contacts and what was done at each visit
Supervision tools and reporting need to be developed
VHTs need to be supervised and mentored/coached regularly

Supervision Models suggested by District Teams and Partners
Community level
Supervisor visits VHT on the job in community where he/she works and sees VHT individually or in small groups
(problem solving and feedback)
Supervisor groups VHT in pre designated community or at outreach
Health Centre
Individual Supervision takes place once
monthly when VHT attends for review of
Register, collection of supplies and lunch
money or other incentive

Groups of VHT supervised once monthly at
monthly meeting
Groups of VHT called to health facility for
supervision and peer review
On job training VHT working closely with
health workers on nutritional assessment with
MUAC, Giving health talk case management
(after completing training), closely supervised
on a Rota/roster system
Refresher sessions to introduce new skills or
improve/maintain skills on core
competencies(video and cases)
Combination of community and Health Centre
VHT observed in community setting either individually or in small groups to enable peer input, plus sessions at health
facility to ensure core competences maintained
Visit to home of child treated during past week to observe appropriateness of treatment and counselling given and
whether the caregiver able to follow. plus sessions in health Centre for core competencies at health facility
Other
Other contacts between VHTs and their supervisors eg Use of telephones, SMS
messages reporting the availability of equipment and supplies, and information
discussion of problems such as disease outbreaks.
Section 10: Documentation Reporting and Linkage with HMIS
Documentation
Documentation of the process of Implementation of VHT Strategy at District level is non existent in most Districts
Lists of people attending meetings and trainings is often the only data accessible. Even then this information is not
easily available. A few Districts had quality data available, but this was the exception.
Importantly Coverage data and Impact data which measures progress and can be used for advocacy is very
difficult to access. Almost half of Districts visited did not have an up to date list of NGOs CBOs and CSOs available
at the District Medical Office.
Only 30 Districts kept a list or register of active trained VHTs.
VHT Registers and Record Books
Only in 11% of Districts do all VHTs have a Register or
Record Book. In 36% Districts, some VHTs have a Register
or Record Book. However there are differences between
Registers used in different Districts, depending on which
partner supplied them.
Approximately 20 % of VHTs have more than one Register.
The Ministry of Health VHT Record Books Capture
Information on Village Population and Household
Membership, Births and deaths, Education Status,
Pregnant women and their antenatal status, Child hood
Immunisation and nutrition record, children treated for
Fever, and diarrhoea, Water and sanitation. Some
registers also list members of the community currently
under treatment for tuberculosis and HIV.
There is no section for documenting the actual activities
carried out by the VHT during the previous month, neither
cases of diseases of Epidemic potential nor Vaccine
preventable diseases such as neonatal tetanus or measles.
36%
53%
11%
VHTs Currently have VHT Register?
Yes all No Some

0% 20% 40% 60% 80%
Yes all
No
Some
No Info
Other Registers?
% Having Additional Registers

0 2 4 6 8 10
No.Other Registers Per VHT
1
2
3
4
5
6
Additional Registers used by VHTs
Number of Districts






Collation and Analysis of Data
VHTs are expected to fill in their VHT register and
collate Reports and to share with the Health Centre to
which they are attached. As seen in the training
section some VHTs have neither been trained on how
to use the register nor to summarise and report.
Others do not have registers, but even when they
have been trained and do report, the data collected is
often not collated by the health facility staff and sent
to the next level. At District level on the day of visit
only 6 Districts were able to share recent data
although 10 Districts report that they collate VHT data.
Of those Districts that collate their data few actually
use the data, although it would be very useful for
prioritising health needs and planning activities. The
Data is used largely for planning, monitoring
implementation and disease surveillance.
Births and deaths although often carefully noted by
the VHTs is rarely collated and used.
Vertical Programs such as the Neglected Tropical Diseases
,Malaria, Systematically Collect, Collate and used data for
Monitoring and Planning


Summarising and Collating Data by VHTs
9%
89%
3%
Is Any VHT data used?
Yes No No Data

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%
Advocacy for financial support
District Planning
Malaria Planning
Monitoring VHT Activities
Water and Sanitation Coverage & Planning
Organising Mass campaigns
Documentation of Service utilisation
Outreach Strengthening
Identifying Health Problems & Monitoring
Base line surveys
Births and deaths Registration
Community Death Audit
Family Planning Supply
PMTCT Monitoring
Replenishment of medicines in community
Disease surveillance
Monitoring Referrals
Use Of VHT Data

20%
15%
14%
13%
9%
0%
5%
10%
15%
20%
25%
By VHT By HCII By HSD By DMT VHT Data Used
Data Collation Summary and Analysis
Data Loss and Wasted Effort

Mortality Data
Documenting deaths at home/in the community of Pregnant women,
newborns and the under 5s and the linkage of this data into the HMIS
system will mean that previously undocumented deaths will be counted

Mortality data is essential for tracking progress and measuring impact after
VHT trainings, and the introduction of new treatment strategies into the
villages.
The data in the VHT register is also essential for triangulating data which is
in the National Vital Registration held by UBOS, and for ensuring that all
Newborns are Registered and Obtain a Birth Certificate
It is essential that VHT records are linked into Vital registration via the
Village Data Collector and The District Planning Office.
8
10%
63
79%
9
11%
Village Mortality Data available?
Yes No In Theory


Linkage with Health Management Information systems
Current HMIS Reporting /Indicators for the
community :
Only Malaria activities and Treatment in the community are currently
captured in HMIS data. More importantly Maternal Newborn and
Child deaths at home remain UNCOUNTED
Data Quality
HMIS data was difficult to access and incomplete. The quality of
some data eg mortality data in the under 5 s in some Districts
appears inaccurate. It is unlikely that less than 5 children under 5 die
in a year in a District.
Denominators for calculating EPI and ANC coverage lead to coverage
data that is very difficult to interpret. If Village health Team Register/
Record book data were used to correct the denominators, then much
more accurate data which could be used for effective planning would
result.
Clients crossing Borders areas inflate coverage data in some
Districts
x % of children under five with fever who receive malaria
treatment within 24 hours from a community drug
distributor (Village Health Team)
x Percentage of households with at least one Insecticide
Treated Net (ITN)
x Percentage of households with a pit latrine
x Number of Active VHTs
x Number of Active Community Health Workers
x Number of trained TBSa
x Number Of Community Drug Distributors
However Data Recording is often incomplete.
Good practices
Some Districts and NGO projects collect data from VHTs at monthly visit to the health facility or at monthly or quarterly
meetings. This data is used by the VHTs in collaboration with the communities they serve. Information for Action to change
the health situation
VHT/Corps in Bushenyi and Mbarara meet monthly and share their data which the VHT coordinator collates. The in charge
of the health centre to which the VHTs are attached is also present. Plans for future community activities are agreed with all
present. All deaths in the community are reported documented and discussed. The VHTs also discuss means and actions to
avoid such deaths in the future. In Bukedea , Bushenyi and Mbarara VHTs have a diary or calendar where they can write their
activities, and findings.
Opportunities
The VHT registers are currently being updated and simplified. Now is the time to institutionalise a workable reporting system
integrated into HMIS.
Simple reporting can be via rapid SMS directly into a SMS gateway and then integrated into HMIS or even Vital registration
databases.
Actions : Simplify the VHT register and reporting form, collecting only essential information which will be used.
Ensure that gaps in the registers are addressed such as VHT activities and outbreaks
Ensure that data is summarised and collated analysed and disseminated to the community it came from and up to National
level
x USE THE DATA FOR PLANNING MONITORING AND MEASURING IMPACT
x RECORD AND USE MORTALITY DATA FOR MATERNAL NEWBORN AND CHILD DEATHS IN THE
COMMUNITY TO ASSESS THE REAL SITUATION AND PLAN APPROPRIATE ACTIONS
Average Monthly Under Five Deaths
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
Training 1 year 2 years 3 years
D
e
a
t
h
s

(
m
e
a
n
)
Group 1 (34
villages)
Group 2 (34
villages)
Group 3 (29
villages)
Group 4 (20
villages)

An example of how summarising and analysing data shows impact of VHT activities and
how VHTs saves lives.








Orupapura rwabahereza rwokuhandikaho ebikozirwe omumwaka (Handikaho burimwezi)
Abahereza________________________ EKYARO: ____________________
Okwezi okwok
ubanza
Okwak
abiiri
Okwak
ashatu
Okwaka
na
Okwaka
tano
Okwaam
ukaga
Mutayayire amaka angahi?
Emishomo yoona eyebyamagara
eyimushomeise
Abaana abazirwe nibangahi
Abaana abafiire kuruga aha mwaana
owazarwa kuhika ahawemyaka etano
nibangahi
Abaana abazirwe bafiire nibangahi?
Omwaana owazarwa atarireho,
atitsye nakakye nari atehindwire
Okufa okworahandikye kushemerire
kuba kukwatireine nenda ninga
nokuzara. Abakazi abafiire nibazara
ninga abafiire ahabwebizibu biresirwe
enda nibangahi (baba bakine enda,
nibazara ninga bahezakuzara))

0% 5% 10% 15% 20% 25% 30% 35%
Abim
Amolatar
Amuru
Arua
Bududa
Bukedea
Buliisa
Bushenyi
Butaleja
Gulu
Ibanda
Isingiro
Kaabong
Kabarole
Kalangala
Kamuli
Kanungu
Kasese
Kayunga
Kiboga
Kisoro
Koboko
Kumi
Lira
Lyantonde
Maracha
Masindi
Mbale
Mityana
Moyo
Mubende
Nakapiripirit
Nakasongola
Nebbi
Oyam
Pallisa
Rukungiri
Soroti
Tororo
Yumbe
Deaths Under 5 years Reported in HMIS 2008-9
% of Expected Deaths U5Y


6
54
2
List of VHTs available at Health
Centres (N=62)
Yes No Some
Section 11: Linkages Building Bridges: Access, Availability, Quality of
Care
34
12
16
VHTs Attached to Health Centres
(N=62)
Yes
No
Some

VHTs should be attached to their nearest Health Centre,
the health workers should know the VHTs assigned to
them by the District. However in almost one fifth of
Districts VHTs were not attached. They are called up by
the Districts vertical programs for ad hoc activities.
Even if they are attached and have good relations with
their VHTs, only 8 Districts had any lists available at health
facilities visited. This has implications when staff change
and new staff arrive.

Effective team work between VHTs and all Health
Workers at the health centres was seen in only 10
Districts, and with some health facilities in 29 Districts.
In 61% of Districts VHTs or other Community health
Workers assist with out reach activity.

This activity is seen as very important by the VHTs and
health workers for building good relations, improving
knowledge and skills of VHTs, and the respect that the
VHT receives from their community.
Having VHTs at outreach also allows for some supportive
supervision and on the job training, and also allows some
task shifting with VHTs organising queues, listing patients,
assessing Mid Upper Arm Circumference, and giving
health talk thereby allowing the health worker to carry
out the procedures or activities for which they alone are
trained.

It should be noted that most Districts at outreach carry
out Immunisation alone. This is a lost opportunity
especially in those hard to reach areas with no access to
health facilities.

Activities building links with Health Workers
VHTs assist Health Workers by mobilising for clinics, for
Child health Days and Campaigns. They refer the sick to
their attached health Centre, and follow up discharged
patients at home. A number of VHTs regularly attend their
health centre for supervision, and to help out at
outpatient, antenatal, nutrition and HCT clinics.
61%
6%
3%
14%
15%
1%
Content of Outreach
EPI alone EPI and ANC
EPI ANC and Health Education EPI and Growth Monitoring
Integrated Outreach No Outreach
15%
39%
46%
VHTs or CHW Assist With Outreach
(N=80)
Yes No Some

10
23
29
Team Work Health Centres & VHTs
(N=62)
Yes No Some

VHT Assists in ANC and PNC

Assisted Referrals
VHTs Assist in referrals s from their communities also
referrals using community transport schemes. Bicycles,
bicycle ambulances and community funding schemes were
reported in several Districts visited. Counter referrals were
rare






Access to Health Care
1
Within 5 KM 5 KM
Community - -
Pharmacy Drug Shop 17.5% 8.8%
Clinic 48.7% 32%
Health Centre 23.1% 23.7%
Hospital 10.7% 35.6%
Traditional Doctor - -

VHTs need to be active to
have impact.
In some Districts, the VHTs
are trained but only active for
campaigns. Their
communities effectively have
no access to community
health care.
More than 70% of villages are within 5 KM of a health
facility, however a number of Districts or areas of Districts
can be counted as Special Areas These include the
islands of Kalangala and Mukono. On Kalangala there are
11 health facilities on 7 of 70 Islands . Complications in
pregnancy or childbirth cannot be managed and transport
is expensive or not available and takes hours. In Karamoja
and some Districts in the North such as Nebbi and Koboko
some functional health facilities were over 50kms from
communities(See District Profiles)
Percentage of Households Owning a Bicycle
2



No Data




20-39%

40-80%


>80%-




1
Source Uganda Bureau of Statistics 2009
2
Mapping Socio Economic Indicators for National Development 2007 UBOS
Linkages with Other Sectors
All Districts had some linkage with the local political system,
however it was noted that Districts with well functioning
VHTs often had very strong links and support from District
leadership Examples of support ,local bye laws etc are listed
in Good Practices section. Linkages with other sectors were
not always as strong, however some Districts had very strong
linkages with Water and Sanitation, especially in those areas
subject or previously subject to outbreaks of diarrhoeal
diseases. Where VHTs are actively involved in Sanitation
weeks and other latrine related activities, Districts have been
able to register an impact.In some Districts the links are
strong with Forestry and tree planting schemes and in others
such as Amuria VHTs were rewarded with Oxen for their
services.
Water and Sanitation Environment
Education & Functional Adult Literacy
Agriculture Forestry Fisheries
Gender
Works Roads
Planning Finance
None Given
28%
31%
19%
3%
4%
19%
28%
Linkages With Other Sectors N =80

Female Literacy Rate
3


Linkages with Womens groups and Gender were noted in
few Districts, and need to be strengthened. Linkages with
adult literacy, both for access to classes for VHTs with low
literacy, but also to ensure that key family practice messages
and danger signs are shared and reinforced, should be
encouraged. Child mortality is related to maternal
educational level
Childhood Mortality by Mothers Education
(Mortality per 1000 live births) UDHS 2007
169
149
102
104
83
66
0 50 100 150 200
No Education
Primary
Secondary and Higher
Infant mortality
Under 5 Mortality


No Data

<20%

40-80%

80-100%

Uganda Red Cross Society

Some Districts have excellent relationships with their local Uganda Red Cross Society and some VHTs are also Red
Cross Volunteers. There are strong linkages for Emergency Preparedness and Action, and also for training in First Aid,
for Home care and other health interventions



3

Linkages with Health facilities
for Quality Life Saving Care
For maximum impact on mortality ( to save lives)it is essential that
Health-workers have the knowledge, the skills , the drugs and basic
equipment required . Health facilities linked with VHTs must attain
at least the Minimum Standards of Care.
During the Situation analysis the team observed and checked :
x Organisation at the health facility,
x IEC Materials available
x Basic infection control ( hand-washing practices and
availability of soap and water)
x Key knowledge and skills,
x Availability of ANC drugs and first line drugs for Malaria,
Pneumonia , Diarrhoea in children,
x Key Equipment functional Sphygmomanometers (BP
Machine), functional neonatal Bag and Mask,
x The presence of emergency algorithms ( childbirth,
newborn emergencies and basic emergency procedures
choking unconscious etc).
The team looked for good practices and reinforcement of health
messages and practices, which the VHTs are implementing in their
own communities.

Good Practices
Well organised health facilities were welcoming
and had well organised queues, with babies and
children separated from adults with infectious
diseases such as Tuberculosis.
A few health facilities practiced triage using
VHTs who know the danger signs in sick
children and pregnant women. A child with a
danger sign would be taken immediately for
care and not wait in the queue whilst
deteriorating or even dying.

Health facilities having hand washing facilities
for waiting patients
Health Facilities having hand washing facilities
for inpatients, and their carers

Health facilities with bed-nets hanging above
bed spaces for pregnant women, the newborn
and children.

Health Facilities which distributed Bed-nets to
pregnant women and children under 5 years
with Malaria who do not have a bed net at
home



Findings
x Health Centres with VHTs working as a team were more
likely to have organised queues with triage, less waiting
time and more frequent health talks.
x Health Workers with VHTs assisting at clinic were able to
concentrate on medical/clinical activities and the sick.
x Of the 130 health Centres visited only one health centre had
ALL first-line drugs for children under 5 ( ACTs First line
Antibiotic, Low Osmolarity ORS and Zinc) The remainder had
some of the drugs on the list.
x Only one health centre had zinc on the day of visit. ACTs
were out of stock in many health centres visited June-
September 2009.
x For ANC drugs ( Iron-Folate, SP, deworming drugs etc), only
40% of health facilities had ALL on the day of visit, 60% had
some.

Health worker with ALL drugs for under
5 s and Antenatal women
Many Health centres had no ACTs on
day of visit
Health facilities that had adequate sterilised
child birth sets
Health facilities that had emergency algorithms
displayed where emergencies take place

Health facilities that display IEC materials in
pictures in languages that patients understand,
and place appropriately eg diarrhoea
prevention and bed net usage in paediatric
ward, Breastfeeding , and danger signs for
mother and baby in post natal ward.




Essential Basic Equipment
x Some HCs had no bloodpressure machine (10)
x Of those that did , they only had one, and often it was not
available in the delivery room
x functionalNeonatal Bag and Masks were only available in a
third of health facilities visited.
Knowledge Actions Skills and Work Aids
Handwashing between examination of patients was rare.

Blood Pressure was not routinely measured in pregnant women by
some health workers.

As described in the neonatal section, health workers had poor
knowledge and skills for management of emergencies and the non
breathing newborn.
The management of a baby less than 2.5 kgs was poor even
amongst midwives.

In delivery room it was rare to find algorithms which would help
health workers during emergencies such as hypertension and
bleeding, which Kill .

Health workers were unaware of the importance of Postnatal
Checks and Care for both the mother and infant.

In 60% of health centres visited, children with diarrhoea were not
treated according to guidelines and were prescribed antibiotics for
non bloody diarrhoea.
Unless Health workers Knowledge Practicesand
Skills attain minimum standards, it is unlikely that
mortality will reduce .
ACTIONS
Ensure minimum standards of hygiene are practiced and supervised
Ensure that health workers have knowledge and skills relating to
basic emergencies
Ensure that health workers delivering newborns are competent in
basic newborn resuscitation
Ensure that health workers follow guidelines and that algorithms
and job aids are accessible and visible.
Ensure that basic equipment and drugs for maternal newborn and
child health are available .




Building Links With Future Generations of Health Workers.
In Some Districts Public Health Medical, Nursing, Midwifery and laboratory Students have attachments to the
community. These students work directly with the VHTs in the communities to which they are attached. These
schemes are very effective and help health workers understand the health problems faced by the communities, but
also the enormous capacities that some communities have to solve their own problems
Section 13 Information Education and Communication

IEC at community level:
VHTs in Many Districts write and perform songs, pieces of
theatre and puppet shows to convey health messages.
Some NGOs hold Competitions between Village health teams
for the best performance with prizes. The Communities enjoy
and remember many of the messages, and also the VHTs find
the activity very motivating.
Good examples found were in Child Health , Malaria and HIV.
VHTs linked to health facilities also gave talks at health facilities.
All VHTs met reported giving health talks in their villages.

Only in Karamoja, Northern Districts and areas of Districts
supported by partners did VHTs currently have IEC materials for
use in the community. These are for key family practices,
Reproductive Health, Making Pregnancy Safer, and Family
Planning, HIV Tuberculosis and Malaria prevention and
treatment.
Most IEC materials for community use are held by health
facilities. These include Materials on Making Pregnancy Safer,
Nutrition, HIV and Family Planning. Neglected Tropical Diseases,
Tuberculosis, Immunisation.
VHTs requested laminated flip charts in local language and in
pictures. The authors photographed all IEC materials seen
during field visits and this is available on request.
GAPS
DHEs indicated the need of VHTs to have materials not just
covering key family practices, but also
x What to do, when to do it, and how to for the VHTs
x Prevention of HIV Malaria, Tuberculosis, and adherence
to treatment.
x Neglected tropical diseases signs treatment and
calculating doses
x Simple First Aid
x Danger signs for pregnancy, childbirth, and post natal
period, newborns and Children
x Obstetric Fistula
x Newborn care
x Prevention and treatment of malnutrition
x Community based Surveillance of vaccine preventable
diseases and diseases of epidemic potential
x The importance of post natal checks and visits for both
mother and the newborn during the first week of life
x Care of the Small (low birth weight) infant

IEC at Health Facilities
Many posters are visible at health facilities. However the
majority of those on display at health facilities visited were
aimed at health workers in technical language, or in English.
Case management posters for Malaria, and Sexually transmitted
diseases and NTDs were found at most Health centres visited.
Posters rarely reinforce the messages given by the VHTs in the
Community







Section 12: Information, Education and Communication



GAPS
Few Health facilities had algorithms, posters or work aids on
case management in emergencies such as choking, burns,
unconscious, resuscitation of antepartum or post partum
haemorrhage, eclampsia or resuscitation of the newborn
No Health facilities visited had information about Village Health
Teams, their roles and responsibilities, or linkages with Health
facility.



Appropriate Language
x District teams requested that any IEC materials and
messaging should be in the appropriate local languag
x Many IEC materials are in English and yet literacy
in rural areas in English is often very low.
x Pre-prepared radio messaging for Campaigns and
Child Health days sent from Central level are
sometimes not in the appropriate local languages
for the District.
Key Family Practice flip charts provided to VHTs in ABIM
were in Ngakarimojong, which the VHTs cannot read.
Community Radio
The Majority of Districts had used the radio for disseminating messages to the
community during the past 6 months. The majority had given information on
water and sanitation, Child Health days and Immunisation and other
campaigns. Some had discussed Antenatal Care, PMTCT and family planning.
Only two had mentioned VHTs their role and function, and only one the
importance of postnatal care, and danger signs. The Use of Community Radio
Stations during 2009 by Districts can be found in the Appendix 3. Some Districts
need to make better use of the radio for regular dissemination of life saving
health messages.
61
13
6
Use of Community Radio Stations
2009 (N=80)
Yes No No Information

53%
68%
8%
Radio Spots
Radio-Talks and Phone- Ins
No Information
Type of Broadcast
Type of Broadcast

Radio for VHT
Education

The Ministry of Health is working with Health Communication Partnership (HCP) and other
partners to produce a distance learning radio program for VHTs. The program will work with
and supplement current VHT training efforts by providing continuing education, refresher
training and transfer of knowledge and skills to VHTs on a regular basis and in a cost effective
way. It will provide basic information to VHTs and empower them to do their job of providing
basic information, mobilize communities and refer people to health centers.
The overall purpose of the Radio Distance Learning program for Village Health Teams is to
provide Village Health Team members with information and skills that will assist them to
fulfil their roles and responsibilities as VHT members to maintain good health in the
community, strengthen the capacity of family members to provide quality care and support
in the home, and liaise with health facilities through referral and data collection.
Phone Network Coverage
2009
Use of Mobile phone Technology



Mobile Phone coverage of Uganda is good and ownership of the Mobile Phone is expanding.
SMS messages were recently used to remind subscribers of the dates of immunisation and Chi
Health Days and campaigns. A number of projects are planning to use this technology with
VHTs for reporting, supervision, follow up, drug management, Information dissemination for
outbreaks and for on the job training.
Actions

x The VHT flip charts currently available on Key Family practices should be updated to include simple
information in pictures on:- prevention of diseases and hygiene, disease surveillance, Simple First Aid, Post
Natal Care; Danger signs for Pregnant and Post Partum women, Newborn and Under 5s; Neglected Tropical
diseases , Compliance to drug treatment.
x A ring binder format would allow flexibility for Districts to insert pages related to the local situation
x ALL VHTs should have a copy of flip chart/Job Aid and receive instruction and support in using it.
x IEC materials displayed for community consumption at health facilities need to be simple and in languages
that the community understands.
x Link IEC Displays at health facility to the service being provided (eg danger signs in pregnancy in ANC).
x Health workers need clear algorithms and job aids for managing emergencies accessible at the place they are
needed( antepartum and post partum haemorrhage, non breathing newborn, choking etc) Many of these
have already been produced by the Ministry of Health and other organisations, but they are not available at
the health facility.
x Make algorithms available in EACH and EVERY health facility and save lives.

Section 14: Conclusions Challenges and Actions for
Maximising Impact and Ensuring Sustainability
Conclusions
The Village Health Team has enormous potential to save lives as seen in examples throughout this
document. However, VHTs are volunteers and need nurturing, mentoring and coaching.

Training is only the first step in institutionalising Village Health teams in any location. To be
functional the village Health teams need to be effectively linked to and belong to their nearest
health facility, and engaged regularly in activities. This is all part of a larger motivation package for
VHTs which includes, supervision, on the job training and importantly recognition, along with some
other motivating factors such as tee-shirts, certificates and lunch money.

VHTs need to have effective regular supervision, which is not currently taking place in many Districts.
Supervisors need some training, and simple supports to be effective. VHTs are most effectively
supervised in small groups or individually at health centres or outreach when they pass to drop off
reports and pick up supplies. Monthly and quarterly meetings are an important forum for sharing
information and ideas and knowledge, building links with the VHTs, and motivating VHTs.

Districts with strong VHT implementation have good coordination and strong leadership, and are
able to pool and share resources. However VHT implementation has costs and if a District has no or
insufficient resources, there is nothing to pool, and training and implementation becomes extremely
difficult. Effective planning is essential for quality implementation, but equally for ensuring that
health and environmental problems are prioritised and addressed using simple well known high
impact life saving interventions. These actions need to address both the community perceived needs
and the epidemiological situation.

VHTs are not the low cost answer to all Ugandas health problems, for maximising lives saved, the
VHTs must be linked and refer sick patients to the health service. Health facilities MUST provide at
least the minimum standards of care.
Health workers must also reinforce messages given by the VHTs to their communities, and be a
good example to the communities they serve. This means that health workers must wash their
hands between patients, soap and water must be available for patients and care givers to wash their
hands , and insecticide treated nets should be available for distribution and hanging in the health
facility to protect pregnant women, newborns and children under 5 years.

Health workers MUST also have the minimum knowledge and skills and basic equipment for
managing, emergencies, related to childbirth, the newborn and the severely sick child.
The Districts Ministry of Health and Partners, have a duty to ensure that every health facility
delivering mothers, and managing sick children have the minimum basic equipment , algorithms and
medications necessary to save lives.
All districts need to ensure that VHTs know what diseases, they need to report , what preventative
messages to share with their communities, and what they should do in the event of any outbreak.
All districts need to improve the knowledge of VHTs and communities in danger signs for pregnant
and postpartum women and the newborn. VHTs and communities need to understand that delays
cost lives.
Post natal Care for new mothers and their newborns, although life saving and evidence based is
rarely carried out by many health workers in the crucial hours and days after delivery.

Section 13: Conclusions, Challenges and Actions for
Districts could save thousands of lives every year if they ensure that VHTs and Health workers
addressed basic issues (water and sanitation, hand-washing, improved ,intrapartum and postpartum
care care at health facilities and care of the sick child), by improving linkages with the communities
via the VHTs and by providing quality care that attains minimum standards. Improving standards
services may in turn improve demand for services.

Some Districts will need additional support, and different models of implementation and
supervision, and imaginative solutions for early care and referral as the geographic and social
situation differs greatly from other parts of the country. These areas include Kalangala, the islands of
Mukono, Karamoja, and remote mountainous areas in Districts such as Bundibugyo, Kasese, Bukwo,
Kabaleand Kisoro.

Evidence into action
Districts need to review the epidemiological situation , prioritise activities and plan to implement
activities within the District systematically according to needs ( mortality and morbidity)
Districts Need to document VHT implementation, and their Village Health Teams.
Districts should use the documented situation analysis for advocacy and eliciting support from
relevant partners.
Districts must plan jointly with all partners to avoid duplication and gaps
The Ministry of Health needs to guide partners to work in Districts and areas least supported with
greatest need.
Care during and after delivery for mothers and newborns should be prioritised during 2010 if we are
serious about saving mothers and newborn lives and attaining Millennium Development Goals.
All Mothers and newborns no matter where delivered should receive 3 postnatal checks.
( Within 6 hours, Within 6 days and at 6 weeks)


IMPLEMENTATION OF
VHT ACTIVITIES
Advocacy
Human, material
and financial
resource
mobilization
Human resource
capacity
development
Communication
with families &
communities
Health system
supports
strengthened
Progress tracked
IMPROVED
Availability and
access to health
care
Quality of care
Demand for care
Knowledge of
families and
communities
INCREASED
POPULATION
-BASED
COVERAGE
of key
effective
intervention
s
IMPROVED
SURVIVAL
AND
HEALTH
Other determinants
ALL COMMUNITY HEALTH INTERVENTIONS VIA VHTs
References
1 Baylor College of Medicine Children's Foundation Uganda Annual Report 2007/2008
2 Bkiika C.S (2006), Implementation of PHC through CBHC and Importance of Community Participation in Health
3 BRAC Uganda & Living Goods Simple Habits for Healthy Living; Best Ways to Keep your Familt Healthy
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5 Government of Uganda; Birth & Deaths Registration, Short Birth Certificate
6 Government of Uganda (2007), Peace, Recovery and Development Plan for Northern Uganda (PRDP) 2007-2010
7 Forum on Health and Nutrition (2007), Malaria Control and Prevention, Strategies and Policy Issues
8 MACIS, USAID, CORE Group, CDC & MoH (2009), Counting Malaria Out in Partnership with CSOs
9 Malaria Consortium, DFID & LSHTM: Insecticide Treated Net Projects A Handbook for Managers
10
Malaria Consortium (2007) Rapid Diagnostic Tests (RDTs) for Fever Case Management: Parasitological diagnosis,
RDTs in Uganda - Characteristics & Implementation Experiences, Consensus Building.
11 Malaria Consortium, DFID, USAID, CDC (2006-2007)
12
Malaria Control Programme, (2006) Health Promotion and Education Division, Malaria Stakeholders and
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14
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16

Centre II
17

Centre III
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19

Uganda
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24 MoH (2000) Curriculum for Nursing Assistants
25

Ed.
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27

NTDs
28

Health Facilities
29 MoH - ESD (2003) Field Training Guide on CBDS for VHTs
30 MoH and WFP (2007), Guidelines for Planning and Implementation of MCHN Programme in Uganda 2nd Ed.
31 MoH (2006) Health Facilities Inventory
32 MoH (2008), Management of Diarrhoea Using ORT/Zinc: Implementation Plan within The Child Survival Strategy
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34 MoH (2008), Management of Diarrhoea Using ORT/Zinc: Implementation Plan within The Child Survival Strategy
35

in Uganda
36 MoH Health Sector Strategic Plan II 2005/6 - 2009/10 Volume I
37

Final Draft with Budget
38 MoH (2006) National Hospital Policy
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42 MoH (2006), National Hospital Policy
43 MoH 2007 -2015 Roadmap for Accelerating the Reduction of Maternal and Neonatal
44 MoH, Health Promotion and Education Division
45 PATH, USAID, UNICEF and WHO (2008) Final Report on the Uganda Inventory of Cold Chain Equipment - 2007
REFERENCES
46

Health Centre II
47
The Lancet Vol. 371 No. 9620. (2008), Countdown to 2015 for Maternal, Newborn and Child Survival: "Rapid
Progress is Possible, But Much More Can and Must be Done."
48

Uganda
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51 WHO (2007), Strengthening Health Systems to Improve Health Outcomes
52 WHO PEPFAR UNAIDS (2007), Task Shifting, Global Recommendations and Guidelines
53
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VHT Interventions and Standards using Recommendations
from Global Review of Community Based Primary Care
Community Interventions :Recommendations from Global review
1
Extensive evidence that the following interventions and approaches are effective
x Immunizations for mothers and children (especially tetanus-toxoid for mothers and measles for
children);
x Provision of supplemental vitamin A to children 6-59 months of age;
x Promotion of exclusive breastfeeding during the first 6 months of life and continued breastfeeding
after 6 months of age;
x Promotion of hygiene, safe water, and sanitation;
x Promotion of oral rehydration therapy (ORT) and zinc supplementation for children with diarrhea;
x Promotion of hand-washing before preparing food, before eating, after defecating, and after caring
for a child who has defecated;
x Promotion of clean delivery in areas where most births occur at home and where hygiene is poor;
x Community-based treatment of childhood pneumonia;
x Home-based neonatal care, with promotion of immediate and exclusive breastfeeding, cleanliness
and prevention of hypothermia.
x Community-based rehabilitation of children with severe acute malnutrition by the provision of
ready-to-use therapeutic foods;
x Insecticide-treated bednets (LLINs) in malaria-endemic areas;
x Indoor residual spraying in malaria-endemic areas
x Iodine supplementation in iodine-deficient areas.
The following interventions have evidence of effectiveness of improving child health along with
evidence of having other important benefits:
x Participatory womens groups for empowerment and education about maternal and neonatal
health issues;
x Non-health interventions, including micro-credit programs for women, conditional cash transfers
to women (in which poor women receive cash transfers with the condition that they obtain certain
health services), and education of girls;
x Promotion of socio-political environments which support maternal and child health and access of
the entire population to high-quality basic services
The following community-based interventions have been rigorously evaluated and do not appear to
have a beneficial effect on the health of children:
x Supplementary feeding programs in non-emergency situations;
x De-worming medication for children on growth or on cognition/school performance
The following community-based interventions appear to have adverse effects:
Iron supplementation to children in malaria-endemic areas (because it leads to increased need for
hospitalisation and/or death, and Micronutrient mix of iron, other minerals including zinc, and riboflavin
(an increased risk of diarrhoea)
1 1
How Effective Is Community-Based Primary Health Care in Improving the Health of
Children? A Review of the Evidence Henry Perry and Paul Freeman, Sundeep Gupta and Bahie
Mary Rassekh Community-Based Primary Health Care Working Group, International Health
Section, American Public Health Association 2009.
Appendix 2: Evidence for Community Interventions
Common Strategies of Successful
Community-based Programs
2
Recommendations for Uganda VHT
Implementation
Interventions
Priority should be given to expanding the coverage of
efficacious community-based interventions for promoting
child health.
Ensure that key messages and activities of VHTs cover those
evidence based interventions listed above
Community Trust in the Health System

Achieving high levels of coverage of key interventions
depends on the community having confidence in the local
health system. Trust, respect, and confidence arise when
local people have reason to believe that the health system
provides quality services and has the basic drugs and
supplies that it needs
Build links between the Community and HCII and HCIII and IV
x List VHTs attached to HC visible
x Roster VHTs to assist at HC at least once per month
x VHT Mobilize the population to attend services (EPI,
ANC, PNC, FP HCT at HC and outreach)
x Assist in organisation of queues
x VHT Assist in MUAC weighing
x VHT Assist in giving health promotion talks
x VHT Follow up of patients discharged home to
community including children from feeding
programs
x VHT Observation of adherence to treatment ( DOTs
ARVs and treatment from HC
x Ensure health workers take part in training of VHTs
and understand their roles and responsibilities
x Ensure health workers supervising VHTs have
training on how to supervise VHTs
x Ensure HWs have skills and knowledge equipment
and drugs needed for cases referred by VHT from
the Community
x Ensure that Drugs and Other supplies needed
are included in budget lines
x Build links between Health system and other Sectors
Links with formal health system through outreach
Effective outreach strategies from facilities to ensure
essential education messages and key services reach a high
percentage of families with women of reproductive age,
pregnant women, and young children MUST be in place.

Include assisting at outreach in Roles and responsibilities of
VHTs and content of training
x Social mobilisation for EPI ANC and PNC Child Health
Days and other campaigns and key interventions.
List in roles and responsibilities of VHT
x Build strong links with VHT for outreach. Include the
VHTs in activities (grouping children/women,
updating child health cards assessing MUAC giving
health talks etc

Home Visits
Systematic home visitation (i.e., to all homes on an ongoing
basis) is a common strategy as is the holding of satellite
clinics (i.e., a temporary site at which basic services such
as immunizations, family planning and prenatal care can be
provided intermittently, such as monthly, at locations
convenient to all households). Such approaches promote
equity.
a) Home visits in tasks/roles and responsibilities.
Clearly defined content and actions documented
and included in the VHT training.
b) Standards for home visits defined.(Frequency-of
these visits is not clear from evidence.)
c) Documentation of home visit, content ,action and
result in VHT register
d) Supervision that home visits took place by HCII and
other supervisor

Referral Care
a) Referral: Clear referral guidelines on when to refer
2
How Effective Is Community-Based Primary Health Care in Improving the Health of Children? A
Review of the Evidence Henry Perry and Paul Freeman, Sundeep Gupta and Bahie Mary Rassekh
Community-Based Primary Health Care Working Group, International Health Section, American
Public Health Association 2009

Many successful community-based programs have been able
to provide referral care as part of a systematic approach to
health improvement. Referral to a primary health care facility
and also to a hospital referral facility should be available as
well as counter-referral back to the community
.
incorporated into VHT training
b) Standards:: all referrals have a standard letter and
All are recorded in VHT register
c) Facilitated referral. Look at models where methods
of assisted referral work, and encourage
partners/projects supporting implementing VHTs to
put in place systems for referral care.
d) Include referral how to do it including writing a
referral note in the basic VHT training
e) Standard Home visits for patients discharged with
CLEAR instructions from HC on activities and actions
of VHT

Community Partnerships
Field studies are needed to measure the casual influences of
approaches fostering community partnerships and promoting
community and womens empowerment (including
involvement of communities in assessments of efforts to
improve the health of their children).
Build links between VHT and womens groups, Microfinance
groups, adult literacy groups. Supervisors ensure that VHTs
plan Health talks and share IEC materials with these
organisations..
New born Care

The evidence that community-based interventions can be
effective in reducing neonatal mortality is strong, and major
reductions in neonatal mortality will be required in order to
achieve MDG 4 (of reducing under-five mortality by two-thirds
between 1990 and 2015).
Recommendation: Efficacious home-based neonatal care
interventions need to be given prominence as part of a larger
health care package.

1. Include Standards for VHT relating to New born e.g.
ALL newborns should be weighed within 24hours of
birth. All newborns should have at least 3 post natal
visits 6 hours, 6 days and 6 weeks
2. Ensure that the importance of postnatal care is
included in the health promotion handbook, and
post natal visits are recorded in the VHT register.
3. Ensure that basic simple newborn care, and special
care of the low birth weight baby, included in the
VHT handbook and VHT basic Training
4. Ensure that content of postnatal visit for mother
and baby is clearly defined and shared with HCII and
HCIII. Ensure all health workers know why postnatal
care when postnatal care and what for postnatal
checks for mother and baby
5. Ensure that all VHTs and Health workers know
danger signs for newborn and mother.
6. Develop additional module for VHT training in
collaboration with National Coordination Committee
Indirect approaches.

These interventions include increasing the income of poor
women through micro-credit or direct cash transfers,
empowering women in other ways (e.g., education and literacy
training), and providing a social and political environment
which supports maternal and child health and which ensures
access to high-quality services Recommendation: Greater
emphasis needs to be given to expanding the implementation
of these interventions and to documenting their benefits
1. VHTs encourage education of girls and reduction of
school drop outs
2. Quarterly documentation of children In and Out of
school in Village VHT register and reporting to
District Education Office
3. Close linkage between VHT and literacy training (FAL
Functional Adult literacy). Ensure that relevant Key
messages incorporated into literacy classes and
materials with Coordination by DMT and Education
Department
4. Close linkage between VHTs and microcredit
associations/clubs (DMT)



Section 17: Health Policies, Strategies and Programmes supporting VHT
Implementation
The Village Health Strategy has support at the highest levels and a plethora of supporting policy.
Official Document, Policy or Directive Link to Village Health Teams
The Constitution of the
Republic of Uganda
The Constitution provides a foundation to
develop and improve the quality of life for all
Ugandans. Investment in maternal and
neonatal health within the constitutional
framework underscores the governments
commitment to achieve health and
development for all ll
VHT is vehicle for implementation
Ugandan Policy on
Education
The Ugandan Policy on Education is a step
toward improving education for girls and
women through Universal Primary Education
(UPE) and Universal Secondary education
(USE) policies.35
VHTs document school attendance and
drop out in Village register and in some
Districts report to Education
Department.
The Birth and Registration
Act (1973) and Article 18 of
the 1995 Constitution
The Birth and Registration Act (1973) and
Article 18 of the 1995 Constitution seek to
protect the rights of every child by registering
birth and death.
VHTs are expected to record births and
deaths in their community in village
register
Reproductive Health Policy
The National Policy Guidelines and Services
Standards for Sexual and Reproductive Health
and Rights is a five-year (2005-2010) strategy
to improve reproductive health. The Family
Planning Advocacy Strategy, the National
Reproductive Health Policy, and the
Adolescent Health Policy also promote
effective interventions, such as birth spacing
and delaying the age of first childbirth
VHTs health promotion role includes
reproductive health
Minimum Health Care
Package
Communication Strategy to
PROMOTE the National
Minimum Health Care
To increase to 100% the proportion of villages with trained VHTs by 2010 The VHTs are
expected to support implementation of the strategy through:
Establishing family role models who could have an impact on other families in the
neighbourhood.
Promoting peer education approaches at community and household levels (i.e. man-
to-man, woman-to-woman, youth- to- youth, child- to- child).
Promoting community dialogue between the extension field workers and
communities.
Appendix 3: Health Policies, Strategies and Programmes
supporting VHT implementation
Package 2005-10

Conducting regular health promotion events such as good housing competition.
Conducting regular village health meetings where messages can be disseminated and
members can support each other in taking collective health action.
Organising home visits by extension workers, religious leaders, teachers and CBO
workers.
Disseminating IEC materials (posters, leaflets etc.), facilitating community radio
listenership groups, music and drama groups, and other community social networks.
Ministry of Finance PEAP.
Ugandas Poverty
Eradication Action Plan:
Summary and Main
Objectives. Kampala:
Government of Uganda,
2000.
Ministry of Finance, Planning and
Economic Development.
National Population Policy
for Sustainable Development.
Kampala: Government of
Uganda, 1995.
VHT implementation supports targets of
reducing child and maternal mortality
Ministry of Health. Human
Resources for Health Policy.
Kampala, Uganda:
Government of Uganda,
2006.
Role of VHT described VHTs included in the Health Structure as
HC1
The National Policy Guidelines and
Services Standards for Sexual and
Reproductive Health and Rights
(2005-10)
The Family Planning Advocacy
Strategy
National Reproductive Health
Policy
Adolescent Health Policy
Strategies to improve reproductive health,
promote effective interventions, such as birth
control ,family planning and birth spacing
VHT promote use of family planning and
specially trained VHTs provide
contraceptives at community level
(Condom and oral contraceptive
Distributors)
Ministry of Health, UNFPA.
National Family Planning
Advocacy Strategy 2005-
2010. Kampala: UNFPA,
2005.
Ministry of Health. A Strategy to
Improve Reproductive Health
in Uganda, 2005-2010.
Kampala: Government of
Uganda, 2004.
Ministry of Health. Maternal
Death Review Guidelines.
Kampala: Government of
Uganda, 2006.
VHTs have role to encourage family
planning
Outlines strategies that include
reproductive services and birth spacing ,
prevention of STIs included in VHT TORs
VHTs record pregnant women and
deaths in village register and data
should be reported and linked to HMIS
and UBOS vital registration
Ministry of Health. National
Anaemia Policy. Kampala:
Government of Uganda,
2002.
Ministry of Health. Uganda Food
and Nutrition Policy. Kampala,
Uganda: Government of Uganda,
2002
Ministry of Health Infant and
Young Child Feeding
Guidelines 2009
VHTs distribute iron folate to pregnant
women
VHTs give health messages on adequate
nutrition and nutritional monitoring
(MUAC) described in their roles and
responsibilities
Ministry of Health. Road Map for
Accelerating the Reduction of
Maternal and Neonatal Mortality
and Morbidity in Uganda 2006-
2015. Kampala, Uganda: Ministry
of Health, 2006.
Ministry of Health. Status of
Emergency Obstetric Care
(EmOC) in Uganda. A
National Needs Assessment
of EmOC Process Indicators.
Kampala: Government of
Uganda, 2003.
National Guidelines for Village Health
Teams (VHTs reflecting and prioritising
maternal and newborn health services
Train the VHT, on implementation and
monitoring of maternal and neonatal
health interventions, Provide guidelines,
equipment and management packages
to the VHTVHTs trained to recognize
danger signs in pregnancy and refer for
emergency obstetric care
Ministry of Health. Uganda
National Malaria Control
Strategic Plan. Kampala:
Government of Uganda,
2006.

VHT health promotion and educational
role in the community
VHTs role clearly define d in prevention
promotion and control. Those VHTs
trained in community Case management
ensure treatment with first-line ACT
within 24hoyurs and prompt referral for
complications
Uganda AIDS Commission.
National HIV/AIDS Strategic
Plan Kampala: Uganda AIDS
Commission, 2007
VHTs have clear role in HIV prevention,
HCT and linking of PMTCT to Postnatal
care and Direct Observation of ARVs in
some areas

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List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Incomplete Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting monthly
Joint Planning? Incomplete
Number of Sub Counties 6 Number of Villages 256
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of
VHTs ?
Yes Number Active VHTs 231
Number VHTs 231 TBAs & other former Community
Medicine distributors etc
included in VHT?
Some
% VHTs female 50%
Population 85787
Crude Mortality Rate CMR 0.17%
District has training record for
VHTs
Yes Number of VHTs trained Health
Promotion and Education
231 Fertility Rate 7.2 % (2006)
Duration of Basic Health
Promotion Training
5 days Ratio participants to facilitator 39 to 1
# VHTs basic Health Promotion
trained AND still active
231 Health facilities 18
VHTs additional training
modules
Access to Functional Health
Facility
79.80%
Average time spent volunteering
per month (hours)
No Data % Household owning a
bicycle
No Data
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level
Malnourished
children given
plumpy nut
Access to Improved Water
Source
74%
Contraceptives distributed by
VHTs
Oral Contraceptives Latrine coverage 37%
IEC Available in Community Gross Enrolment Rate 184
IEC needed in Community Female Literacy rate No Data
Main languages Ng'akarimojong
All VHTs attached to a Specified
HC?
Yes All List of VHTs available on day of
visit
Incomplete Access to mass media No Data
Established Links to HC 2, 3, 4 Yes All % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities Some Operational Radio Stations Radio Lira, Voice
of Lango, Radio
Unity
Content of outreach EPI ANC VHTs Record and Report
Diseases of Epidemic
Potential?
Some (capacity
still low)
VHTs have VHT Village Register? Some
Any Supervision activity of VHTs
during past 6 months ?
Yes Other Registers? If Yes How
many?
No Data Have VHTs been trained on
who to refer?
None
Who Supervises? Incharges Any VHT data collated? By VHT Yes How are these done by
VHTs?
No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? Yes By HSD Yes
Any Supervision Reports
Available?
Yes By DMT Yes Motivation & Incentives
Given in District
Trainings,
allowances
Is Any VHT data used? Yes What Motivates the VHTs? Recognition
Village Mortality Data available? No What for? Strengthening
outreaches
Why do they volunteer? For incentives
given in District
VHTs - Need to
know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Abim
Demographics
Health Services
Other Background
selected EPI diseases, disease surveillence,
malnutrition
Evidence for IMPACT of VHT Implementation,
best practices, factors affecting implementation
Supervision of VHTs Referrals
Motivation & Incentives
Given in District
VHT Reporting and District
Data Management
HW - Need to know danger signs for newborns
and how to manage LBW infants .Content and
timing of post natal checks for both mother and
baby Nutritional assessment of all children
and pregnant women.
Actions Needed to Save Lives
VHT Implementation
- VHTs help in mobilisation of families and communities for immunisation
- Students were selected and immediately lost resulting in the need to retrain more
VHTs, few VHTs have been trained-other operating without any trainings
Linkages with other sectors in
the District
Water
Department
Current VHT Activities (during last 6 months)
Mobilisation for child days, FP education and
commodity distribution
Flip Charts for VHTs with Danger Signs, Key
family Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Coordination of VHT by DHT
Linkages between VHT, Health System and Other Sectors
Other Community Health Workers NOT included
in VHTs
None
VHT Training
Non standard additional training provided
STATUS OF VHT IMPLEMENTATION
Women of reproductive age 17328 Births 2008-9 4161 Population Under 5 years 17328
Estimated number of pregnancies
2008-9
4289 % Births registered No Data Morbidity under 5 years Malaria 45.7%
Diarrhoea 4.8%
ARI 19.7%
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
26/1000
(UDHS 2006
Regional data)
U5MR (deaths per 1000 live
births)
174/1000 (UDHS
2006 Regional data)
ANC 1 94% Any Postnatal Check? No Data
ANC 4 48% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
66% % Low Birth Weight 10%
TT-25 WCBA 20%
Number Pregnant women tested for
HIV
3979 (93%) Newborns treated ARVs at
Birth
28 (60%)
Number pregnant women positive
for HIV
143 (4%) Post Natal visit when? No Data
Positive Pregnant women given
ARVs for prophylaxis
75 (52%)
% deliveries at Health Facility 27%
% skilled traditional birth
attendant
6% BCG <1y 67% Infant Mortality 105/1000 (UDHS
2006 Regional data)
DPT HEP HIB 3 <1y 89% Measles <1y 80%
VHTs interviewed know danger
signs pregnant or postpartum
women?
Few VHTs interviewed know
New Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 32% Perinatal Cases 25 Population under 1 year 3689
Post Natal visit when? Day 1 and Day
42
Perinatal Deaths 5
Malaria
No Data ACTs available on day of
Visit
Yes
LLIN Hanging to protect at
pregnant women at HCs Visited?
Some LLIN Hanging to protect
newborns at HCs Visited?
None LLIN Hanging to protect
under 5 at HCs Visited?
None
LLINs for ANC distribution at HCs
visited
Most LLINs for NB distribution at
HC visited
None LLINs for distribution for
U5s without net at home at
HCs visited
None
IPT 2 41.20% Cases No Data U5s treated with malaria
inpatient
2619
Malaria Cases pregnant women 289 Deaths No Data U5s treated with malaria
outpatient
28946
Malaria Deaths 37% of all in
patient deaths
Deaths 34
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases No Data Cases 398
Deaths No Data Deaths 9
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 276
Zinc available on day of visit None Deaths No Data Deaths 0
Nutrition
Health Centres visited have
MUACs?
Some Cases Severe Malnutrition 121
VHTs can Read MUAC? Some VHTs Have MUACs? Some CasesLow weight for Age 221
VHTs follow up of discharged
patients?
very few
CESVI DwA CUAMM Malaria Consortium UNFPA UNICEF WHO
Good collaboration between health staff and VHTs
at hospital, better monitoring and supervision of
VHT activities
Under 5's
Abim Health Situation
Health workers as good
examples for key
practices
Women Newborn
Estimated District LLIN Coverage
Lessons learned and
cultural practices
If not
supervised,
friends/relative
s of community
leaders may be
selected as
VHTs
NGOs CBOS CSOs working at community level in the District
36%
10%
3%
25%
3%
23%
Abim Cause of Deaths Under 5's (n=94)
Malaria Pneumonia
Diarrhoea Anaemia
Trauma Other
List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review ? Yes All
ALL Registered at Community
Development Office?
No Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Yes
Number of Sub Counties 6 Number of Villages 142
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs
?
No Number Active VHTs 596
Number VHTs 994 TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
% VHTs female No data
Population 312100
Crude Mortality Rate CMR No Data
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
994 Fertility Rate No Data
Duration of Basic Health Promotion
Training
10 days Ratio participants to facilitator 21
# VHTs basic Health Promotion
trained AND still active
596 Health facilities 1 Hospital 11
HCIII 20 HCII
VHTs additional training modules Access to Functional Health
Facility
No Data
Average time spent volunteering
per month (hours)
Unknown % Household owning a bicycle 36%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level
NA Access to Improved Water
Source
67%
Contraceptives distributed by VHTs Condoms, Injectables and Oral Contraceptives Latrine coverage 70%
IEC Available in Community Education-Gross Enrolment
Rate
67
IEC needed in Community Female Literacy rate 53%
Main languages Madi, Lugbara,
Acholi
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No Access to mass media No Data
Established Links to HC 2, 3, 4 No % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities No Operational Radio Stations
2, Radio Paidha
Ltd., Radio TPS
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
Yes
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers? If Yes How many? None Have VHTs been trained on
who to refer?
None
Who Supervises? Incharges Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
training, 2000=
/day for
mobilising, t-
shirts, umbrellas
Is Any VHT data used? No What Motivates the VHTs? Involvement in
community health
activities
Village Mortality Data available? No What for? n/a Why do they volunteer? Did not meet VHTs
VHTs - Need to
know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
HW - Need to know danger signs for newborns
and how to manage LBW infants .Content and
timing of post natal checks for both mother and
baby Nutritional assessment of all children and
pregnant women.
Supervision of VHTs Referrals
Actions Needed to Save Lives
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Other Background
Reproductive Health and Family Planning
Current VHT Activities (during last 6 months)
Community Mobilisation , Water and Sanitation
Disease Surveillance
Motivation & Incentives
Given in District
Evidence for IMPACT of VHT Implementation, best
practices, factors affecting implementation
VHTs (formers TBAs) work side by side with health workers to assist in deliveries of
babies
Linkages between VHT, Health System and Other Sectors
VHT Reporting and District
Data Management
Linkages with other sectors in the
District
Water and
Sanitation
Marie Stopes trained them on Reproductive Health / Family Planning;
Uganda Redcross - Epidemic Prone Diseases
Coordination of VHT by DHT
VHT Training
Health Services
Other Community Health Workers NOT included in
VHTs
Yes, CHWs trained by AHA
Demographics
STATUS OF VHT IMPLEMENTATION
VHT Implementation Adjumani
Women of reproductive age 63044 Births 2008-9 15137 Population Under 5 years 63044
Estimated number of pregnancies
2008-9
15605 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 50% Any Postnatal Check? No Data
ANC 4 34% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women) 2+ doses
3736 % Low Birth Weight No Data Infant Mortality No Data
Number Pregnant women tested for
HIV
9%
Number pregnant women positive for
HIV
2% Newborns treated ARVs at
Birth
26 (79%)
Positive Pregnant women given ARVs
for prophylaxis
47 Post Natal visit when? No Data
% deliveries at Health Facility 20% BCG <1y 5366 Population under 1 year 13420
% skilled birth attendant No Data DPT HEP HIB 3 <1y 4898
Did VHTs interviewed know danger
signs pregnant or postpartum
women?
None VHTs interviewed know New
Born danger signs?
None Measles <1y 3910
Any PNC visit? 18% Perinatal Cases 10 VHTs interviewed know
danger signs?
For malaria
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 1
Malaria
No Data ACTs available on day of Visit No
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 24% Cases No Data U5s treated with malaria inpatient 6157
Malaria Cases pregnant women 467 Deaths No Data U5s treated with malaria
outpatient
52077
Malaria Deaths No Data Deaths 53
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
No Cases No Data Cases 594
Deaths No Data Deaths 13
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 310
Zinc available on day of visit None Deaths No Data Deaths 2
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 86
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 297
VHTs follow up of discharged
patients?
None
Adjumani Beekeeper Association Basic Education &
Development
Network (BEDEN)
Madi Youth Association
(MAYA)
Nutrition
Initiative For
Rural
Development
Adjumani People Living With
HIV/AIDS Association
Community
Empowerment
For Rural
Marie Stopes SNV Uganda
Adjumani Women Association DASS MS Uganda Uganda
Redcross
Society
Africa Humanitarian Action (AHA) Finnish Refugee
Council
Nile Development Foundation
(NIDEF)
West Nile
Private Sector
Development
Promotion
Agency For Cooperation Research And
Development (ACORD)
Kenyi Bekka
Rural Dept.
Initiative (KEN
BERUDI)
NUDIPU - Adjumani Branch West Nile
Women
Association
(WENWA)
NGOs CBOS CSOs working at community level in the District
Estimated District LLIN Coverage
Women Newborn
Adjumani Health Situation
Under 5's
42%
18%
4%
3%
29%
Adjumani Cause of Deaths Under 5's
(n=125)
Malaria Pneumonia
Diarrhoea Malnutrition
Anaemia Infection Sepsis Septicaemia
Perinatal Conditions Meningitis
Other
List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review ? Some
ALL Registered at Community
Development Office?
No Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 5 Number of Villages 347
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of
VHTs ?
Yes Number Active VHTs 486
Number VHTs 694 TBAs & other former Community
Medicine distributors etc
included in VHT?
No Information
% VHTs female No data
Population 113720
Crude Mortality Rate CMR No Data
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
694 Fertility Rate No Data
Duration of Basic Health
Promotion Training
Unknown Ratio participants to facilitator 28
# VHTs basic Health Promotion
trained AND still active
486 Training support MoH, UNICEF Health facilities 11
VHTs additional training
modules
Access to Functional Health
Facility
No Data
Average time spent volunteering
per month (hours)
80 % Household owning a
bicycle
58%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Schistosomias
is, Filariasis
Access to Improved Water
Source
59%
Contraceptives distributed by
VHTs
Condoms, Injectables and Oral Contraceptives Latrine coverage 49%
IEC Available in Community Education-Gross Enrolment
Rate
119
IEC needed in Community Female Literacy rate No Data
Main languages Luo, Lango
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No Access to mass media No Data
Established Links to HC 2, 3, 4 Some % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities No Operational Radio Stations
No Data
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers? If Yes How
many?
NONE Have VHTs been trained on
who to refer?
None
Who Supervises? Incharges Any VHT data collated? By VHT No How are these done by
VHTs?
Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives
Given in District
Bicycles, Involve
as mobilisers
during child
days, T-Shirts,
Caps, Transport
Is Any VHT data used? No What Motivates the VHTs? Appreciation,
Certificates of
Recognition
Village Mortality Data available? Yes What for? n/a Why do they volunteer? No Information
VHTs - Need to
know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Community
Development,
Water Sector,
Local
Government
HW - Need to know danger signs for newborns
and how to manage LBW infants .Content and
timing of post natal checks for both mother and
baby Nutritional assessment of all children
and pregnant women.
Actions Needed to Save Lives
Supervision of VHTs Referrals
Linkages with other sectors in
the District
VHT Reporting and District
Data Management
Motivation & Incentives
Given in District
Evidence for IMPACT of VHT Implementation,
best practices
- Couple Year Protection (CYP) rose from 170 to 235 after VHT (CBDA) training by
Pathfinder International although contraceptive usage is still low at 8%
- VHT (former TBAs) work with midwives at health centre II Assist at ANC
Demographics
VHT Training
none
Flip Charts for VHTs with Danger Signs, Key
family Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Linkages between VHT, Health System and Other Sectors
Health Services
Other Community Health Workers NOT included
in VHTs
None
60 VHTs (CBDAs) trained by Pathfinder International on Family
Planning methods
Current VHT Activities (during last 6 months)
Refferals, Mobilisation for Family Planning and
Immunisation, Environmental Health, NTD drug
distribution
Other Background
Coordination of VHT by DHT
Amolatar VHT Implementation Amolatar
STATUS OF VHT IMPLEMENTATION
Women of reproductive age 22971 Births 2008-9 5515 Population Under 5 years 22971
Estimated number of pregnancies
2008-9
5686 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 6223 (109%) Any Postnatal Check? No Data
ANC 4 697 (12%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
450400% % Low Birth Weight No Data
Number Pregnant women tested for
HIV
4383 (77%)
Number pregnant women positive
for HIV
369 (8%) Newborns treated ARVs at
Birth
83 (81%)
Positive Pregnant women given
ARVs for prophylaxis
218 (59%) Post Natal visit when? Population under 1 year 4889
% deliveries at Health Facility 23% BCG <1y 7669 DPT HEP HIB 3 <1y 6495
% skilled birth attendant No Data Measles <1y 5049
Did VHTs interviewed know danger signs pregnant or postpartum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? 2126 (39%) Perinatal Cases 4
Post Natal visit when? Day 1 and Day 42Perinatal Deaths 2
Malaria
No Data ACTs available on day of
Visit
No
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
None LLIN s for NB distribution at
HC visited
None LLIN s for distribution for
u5s without net at home at
HCs visited
None
IPT 2 161000% Cases No Data U5s treated with malaria inpatient 2064
Malaria Cases pregnant women 368 Deaths No Data U5s treated with malaria
outpatient
21150
Malaria Deaths 2 Deaths 26
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases No Data Cases 478
Deaths No Data Deaths 5
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 73
Zinc available on day of visit None Deaths No Data Deaths 0
Nutrition
Health Centres Have
MUACs?
None Cases Severe Malnutrition 133
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 4
VHTs follow up of discharged
patients?
No
Lessons Learned and cultural
practices
Lack of community ACTs
has demotivated some
VHTs and Some have lost
respect and trust of the
community
NGOs CBOS CSOs working at
community level in the District
same as Lira
Estimated District LLIN Coverage
Amolatar Health Situation
Women Newborn Under 5's
35%
7%
4%
3%
51%
Amolatar Cause of Deaths Under 5's
(n=73)
Malaria
Pneumonia
Anaemia
Perinatal Conditions
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Incomplete Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? No
Number of Sub Counties 10 Number of Villages 425
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of
VHTs ?
No Number Active VHTs 6 per village 2550
Number VHTs 2,550 Trained as health promoters, 802 trained in HBMF, 90 trained on reproductive health TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
% VHTs female 40%
Population 85787
Crude Mortality Rate CMR 0.17%
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
all Fertility Rate 7.2 % (2006)
Duration of Basic Health Promotion
Training
5 Ratio participants to facilitator 17
# VHTs basic Health Promotion
trained AND still active
all Health facilities 18
VHTs additionional training
modules
Access to Functional Health
Facility
79.80%
Average time spent volunteering
per month (hours)
7d per month % Household owning a bicycle No Data
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
fever diarrhoea Access to Improved Water
Source
74%
Contraceptives distributed by VHTs No Latrine coverage 37%
IEC Available in Community Gross Enrolment Rate 184
IEC needed in Community Female Literacy rate No Data
Main languages Ng'akarimojong
All VHTs attached to a Specified
HC?
Yes All List of VHTs available on day of
visit
No Access to mass media No Data
Established Links to HC 2, 3 and 4 Some % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities Some Operational Radio Stations
Radio Lira, Voice
of Lango, Radio
Unity
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
Some (capacity
still low)
VHTs have VHT Village Register? Some
Any Supervision activity of VHTs
during past 6 months ?
Yes Other Registers? If Yes How many? yes family planning Have VHTs been trained on
who to refer?
None
Who Supervises? focal person Any VHT data collated? By VHT
some
Yes How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
Trainings,
allowances
Is Any VHT data used? Yes What Motivates the VHTs? Recognition
Village Mortality Data available? Theoretically What for? Family
Planning
Why do they volunteer? For incentives
given in District
VHTs - Need to
know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Motivation & Incentives
Given in District
HW - Need to know danger signs for newborns
and how to manage LBW infants .Content and
timing of post natal checks for both mother and
baby Nutritional assessment of all children and
pregnant women.
Referrals
VHT Implementation Amuria
Coordination of VHT by DHT
STATUS OF VHT IMPLEMENTATION
HIV HBMF 2 per village
Current VHT Activities (during last 6 months)
Other Community Health Workers NOT included in
VHTs
Demographics
Health Services
Other Background
Community Counsellors
VHT Training
Actions Needed to Save Lives Evidence for IMPACT of VHT Implementation, best
practices and factors affecting implementation
- PELE Program filariasis control great success
- VHT/CMDs are effectively progessing towards the eradication of NTDs -
Good links with Agriculture resulted in the best VHTs being rewarded with Oxen to till
their land
Supervision of VHTs
Social Mobilisation for Campaigns Home based
management of fever,control of diarrhoel diseases,
community surveillance, reproductive heath, health
promotion and education.
No Data
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Linkages between VHT, Health System and Other Sectors
VHT Reporting and District
Data Management
Linkages with other sectors in the
District vaccinators
Education and
private health
sector
Agriculture
Women of reproductive age 0 Births 2008-9 0 Population Under 5 years 0
Estimated number of pregnancies
2008-9
0 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 70% Any Postnatal Check? No Data
ANC 4 0.13 %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
1815900% % Low Birth Weight No Data
Number Pregnant women tested for
HIV
60%
Number pregnant women positive for
HIV
0.04 Newborns treated ARVs at
Birth
94 (76%)
Positive Pregnant women given ARVs
for prophylaxis
177 (52%) Population under 1 year 0
% deliveries at Health Facility 23% BCG <1y 8456 DPT HEP HIB 3 <1y 9047
% skilled birth attendant No Data Measles <1y 8584
Did VHTs interviewed know danger signs pregnant or postpartum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
yes
Any PNC visit? 0.23 Perinatal Cases 11
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
No VISIT LLIN Hanging to protect
newborns at HF Visited?
No Visit LLIN Hanging to protect under
5 at HF Visited?
no Visit
LLIN s for ANC distribution at HCs
visited
No VISIT LLIN s for NB distribution at
HC visited
No Visit LLINs for distribution for u5s
without net at home at HCs
visited
No Visit
IPT 2 36% Cases No Data U5s treated with malaria inpatient 6419
Malaria Cases pregnant women 769 Deaths No Data U5s treated with malaria
outpatient
49777
MalariaDeaths 0 Deaths 92
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
No VISIT Cases No Data In Patient Cases 83
Deaths No Data Deaths 4
Diarrhoea
ORS Available on day of visit No VISIT Cases No Data Cases 96
Zinc available on day of visit No VISIT Deaths No Data Deaths 0
Nutrition
Health Centres visited have
MUACs?
No Visit Cases Severe Malnutrition 3
VHTs can Read MUAC? Some VHTs Have MUACs? Some Cases Low weight for Age 78
VHTs follow up of discharged
patients?
no
NGOs CBOS CSOs working at
community level in the District
NA
Estimated District LLIN Coverage
Amuria Health Situation
Women Newborn Under 5's
89%
4%
1%
6%
Amuria Cause of Deaths Under 5's
(n=103)
Malaria Pneumonia
Anaemia Other
List of CBO CSO and NGOs
operating in District Available at
DHO?
Incomplete Joint Review ? Some
ALL Registered at Community
Development Office?
No Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 8 Number of Villages 114
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs
?
Yes Number Active VHTs Unknown
Number VHTs 650 TBAs & other former Community
Medicine distributors etc included
in VHT?
All
% VHTs female No Data
Population 221619
Crude Mortality Rate CMR No Data
District has training record for
VHTs
Incomplete Number of VHTs trained Health
Promotion and Education
650 Fertility Rate No Data
Duration of Basic Health Promotion
Training
10 days Ratio participants to facilitator 25
# VHTs basic Health Promotion
trained AND still active
Unknown Health facilities 35 / 45 functional
Health Centres
VHTs additional training modules Access to Functional Health
Facility
No Data
Average time spent volunteering
per month (hours)
Unknown % Household owning a bicycle 39%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Diarrhoea Access to Improved Water
Source
66%
Contraceptives distributed by VHTs No Latrine coverage 29%
IEC Available in Community Education-Gross Enrolment
Rate
116
IEC needed in Community Female Literacy rate ND
Main languages Luo
All VHTs attached to a Specified
HC?
Yes All List of VHTs available on day of
visit
No Access to mass media No Data
Established Links to HC 2, 3, 4 Some % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities No Operational Radio Stations
4, Radio Four
Gulu, Norah Media
Group Ltd, Uganda
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
Yes
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? Yes, one Have VHTs been trained on
who to refer?
None
Who Supervises? Subcounty and
Parish
Supervisors
Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
T-shirts,
Gumboots,
Bicycles for all
Parish Supervisors
except in 2
Is Any VHT data used? No What Motivates the VHTs? Money
Village Mortality Data available? No What for? n/a Why do they volunteer? ND
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Demographics
Supervision of VHTs
Community Mobilisation for Immnuisation, Health
Education, Surveillance of diseases of epidemic
potential, TB DOTs
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Linkages between VHT, Health System and Other Sectors
Health Services
VHT Reporting and District
Data Management
Linkages with other sectors in the
District
None
Water and Sanitation
Other Background
VHT Training
None
Current VHT Activities (during last 6 months)
Coordination of VHT by DHT
VHT Implementation Amuru
STATUS OF VHT IMPLEMENTATION
Other Community Health Workers NOT included in
VHTs
None
Referrals
Evidence for IMPACT of VHT Implementation, best
practices
- Lack of community and Health facility ACTs have led to clinical diagnosis of Malaria
OPD cases to rise from 80 to 200 cases -
VHTs assist health workers to build staff houses
Motivation & Incentives
Given in District
Actions Needed to Save Lives
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Women of reproductive age 44767 Births 2008-9 10749 Population Under 5 years 44767
Estimated number of pregnancies
2008-9
11081 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 10895 (98%) Any Postnatal Check? No Data
ANC 4 4729 (43%) % Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
728400% % Low Birth Weight No Data
Number Pregnant women tested for
HIV
8450 (76%)
Number pregnant women positive for
HIV
359 (4%) Newborns treated ARVs at
Birth
193 (100%)
Positive Pregnant women given ARVs
for prophylaxis
208 (58%) Post Natal visit when? No Data Population under 1 year 9530
% deliveries at Health Facility 27% BCG <1yr 8726 DPT HEP HIB 3 < 1yr 6806
% skilled birth attendant No Data Measles <1yr 7365
Did VHTs interviewed know danger signs pregnant or postpartum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? 1348 (13%) Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit some
LLIN Hanging to protect pregnant
women at HCs Visited?
Yes LLIN Hanging to protect
newborns at HF Visited?
Yes LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 471100% Cases No Data U5s treated with malaria inpatient 1899
Malaria Cases pregnant women 323 Deaths No Data U5s treated with malaria
outpatient
56644
Malaria Deaths 0 Deaths 25
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
Yes Cases No Data Cases 580
Deaths No Data Deaths 0
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases No Data
Zinc available on day of visit None Deaths No Data Deaths No Data
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 16
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 46
VHTs follow up of discharged
patients?
None
NGOs CBOS CSOs working at
community level in the District
AMREF MS Uganda UNFPA
AT Uganda Ltd. People's Voice
For Peace
UNICEF
FPAU Punena Child And
Family
Programme
World Vision
Jamii Ya Kupatanisha Send A Cow
Uganda
Estimated District LLIN Coverage
Amuru Health Situation
Women Newborn Under 5's
Lessons Learned and cultural practices
93%
7%
Amuru Cause of Deaths Under 5's (n=27)
Malaria Anaemia
List of CBO CSO and NGOs
operating in District Available at
DHO?
Incomplete Joint Review ? Yes All
ALL Registered at Community
Development Office?
No Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 15 Number of Villages 1444
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs
?
No Number Active VHTs Unknown
Number VHTs 5776 TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
% VHTs female No data
Population 515500
Crude Mortality Rate CMR No Data
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
5776 Fertility Rate No Data
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 20
# VHTs basic Health Promotion
trained AND still active
Unknown Training Support MoH, UNICEF Health facilities 38; 1 Hospital 2
HCIV 13 HCIII 22
HCII
VHTs additional training modules Access to Functional Health
Facility
No Data
Average time spent volunteering
per month (hours)
Unknown % Household owning a bicycle 53%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Malaria,
Filariasis,
Schistosomiasi
Access to Improved Water
Source
64%
Contraceptives distributed by VHTs No Latrine coverage 66%
IEC Available in Community Education-Gross Enrolment
Rate
134
IEC needed in Community Female Literacy rate 58%
Main languages Luo, Lango
All VHTs attached to a Specified
HC?
Yes All List of VHTs available on day of
visit
No Access to mass media No Data
Established Links to HC 2, 3, 4 Some % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities No Operational Radio Stations
1, Radio Apac
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
Yes Other Registers? If Yes How many? No Have VHTs been trained on
who to refer?
None
Who Supervises? Incharges Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? Yes By DMT No Motivation & Incentives Given
in District
Bicycles, Lunch,
Involvement in
mobilisation for
child days,
Workshops
Is Any VHT data used? No What Motivates the VHTs? Quarterly
Meetings
Village Mortality Data available? Yes What for? n/a Why do they volunteer? To help
community to get
better
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Other Community Health Workers NOT included in
VHTs
Community Reproductive Health Workers CRHWs
VHT Training
Health Services
Motivation & Incentives
Given in District
VHT Reporting and District
Data Management
Linkages with other sectors in the
District
Water and
Sanitation,
Education
Linkages between VHT and Health System and Other Sectors
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
NUMAT trained VHTs in 12 subcounties on Coartem dispensing (1
day)
Current VHT Activities (during last 6 months)
Social mobilisation for Family Planning and
Immunisation, NTDs drug distribution, Distribution
of ITNs, Community based integrated disease
surveillance
No Information
Coordination of VHT by DHT
VHT Implementation Apac
STATUS OF VHT IMPLEMENTATION
Demographics
Other Background
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Actions Needed to Save Lives
Referrals
Evidence for IMPACT of VHT Implementation, best
practices
- 93% coverage IRS by VHTs, as a result, Malaria OPD attendance reduced from 78% to
53% - VHT (former TBA) registering mothers for ANC at one health
centre III visited; District keep numbers of their VHTs plus drop outs
Supervision of VHTs
Women of reproductive age 104131 Births 2008-9 25002 Population Under 5 years 104131
Estimated number of pregnancies
2008-9
25775 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 79% Any Postnatal Check? No Data
ANC 4 18% % Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
10534 % Low Birth Weight No Data Infant Mortality No Data
Number Pregnant women tested for
HIV
45%
Number pregnant women positive for
HIV
5% Newborns treated ARVs at
Birth
0.89
Positive Pregnant women given ARVs
for prophylaxis
0.62 Post Natal visit when? No Data Population under 1 year 22167
% deliveries at Health Facility 24% BCG <1y 20316 DPT HEP HIB 3 <1y 14769
% skilled birth attendant No Data Measles <1y 12770
Did VHTs interviewed know danger
signs pregnant or postpartum
women?
None VHTs interviewed know New
Born danger signs?
None
Any PNC visit? 9% Perinatal Cases 16 VHTs interviewed know
danger signs?
For malaria
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 1
U5's slept under net survey night 0.79
Malaria
0.64 ACTs available on day of Visit No
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLINs for ANC distribution at HCs
visited
Some LLINs for NB distribution at
HC visited
None LLINs for distribution for u5s
without net at home at HCs
visited
None
IPT 2 31% Cases ND U5s treated with malaria inpatient 4134
Malaria Cases pregnant women 563 Deaths ND U5s treated with malaria
outpatient
58632
Malaria Deaths 0 Deaths 24
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases No Data Cases 288
Deaths No Data Deaths 12
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 439
Zinc available on day of visit None Deaths No Data Deaths 1
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 125
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 91
VHTs follow up of discharged
patients?
No
NGOs CBOS CSOs working at
community level in the District
ACF, Action Aid Uganda Apac Dev't
Initiative
Apac District
Scouts Council,
Apac District
Christian Charity Centre Uganda Minakulu
Wildlife Club
Organisation For Socio Economic Change And Advancement Uganda National Students Association
Agency For Performing Sustainable
Development Initiatives
Apac Under
Privilege
Development
Organisation
Concerned Parents
Association -Apac Branch
MS Uganda Send A Cow Uganda Uganda Pioneers Association
Apac Development Foundation Limited Campaign
Against Domestic
Violence In The
Community
Golgotha Orphanage Care National
Guidance For
Empowerment
For People
Strengthening Decentralisation In Uganda (SDU) Project WACANE
Apac Disabled Persons Union Care
International In
Uganda
Joint Women Restoration And
Welfare Uganda
Noto Tam Kelo
Kuc
Development
Association
THETA, UNFPA, UNICEF Youth Aids Association Chawente
Apac Health Situation
Under 5's Women Newborn
Estimated District LLIN Coverage (HH with 2+
nets)
Lessons Learned and cultural practices
63%
31%
3%
3%
Apac Cause of Deaths Under 5's (n=38)
Malaria Pneumonia
Diarrhoea Perinatal Conditions
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review ? No
ALL Registered at Community
Development Office?
Incomplete Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Yes Frequency of reporting never
Joint Planning? No
Number of Sub Counties 8 Number of Villages 190
% SC Covered by VHT's 13% % Villages Covered VHT 2%
District has Register or List of VHTs
?
No Number Active VHTs 3
Number VHTs 20 TBAs & other former Community
Medicine distributors etc included
in VHT?
All
% VHTs female No data Population 160100
Crude Mortality Rate CMR No Data
Fertility Rate No Data
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
20
Duration of Basic Health Promotion
Training
3-5 days Ratio participants to facilitator 10 Health facilities 16; 1 HCIV 8
HCIII 3 HCII NGO
4 HCIII
# VHTs basic Health Promotion
trained AND still active
3 Training Support Plan for Modernisation of Agriculture (PMA), PHC funds Access to Functional Health
Facility
No Data
VHTs additional training modules
% Household owning a bicycle 42%
Average time spent volunteering
per month (hours)
unknown Access to Improved Water
Source
53%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level
NA Latrine coverage 60%
Contraceptives distributed by VHTs No Education-Gross Enrolment
Rate
145
IEC Available in Community Female Literacy rate No Data
IEC needed in Community Main languages Ateso, Lugwere
Access to mass media No Data
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
No Data
Established Links to HC 2, 3, 4 No Operational Radio Stations
No Data
VHTs Assist Outreach Activities No Adult literacy 49%
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? No Have VHTs been trained on
who to refer?
None
Who Supervises? No one Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
Quarterly
meetings
Is Any VHT data used? No What Motivates the VHTs? Bicycles, Meetings
Village Mortality Data available? No What for? NA Why do they volunteer? Recognition, Non-
monetary benefits
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Budaka
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
VHT Reporting and District
Data Management
Health Services
Other Background
STATUS OF VHT IMPLEMENTATION
VHT Implementation
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, TB,
Filariasis Request all in picture format
Other Community Health Workers NOT included in
VHTs
455 CMDs / CHWs, 51 CCAs, 23 trained TBAs,
Malaria, HIV/AIDS, Immunisation
Coordination of VHT by DMT
Linkages with other sectors in the
District
Agriculture,
Water and
Sanitation
Linkages between VHT, Health System and Other Sectors
Evidence for IMPACT of VHT Implementation, best
practices
Actions Needed to Save Lives
Supervision of VHTs Referrals
Motivation & Incentives
Given in District
No Data
VHT Training
None
Current VHT Activities (during last 6 months)
mobilisation for child days , bednets distribution
Women of reproductive age 32340 Births 2008-9 7765 Population Under 5 years 32340
Estimated number of pregnancies
2008-9
8005 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 145% Any Postnatal Check? No Data
ANC 4 32% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
5143 % Low Birth Weight No Data Infant Mortality No Data
Number Pregnant women tested for
HIV
87%
Number pregnant women positive for
HIV
2% Newborns treated ARVs at
Birth
23
Positive Pregnant women given ARVs
for prophylaxis
66 Post Natal visit when? No Data
% deliveries at Health Facility 33% BCG <1y 7678 Population under 1 year 6884
% skilled birth attendant No Data DPT HEP HIB 3 <1y 6273
Did VHTs interviewed know danger
signs pregnant or postpartum
women?
None VHTs interviewed know New
Born danger signs?
None Measles <1y 6025
Any PNC visit? 20% Perinatal Cases 14 VHTs interviewed know
danger signs?
For malaria
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 50% Cases No Data U5s treated with malaria inpatient 7514
Malaria Cases pregnant women 960 Deaths No Data U5s treated with malaria
outpatient
39174
Malaria Deaths 0 Deaths 36
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases No Data Cases 1516
Deaths No Data Deaths 14
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 2020
Zinc available on day of visit None Deaths No Data Deaths 14
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 44
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 49
VHTs follow up of discharged
patients?
None
NGOs CBOS CSOs working at
community level in the District
Baylor Uganda STAR EC (MSH)
GFTAM
PREFA
Estimated District LLIN Coverage
Lessons Learned and cultural practices
Budaka Health Situation
Women Newborn Under 5's
56%
22%
22%
Budaka Cause of Deaths Under 5's
(n=64)
Malaria Pneumonia Diarrhoea
List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review ? Yes All
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Yes Frequency of reporting never
Joint Planning? Yes
Number of Sub Counties 8 Number of Villages 491
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs
?
No Number Active VHTs NA
Number VHTs None TBAs & other former Community
Medicine distributors etc included
in VHT?
None
% VHTs female NA Population 159898
Crude Mortality Rate CMR No Data
Fertility Rate No Data
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
None
Duration of Basic Health Promotion
Training
NA Ratio participants to facilitator NA Health facilities 12; 1 Hospital 7
HCIII 4 HCII
# VHTs basic Health Promotion
trained AND still active
NA Access to Functional Health
Facility
No Data
VHTs additional training modules
% Household owning a bicycle 4%
Average time spent volunteering
per month (hours)
NA Access to Improved Water
Source
72%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level
CMDs treat
Onchocerciasis
(Ivermectin)
Latrine coverage 58%
Contraceptives distributed by VHTs No Education-Gross Enrolment
Rate
164
IEC Available in Community Female Literacy rate No Data
IEC needed in Community Main languages Lumasaba
Access to mass media No Data
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
No Data
Established Links to HC 2, 3, 4 Some Operational Radio Stations
No Data
VHTs Assist Outreach Activities No Adult Literacy 60%
Content of outreach Integrated Outreach VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? none Have VHTs been trained on
who to refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
Lunch
Is Any VHT data used? No What Motivates the VHTs? having medicines
Village Mortality Data available? No What for? NA Why do they volunteer? NA
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Actions Needed to Save Lives
VHT Reporting and District
Data Management
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Referrals
Motivation & Incentives
Given in District
Evidence for IMPACT of VHT Implementation, best
practices
CCAs are attached to health centres they stay and help and are a good entry point for
VHTs into the community
Supervision of VHTs
NA but CMDs treat onchocerciasis in community
Bududa
STATUS OF VHT IMPLEMENTATION
Vector Control - MoH (Carter Centre)
VHT Training
Current VHT Activities (during last 6 months)
None
Linkages between VHT, Health System and Other Sectors
Linkages with other sectors in the
District
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Onchocerciasis Request all in picture format
NA
Other Background
Health Services
Coordination of VHT by DMT
VHT Implementation
Other Community Health Workers NOT included in
VHTs
982 CMDs, 200 CCAs (Community Counselling Aides) of PREFA
Women of reproductive age 32299 Births 2008-9 7755 Population Under 5 years 32299
Estimated number of pregnancies
2008-9
7995 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 5751 (72%) Any Postnatal Check? No Data
ANC 4 2743 (34%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
637400% % Low Birth Weight No Data
Number Pregnant women tested for
HIV
5709 (71%)
Number pregnant women positive for
HIV
116 (2%) Newborns treated ARVs at
Birth
61(100%)
Positive Pregnant women given ARVs
for prophylaxis
178 (153%) Post Natal visit when? Population under 1 year 6876
% deliveries at Health Facility 23% BCG <1y 9135 DPT HEP HIB 3 <1y 9713
% skilled birth attendant No Data Measles <1y 10458
Did VHTs interviewed know danger signs pregnant or postparum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? 2629 (34%) Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit No visit
LLIN Hanging to protect pregnant
women at HCs Visited?
no visit LLIN Hanging to protect
newborns at HF Visited?
no visit LLIN Hanging to protect under
5 at HF Visited?
no visit
LLIN s for ANC distribution at HCs
visited
no visit LLIN s for NB distribution at
HC visited
no visit LLIN s for distribution for u5s
without net at home at HCs
visited
no visit
IPT 2 2022 (25%) Cases No Data U5s treated with malaria inpatient 3365
Malaria Cases pregnant women 227 Deaths No Data U5s treated with malaria
outpatient
25148
Malaria Deaths 0 Deaths 23
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
no visit Cases No Data Cases 272
Deaths No Data Deaths 1
Diarrhoea
ORS Available on day of visit no visit Cases No Data Cases 242
Zinc available on day of visit no visit Deaths No Data Deaths 0
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition 23
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 145
VHTs follow up of discharged
patients?
None
NGOs CBOS CSOs working at
community level in the District
Baylor Uganda
Carter Center
PREFA
STAR-EC (MSH)
Lessons Learned and cultural practices
Under 5's
Estimated District LLIN Coverage
Bududa Health Situation
Women Newborn
Bududa Cause of Deaths Under 5's
(n=31)
Malaria Pneumonia Malnutrition Anaemia
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 18 Number of Villages 607
% SC Covered by VHT's 17% % Villages Covered VHT 12%
District has Register or List of VHTs
?
No Number Active VHTs 75
Number VHTs 75 TBAs & other former Community
Medicine distributors etc included
in VHT?
All
% VHTs female no data Population 543900
Crude Mortality Rate CMR No data
Fertility Rate No data
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
75
Health Services
Duration of Basic Health Promotion
Training
3 days Ratio participants to facilitator 8 Health facilities 70; 1 Hospital 2
HCIV 13 HCIII (12
Govt 1 NGO) 37
# VHTs basic Health Promotion
trained AND still active
75 Training Support MoH Access to Functional Health
Facility
No data
VHTs additional training modules
Other Background
% Household owning a bicycle 45%
Average time spent volunteering
per month (hours)
Unknown Access to Improved Water
Source
36%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Schistosomiasi
s Malaria
Latrine coverage 74%
Contraceptives distributed by VHTs No 1066 coartem distributors Education-Gross Enrolment
Rate
114
IEC Available in Community Female Literacy rate 50%
IEC needed in Community Main languages Lusoga, Lusamia-
Lugwe
Access to mass media No data
All VHTs attached to a Specified
HC?
Yes All List of VHTs available on day of
visit
No % of District covered by
mobile phone network
No data
Established Links to HC 2, 3, 4 No Operational Radio Stations
Eastern voice
radio
VHTs Assist Outreach Activities No VHTs Record and Report
Diseases of Epidemic
Potential?
No
Content of outreach EPI alone
Referrals
VHTs have VHT Village Register? No Have VHTs been trained on
who to refer?
None
Any Supervision activity of VHTs
during past 6 months ?
Yes Other Registers??If Yes How many? none How are these done by VHTs? Verbal
Who Supervises? Incharges at
HCIII
Any VHT data collated? By VHT No Are referrals recorded in VHT
register?
No
Standard Supervision Training? No By HCII No VHTs follow up of discharged
patients?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
None
Is Any VHT data used? No What Motivates the VHTs? Meetings
Stationary
Village Mortality Data available? No What for? NA Why do they volunteer? Serve their communitites
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
In Nankoma s/c in 2007, VHTs selected increased pit latrine coverage from 66% to 90%
within three months
Promotion of Maternity Hygiene and Sanitation
Nutrition and Growth Monitoring Mobilisation for
mass campaigns, immunisation, Health talks on
HIV/AIDS, Schistosomiasis, Reproductive Health
Current VHT Activities (during last 6 months)
None
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Evidence for IMPACT of VHT Implementation, best
practices
Coordination of VHT by DHMT
Other Community Health Workers NOT included in
VHTs
none
VHT Training
Immunisation, Nutrition
Flip Charts for VHTs with Danger Signs, ARI, Malaria,
Hookworms, Malnutrition, Key family
Practices.Water and Sanitation, Trauma Request all
in picture format
Supervision of VHTs
Motivation & Incentives
Given in District
None
VHT Reporting and District
Data Management
Actions Needed to Save Lives
Linkages between VHT, Health System and Other Sectors
Linkages with other sectors in the
District
VHT Implementation Bugiri
STATUS OF VHT IMPLEMENTATION
Women of reproductive age 109868 Births 2008-9 26379 Population Under 5 years 109868
Estimated number of pregnancies
2008-9
27195 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 74% Any Postnatal Check? No Data
ANC 4 20% % Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
13972 % Low Birth Weight No Data Infant Mortality No Data
Number Pregnant women tested for
HIV
30%
Number pregnant women positive for
HIV
4% Newborns treated ARVs at
Birth
115 (100%)
Positive Pregnant women given ARVs
for prophylaxis
232 (81%) Post Natal visit when? No Data
% deliveries at Health Facility 17% BCG <1y 21363 Population under 1 year 23388
% skilled birth attendant No Data DPT HEP HIB 3 <1y 13930
Did VHTs interviewed know danger
signs pregnant or postparum women?
None VHTs interviewed know New
Born danger signs?
None Measles <1y 15171
Any PNC visit? 10% Perinatal Cases 44 VHTs interviewed know
danger signs?
For malaria
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 33% Cases No Data U5s treated with malaria inpatient 2348
Malaria Cases pregnant women 531 Deaths No Data U5s treated with malaria
outpatient
26446
Malaria Deaths 0 Deaths 23
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases No Data Cases 209
Deaths No Data Deaths 4
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 201
Zinc available on day of visit None Deaths No Data Deaths 0
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 68
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 392
NGOs CBOS CSOs working at
community level in the District
Organisation Rural Development Uganda Muslim Rural Development Assoc.
Aids Free Generation Project Caring For
Orphans' Widows
And The Elderly
Idudi Development
Association
Mucobadi Rural Microentreprise Credit SchemeUganda Nedagala Lyayo
Bugiri Focus Association Foundation For
Community
Empowerment
Integrated Dev. Activities And Aids Concern Muterere NGO
Busoga Diocese
Sigulu Islands Women DevelopmentUganda Red Cross Soociety- Bugiri Sub- Branch
Bugiri Network For Aids Services
Organisation Bunaso
GOAL Islamic Medical Association
Of Uganda
Naluwelule
Community
Based
Development
Assoc.
St. Matia Mulumba Dispensary URHB
Bukooli Initiative Development Association Great Exploits
Christian Ministry
Kind To The Women &
Orphans Dev't Agency
NACWOLA Tufungize Drama Group Uganda Womens Enterpreneurs Assoc. Ltd
Busiro COU Habitat For
Humanity Bukooli
Bugiri Affiliate
Kirongero COU National
Women
Development
Uganda Change Agent
Association
UCOBAC
Action For Community Development & Health Care
Estimated District LLIN Coverage
Bugiri Health Situation
Insert Pie Chart for causes of death
Women Newborn Under 5's
79%
14%
7%
Bugiri Cause of Deaths Under 5's (n=29)
Malaria Pneumonia Trauma
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting monthly
Joint Planning? No
Number of Sub Counties 5 Number of Villages 287
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs
?
Yes Number Active VHTs Unknown
Number VHTs 417 TBAs & other former Community
Medicine distributors etc included
in VHT?
All
% VHTs female 52% Population 159400
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
417
Duration of Basic Health Promotion
Training
5days Ratio participants to facilitator 7 Health facilities 11; 1 HCIV 5
HCIII 5 HCII
# VHTs basic Health Promotion
trained AND still active
Unknown Training Support Malteser trained 2007/8, MoH NTD program Access to Functional Health
Facility
ND
VHTs additional training modules
% Household owning a bicycle 51%
Average time spent volunteering
per month (hours)
48 Access to Improved Water
Source
89%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level
NA Latrine coverage 66%
Contraceptives distributed by VHTs No Education-Gross Enrolment
Rate
122
IEC Available in Community Female Literacy rate ND
IEC needed in Community Main languages Ateso
Access to mass media ND
All VHTs attached to a Specified
HC?
Yes All List of VHTs available on day of
visit
No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 Some Operational Radio Stations
Continental FM
Station Ltd.
VHTs Assist Outreach Activities Yes All Adult Literacy 0.58
Content of outreach Integrated Outreach VHTs Record and Report Diseases of Epidemic Potential? No
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on
who to refer?
Some
Who Supervises? Health Asst.,
Disease
Surveillance
Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
Yes
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
Bags, T-shirts,
Pens, Diaries
Is Any VHT data used? No What Motivates the VHTs? Training, Re-
orientation
meetings
Village Mortality Data available? No What for? NA Why do they volunteer? Get new skills
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Evidence for IMPACT of VHT Implementation, best
practices
Supervision of VHTs
VHT Reporting and District
Data Management
Linkages between VHT, Health System and Other Sectors
None
Motivation & Incentives
Given in District
Current VHT Activities (during last 6 months)
Sensitisation and mobilisation of community for
health activities TB DOTS ITNs distribution health
data collection
Other Background
STATUS OF VHT IMPLEMENTATION
Coordination of VHT by DMT
Health Services
None
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Linkages with other sectors in the
District
Water and
Sanitation
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Filariasis,
Helminths, Onchocerciasis, Trypanosomiasis
Request all in picture format
Inadequate in all
No Data
Actions Needed to Save Lives
VHT Implementation Bukedea
VHT Training
Other Community Health Workers NOT included in
VHTs
Referrals
Women of reproductive age 32199 Births 2008-9 7731 Population Under 5 years 32199
Estimated number of pregnancies
2008-9
7970 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 39% Any Postnatal Check? No Data
ANC 4 8% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
1756 % Low Birth Weight No Data Infant Mortality No Data
Number Pregnant women tested for
HIV
37%
Number pregnant women positive for
HIV
2% Newborns treated ARVs at
Birth
15 (68%)
Positive Pregnant women given ARVs
for prophylaxis
1 Post Natal visit when? No Data
% deliveries at Health Facility 25% BCG <1y 4072 Population under 1 year 6854
% skilled birth attendant No Data DPT HEP HIB 3 <1y 1719
Did VHTs interviewed know danger
signs pregnant or postpartum
women?
None VHTs interviewed know New
Born danger signs?
None Measles <1y 5045
Any PNC visit? (Number) 4% Perinatal Cases 0 VHTs interviewed know
danger signs?
For malaria
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit No
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 26% Cases ND U5s treated with malaria inpatient 195
Malaria Cases pregnant women 20 Deaths ND U5s treated with malaria
outpatient
5426
Malaria Deaths 0 Deaths 1
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases ND Cases 14
Deaths ND Deaths 0
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 4
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 0
VHTs can Read MUAC? Some VHTs Have MUACs? None Cases Low weight for Age 23
VHTs follow up of discharged
patients?
Some
NGOs CBOS CSOs working at
community level in the District
Nulife
PREFA
TB CAP
Under 5's
Bukedea Health Situation
Women Newborn
Estimated District LLIN Coverage
20%
80%
Bukedea Cause of Deaths Under 5's (n=5)
Malaria Diarrhoea
List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review ? Yes All
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Yes All
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Yes
Number of Sub Counties 5 Number of Villages 161
% SC Covered by VHT's 80% % Villages Covered VHT 99%
District has Register or List of VHTs
?
Yes Number Active VHTs 322
Number VHTs 473 TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
% VHTs female 40% Population 65309
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
473
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 13 Health facilities 12; 1 HCIV 3
HCIII 8 HCII
# VHTs basic Health Promotion
trained AND still active
322 Training Support MoH Access to Functional Health
Facilty
ND
VHTs additional training modules
% Household owning a bicycle
ND
Average time spent volunteering
per month (hours)
Depends Access to Improved Water
Source
71%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Diarrhoea Latrine coverage
60%
Contraceptives distributed by VHTs Condoms Education-Gross Enrolment
Rate
205
IEC Available in Community Female Literacy rate
ND
IEC needed in Community Main languages Kuksabin
Access to mass media ND
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 No Operational Radio Stations ND
VHTs Assist Outreach Activities Some Adult Literacy 54%
Content of outreach Integrated Outreach VHTs Record and Report
Diseases of Epidemic
Potential?
Not active
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? no Have VHTs been trained on
who to refer?
All
Who Supervises? Health Asst,
Incharges, DHE
Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
meetings;
involvement
Is Any VHT data used? Yes What Motivates the VHTs? reduced IMR due
to malaria in
community(56%),
Village Mortality Data available? No What for? Get information
on births in
community for
planning
Why do they volunteer? the above
motivating
factors; hope for
permanent
placements
VHTs - Need to
be actively
involved in
mobilisation for
hygiene and
water and
sanitation to
prevent water
borne diseases
that are common
Supervision of VHTs
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
VHT Reporting and District
Data Management
Incidence of severe malaria decreased with homapak;
Referrals
Motivation & Incentives
Given in District
Evidence for IMPACT of VHT Implementation, best
practices
Actions Needed to Save Lives
Coordination of VHT by DMT
VHT Implementation Bukwo
STATUS OF VHT IMPLEMENTATION
Agriculture,
Water and
Sanitation
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Request all
in picture format
Other Background
Community sensitisation and mobilisation on TB,
HIV/AIDs, PMTCT, Typhoid, Refferals, Medicine and
condom distribution
None
Linkages with other sectors in the
District
100 VHTs refresher training - 2008, 70 VHTs in control of diarheaol
diseases CDD, 28 VHTs on water and sanitation, PMTCT - PREFA
Current VHT Activities (during last 6 months)
Linkages between VHT, Health System and Other Sectors
Health Services
Other Community Health Workers NOT included in
VHTs
10 Peer counselors, 10 Case Managers, 161 CCAs (1/village are all VHTs)
VHT Training
Women of reproductive age 13192 Births 2008-9 3167 Population Under 5 years 13192
Estimated number of pregnancies
2008-9
3265 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 3131(96%) Any Postnatal Check? No Data
ANC 4 786 (24%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (Pregnant
women 2+ doses)
1734 % Low Birth Weight 1% Infant Mortality No Data
Number Pregnant women tested for
HIV
2687 (82%)
Number pregnant women positive for
HIV
60 (2%) Newborns treated ARVs at
Birth
4 (31%)
Positive Pregnant women given ARVs
for prophylaxis
29 (48%) Post Natal visit when? Day 1 and Day 42
% deliveries at Health Facility 16% BCG <1y 3214 Population under 1 year 2808
% skilled birth attendant No Data DPT HEP HIB 3 <1y 2561
Did VHTs interviewed know danger
signs pregnant or postpartum
women?
None VHTs interviewed know New
Born danger signs?
None Measles <1y 2850
Any PNC visit? 617 (19%) Perinatal Cases 4 VHTs interviewed know
danger signs?
For malaria
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 1146 (35%) Cases ND U5s treated with malaria inpatient 942
Malaria Cases pregnant women 85 Deaths ND U5s treated with malaria
outpatient
11809
Malaria Deaths 1 Deaths 6
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases ND Cases 177
Deaths ND Deaths 2
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 261
Zinc available on day of visit None Deaths ND Deaths 1
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 41
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 40
VHTs follow up of discharged
patients?
No
NGOs CBOS CSOs working at
community level in the District
PREFA
Bukwo Health Situation
Women Newborn Under 5's
Lessons Learned and cultural practices
Estimated District LLIN Coverage
67%
22%
11%
Bukwo Cause of Deaths Under 5's (n=9)
Malaria Pneumonia Diarrhoea
List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review ? Some
ALL Registered at Community
Development Office?
Incomplete Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Yes Frequency of reporting irregular
Joint Planning? Incomplete
Number of Sub Counties 3 Number of Villages 91
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs
?
No Number Active VHTs NA
Number VHTs NA TBAs & other former Community
Medicine distributors etc included
in VHT?
None
% VHTs female NA Population 104,942
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
NA
Duration of Basic Health Promotion
Training
NA Ratio participants to facilitator NA Health facilities 9, 1 HCIV 1HCIII
7 HCII
# VHTs basic Health Promotion
trained AND still active
NA Access to Functional Health
Facilty
ND
VHTs additional training modules
% Household owning a bicycle
43%
Average time spent volunteering
per month (hours)
NA Access to Improved Water
Source
50%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Malaria
Onchocerciasis
Latrine coverage
49%
Contraceptives distributed by VHTs No Education-Gross Enrolment
Rate
107
IEC Available in Community Female Literacy rate
ND
IEC needed in Community Main languages Runyoro
Access to mass media ND
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 No Operational Radio Stations ND
VHTs Assist Outreach Activities No Adult Literacy 59%
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on
who to refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
None
Is Any VHT data used? No What Motivates the VHTs? NA
Village Mortality Data available? No What for? NA Why do they volunteer? NA
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Evidence for IMPACT of VHT Implementation, best
practices
No Data
Actions Needed to Save Lives
Linkages with other sectors in the
District
None
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Linkages between VHT, Health System and Other Sectors
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Buliisa
Supervision of VHTs
Other Community Health Workers NOT included in
VHTs
CMDs 3/village, 6 Parish Health Workers, 90 CHWs, 20 trained TBAs, 180 coartem distributors, Immunisation volunteers 3/village
Other Background
Health Services
VHT Reporting and District
Data Management
VHT Training
None
Current VHT Activities (during last 6 months)
NA but CMDs currently treat onchocerciasis,
intestinal worms, involved in EPI outreaches
Immunisation, Meningitis, HIV/AIDS, Water and
Sanitation
Referrals
Motivation & Incentives
Given in District
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Women of reproductive age 21198 Births 2008-9 5090 Population Under 5 years 21198
Estimated number of pregnancies
2008-9
5247 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 3719 (101%) Any Postnatal Check? No Data
ANC 4 1158 (34%) % Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
80500% % Low Birth Weight 0.013297872
Number Pregnant women tested for
HIV
2925 (85%)
Number pregnant women positive for
HIV
133 (5%) Newborns treated ARVs at
Birth
17 (53%)
Positive Pregnant women given ARVs
for prophylaxis
103 (71%) Post Natal visit when? No Data Population under 1 year 4513
% deliveries at Health Facility 14% BCG <1y 3403 DPT HEP HIB 3 <1y 2552
% skilled birth attendant No Data Measles <1y 2204
Did VHTs interviewed know danger signs pregnant or postparum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? 692 (19%) Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
ACTs available on day of Visit No
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 1836 (50%) Cases ND U5s treated with malaria inpatient 557
Malaria Cases pregnant women 28 Deaths ND U5s treated with malaria
outpatient
13180
Malaria Deaths 0 Deaths 11
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases ND Cases 52
Deaths ND Deaths 0
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 126
Zinc available on day of visit None Deaths ND Deaths 1
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 2
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 2
VHTs follow up of discharged
patients?
NA Village Health Teams
NGOs CBOS CSOs working at
community level in the District
same as Masindi
Estimated District LLIN Coverage
Buliisa Health Situation
Women Newborn Under 5's
92%
8%
Buliisa Cause of Deaths Under 5's (n=12)
Malaria Diarrhoea
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting irregular
Joint Planning? Incomplete
Number of Sub Counties 20 Number of Villages 529
% SC Covered by VHT's 50% % Villages Covered VHT 79%
District has Register or or List of
VHTs ?
No Number Active VHTs 2568
Number VHTs 2568 TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
% VHTs female no data
Population 282130
Crude Mortality Rate CMR No Data
District has training record for
VHTs
Incomplete Number of VHTs trained Health
Promotion and Education
2568 Fertility Rate No Data
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator No Data
# VHTs basic Health Promotion
trained AND still active
no data Training Support MoH Health facilities 32; 1 Hospital 3
HCIV 9 HCIII 19
HCII
VHTs additionional training
modules
Access to Functional Health
Facilty
No Data
Average time spent volunteering
per month (hours)
unknown % Household owning a bicycle 16%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level
NA Access to Improved Water
Source
79%
Contraceptives distributed by VHTs No Latrine coverage 61%
IEC Available in Community Education-Gross Enrolment
Rate
86
IEC needed in Community Female Literacy rate 48%
Main languages Rwamba, Rutooro
All VHTs attached to a Specified
HC?
Some List of VHTs available on day of
visit
No Access to mass media No Data
Established Links to HC 2, 3, 4 Some % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities Some Operational Radio Stations
No Data
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
Yes
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on
who to refer?
All
Who Supervises? incharges Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
none
Is Any VHT data used? No What Motivates the VHTs? Recognition,
Appreciation,
Respect, high
Village Mortality Data available? No What for? NA Why do they volunteer? give health
education in
community to
improve health
and reduce
morbidity and
Need to Know
danger signs for
ALL and when to
refer needs to
be incorporated
into training
Other Community Health Workers NOT included in
VHTs
None
VHT Training
Social Mobilisation for Campaigns, Hygiene and
Sanitation Protection of water sources NTD drug
distribution Surveillance NTD diseases Family
Planning Education Referrals School Health
handwashing to prevent diarrhoea, use of mosquito
nets - malaria prevention
Current VHT Activities (during last 6 months)
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Linkages between VHT, Health System and Other Sectors
Evidence for IMPACT of VHT Implementation, best
practices
- Ebola outbreak was contained due to VHTs moving house to house and kept daily
registers . - Cholera no longer a problem because of VHT interventions; increased latrine
and EPI coverage, - VHTs attend clinic once per month are supervised and gain new skills
they also stay and help to register and immunise children
VHT Implementation Bundibugyo
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Demographics
Health Services
Other Background
Referrals
Motivation & Incentives
Given in District
Supervision of VHTs
VHT Reporting and District
Data Management
Linkages with other sectors in the
District
Danger signs for newborns and how to manage
LBW infants .Content and timing of post natal
checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Actions Needed to Save Lives
None
Women of reproductive age 56990 Births 2008-9 13683 Population Under 5 years 56990
Estimated number of pregnancies
2008-9
14107 % Births registered
Maternal Mortality Rate no data Neonatal Mortality (deaths
per 1000 live births)
ANC 1 86% Any Postnatal Check? No Data
ANC 4 35% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
4680 % Low Birth Weight No Data
Number Pregnant women tested for
HIV
82%
Number pregnant women positive for
HIV
2% Newborns treated ARVs at
Birth
106 (80%)
Positive Pregnant women given ARVs
for prophylaxis
182 (68%)
% deliveries at Health Facility 30% BCG <1y 11488 Population under 1 year 12132
% skilled birth attendant no data DPT HEP HIB 3 <1y 10127
Did VHTs interviewed know danger
signs pregnant or postpartum
women?
None VHTs interviewed know New
Born danger signs?
None Measles <1y 8251
Any PNC visit? 7% Perinatal Cases 1 VHTs interviewed know
danger signs?
None
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit Some
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
None LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 38% Cases No Data U5s treated with malaria inpatient 4165
Malaria Cases pregnant women 377 Deaths No Data U5s treated with malaria
outpatient
49705
MalariaDeaths 4 Deaths 77
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
None Cases No Data Cases 1136
Deaths No Data Deaths 7
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 416
Zinc available on day of visit None Deaths No Data Deaths 8
Nutrition
Health Centres v sited have
MUACs?
None Cases Severe Malnutrition 335
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age 242
VHTs follow up of discharged
patients?
No
NGOs CBOS CSOs working at
community level in the District
Abanya Rwenzori Mountaineering Ass Bubandi Youth
Performers
Organisation
Bundibugyo Integrated Prog For Rural Development Family
Nurturing Assoc-
Network
Nawou Thukolendeke Disabled Group
Actionaid Uganda Bughendera
Rural Youth
Development
Assoc.
Bundibugyo Ntuha Drama
Performers
Green Dove
Puppeter For
Adolescent
Awareness
North Rwenzori Rural Community Agriculture&Conservation Link Uganda Red Cross Society Bundibugyo Branch
Baghendera Farmers Organisation Of Organic Farming Bundibugyo
Association Of
Women Living
With Aids/Hiv
Community Hygiene And
Sanitation Promoters
Association
Intergrated
Rural Women
,Orphans And
Youth
Nulife UNICEF
Bhassao Bundibugyo Deaf Dumba Womens Group Mataisa
Womens Group
Self Care Bundibugyo WVI
Estimated District LLIN Coverage
Lessons Learned and cultural practices
Bundibugyo Health Situation
Women Newborn Under 5's
50%
11%
5%
21%
13%
Bundibugyo Cause of Deaths Under 5's
(n=155)
Malaria Pneumonia Diarrhoea Anaemia Other
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 36 Number of Villages 2034
% SC Covered by VHT's 3% % Villages Covered VHT 12%
District has Register or or List of
VHTs ?
No Number Active VHTs 256
Number VHTs 256 TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
% VHTs female ND
Population 840091
Crude Mortality Rate CMR ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
256 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 10
# VHTs basic Health Promotion
trained AND still active
256 Health facilities 110
VHTs additionional training
modules
Access to Functional Health
Facilty
ND
Average time spent volunteering
per month (hours)
% Household owning a bicycle 25%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Onchocerciasis
First Aid,
Diarrhoea
Access to Improved Water
Source
85%
Contraceptives distributed by VHTs No Latrine coverage 91%
IEC Available in Community Education-Gross Enrolment
Rate
118
IEC needed in Community Female Literacy rate 71%
Main languages Runyankore
All VHTs attached to a Specified
HC?
Some List of VHTs available on day of
visit
No Access to mass media No Data
Established Links to HC 2, 3, 4 Some % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities Some Operational Radio Stations
No Data
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
Yes
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs
during past 6 months ?
Yes Other Registers??If Yes How many? Yes, two Have VHTs been trained on
who to refer?
All
Who Supervises? NGO that did
training
Any VHT data collated? By VHT Yes How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII Yes Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
Refresher
training, bicycles,
lunch, T-shirts all
tagged to
performance
Is Any VHT data used? Yes What Motivates the VHTs? Recognition
Village Mortality Data available? Yes What for? what could
have been done
differently to
prevent deaths
in the
community
Why do they volunteer? To improve health
of community,
neighbours and
family.
Need to Know
danger signs for
ALL and when to
refer needs to
be incorporated
into training
Evidence for IMPACT of VHT Implementation, best
practices
Coverage of ivermectin increased from 80% to 100%. Deliveries via caeserian section
reduced from 10 to 2 women per week due to reproductive health education on danger
signs that resulted in quick refferals
Actions Needed to Save Lives
Supervision of VHTs Referrals
Motivation & Incentives
Given in District
Danger signs for newborns and how to manage
LBW infants .Content and timing of post natal
checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Other Background Current VHT Activities (during last 6 months)
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Helminths,
Onchocerciasis HIV/AIDS & TB prevention and
adherence to treatment Request all in picture format
None
Social Mobilisation for Campaigns NTD drug
distribution Surveillance NTD diseases Reproductive
Health / Family Planning Education and commodity
distribution Referrals
VHT Reporting and District
Data Management
Linkages with other sectors in the
District
none
Linkages between VHT and Health System and Other Sectors
Other Community Health Workers NOT included in
VHTs
170 CORPs trained in NBC; 2CMDs / village
Demographics
Health Services
VHT Training
Coordination of VHT by DHMT
VHT Implementation Bushenyi
STATUS OF VHT IMPLEMENTATION
Women of reproductive age 169698 Births 2008-9 40744 Population Under 5 years 169698
Estimated number of pregnancies
2008-9
42005 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 84% Any Postnatal Check? No Data
ANC 4 0.32 %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
2888800% % Low Birth Weight No Data
Number Pregnant women tested for
HIV
76%
Number pregnant women positive for
HIV
0.06 Newborns treated ARVs at
Birth
852 (93%)
Positive Pregnant women given ARVs
for prophylaxis
1533 (83%) Population under 1 year 36124
% deliveries at Health Facility 31% BCG <1y 36796 DPT HEP HIB 3 <1y 34477
% skilled birth attendant No Data Measles <1y 28525
Did VHTs interviewed know danger signs pregnant or postparum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 0.24 Perinatal Cases No Data
Post Natal visit when? Day 42 Perinatal Deaths No Data
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
Some LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 41% Cases No Data U5s treated with malaria inpatient
Malaria Cases pregnant women 3333 Deaths No Data U5s treated with malaria
outpatient
78208
MalariaDeaths No Data Deaths No Data
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases No Data Cases No Data
Deaths No Data Deaths No Data
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases No Data
Zinc available on day of visit None Deaths No Data Deaths No Data
Nutrition
Health Centres visited have
MUACs?
None Cases Severe Malnutrition No Data
VHTs can Read MUAC? Some VHTs Have MUACs? None CasesLow weight for Age 374
VHTs follow up of discharged
patients?
yes
ADRICA Bushenyi
Disabled Persons
Association
FPAU JCRC National Adult Education AssociationVSO Uganda
Association For The Advancement Of
Sustainable Rural Development
Bushenyi Women
In Development
Association
Hand In Hand Group Kataagu
Bakyara
Twimukye
Nyaburare Pearl Group Wakame Drama Actors
Bushenyi Banana And Plantain
Farmers Association
Community
Initiatives
Development
Association
Healthy Child Uganda Kibaare Ant
Aids Initiative
Group
Nyanga Kwentungura Group
Bushenyi Beekeepers Association Ebenezer Women
Group
Integrated Community Based
Initiatives
Kitabi Parish
Catechechists
Association
Trust For Community Empowerment(Truce)
Bushenyi Community Development
Agency
EGPAF Ishaka Bakyara Twendezane Kyeizooba
Community
Based Health
Workers
UWESO Bushenyi Branch
Under 5's
Pie Chart for causes of death
Estimated District LLIN Coverage
NGOs CBOS CSOs working at community level in the District
Bushenyi Health Situation
Women Newborn
Women of reproductive age 169698 Births 2008-9 40744 Population Under 5 years 169698
Estimated number of pregnancies
2008-9
42005 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 84% Any Postnatal Check? No Data
ANC 4 0.32 %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
2888800% % Low Birth Weight No Data
Number Pregnant women tested for
HIV
76%
Number pregnant women positive for
HIV
0.06 Newborns treated ARVs at
Birth
852 (93%)
Positive Pregnant women given ARVs
for prophylaxis
1533 (83%) Population under 1 year 36124
% deliveries at Health Facility 31% BCG <1y 36796 DPT HEP HIB 3 <1y 34477
% skilled birth attendant No Data Measles <1y 28525
Did VHTs interviewed know danger signs pregnant or postparum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 0.24 Perinatal Cases No Data
Post Natal visit when? Day 42 Perinatal Deaths No Data
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
Some LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 41% Cases No Data U5s treated with malaria inpatient
Malaria Cases pregnant women 3333 Deaths No Data U5s treated with malaria
outpatient
78208
MalariaDeaths No Data Deaths No Data
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases No Data Cases No Data
Deaths No Data Deaths No Data
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases No Data
Zinc available on day of visit None Deaths No Data Deaths No Data
Nutrition
Health Centres visited have
MUACs?
None Cases Severe Malnutrition No Data
VHTs can Read MUAC? Some VHTs Have MUACs? None CasesLow weight for Age 374
VHTs follow up of discharged
patients?
yes
ADRICA Bushenyi
Disabled Persons
Association
FPAU JCRC National Adult Education AssociationVSO Uganda
Association For The Advancement Of
Sustainable Rural Development
Bushenyi Women
In Development
Association
Hand In Hand Group Kataagu
Bakyara
Twimukye
Nyaburare Pearl Group Wakame Drama Actors
Bushenyi Banana And Plantain
Farmers Association
Community
Initiatives
Development
Association
Healthy Child Uganda Kibaare Ant
Aids Initiative
Group
Nyanga Kwentungura Group
Bushenyi Beekeepers Association Ebenezer Women
Group
Integrated Community Based
Initiatives
Kitabi Parish
Catechechists
Association
Trust For Community Empowerment(Truce)
Bushenyi Community Development
Agency
EGPAF Ishaka Bakyara Twendezane Kyeizooba
Community
Based Health
Workers
UWESO Bushenyi Branch
Under 5's
Pie Chart for causes of death
Estimated District LLIN Coverage
NGOs CBOS CSOs working at community level in the District
Bushenyi Health Situation
Women Newborn
List of CBO CSO and NGOs
operating in District Available at
DHO?
Incomplete Joint Review ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DHT? No Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 10 Number of Villages 580
% SC Covered by VHT's 40% % Villages Covered VHT 8%
District has Register or List of VHTs
?
Yes Number Active VHTs 30
Number VHTs 225 TBAs & other former Community
Medicine distributors etc included
in VHT?
All
% VHTs female 40% Demographics
Population 27028200.00%
Crude Mortality Rate CMR No Data
District has training record for
VHTs
Yes Number of VHTs trained Health
Promotion and Education
225
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 16 Health Services
# VHTs basic Health Promotion
trained AND still active
30 Training Support District Livelihood Support Program DLSP Health facilities 25; 1 Hospital 3 HCIV 7 HCIII 14 HCII
VHTs additional training modules
Other Background
Average time spent volunteering
per month (hours)
unknown % Household owning a bicycle 45%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level
NA Access to Improved Water Source 68%
Contraceptives distributed by VHTs No Latrine coverage 1
IEC Available in Community Education-Gross Enrolment Rate14300%
IEC needed in Community Female Literacy rate 0.541
Main languages Lusamia-Lugwe
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No Access to mass media No Data
Established Links to HC 2, 3, 4 No % of District covered by
mobile phone network
No Data
VHTs Assist Outreach Activities Some Operational Radio Stations Eastern Radio
Bugiri
Content of outreach EPI alone VHTs Record and Report Diseases of Epidemic Potential? none
Other Registers??If Yes How many? none
Any Supervision activity of VHTs
during past 6 months ?
No Any VHT data collated? By VHT No Have VHTs been trained on
who to refer?
All
Who Supervises? Health Assts.at
s/c
By HCII No How are these done by VHTs? Verbal
Standard Supervision Training? No By HSD No Are referrals recorded in VHT
register?
No
Supervision checklist? No By DMT No
Any Supervision Reports Available? No Is Any VHT data used? No Motivation & Incentives Given
in District
none
What for? NA What Motivates the VHTs? Certificates
Village Mortality Data available? No Why do they volunteer? no information
VHTs- Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Actions Needed to Save Lives
Supervision of VHTs Referrals
Motivation & Incentives
Given in District
Linkages with other sectors in the
District
Linkages between VHT, Health System and Other Sectors
Other Community Health Workers NOT included in
VHTs
CORPs
Fertility Rate
Access to Functional Health
Facilty
VHT Training
Coordination of VHT by DHT
VHT Implementation Busia
STATUS OF VHT IMPLEMENTATION
none
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
none
Current VHT Activities (during last 6 months)
sanitation, EPI, Family Planning, refferals
Planning and
Finance
VHTs have VHT Village
Register?
Evidence for IMPACT of VHT Implementation, best
practices
- increased TT and PMTCT coverage; latrine coverage from 74% to 85% -
have PMTCT drama groups
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Women of reproductive age 54597 Births 2008-9 13109 Population Under 5 years 54597
Estimated number of pregnancies
2008-9
13514 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 87% Any Postnatal Check? No Data
ANC 4 0.26 %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
276200% % Low Birth Weight ND
Number Pregnant women tested for
HIV
53%
Number pregnant women positive for
HIV
0.06 Newborns treated ARVs at
Birth
143 (61% Population under 1 year 11622.126
Positive Pregnant women given ARVs
for prophylaxis
175 (42%) Post Natal visit when? DPT HEP HIB 3 <1y 10477
% deliveries at Health Facility 31% BCG <1y 13987 Measles <1y 9555
% skilled birth attendant ND
Did VHTs interviewed know danger signs pregnant or postparum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? 0.12 Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit No visit
LLIN Hanging to protect pregnant
women at HCs Visited?
no visit LLIN Hanging to protect
newborns at HF Visited?
no visit LLIN Hanging to protect under
5 at HF Visited?
no visit
LLIN s for ANC distribution at HCs
visited
no visit LLIN s for NB distribution at
HC visited
no visit LLIN s for distribution for u5s
without net at home at HCs
visited
no visit
IPT 2 46% Cases No Data U5s treated with malaria inpatient 7030
Malaria Cases pregnant women 116 Deaths No Data U5s treated with malaria
outpatient
70838
Malaria Deaths 0 Deaths 43
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
no visit Cases No Data Cases 299
Deaths No Data Deaths 5
Diarrhoea
ORS Available on day of visit no visit Cases No Data Cases 519
Zinc available on day of visit no visit Deaths No Data Deaths 4
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition 72
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 208
VHTs follow up of discharged
patients?
none
Africa 2000 Network Uganda Busia Women
Producers
Association
Environmental Alert Kamukamu
Women
Integrated
Dev't Initiatives
Pentacostal Association Of Jesus World Gospel Mission Busia Cbhc
Africa Inland Church- Uganda Busime Rural
Dev. Assoc.
Friends Of Christ Revival Ministries Kaptoyoy
Integrated
Farmers Assoc.
PREFA
Baylor Uganda Buyengo C.C.P
Project
Grace World Mission Nubian
Community
Development
Association
Assoc.
Send A Cow Uganda
Busia Anti Aids Youth&Women Assoc. Catholic Diocese Hope Case Foundation Olympafrica
Youth Centre
U.S.C.G
Busia District Farmers Association Compassion
International
Human Rights And Paralegal
Services
Partnership
Evangelical
Church
International
UWESO
Estimated District LLIN Coverage
NGOs CBOS CSOs working at community level in the District
Busia Health Situation
Women Newborn Under 5's
55%
8%
5%
1%
17%
9%
5%
Busia Cause of Deaths Under 5's (n=78)
Malaria Pneumonia Diarrhoea
Malnutrition AIDS Anaemia
Other
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Yes Frequency of reporting irregular
Joint Planning? No
Number of Sub Counties 12 Number of Villages 400
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs
?
No Number Active VHTs NA
Number VHTs NA TBAs & other former Community
Medicine distributors etc included
in VHT?
None
% VHTs female NA Population 192400
Crude Mortality Rate CMR No Data
Fertility Rate No Data
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
NA
Duration of Basic Health Promotion
Training
NA Ratio participants to facilitator NA Health facilities 23; 2 Hospitals (1
govt. 1 private) 11
HCIII 10 HCII
# VHTs basic Health Promotion
trained AND still active
NA Access to Functional Health
Facility
No Data
VHTs additional training modules
% Household owning a bicycle 47%
Average time spent volunteering
per month (hours)
4hrs a day Access to Improved Water
Source
60%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Malaria
Diarrhoea
Latrine coverage 91%
Contraceptives distributed by VHTs No Education-Gross Enrolment
Rate
145
IEC Available in Community Female Literacy rate No Data
IEC needed in Community Main languages Japadhola,
Lusamia-Lugwe,
Ateso, Lugwere,
Lunyoli
Access to mass media No Data
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
No Data
Established Links to HC 2, 3, 4 No Operational Radio Stations
No Data
VHTs Assist Outreach Activities No Adult Literacy 0.54
Content of outreach EPI alone VHTs Record and Report Diseases of Epidemic Potential? CHWs do
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on
who to refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
CHWs are involved
in activites that
give allowances
Is Any VHT data used? No What Motivates the VHTs? NA
Village Mortality Data available? No What for? NA Why do they volunteer? NA
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
VHT Implementation Butaleja
Coordination of VHT by DMT
Linkages between VHT, Health System and Other Sectors
Other Community Health Workers NOT included in
VHTs
282 active CHWs of which 25 are TBAs; 816 coartem distributors
VHT Training
NA
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Filariasis,
Request all in picture format
None
Current VHT Activities (during last 6 months)
CHWs / CMDs do community treatment for
Diarrheoa and Malaria, mobilisation and education
for PMTCT, ANC, Immunisation and Disease
surveillance
Supervision of VHTs Referrals
Motivation & Incentives
Given in District
Linkages with other sectors in the
District
the political
wing;
community
leaders like the
Religious
VHT Reporting and District
Data Management
STATUS OF VHT IMPLEMENTATION
Evidence for IMPACT of VHT Implementation, best
practices
No Data
Actions Needed to Save Lives
Health Services
Other Background
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Women of reproductive age 38865 Births 2008-9 9331 Population Under 5 years 38865
Estimated number of pregnancies
2008-9
9620 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 145% Any Postnatal Check? No Data
ANC 4 0.47 %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
344200% % Low Birth Weight No Data
Number Pregnant women tested for
HIV
116%
Number pregnant women positive for
HIV
0.02 Newborns treated ARVs at
Birth
65 (92%)
Positive Pregnant women given ARVs
for prophylaxis
200 (84%) Post Natal visit when? No Data Population under 1 year 8273
% deliveries at Health Facility 38% BCG <1y 10670 DPT HEP HIB 3 <1y 7908
% skilled birth attendant No Data Measles <1y 9137
Did VHTs interviewed know danger signs pregnant or postparum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? 0.2 Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
ACTs available on day of Visit no visit
LLIN Hanging to protect pregnant
women at HCs Visited?
no visit LLIN Hanging to protect
newborns at HF Visited?
No Visit LLIN Hanging to protect under
5 at HF Visited?
no visit
LLIN s for ANC distribution at HCs
visited
no visit LLIN s for NB distribution at
HC visited
No Visit LLIN s for distribution for u5s
without net at home at HCs
visited
no visit
IPT 2 77% Cases No Data U5s treated with malaria inpatient 5168
Malaria Cases pregnant women 520 Deaths No Data U5s treated with malaria
outpatient
78994
Malaria Deaths 0 Deaths 62
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
no visit Cases No Data Cases 1400
Deaths No Data Deaths 10
Diarrhoea
ORS Available on day of visit no visit Cases No Data Cases 904
Zinc available on day of visit no visit Deaths No Data Deaths 1
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition 86
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 250
VHTs follow up of discharged
patients?
NA
same as Tororo
Butaleja Health Situation
Women Under 5's
NGOs CBOS CSOs working at community level in the District
Estimated District LLIN Coverage
Newborn
53%
8%
1%
31%
2%
5%
Butaleja Cause of Deaths Under 5's
(n=117)
Malaria
Pneumonia
Diarrhoea
Anaemia
Infection Sepsis Septicaemia
Other
List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review ? Yes All
ALL Registered at Community
Development Office?
No Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Yes
Number of Sub Counties 6 Number of Villages 355
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs
?
Yes Number Active VHTs 800-850
Number VHTs 1320 TBAs & other former Community
Medicine distributors etc included
in VHT?
All Demographics
% VHTs female No data Population 159200
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
Incomplete Number of VHTs trained Health
Promotion and Education
1320
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 25 Health facilities 15
# VHTs basic Health Promotion
trained AND still active
800-850 Access to Functional Health
Facilty
ND
VHTs additional training modules
% Household owning a bicycle 98%
Average time spent volunteering
per month (hours)
480 hours Access to Improved Water
Source
83%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Diarrhoea,
Malaria,
Pneumonia,
Latrine coverage 46%
Contraceptives distributed by VHTs Condoms, Injectables and Oral Contraceptives Education-Gross Enrolment
Rate
130
IEC Available in Community Female Literacy rate ND
IEC needed in Community Main languages Luo, Lango
Access to mass media ND
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 No Operational Radio Stations
Radio Rhino, Voice
of Lango, unity
radio
VHTs Assist Outreach Activities No Adult Literacy 0.79
Content of outreach EPI alone VHTs Record and Report Diseases of Epidemic Potential? None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? Yes, 1 for CBDAsHave VHTs been trained on
who to refer?
Some
Who Supervises? DHT, Health
Assistants
Any VHT data collated? By VHT No How are these done by VHTs? Standard letter
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
Bicycle, T-shirts,
Recognition, Bags
and allowance if
they participate in
some health
Is Any VHT data used? No What Motivates the VHTs? Certificates
Village Mortality Data available? No What for? n/a Why do they volunteer? No Information
Evidence for
IMPACT of VHT
Implementation,
Factors affecting
implementation
No Data Lack of sensitisation of district
leaders on roles of VHTs because
basic training occurred when
Dokolo was a health sub-district
under Lira; Lack of medicines for
community distribution;
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
Current VHT Activities (during last 6 months)
Distribution of ORS, coartem, condoms, and other
contraceptives like pills. Health education, referral
and reporting
Referrals
Linkages between VHT, Health System and Other Sectors
Linkages with other sectors in the
District
TseTse fly
control, Water
Department,
Community
Development,
Actions Needed to Save Lives
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Dokolo
Health Services
Other Background
No data
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
192 Community Vaccinators, 60 CBDAs, 710 CMDs for NTDs, 400
VHTs trained in PMTCT, 180 Condom distributors
VHT Reporting and District
Data Management
Motivation & Incentives
Given in District
Other Community Health Workers NOT included in
VHTs
None
VHT Training
Supervision of VHTs
Women of reproductive age 32158 Births 2008-9 7721 Population Under 5 years 35024
Estimated number of pregnancies
2008-9
7960 % Births registered
ANC 1 8702 (109%) Any Postnatal Check? No Data
ANC 4 2503 (31%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
684200% % Low Birth Weight
Number Pregnant women tested for
HIV
5800 (73%)
Number pregnant women positive for
HIV
272 (5%) Newborns treated ARVs at
Birth
91 (99%)
Positive Pregnant women given ARVs
for prophylaxis
231 (85%) Post Natal visit when? Population under 1 year 6846
% deliveries at Health Facility 24% BCG <1y 7654 DPT HEP HIB 3 <1y 6123
% skilled birth attendant ND Measles <1y 6337
Did VHTs interviewed know danger signs pregnant or postparum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? 1489 (19%) Perinatal Cases 2
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 1
Malaria
No Data ACTs available on day of Visit No
LLIN Hanging to protect pregnant
women at HCs Visited?
Yes LLIN Hanging to protect
newborns at HF Visited?
Yes LLIN Hanging to protect under
5 at HF Visited?
Yes
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 5137 (65%) Cases No Data U5s treated with malaria inpatient 2957
Malaria Cases pregnant women 916 Deaths No Data U5s treated with malaria
outpatient
36503
Malaria Deaths 0 Deaths 11
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
Yes Cases No Data Cases 3491
Deaths No Data Deaths 1
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 3
Zinc available on day of visit None Deaths No Data Deaths 0
Nutrition
Health Centres Have MUACs? None Inpatient Cases Severe
Malnutrition
3
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 19
VHTs follow up of discharged
patients?
No
Lessons Learned and
cultural practices
Vertical VHT
implementation
and training by
Health workers as good examples for
key practices
Health workers at health
centres visited exhibited good
handwashing practices
NGOs CBOS CSOs working at
community level in the District
Aboa Care For Children With Hiv/Aids CPAR IBFAN Rural Facilities
Development
Foundation
UNICEF UWESO
Christian Renewal Church Women Faith Vocational
And Technical
Training Institute
North East Chili Producers
Association
UNFPA Uganda Shelter Programmde
Estimated District LLIN Coverage
Dokolo Health Situation
Women Newborn Under 5's
33%
3%
6%
6%
3%
49%
Dokolo Cause of Deaths Under 5's (n=33)
Malaria
Pneumonia
Anaemia
Infection Sepsis Septicaemia
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review ? Yes All
ALL Registered at Community Development
Office?
No Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Yes CSOs CBOs are often not included
in the planning
Number of Sub Counties 15 Number of Villages 324
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs ? No Number Active VHTs Unknown
Number VHTs 889
% VHTs female No data Population 357,400
Crude Mortality Rate CMR No Data
Fertility Rate No Data
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
889
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 10 Health facilities 33; 1 Regional Referral
Hospital 2 District
Hospitals 2 HCIV 8 HCIII
14 HCII Private and NGO
1 Hospital 3 HCIII 2 HCII
# VHTs basic Health Promotion trained AND
still active
Unknown Training Support MoH WHO UNICEF Access to Functional Health Facilty No Data
VHTs additional training modules (List and
numbers)
% Household owning a bicycle 50%
Average time spent volunteering
per month (hours)
fulltime Access to Improved Water Source 91%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community
level (List)
Diarhhoea,
Pneumonia,
Schistosomiasis
Malaria First Aid
Latrine coverage 36%
Contraceptives distributed by VHTs Education-Gross Enrolment Rate 142
IEC Available in Community Female Literacy rate 47%
IEC needed in Community Main languages Luo
Access to mass media No Data
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of
visit
No % of District covered by mobile phone
network
No Data
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
No Operational Radio Stations 4, Radio Four Gulu,
Norah Media Group Ltd,
Uganda Broadcasting
Corporation Radio, Radio
Maria Uganda
VHTs Assist Outreach Activities No VHTs Record and Report Diseases of
Epidemic Potential?
No
Content of outreach EPI alone
VHTs have VHT Village Register? Yes All Have VHTs been trained on who to
refer?
Some
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How
many?
Yes, one How are these done by VHTs? Standard letter
Who Supervises? Incharges Any VHT data collated? By VHT No Are referrals recorded in VHT register? No
Standard Supervision Training? No By HCII No VHTs follow up of discharged
patients?
None
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Monthly meetings,
transport refund 3000=,
Lunch 3000=, Soap
Is Any VHT data used? No What Motivates the VHTs? Refresher Training
Village Mortality Data available? Yes What for? n/a Why do they volunteer? No Information
Factors affecting
implementation
Frequent stock outs of community
medicines lead to more cases of
malaria
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Health Services
Other Background
Referrals
Evidence for IMPACT of VHT
Implementation, best practices
Motivation & Incentives Given in
District
Actions Needed to Save Lives
No Data HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
VHT Reporting and District Data
Management
Medicine distribution - coartem, ivermectin, filtricide (NTDs);
community vacinnators, diarrhoea
None
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
None
Current VHT Activities (during last 6 months)
TBAs & other former Community
Medicine distributors etc included
in VHT?
All
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
263 Coartem distributors
VHT Training
Coordination of VHT by DHMT
VHT Implementation Gulu
STATUS OF VHT IMPLEMENTATION
Demographics
Under 5's
Women of reproductive age 72195 Births 2008-9 17334 Population Under 5 years 72195
Estimated number of pregnancies 2008-9 17870 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data
ANC 1 28075 (157%) Any Postnatal Check? No Data
ANC 4 4684 (26%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
10931 % Low Birth Weight No Data
Number Pregnant women tested for HIV 25859 (145%)
Number pregnant women positive for HIV 3724 (14%) Newborns treated ARVs at Birth 757 (83%)
Positive Pregnant women given ARVs for
prophylaxis
1573 (42%) Post Natal visit when? Population under 1 year 15368
% deliveries at Health Facility 58% BCG <1y 17559 DPT HEP HIB 3 <1y 14470
% skilled birth attendant No Data Measles <1y 15161
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 2369 (14%) Perinatal Cases 17
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 4 U5's slept under net survey night 44%
Malaria
10% ACTs available on day of Visit No
LLIN Hanging to protect pregnant women
at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to protect under 5 at
HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 11659 (65%) Cases ND U5s treated with malaria inpatient 12039
Malaria Cases pregnant women 610 Deaths ND U5s treated with malaria
outpatient
117476
Malaria Deaths 2 Deaths 188
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
yes Cases ND Cases 3348
Deaths ND Deaths 119
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 1964
Zinc available on day of visit None Deaths ND Deaths 51
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 913
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 274
ACCORD CARE CARITAS Malaria Consortium PACE TASO World Vision Uganda WFP
ACF CPAR Maries-stopes People's Voice For
Peace
UNFPA
AMREF FPAU MAP Punena Child And
Family Programme
UNHCR
ARC GLRA MSF Spain Save the Children UNICEF
AT Uganda Ltd. ICRC MS Uganda Send A Cow Uganda UNOCHA
AVSI Jamii Ya Kupatanisha NUMAT SOS WHO
NGOs CBOS CSOs working at community level in the District
Estimated District LLIN Coverage (HH with 2+ nets)
Gulu Health Situation
Women Newborn
20%
11%
11%
16%
8%
34%
Gulu Cause of Deaths Under 5's (n=1238)
Malaria
Pneumonia
Malnutrition
Anaemia
Infection Sepsis Septicaemia
Other
List of CBO CSO and NGOs operating in District
Available at DHO?
Incomplete Joint Review ? Some
ALL Registered at Community Development Office? Yes Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? No Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 13 Number of Villages 553
% SC Covered by VHT's 23% % Villages Covered VHT 14%
District has Register or List of VHTs ? No Number Active VHTs 300
Number VHTs 416
% VHTs female No Data
Population 451800
Crude Mortality Rate CMR No Data
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
416
Duration of Basic Health Promotion Training 3 days Ratio participants to facilitator 15.66666667 Health Services
# VHTs basic Health Promotion trained AND still
active
300 Training Support MoH Health facilities 51; 1 Regional Referral Hospital 2 HCIV 22 HCIII 26 HCII
VHTs additional training modules
Other Background
Average time spent volunteering per month
(hours)
3 % Household owning a bicycle 5100%
Are VHTs treating diseases at Community level?
(Currently)
No Diseases Treated at community level NA Access to Improved Water Source 74%
Contraceptives distributed by VHTs Condoms Latrine coverage 1
IEC Available in Community Education-Gross Enrolment Rate9600%
IEC needed in Community Female Literacy rate 0.627
Main languages Runyoro
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the District NGOs such as World Vision % of District covered by mobile
phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Hoima Radio, Kisembo Electronics Engineers Ltd., Madison Baptist Church, Ababaigara Company
Content of outreach EPI alone
VHTs have VHT Village Register? No Referrals
Any Supervision activity of VHTs during past 6
months ?
No Other Registers??If Yes How many? None Have VHTs been trained on
who to refer?
None
Who Supervises? Incharges, Health Assts. Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given
in District
None
Is Any VHT data used? No What Motivates the VHTs? Recognition
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
Follow-up of VHTs needs to be facilitated VHTs - Need to Know
danger signs for ALL and
when to refer needs to be
incorporated into training
Demographics
Fertility Rate
Access to Functional Health Facilty
VHTs Record and Report Diseases of Epidemic Potential?
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
STATUS OF VHT IMPLEMENTATION
Mobilisation for health activities
Immunisation, Bilharzia, FP
Actions Needed to Save Lives
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Supervision of VHTs
Evidence for IMPACT of VHT
Implementation, best practices
Motivation & Incentives Given in
District
TBAs & other former Community Medicine
distributors etc included in VHT?
No Information
VHT Implementation Hoima
Coordination of VHT by DHMT
Flip Charts for VHTs with Danger Signs, Key family Practices.Water
and Sanitation, Trauma, Onchocerciasis, Request all in picture
format
No Data
None
Current VHT Activities (during last 6 months)
Other Community Health Workers NOT included in VHTs Condom Distributors, Counselling Aides, TBAs, Community Resourse
Persons, Peer Groups, CMDs
VHT Training
Under 5's
Women of reproductive age 91264 Births 2008-9 21912 Population Under 5 years 91264
Estimated number of pregnancies 2008-9 22590 % Births registered No Data
Maternal Mortality Rate calculate from HMIS Neonatal Mortality (deaths per 1000 live
births)
No Data
ANC 1 0.83 Any Postnatal Check? No Data
ANC 4 0.16 %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
8838 % Low Birth Weight ND
Number Pregnant women tested for HIV 0.72
Number pregnant women positive for HIV 0.05 Newborns treated ARVs at Birth 326 (103%)
Positive Pregnant women given ARVs for
prophylaxis
619 (76%) Post Natal visit when? Population under 1 year 19427.4
% deliveries at Health Facility 34% BCG <1y 17486 DPT HEP HIB 3 <1y 12602
% skilled birth attendant ND Measles <1y 11425
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born danger
signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 0 Perinatal Cases 7
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 6
Malaria
ACTs available on day of Visit No visit
LLIN Hanging to protect pregnant women at HCs
Visited?
No visit LLIN Hanging to protect newborns at HF
Visited?
No visit LLIN Hanging to protect under 5 at HF
Visited?
No visit
LLIN s for ANC distribution at HCs visited No visit LLIN s for NB distribution at HC visited No visit LLIN s for distribution for u5s without net at
home at HCs visited
No visit
IPT 2 0.37 Cases ND U5s treated with malaria inpatient 3637
Malaria Cases pregnant women 286 Deaths ND U5s treated with malaria outpatient 50100
Malaria Deaths 1 Deaths 103
Pneumonia
Pneumonia 1st line antibiotics available on day of
Visit
No visit Cases ND Cases 327
Deaths ND Deaths 27
Diarrhoea
ORS Available on day of visit No visit Cases ND Cases 274
Zinc available on day of visit No visit Deaths ND Deaths 5
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition 183
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 60
NGOs CBOS CSOs working at community level in
the District
Abomulembe W/ G Hoima District Change Agent Association Kinogou Integrated Rural Dev't
Organisation (KIRDO)
Support Organisation For Micro-
Enterprises Dev't
UWESO
Africa 2000 Network Uganda Hoima District Farmers
Asociation
Mirembe Multi-Purpose THETA Unisex Exparts Band And Artists
Environmental Alert Hoima Environmental
Project
MS Uganda Uganda Red Cross Society -
Hoima Branch
World Vision Uganda
FPAU Kidea Cooperative Savings
And Credit Society Ltd
Nulife Uganda Society For Disabled
Children ,Hoima
Morbidity under 5 years
Estimated District LLIN Coverage
VHTs follow up of discharged patients?
Hoima Health Situation
Women Newborn
24%
6%
2% 18%
50%
Hoima Cause of Deaths Under 5's (n=432)
Malaria Pneumonia Diarrhoea Anaemia Other
List of CBO CSO and NGOs operating in District
Available at DHO?
No Joint Review with all partners ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting Activities to
DMT?
Some
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? No
Number of Sub Counties 13 Number of Villages 512
% SC Covered by VHT's 46% % Villages Covered VHT 51%
District has Register or or List of VHTs ? Yes Number Active VHTs 813, just trained 2
months ago
Number VHTs 813
% VHTs female 40% Population 236115
Crude Mortality Rate CMR No Data
Fertility Rate No Data
District has training record for VHTs No Number of VHTs trained Health Promotion
and Education
813
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 23 Health facilities 39; 1 Hospital 2 HCIV 8
HCIII 28 HCII
# VHTs basic Health Promotion trained AND
still active
813 Access to Functional Health Facilty No Data
VHTs additionional training modules (List and
numbers)
% Household owning a bicycle 34.5
Average time spent volunteering per
month (hours)
No Data Access to Improved Water Source 73%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level Onchocerciasis Latrine coverage 89%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate 121
IEC Available in Community Female Literacy rate No Data
IEC needed in Community Main languages Runyankore
Access to mass media No Data
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No % of District covered by mobile phone
network
No Data
Established Links to HC 2, 3, 4 No Operational Radio Stations
Radio Edigito, Radio
West, Radio Efirimbi
VHTs Assist Outreach Activities Yes All Adult Literacy 64%
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
yes
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past 6
months ?
Yes Other Registers??If Yes How many? None Have VHTs been trained on who to refer? All
Who Supervises? DHT / E Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District Supervision, Follow-up
Is Any VHT data used? No What Motivates the VHTs? Bags, T-shirts, Means of
Identification
Village Mortality Data available? No What for? NA Why do they volunteer? To improve health of
community members
Factors affecting
implementation
lack of transport for parish supervisors, no
means of identification of VHTs
Other Community Health Workers NOT included in VHT HPV Community Mobilisers, Community Vaccinators, Parish
Mobilisers, CMDs
VHT Training
TBAs & other former Community Medicine
distributors etc included in VHT?
Some
VHT Implementation Ibanda
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma Swine flu, First Aid,
Disease Surveillance Request all in picture format
Linkages between VHT and Health System and Other Sectors
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Refresher training in HBMF by UPHOLD
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns NTD drug distribution
Surveillance NTD diseases, Family Planning Education, Home
improvement campaigns, Sanitation, Referrals
HPV
VHT Reporting and District Data
Management
Linkages with other sectors in the District Agriculture,
Education - FAL,
Water Dept.
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Demographics
Health Services
Other Background
Referrals
Motivation & Incentives Given in District
Actions Needed to Save Lives
Supervision of VHTs
Evidence for IMPACT of VHT
Implementation, best practices
- NTD drug (Ivermectin)distribution coverage went up from
56% to 90% with CMDs - VHTs go to health centres
regularly and help out
Under 5's
Women of reproductive age 47695 Births 2008-9 11452 Population Under 5 years 47695
Estimated number of pregnancies 2008-9 11806 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live
births)
No Data
ANC 1 86% Any Postnatal Check? No Data
ANC 4 40% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
5674 % Low Birth Weight
Number Pregnant women tested for HIV 73%
Number pregnant women positive for HIV 5% Newborns treated ARVs at Birth 154 (91%)
Positive Pregnant women given ARVs for
prophylaxis
172 (39%) Population under 1 year 10152.945
% deliveries at Health Facility 29% BCG <1y 10891 DPT HEP HIB 3 <1y 9267
% skilled birth attendant No Data Measles <1y 7888
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born danger
signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 11% Perinatal Cases 0
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit some
LLIN Hanging to protect at pregnant women at
HCs Visited?
Some LLIN Hanging to protect newborns at HF
Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net
at home at HCs visited
None
IPT 2 26% Cases ND U5s treated with malaria inpatient 2770
Malaria Cases pregnant women 175 Deaths ND U5s treated with malaria outpatient 29089
MalariaDeaths 0 Deaths 47
Pneumonia
Pneumonia 1st line antibiotics available on day
of Visit
yes Cases ND Cases 228
Deaths ND Deaths 14
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 383
Zinc available on day of visit None Deaths ND Deaths 2
Nutrition
Health Centres v sited have MUACs? None Cases Severe Malnutrition 35
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 250
VHTs follow up of discharged patients? No
Carter Center
EGPAF
PACE
UPHOLD
NGOs CBOS CSOs working at community level in the District
Estimated District LLIN Coverage
Ibanda Health Situation
Women Newborn
48%
14%
3%
8%
8%
19%
Ibanda Cause of Deaths Under 5's (n=98)
Malaria Pneumonia
Malnutrition Anaemia
Infection Sepsis Septicaemia Other
List of CBO CSO and NGOs operating in District
Available at DHO?
Yes Joint Review ? Some
ALL Registered at Community Development Office? Yes Partners Regularly Reporting Activities to
DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 21 Number of Villages 697
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs ? No Number Active VHTs NA
Number VHTs NA
% VHTs female NA
Population 648,954
Crude Mortality Rate CMR 57
District has training record for VHTs No Number of VHTs trained Health Promotion
and Education
NA Fertility Rate ND
Duration of Basic Health Promotion Training Ratio participants to facilitator NA
# VHTs basic Health Promotion trained AND still
active
Health facilities 81; 1 Hospital 3 HCIV 20 HCIII
57 HCII
VHTs additional training modules Access to Functional Health Facilty No Data
Average time spent volunteering per month
(hours)
40 for Parish Mobilisers % Household owning a bicycle 45%
Are VHTs treating diseases at Community level?
(Currently)
No Diseases Treated at community level CHWs - Malaria Pneumonia
NTDs
Access to Improved Water Source 58%
Contraceptives distributed by VHTs No Latrine coverage 64%
IEC Available in Community Education-Gross Enrolment Rate 119
IEC needed in Community Female Literacy rate 59%
Main languages Lusoga
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities No Operational Radio Stations
Radio Kiyira
Content of outreach EPI alone VHTs Record and Report Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past 6
months ?
No Other Registers??If Yes How many? No Have VHTs been trained on who to refer? None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District none but partners give
CMDs/CHWs 5000= monthly
allowance, bicycles,
nametags/badges, T-shirts
Is Any VHT data used? No What Motivates the VHTs? Support supervision
Village Mortality Data available? No What for? NA Why do they volunteer? CHWs volunteer to help their
communities
Evidence for IMPACT of VHT
Implementation, best
No Data VHTs - Need to Know danger
signs for ALL and when to
refer needs to be incorporated
into training
Factors affecting implementation
- Volunterism has a limit, MoH has to motivate VHTs; Communities
and health workers need sensitisation about roles of VHTs Lack of
support supervision and irregular supply of logistics
Motivation & Incentives Given in District
Other Community Health Workers NOT included in VHTs 45 CHWs for Saving Newborn lives (Makerere University); 1394 CMDs (102
of Malaria Pneumonica Study); Peer Educators, Counselling Aides, 60
Nulife volunteers, 113 Parish Mobilisers of Redcross
VHT Training
Linkages with other sectors in the District Education Water LCs NGOs
Current VHT Activities (during last 6 months)
Supervision of VHTs
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Trachoma, Helminths,
Filariasis, Trypanosomiasis Request all in picture format
Linkages between VHT, Health System and Other Sectors
VHT Reporting and District Data
Management
VHT Implementation Iganga
Coordination of VHT by DHMT
Demographics
Health Services
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine
distributors etc included in VHT?
None
CHWs do sanitation, HBMF, NTDs nutrition managing newborn,
pneumonia and malaria studies.
Malaria, Health Seeking Behaviour, Counselling Cards on
Newborn Survival
Other Background
Referrals
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants .Content and timing
of post natal checks for both mother and baby Nutritional assessment of all children
and pregnant women.
Women of reproductive age 131089 Births 2008-9 31474 Population Under 5 years 131089
Estimated number of pregnancies 2008-9 32448 % Births registered
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live
births)
ANC 1 90% Any Postnatal Check? No Data
ANC 4 21% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
7881 % Low Birth Weight
Number Pregnant women tested for HIV 73%
Number pregnant women positive for HIV 3% Newborns treated ARVs at Birth 191 (72%)
Positive Pregnant women given ARVs for
prophylaxis
308 (46%) Post Natal visit when? Population under 1 year 27905.022
% deliveries at Health Facility 34% BCG <1y 28273 DPT HEP HIB 3 <1y 16203
% skilled birth attendant Measles <1y 15518
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born danger
signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 19% Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit No visit
LLIN Hanging to protect pregnant women at HCs
Visited?
no visit LLIN Hanging to protect newborns at HF
Visited?
no visit LLIN Hanging to protect under 5 at
HF Visited?
no visit
LLIN s for ANC distribution at HCs visited no visit LLIN s for NB distribution at HC visited no visit LLIN s for distribution for u5s
without net at home at HCs visited
no visit
IPT 2 3% Cases No Data U5s treated with malaria inpatient 6655
Malaria Cases pregnant women 152 Deaths No Data U5s treated with malaria
outpatient
70260
Malaria Deaths 0 Deaths 136
Pneumonia
Pneumonia 1st line antibiotics available on day
of Visit
no visit Cases ND Cases 599
Deaths ND Deaths 40
Diarrhoea
ORS Available on day of visit no visit Cases ND Cases 229
Zinc available on day of visit no visit Deaths ND Deaths 14
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition 100
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 373
VHTs follow up of discharged patients? None
Africa 2000 Network Uganda Bukaire Magezi Assoc. FPAU Iganga District
Farmers Association
Musingi Rural Development
Association
Send A Cow Uganda
Anppcn Centre For Evangelism Iam Not Alone Girl Child Iganga Muslim
Youth Org
National Women Association For
Social Education Advancement
Tweyambe Womens
Club
Association For Integrated Community
Development
Charismatic Episcopial Church
(U) Iganga
Idudi Development Association Idda Iganga United
Development
Association
Ngangali Agali Awamu Women's
Group
Uganda Biogass
Development
Associationfor The Cooperation Between Tiliko
And Uganda
E4h Farmers Association Iganga District Credit & Saving Society Integrated
Development
Activities & Aids
Rural & Urban Development
Foundation
UWESO
Bakuseka Majja Womens Farmers Dev. Assoc. Foundation For Kigulu South
Development Association
Iganga District Elders Development
Association
Kigulu Development
Group
SCiU Wider Opportunities For
Women And Youth
Association
NGOs CBOS CSOs working at community level in the District
Estimated District LLIN Coverage
Iganga Health Situation
Women Under 5's Newborn
39%
12% 7%
4%
20%
3% 15%
Iganga Cause of Deaths Under 5's (n=347)
Malaria Pneumonia Diarrhoea Malnutrition
Anaemia Trauma Other
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review with all partners ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting monthly
Joint Planning? No
Number of Sub Counties 15 Number of Villages 712
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or or List of
VHTs ?
No Number Active VHTs none, just
selected 1119
VHTs not
trained
Number VHTs 0
% VHTs female no data Population 316025
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
0
Duration of Basic Health
Promotion Training
NA Ratio participants to facilitator NA Health facilities 57( 32 of which
have midwives);
4 HCIV 15 HCIII
38HCII
# VHTs basic Health Promotion
trained AND still active
0 Training Support MoH Access to Functional Health
Facilty
ND
VHTs additionional training
modules (List and numbers)
% Household owning a bicycle
30
Average time spent volunteering
per month (hours)
NA Access to Improved Water
Source
37%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level (List)
NA Latrine coverage
77%
Contraceptives distributed by
VHTs
No Education-Gross Enrolment
Rate
106
IEC Available in Community Female Literacy rate
ND
IEC needed in Community Main languages Ruyankore
Access to mass media ND
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
Community Development Operational Radio Stations
Radio West
VHTs Assist Outreach Activities No Adult Literacy 64%
Content of outreach Integrated
Outreach
VHTs Record and Report
Diseases of Epidemic
Potential?
None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
None Have VHTs been trained on
who to refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives Given
in District
allowances,
bicycles, basic
kits, CHWs are
part of the
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? CHWs in refugee
settlements
volunteer to keep
Factors affecting
implementation
VHTs need training, support
supervision and follow-up
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
- CHWs of Millenium Villages Project( found in 1
county) increased delivery in health units from 12%-
15% to over 80% CHWs in refugee settlements
encourage mothers to go for post natal visits and give
health education talks
VHT Reporting and District
Data Management
Actions Needed to Save Lives
Motivation & Incentives
Given in District
Evidence for IMPACT of VHT
Implementation, best
practices
65 VHTs trained for 2 days
Demographics
Current VHT Activities (during last 6 months)
CHWs do disease surveillance for measles, acute
flacid paralysis, health talks, post natal visits in
refugee settlement, Refferals, nutrition
demonstration camps at post natal visits, followup
on ITN use TB DOTS
none
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma Request
all in picture format
Health Services
Other Background
Other Community Health Workers NOT included in
VHTs (List and estimate numbers)
Linkages between VHT and Health System and Other Sectors
36 CHWs, 30 Peer Educators at 6 health units, 1236 CMDs
VHT Training
TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Supervision of VHTs Referrals
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Isingiro
Under 5's
Women of reproductive age 63837 Births 2008-9 15327 Population Under 5 years 63837
Estimated number of pregnancies
2008-9
15801 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 85% Any Postnatal Check? No Data
ANC 4 43% %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
13947 % Low Birth Weight ND
Number Pregnant women tested for
HIV
104%
Number pregnant women positive
for HIV
2% Newborns treated ARVs at
Birth
128 (65%)
Positive Pregnant women given ARVs
for prophylaxis
346 (70%) Population under 1 year 13589.075
% deliveries at Health Facility 24% BCG <1y 17826 DPT HEP HIB 3 <1y
16532
% skilled birth attendant ND Measles <1y 14129
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 11% Perinatal Cases ND
Post Natal visit when? Day 42 Perinatal Deaths ND
Malaria
Estimated
District LLIN
Coverage
ND ACTs available
on day of Visit
some
LLIN Hanging to protect at pregnant
women at HCs Visited?
some LLIN Hanging to protect
newborns at HF Visited?
some LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for
u5s without net at home at
HCs visited
None
IPT 2 37% Cases ND U5s treated with malaria inpatient ND
Malaria Cases pregnant women ND Deaths ND U5s treated with malaria
outpatient
39606
MalariaDeaths ND Deaths ND
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases ND Cases ND
Deaths ND Deaths ND
Diarrhoea
ORS Available on day of visit yes Cases ND Cases ND
Zinc available on day of visit Some at Juru
HCII (UNHCR
refugee
settlement)
Deaths ND Deaths ND
Nutrition
Health Centres visited have
MUACs?
None Cases Severe Malnutrition ND
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age 123
VHTs follow up of discharged
patients?
No
AHA UNHCR
GTZ
Millenium Villages Project
Save the Children in Uganda
NGOs CBOS CSOs working at community level in the District
Isingiro Health Situation
Women Newborn
Pie chart for deaths u5's No Data
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? No Frequency of reporting never
Joint Planning? No
Number of Sub Counties 12 Number of Villages 392
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of
VHTs ?
No Number Active VHTs none
Number VHTs none
% VHTs female 50% Population 441660
Crude Mortality Rate CMR No Data
Fertility Rate No Data
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
None
Duration of Basic Health
Promotion Training
NA Ratio participants to facilitator NA Health facilities 26
# VHTs basic Health Promotion
trained AND still active
NA Training Support Bujagali Energy Ltd. Access to Functional Health
Facilty
No Data
VHTs additional training modules
% Household owning a
bicycle
34
Average time spent volunteering
per month (hours)
NA Access to Improved Water
Source
72%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level
NTDs Latrine coverage 88%
Contraceptives distributed by
VHTs
No Education-Gross Enrolment
Rate
95
IEC Available in Community Female Literacy rate 73%
IEC needed in Community Main languages Lusoga
Access to mass media No Data
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
No Data
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
Agriculture
(NAADS,
Poverty
Operational Radio Stations Radio Kiira Ltd.,
Nkabi
Broadcasting
VHTs Assist Outreach Activities No VHTs Record and Report
Diseases of Epidemic
Potential?
No
Content of outreach EPI alone
VHTs have VHT Village Register? No Have VHTs been trained on
who to refer?
None
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
Local exercise books How are these done by
VHTs?
Verbal
Who Supervises? DHE, Sub
county
coordinators,
Any VHT data collated? By VHT No Are referrals recorded in VHT
register?
No
Standard Supervision Training? No By HCII No VHTs follow up of discharged
patients?
None
Supervision checklist? No By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives Given
in District
None
Is Any VHT data used? Yes What Motivates the VHTs? Recognition,
Appreciation
Village Mortality Data available? No What for? identifying TB
defaulters and
following them
Why do they volunteer? to serve their
communities
Factors affecting
implementation
- Lack of identification for
recognition in community and
protective gear / work aides to
VHTs - Need to
Know danger
signs for ALL
Some
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma,
Schistosomiasis, Trypanosomiasis Request all in
Other Background
Other Community Health Workers NOT included in
VHTs
Selection just ended
VHT Training
None
Current VHT Activities (during last 6 months)
Linkages between VHT and Health System and Other Sectors
Actions Needed to Save Lives
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
VHT Implementation Jinja
CMDs involved in distribution of medicines for
NTDs - deworming tablets, Sanitation and
Hygiene, Mobilisation for Immunisation, ITN
None
Demographics
Health Services
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc included
in VHT?
Referrals
Motivation & Incentives
Given in District
Supervision of VHTs
VHT Reporting and District
Data Management
Evidence for IMPACT of VHT
Implementation, best
practices Home improvement campaigns were organised by
DHT and with mobilisation / education by VHTs
best homes got prizes (box of soap) and selected
Under 5's
Women of reproductive age 89,215 Births 2008-9 21421 Population Under 5 years
89,215
Estimated number of pregnancies
2008-9
22083 % Births registered No Data Morbidity under 5 years
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
ANC 1 23192 (105%) Any Postnatal Check? No Data
ANC 4 11347 (51%) % Infants weighed at Birth No Data Infant Mortality
Tetanus Toxoid coverage (pregnant
women) 2+ doses
15810 % Low Birth Weight No Data
Number Pregnant women tested for
HIV
15664 (71%)
Number pregnant women positive
for HIV
780 (5%) Newborns treated ARVs at
Birth
503 (64%)
Positive Pregnant women given
ARVs for prophylaxis
686 (88%) Post Natal visit when? Population under 1 year 18991.38
% deliveries at Health Facility 59% BCG <1y 17572 DPT HEP HIB 3 <1y 14030
% skilled birth attendant No Data Measles <1y 13056
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 7058 (33%) Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for
u5s without net at home at
HCs visited
None
IPT 2 10390 (47%) Cases No Data U5s treated with malaria inpatient 4499
Malaria Cases pregnant women 252 Deaths No Data U5s treated with malaria
outpatient
89404
Malaria Deaths 1 Deaths 74
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
Yes Cases No Data Cases 691
Deaths No Data Deaths 23
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 232
Zinc available on day of visit None Deaths No Data Deaths 2
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 83
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 735
Act Africa Bujagali Energy
Limited (Bel)
Family Hope Clinic Jinja Network
Of People
Living With
Hiv/Aids
Marie Stopes Uganda TASO
Action On Aids And Development
Foundation
Busoga Trust
Water And
Sanitation Sector
Family Life Education
Project (Flep)
Jinja Child
Development
Centre
National Assoc Of Women
Organisation
The Aids Initiative
Project (Taip)
AIC Butembe
Development
Agency
First African Bicycle
Information Orgfanisation
And Workshop Fabio
Jinja District
Ngo Network
Pediatric Infectious Disease
Clinic (Pidc)
Uganda Change
Agent Assoc
Aids Orphans Education Trust
(AOET)
Child Fund
Uganda (Former
CCF)
Hands Of Help Jinja
Municipality
Women's
Rays of Hope Hospice, Jinja Uganda Church
Women Development
Centre
Anppcn Child
Restoration
Outreach
Health Child JCRC Red Shining Performers UHMG
Arise Africa International Ecov (U) Chapter International HIV/AIDS
Alliance
Lutheran
Church Mission
In Uganda
School Drop Out Women And
Disabled
Uganda Parents Of
Children With
Disabilities
Bandera Community Project Fatima Helper
Project
Jinja Diocese Development
(Jiddeco)
Mamajane
Children Care
Centre
Student Partnership
Worldwide (Spw)
Uganda Red Cross
NGOs CBOS CSOs working at community level in the District
Jinja Health Situation
Women Newborn
Estimated District LLIN Coverage
47%
15%
3%
20%
15%
Jinja Cause of Deaths Under 5's
(n=156)
Malaria Pneumonia Diarrhoea
Anaemia Other
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review with all partners ? Yes All
ALL Registered at Communiy
Development Office?
Incomplete Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Yes
Number of Sub Counties 9 Number of Villages 258
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs
?
No Number Active VHTs 760
Number VHTs 760 Population 301200
% VHTs female 20% Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
760
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 20 Health facilities 30
# VHTs basic Health Promotion
trained AND still active
760 Training Support MoH WHO UNICEF Access to Functional Health Facilty ND
VHTs additionional training modules
% Household owning a bicycle ND
Average time spent volunteering
per month (hours)
not specified Access to Improved Water Source 24%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level (List)
NTDs Latrine coverage 2%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate 48
IEC Available in Community Female Literacy rate ND
IEC needed in Community Main languages Ng'akarimojong
Access to mass media ND
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of
visit
No % of District covered by mobile
phone network
ND
Established Links to HC 2, 3, 4 No Operational Radio Stations ND
VHTs Assist Outreach Activities Some Adult Literacy 8.4
Content of outreach EPI Growth
monitoring
VHTs have VHT Village Register? No Have VHTs been trained on who to
refer?
Some
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
None How are these done by VHTs? Verbal
Who Supervises? ND Any VHT data collated? By VHT No Are referrals recorded in VHT
register?
No
Standard Supervision Training? No Information By HCII No
Supervision checklist? No Information By HSD No Motivation & Incentives Given in
District
Meetings, Bicycles
Any Supervision Reports Available? No By DMT No What Motivates the VHTs? ND
Is Any VHT data used? No Why do they volunteer? ND
Village Mortality Data available? No What for? NA
Factors affecting
implementation
poor motivation VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Demographics
Social Mobilisation for Campaigns Referrals Nutrition
Screening, NTD medicines distribution, Administering
polio vaccine
Yes
Health Services
Other Background
VHT Implementation Kaabong
Coordination of VHT by DHMT
Current VHT Activities (during last 6 months)
Improvement in EPI,reproductive services, Increased
access to health services; child health days coverage
increased from 60 -over 90% and treatment for NTDs
rose from 63% to 97%
Motivation & Incentives Given in
District
Linkages with other sectors in the
District
Food Security and food
distribution
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both
mother and baby Nutritional assessment of all children and
pregnant women.
Actions Needed to Save Lives
Referrals
STATUS OF VHT IMPLEMENTATION
Evidence for IMPACT of VHT
Implementation, best practices
Supervision of VHTs
VHT Reporting and District Data
Management
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Linkages between VHT, Health System and Other Sectors
Nutrition
TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
Other Community Health Workers NOT included in VHTs Nutrition Workers
VHT Training
Women of reproductive age 69276 Births 2008-9 14608 Population Under 5 years 60842
Estimated number of pregnancies 2008-9 15060 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data
ANC 1 40.13% Any Postnatal Check? No Data
ANC 4 15.40% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
62.51%
TT 2-5 WCBA 16.61% % Low Birth Weight No Data
Number Pregnant women tested for HIV 3236 (21%)
Number pregnant women positive for HIV 42 (1%) Newborns treated ARVs at Birth 4 (50%)
Positive Pregnant women given ARVs for
prophylaxis
11 (26%) Post Natal visit when? No Data Population under 1 year 12951
% deliveries at Health Facility 5% BCG <1y 51.40% DPT HEP HIB 3 <1y 66.40%
% skilled traditional birth attendant 18% Measles <1y 81.80%
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? 19% Perinatal Cases 14
Post Natal visit when? Day 1 and Day 42Perinatal Deaths 1
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5
at HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 18.00% Cases No Data U5s treated with malaria inpatient 1006
Malaria Cases pregnant women 186 Deaths No Data U5s treated with malaria
outpatient
33757
MalariaDeaths 1 Deaths 15
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
ND Cases ND Cases 535
Deaths ND Deaths 14
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 286
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres v sited have MUACs? Some Cases Severe Malnutrition 1791
VHTs can Read MUAC? Some VHTs Have MUACs? Some CasesLow weight for Age 926
VHTs follow up of discharged patients? Some
ACF MEDAIR WFP
CESVI MSF
CUAMM UNICEF
Lessons Learned and cultural
practices
NGOs CBOS CSOs working at community level in the District
low literacy. Long distances to health centres, Pastoralist community so VHT males are absent
for long periods of time as they go hunting
Estimated District LLIN Coverage
Kaabong Health Situation
Women Newborn Under 5's
28%
26%
23%
6%
17%
Kaabong Cause of Deaths Under 5's (n=53)
Malaria
Pneumonia
Infection Sepsis Septicaemia
Meningitis
Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review with all partners ? Some
ALL Registered at Community Development
Office?
Incomplete Partners Regularly Reporting Activities
to DMT?
No
Partners have MoUs with DHT? Incomplete Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 20 Number of Villages 1387
% SC Covered by VHT's 20% % Villages Covered VHT 21%
District has Register or or List of VHTs ? Yes Number Active VHTs 1022
Number VHTs 1022
% VHTs female 60%
Population 501535
Crude Mortality Rate CMR ND
District has training record for VHTs Yes Number of VHTs trained Health
Promotion and Education
1022 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 Days Ratio participants to facilitator 13
# VHTs basic Health Promotion trained AND
still active
just completed
training
Training Support MoH Health facilities 105 (Govt. and NGO); 2
Hospitals 7 HCIV 20 HCIII 76
HCII
VHTs additionional training modules Access to Functional Health Facilty ND
Average time spent volunteering per
month (hours)
unknown % Household owning a bicycle 20
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level
(List)
Onchocerciasis Access to Improved Water Source 92%
Contraceptives distributed by VHTs Condoms Latrine coverage 91%
IEC Available in Community Education-Gross Enrolment Rate 130
IEC needed in Community Female Literacy rate 66%
Main languages Rukiga, Runyarwanda
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the
District
None % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Voice of Kigezi, 89.3FM,
Radio West, 94.3FM, UBC
Radio, The Roots (U) Ltd.
Content of outreach EPI ANC VHTs Record and Report Diseases of
Epidemic Potential?
None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on who to
refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
None
Is Any VHT data used? No What Motivates the VHTs? Quarterly Meetings
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
No supervision and stationary. VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
TBAs & other former Community
Medicine distributors etc included in
VHT?
Coordination of VHT by DHT
VHT Implementation
STATUS OF VHT IMPLEMENTATION
Demographics
VHT Reporting and District Data
Management
Health Services
Kabale
Evidence for IMPACT of VHT
Implementation, best practices
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns Ivermectin Distribution
Family Planning Education and commodity distribution
Referrals TB DOTS Record Keeping, Follow-up of routine
immunisation
Malaria HIV/AIDS
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma Reproductive
Health Prevention and adherence to treatment in HIV/AIDS
Actions Needed to Save Lives
Motivation & Incentives Given in District
Linkages between VHT, Health System and Other Sectors
Other Background
Referrals Supervision of VHTs
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Some
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
- EPI coverage increased fron 52% to 81% due to
mobilisation by VHTs. VHTs carry out IRS and malaria cases
have reduced. - VHTs
(former TBAs) at Bukinda HCIII carry out assisted refferals
and have monthly meetings with health workers making
deliveries here second to those at the regional refferal
hospital as a result MoH accredited this HC to do ART;
none
VHT Training
none
Women of reproductive age 69276 Births 2008-9 14608 Population Under 5 years 60842
Estimated number of pregnancies 2008-9 15060 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data
ANC 1 40.13% Any Postnatal Check? No Data
ANC 4 15.40% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
62.51%
TT 2-5 WCBA 16.61% % Low Birth Weight No Data
Number Pregnant women tested for HIV 3236 (21%)
Number pregnant women positive for HIV 42 (1%) Newborns treated ARVs at Birth 4 (50%)
Positive Pregnant women given ARVs for
prophylaxis
11 (26%) Post Natal visit when? No Data Population under 1 year 12951
% deliveries at Health Facility 5% BCG <1y 51.40% DPT HEP HIB 3 <1y 66.40%
% skilled traditional birth attendant 18% Measles <1y 81.80%
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? 19% Perinatal Cases 14
Post Natal visit when? Day 1 and Day 42Perinatal Deaths 1
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5
at HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 18.00% Cases No Data U5s treated with malaria inpatient 1006
Malaria Cases pregnant women 186 Deaths No Data U5s treated with malaria
outpatient
33757
MalariaDeaths 1 Deaths 15
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
ND Cases ND Cases 535
Deaths ND Deaths 14
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 286
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres v sited have MUACs? Some Cases Severe Malnutrition 1791
VHTs can Read MUAC? Some VHTs Have MUACs? Some CasesLow weight for Age 926
VHTs follow up of discharged patients? Some
ACF MEDAIR WFP
CESVI MSF
CUAMM UNICEF
Lessons Learned and cultural
practices
NGOs CBOS CSOs working at community level in the District
low literacy. Long distances to health centres, Pastoralist community so VHT males are absent
for long periods of time as they go hunting
Estimated District LLIN Coverage
Kaabong Health Situation
Women Newborn Under 5's
28%
26%
23%
6%
17%
Kaabong Cause of Deaths Under 5's (n=53)
Malaria
Pneumonia
Infection Sepsis Septicaemia
Meningitis
Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review with all partners ? Some
ALL Registered at Community Development
Office?
Incomplete Partners Regularly Reporting Activities
to DMT?
No
Partners have MoUs with DHT? Incomplete Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 20 Number of Villages 1387
% SC Covered by VHT's 20% % Villages Covered VHT 21%
District has Register or or List of VHTs ? Yes Number Active VHTs 1022
Number VHTs 1022
% VHTs female 60%
Population 501535
Crude Mortality Rate CMR ND
District has training record for VHTs Yes Number of VHTs trained Health
Promotion and Education
1022 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 Days Ratio participants to facilitator 13
# VHTs basic Health Promotion trained AND
still active
just completed
training
Training Support MoH Health facilities 105 (Govt. and NGO); 2
Hospitals 7 HCIV 20 HCIII 76
HCII
VHTs additionional training modules Access to Functional Health Facilty ND
Average time spent volunteering per
month (hours)
unknown % Household owning a bicycle 20
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level
(List)
Onchocerciasis Access to Improved Water Source 92%
Contraceptives distributed by VHTs Condoms Latrine coverage 91%
IEC Available in Community Education-Gross Enrolment Rate 130
IEC needed in Community Female Literacy rate 66%
Main languages Rukiga, Runyarwanda
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the
District
None % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Voice of Kigezi, 89.3FM,
Radio West, 94.3FM, UBC
Radio, The Roots (U) Ltd.
Content of outreach EPI ANC VHTs Record and Report Diseases of
Epidemic Potential?
None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on who to
refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
None
Is Any VHT data used? No What Motivates the VHTs? Quarterly Meetings
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
No supervision and stationary. VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
TBAs & other former Community
Medicine distributors etc included in
VHT?
Coordination of VHT by DHT
VHT Implementation
STATUS OF VHT IMPLEMENTATION
Demographics
VHT Reporting and District Data
Management
Health Services
Kabale
Evidence for IMPACT of VHT
Implementation, best practices
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns Ivermectin Distribution
Family Planning Education and commodity distribution
Referrals TB DOTS Record Keeping, Follow-up of routine
immunisation
Malaria HIV/AIDS
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma Reproductive
Health Prevention and adherence to treatment in HIV/AIDS
Actions Needed to Save Lives
Motivation & Incentives Given in District
Linkages between VHT, Health System and Other Sectors
Other Background
Referrals Supervision of VHTs
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Some
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
- EPI coverage increased fron 52% to 81% due to
mobilisation by VHTs. VHTs carry out IRS and malaria cases
have reduced. - VHTs
(former TBAs) at Bukinda HCIII carry out assisted refferals
and have monthly meetings with health workers making
deliveries here second to those at the regional refferal
hospital as a result MoH accredited this HC to do ART;
none
VHT Training
none
Women of reproductive age 101310 Births 2008-9 24324 Population Under 5 years 101310
Estimated number of pregnancies 2008-9 25077 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 21105 (84%) Any Postnatal Check? No Data
ANC 4 9743 (39%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
8588 % Low Birth Weight
Number Pregnant women tested for HIV 15789 (63%)
Number pregnant women positive for HIV 727 (5%) Newborns treated ARVs at Birth 297 (90%)
Positive Pregnant women given ARVs for
prophylaxis
391 (54%) Population under 1 year 21566.005
% deliveries at Health Facility 24% BCG <1y 16264 DPT HEP HIB 3 <1y 17218
% skilled birth attendant Measles <1y 17325
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 4446 (18%) Perinatal Cases ND
Post Natal visit when? Day 42 Perinatal Deaths ND
Malaria
No Data ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant women at
HCs Visited?
None LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without
net at home at HCs visited
None
IPT 2 7729 (31%) Cases ND U5s treated with malaria inpatient 2369
Malaria Cases pregnant women 165 Deaths ND U5s treated with malaria outpatient 47075
MalariaDeaths 1 Deaths 76
Pneumonia
Pneumonia 1st line antibiotics available on day of
Visit
Yes Cases ND Cases 1193
Deaths ND Deaths 33
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 364
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres vIsited have MUACs? None Cases Severe Malnutrition 172
VHTs can Read MUAC? All VHTs Have MUACs? All CasesLow weight for Age 230
VHTs follow up of discharged patients? yes
Africa 2000 Network Uganda CARE International in
Uganda
Africare Compassion
International
AMREF WVU
Have political goodwill and support, CAO meets incharges of health centres plus DHT regularly to
discuss and enforce minimum standards at their workplaces
Kabale Health Situation
Women Newborn Under 5's
Health workers as good examples for key
practices
Estimated District LLIN Coverage
NGOs CBOS CSOs working at community level in the District
38%
16%
1%
19%
1%
25%
Kabale Cause of Deaths Under 5's (n=201)
Malaria Pneumonia
Infection Sepsis Septicaemia AIDS
Tuberculosis Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review with all partners ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting Activities
to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? No
Number of Sub Counties 16 Number of Villages 634
% SC Covered by VHT's 69% % Villages Covered VHT 59%
District has Register or or List of VHTs ? No Number Active VHTs 1799
Number VHTs 1799
% VHTs female 60%
Population 427426
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
1799 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 17
# VHTs basic Health Promotion trained AND
still active
1799 Training Support MoH Health facilities 84
VHTs additionional training modules Access to Functional Health Facilty ND
Average time spent volunteering per
month (hours)
nd % Household owning a bicycle
34
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level
(List)
Onchocerciasis,
Helminths
Access to Improved Water Source
64%
Contraceptives distributed by VHTs Condoms Latrine coverage
74%
IEC Available in Community Education-Gross Enrolment Rate
109
IEC needed in Community Female Literacy rate
68%
Main languages Rutooro
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
Community
Development
% of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Voice of Tooro, Radio West
Ltd., World Evangelical
Ministries, Radio Maria
Uganda Association, Life FM
Radio
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
Yes
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
Yes Other Registers??If Yes How many? none Have VHTs been trained on who to
refer?
All
Who Supervises? Health Asst. Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Quarterly review meetings,
Recognition, Umbrellas,
Gumboots, ITNs+E14
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? Like to serve
Factors affecting
implementation
No stationary for reporting, lack of
follow-up and low involvement
- Prompt reporting by VHTs of 10 suspected cholera cases in
August 2009 resulted in 7 lives saved.Latrine coverage
increased from 83% to 88%.
- VHTs attend clinic once per month are supervised and gain
new skills they also stay and help
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Linkages between VHT and Health System and Other Sectors
Other Community Health Workers NOT included in VHTs CMDs, Peer Educators, Community Development Assistants,
Popular opinion leaders of UHMG, Sanitation Volunteers of
Redcross
Health Services
VHT Training
TBAs & other former Community
Medicine distributors etc included in
VHT?
All
nd
Demographics
Coordination of VHT by DHMT
VHT Implementation Kabarole
STATUS OF VHT IMPLEMENTATION
Other Background
Referrals
Motivation & Incentives Given in District
Actions Needed to Save Lives
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns, ANC, Sanitation and
Hygiene, VCT NTD drug distribution Community based Disease
Surveillance Family Planning Education Homevisiting Referrals
TB DOTs
EPI, HIV/AIDS, Watsan related diseases
Supervision of VHTs
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, First Aid,
Environmental Sanitation, VCT Request all in picture
format
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
VHT Reporting and District Data
Management
Evidence for IMPACT of VHT
Implementation, best practices
Under 5's
Women of reproductive age 86340 Births 2008-9 20730 Population Under 5 years 86340
Estimated number of pregnancies 2008-9 21371 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 76% Any Postnatal Check? No Data
ANC 4 40% %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
8183 % Low Birth Weight ND
Number Pregnant women tested for HIV 59%
Number pregnant women positive for HIV 11% Newborns treated ARVs at Birth 577 (76%) Population under 1 year 18379.318
Positive Pregnant women given ARVs for
prophylaxis
875 (66%) DPT HEP HIB 3 <1y
13590
% deliveries at Health Facility 32% BCG <1y 15772 Measles <1y 12518
% skilled birth attendant ND
Did VHTs interviewed know danger signs
pregnant or postparum women?
Few VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 10% Perinatal Cases 12
Post Natal visit when? Day 42 Perinatal Deaths 0 U5's slept under net survey night 25%
Malaria
Estimated District LLIN
Coverage (HH with 2+
nets)
16% ACTs available on
day of Visit
Yes
LLIN Hanging to protect at pregnant women at
HCs Visited?
Some LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without
net at home at HCs visited
None
IPT 2 32% Cases ND U5s treated with malaria inpatient 4452
Malaria Cases pregnant women 508 Deaths ND U5s treated with malaria outpatient 35368
Malaria Deaths 0 Deaths 190
Pneumonia
Pneumonia 1st line antibiotics available on day of
Visit
yes Cases ND Cases 660
Deaths ND Deaths 112
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 200
Zinc available on day of visit None Deaths ND Deaths 36
Nutrition
Health Centres v sited have MUACs? None Cases Severe Malnutrition 38
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age 324
VHTs follow up of discharged patients? Some
Africare GTZ Kasese Town Council Women Group Mawandako
Women Vol Ass
Sunrise Associated Trainers Uganda Project
Implementation And
Management Centre
Bunyangavu Workers Association Kaanyegero Catholic
Bakazi Tutungude Ass.
Kavambi Women Associates Mbuzi Youth Self
Help
Toro Katebwa Was Veterans Association Urcs
Burungu Kkweterana Group Kabarole District
Disabled Peoles Union
Kibiito Enterprises Support Ltd (Ketu) Muhusu Rural
Dev't Association
Twimuke Tukole Youth & Women Devp
Group
Uganda Small Scale
Industries Association
Diabetic Association Of Tooro Kabarole District
Farmers Association
Kicucu Lyamabwa Rural Development
Organisation
Rural Women
Development
Agency
Uganda Development Initiative
Foundation
UNICEF
FPAU Kagute Cooperative
Savings And Credit
SCiU UHMG UWESO
NGOs CBOS CSOs working at community level in the District
Kabarole Health Situation
Women Newborn
56%
33%
11%
Kabarole Cause of Deaths Under 5's (n=338)
Malaria Pneumonia Diarrhoea
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? No
ALL Registered at Community Development
Office?
No Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting never
Joint Planning? No
Number of Sub Counties 9 Number of Villages 318
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs ? Yes Number Active VHTs 689
Number VHTs 1272
% VHTs female No data
Population 166,955
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
1272 Fertility Rate ND
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 14
# VHTs basic Health Promotion trained AND
still active
689 Training Support Pathfinder, Malteser Health facilities 19
VHTs additional training modules Access to Functional Health Facilty ND
Average time spent volunteering
per month (hours)
Fulltime % Household owning a bicycle 52
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community
level
Schistosomiasis,
Filariasis, Malaria,
Diarrhoea, Cough
Access to Improved Water Source 92%
Contraceptives distributed by VHTs No Latrine coverage 48%
IEC Available in Community Education-Gross Enrolment Rate 138
IEC needed in Community Female Literacy rate 55%
Main languages Ateso, Kumam, Kiswahili
All VHTs attached to a Specified HC? Some List of VHTs available on day of
visit
No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the
District
Water and Sanitation,
Community
Development,
% of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities No Operational Radio Stations ND
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How
many?
No Have VHTs been trained on who to
refer?
None
Who Supervises? 8 Health Assistants 1
per subcounty
Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Training, Transport
refund, T-Shirts, Bicycles
Is Any VHT data used? No What Motivates the VHTs? Refresher Training
Village Mortality Data available? No What for? n/a Why do they volunteer? No Information
Factors affecting
implementation
lack of logistics such as stationary
and medicines
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
VHT Reporting and District Data
Management
VHTs dig latrines in the community as a good example
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Linkages between VHT, Health System and Other Sectors
None
Current VHT Activities (during last 6 months)
Community mobilisation for child days, DOTS TB, Distribution of
drugs for Diarrhoea, Cough and Fever / Malaria
Supervision of VHTs Referrals
Motivation & Incentives Given in
District
Evidence for IMPACT of VHT
Implementation, best practices
ND
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma Trypanosomiasis
Request all in picture format
Other Background
Demographics
VHT Training
Health Services
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc included
in VHT?
All
Other Community Health Workers NOT included in VHTs None
Coordination of VHT by DHMT
VHT Implementation Kaberamaido
Women of reproductive age 33724 Births 2008-9 8097 Population Under 5 years 33724
Estimated number of pregnancies 2008-9 8347 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 8617 (99%) Any Postnatal Check? No Data
ANC 4 3115 (36%) % Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women
2+ doses)
3050 % Low Birth Weight
Number Pregnant women tested for HIV 6377 (73%)
Number pregnant women positive for HIV 211 (3%) Newborns treated ARVs at Birth 93 (4%)
Positive Pregnant women given ARVs for
prophylaxis
108 (51%) Post Natal visit when? No Data Population under 1 year 7179
% deliveries at Health Facility 30% BCG <1y 8627 DPT HEP HIB 3 <1y 7227
% skilled birth attendant No Data Measles <1y 6233
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 2470 (29%) Perinatal Cases 44
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 4 U5's slept under net survey night 73%
Malaria
52% ACTs available on day of Visit No Data
LLIN Hanging to protect pregnant women at
HCs Visited?
No Information LLIN Hanging to protect newborns
at HF Visited?
No Data LLIN Hanging to protect under 5 at
HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 3390 (39%) Cases ND U5s treated with malaria inpatient 4176
Malaria Cases pregnant women 630 Deaths ND U5s treated with malaria
outpatient
5294
Malaria Deaths 1 Deaths 39
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
No Information Cases Cases 279
Deaths Deaths 8
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 115
Zinc available on day of visit None Deaths ND Deaths 8
Nutrition
Health Centres Have MUACs? Cases Severe Malnutrition 10
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 36
VHTs follow up of discharged patients? No
Abola Youth Group Care For Others Jerusalem Women Organisation Kalaki Women Associate
Group
Pathfinder UNICEF
Agency For Promoting Sustainable
Development Initiatives
Dedicated Women In
Development
Kalaki Livestock Women Group Kamuda Helders Groups Ray Cooperative Christian
Association
Youth With A Message
Of Health
Amoru Based Environmental Conservation
Organisation
Full Pentecoastal Mission Kalaki Planning Group Livingstone Christian
Development
Association
Teso Islamic Development
Organisation
St. Caroli Catholic
Womens Association
AMREF Gwetom Growers
Cooperative Society
Kalaki Rural Development
Association
Malteser Uganda Oil Seed Producers And
Processors Association
Angwalo Peny Ryeko Omii Disabled
Association
Igoria Womens
Development
Kalaki Widowsa/Orphans And
Helders Center
Uganda Redcross Society
Kaberamaido Sub-Branch
NGOs CBOS CSOs working at community level in the District
Ochero Persons With
Disabilities & Orphans
Association
Estimated District LLIN Coverage (HH with 2+ nets)
Kaberamaido Health Situation
Women Newborn Under 5's
38%
13% 8%
1%
19%
5%
10%
4% 2%
Kaberamaido Cause of Deaths Under 5's (n
=101)
Malaria Pneumonia
Diarrhoea Malnutrition
Anaemia Trauma
Other Perinatal Conditions
Meningitis
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review with all partners ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? No
Number of Sub Counties 7 Number of Villages 120
% SC Covered by VHT's 75% % Villages Covered VHT 38%
District has Register or or List of VHTs ? Yes Number Active VHTs 146
Number VHTs 146
% VHTs female 38%
Population 47,430
Crude Mortality Rate CMR ND
District has training record for VHTs Yes Number of VHTs trained Health
Promotion and Education
146 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 6
# VHTs basic Health Promotion trained
AND still active
146 Health facilities 11; 2 HCIV 6 HCIII 3
HCII
VHTs additionional training modules Access to Functional Health Facilty ND
Average time spent volunteering
per month (hours)
ND % Household owning a bicycle 8%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community
level
Schistosomiasis Access to Improved Water Source 88%
Contraceptives distributed by VHTs Condoms Latrine coverage 52%
IEC Available in Community Education-Gross Enrolment Rate 39
IEC needed in Community Female Literacy rate 82%
Main languages Luganda
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of
visit
Yes Access to mass media ND
Established Links to HC 2, 3, 4 Yes All Linkages with other sectors in
the District
Beach Management
Services, Fisheries
Dept.
% of District covered by mobile
phone network
ND
VHTs Assist Outreach Activities Yes All Operational Radio Stations ND
Content of outreach EPI ANC Health
Education
VHTs Record and Report Diseases of
Epidemic Potential?
yes
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How
many?
None Have VHTs been trained on who to
refer?
All
Who Supervises? DHT Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Plan to give VHT kit
with T-shirt, badge,
register
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? ND
Factors affecting
implementation
Transport is very expensive and
some islands are unreached - of
the 84 islands only 7 have health
centres - VHTs cannot afford to
travel to health centres monthly
VHTs - Need to
Know danger signs
for ALL and when to
refer needs to be
incorporated into
training
Evidence for IMPACT of VHT
Implementation, best practices
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both
mother and baby Nutritional assessment of all children and
pregnant women.
- HCT for HIV coverage increased from 45% to 65% due to
VHT mobilisation, while immunisation of children in hard to
reach areas / islands increased from 20%-30% to 85% where
VHTs had been trained.
- VHTs attend clinic once per month are supervised and gain
new skills they also stay and help
None
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Schistosomiasis, STDs, HIV/AIDS (some landing
sites have a very high prevalence 35%-40%),
PMTCT, PNC Request all in picture format
VHT Training
None
Referrals
Motivation & Incentives Given in
District
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
VHT Reporting and District
Data Management
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns, Health, EPI, Sanitation at
landing sites NTD drug distribution Surveillance NTD diseases
Family Planning Education and commodity disrtibution
Referrals
Health Services
Other Background
Other Community Health Workers NOT included in VHTs Peer Educators, Beach Management Unit Chairpersons
TBAs & other former Community
Medicine distributors etc
included in VHT?
Demographics
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Kalangala
Some
Under 5's
Women of reproductive age
9,581
Births 2008-9 2300 Population Under 5
years
9581
Estimated number of pregnancies 2008-
9
2,372
% Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data
ANC 1
1764 (74%)
Any Postnatal Check? No Data
ANC 4
581 (24%)
%Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
698 % Low Birth Weight No Data
Number Pregnant women tested for HIV 1548 (65%)
Number pregnant women positive for
HIV
313 (20%) Newborns treated ARVs at Birth 64 (91%)
Positive Pregnant women given ARVs for
prophylaxis
275 (88%) Population under 1 year 2039
% deliveries at Health Facility 12% BCG <1y 1760 DPT HEP HIB 3 <1y 1822
% skilled birth attendant ND Measles <1y 1753
Did VHTs interviewed know danger
signs pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 257 (11%) Perinatal Cases 1
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day
of Visit
Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to
protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution
for u5s without net at
home at HCs visited
None
IPT 2 477 (20%) Cases ND U5s treated with malaria inpatient 118
Malaria Cases pregnant women 18 Deaths ND U5s treated with
malaria outpatient
5459
MalariaDeaths 0 Deaths 0
Pneumonia
Pneumonia 1st line antibiotics available
on day of Visit
Yes Cases ND Cases 27
Deaths ND Deaths 0
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 18
Zinc available on day of visit None Deaths ND Deaths 1
Nutrition
Health Centres v sited have
MUACs?
Some Cases Severe
Malnutrition
1
VHTs can Read MUAC? Some VHTs Have MUACs? Some CasesLow weight for
Age
44
VHTs follow up of discharged patients? None
Actionaid Uganda Few But Determined Kalangala District Development
Program KDDP
National Association of
Women Organisations
STRIDES
AGALYAWAMU Iceland Development
Agency ICEDA
Kalangala District Farmers Assoc. Nulife URCS
Bufumira Islands Development
Association
Kalangala AIDS Care
Education and Training
Kalangala District Womens
Association
PREFA
Bussumba Initiative for Adult Education
and Development
KALANGANETT Mothers Union Ssesse Islands
Community
Development
Organisation
NGOs CBOS CSOs working at community level in the District
Kalangala Health Situation
Women Newborn
100%
Kalangala Cause of Deaths
Under 5's (n=1)
Diarrhoe
a
List of CBO CSO and NGOs operating in
District Available at DHO?
Incomplete Joint Review ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 6 Number of Villages 294
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs ? No Number Active VHTs NA
Number VHTs NA
% VHTs female NA
Crude Mortality Rate CMR No Data
Fertility Rate No Data
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
NA Health Services
Duration of Basic Health Promotion Training NA Ratio participants to facilitator NA
# VHTs basic Health Promotion trained AND
still active
NA Access to Functional Health Facilty No Data
VHTs additional training modules Other Background
Average time spent volunteering per month (hours) NA Access to Improved Water Source 0.61
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community level Filariasis,
Trachoma,
Intestinal
worms
Latrine coverage 81%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate 12500%
IEC Available in Community Female Literacy rate No Data
IEC needed in Community Main languages Lusoga
Access to mass media No Data
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No % of District covered by mobile phone
network
No Data
Established Links to HC 2, 3, 4 No Linkages with other sectors in the District None Operational Radio Stations Victoria Radio
VHTs Assist Outreach Activities No Adult Literacy 63%
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
ND
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on who to
refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
None
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? NA
Factors affecting
implementation
Support for training, ongoing support supervision
and IEC materials
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be
incorporated
into training
Other Community Health Workers NOT included in VHTs Community Vaccinators, 588 CMDs
Supervision of VHTs
VHT Reporting and District Data
Management
Current VHT Activities (during last 6 months)
None
VHT Training
Linkages between VHT, Health System and Other Sectors
CMDs distributes medicines for NTDs and during child days
Immunisation, HIV/AIDS
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation, Trauma, Filariasis, Trachoma, Intestinal Worms,
Trypanosomiasis Request all in picture format
Sensitisation needed at all levels, district, local government
structures and health workers
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Evidence for IMPACT of VHT
Implementation, best practices
Motivation & Incentives Given in
District
VHT Implementation Kaliro
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine
distributors etc included in VHT?
None
Coordination of VHT by DHMT
Population
Health facilities
% Household owning a bicycle
Referrals
Under 5's
Women of reproductive age 36685 Births 2008-9 8808 Population Under 5 years 36685
Estimated number of pregnancies 2008-9 9081 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data
ANC 1 113% Any Postnatal Check? No Data
ANC 4 64% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
6442 % Low Birth Weight No Data
Number Pregnant women tested for HIV 81%
Number pregnant women positive for HIV 2% Newborns treated ARVs at Birth 4 (44%)
Positive Pregnant women given ARVs for
prophylaxis
48 (36%) Post Natal visit when? Population under 1 year 7809.23
% deliveries at Health Facility 20% BCG <1y 10757 DPT HEP HIB 3 <1y 7599
% skilled birth attendant No Data Measles <1y 7895
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 9% Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
No Data ACTs available on day of Visit no visit
LLIN Hanging to protect pregnant women at
HCs Visited?
No visit LLIN Hanging to protect newborns at
HF Visited?
No visit LLIN Hanging to protect under 5 at HF
Visited?
No visit
LLIN s for ANC distribution at HCs visited No visit LLIN s for NB distribution at HC visited No visit LLIN s for distribution for u5s without
net at home at HCs visited
No visit
IPT 2 38% Cases No Data U5s treated with malaria inpatient 1824
Malaria Cases pregnant women 408 Deaths No Data U5s treated with malaria outpatient 23861
Malaria Deaths 0 Deaths 22
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
No visit Cases No Data Cases 912
Deaths No Data Deaths 10
Diarrhoea
ORS Available on day of visit No visit Cases No Data Cases 120
Zinc available on day of visit No visit Deaths No Data Deaths 0
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition 124
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 330
VHTs follow up of discharged patients? None
AMREF GFTAM NACWOLA Strides URHB
Busoga Diocese COU Jinja Diocese PACE TASO WHO
Busoga Trust Malaria Consortium STAR EC THETA
Germany Leprosy and Relief Services Marie Stopes Straight Talk UAC
Kaliro Health Situation
NGOs CBOS CSOs working at community level in the District
Women Newborn
Estimated District LLIN Coverage
69%
31%
Kaliro Cause of Deaths Under 5's (n=32)
Malaria Pneumonia
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? No
ALL Registered at Community Development
Office?
No Partners Regularly Reporting Activities to DMT? No
Partners have MoUs with DMT? No Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 5 Number of Villages 2959
% SC Covered by VHT's 20% % Villages Covered VHT 2%
District has Register or List of VHTs ? No Number Active VHTs unknown
Number VHTs 129
% VHTs female 60%
Population 1,507,363
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
129 Fertility Rate ND
Duration of Basic Health Promotion Training Unknown Ratio participants to facilitator 30
# VHTs basic Health Promotion trained AND
still active
Unknown Training Support Plan
International;
Had 6
facilitators
teaching
different
Health facilities 276
VHTs additional training modules (List and
numbers)
Access to Functional Health Facilty ND
Average time spent volunteering per month
(hours)
16 % Household owning a bicycle 0.07
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level (List) NA Access to Improved Water Source 98%
Contraceptives distributed by VHTs Condoms and Oral Contraceptives Latrine coverage ND
IEC Available in Community Education-Gross Enrolment Rate 51
IEC needed in Community Female Literacy rate 92%
Main languages Luganda, English, Swahili
and other local languages
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the District Engineering,
Education -
Foster Child
Support
% of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Top Radio, CBS, Power FM, BBC World Service, Voice of Africa, Radio Maria, Impact FM, Star Radio, Radio Sapientia, Radio France International, Butebo Radio, UBC Radio, Capital Radio, Radio Simba, Sanyu FM, Radio West, East African Radio, Greater Africa Radio, Radio Two, Super Station INC Ltd., Christian Life Ministries, Radio One Ltd., Ddembe FM, Seventh Day Adventist, KFM, Uganda Episcopal Conference, Buddu Broadcasting, Touch FM Radio Ltd., Beat Radio FM Ltd., Africa FM Ltd., Christian Radio Network, FM Holdings, Uganda Media Women Association, UNESCO Nabweru, UNESCO Nakaseke, S & J Promotions Ltd., Family Broadcasting Network, Makerere University and Kampala International University (KIU),
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
some
VHTs have VHT Village Register? Some
Any Supervision activity of VHTs during past
6 months ?
No Information Other Registers??If Yes How many? None Have VHTs been trained on who to
refer?
None
Who Supervises? NGO Health
Coordinator /
Parish Supervisor
Any VHT data collated? By VHT Yes How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII Yes Are referrals recorded in VHT register? No
Supervision checklist? No By HSD Yes
Any Supervision Reports Available? Yes By DMT No Motivation & Incentives Given in
District
Is Any VHT data used? No Motivation & Incentives Given in
District
A monthly allowance was given until December 2006
Village Mortality Data available? No What for? n/a What Motivates the VHTs? Monthly Allowance
Factors affecting
implementation
Lack of motivation / incentives VHTs - Need to
Know danger
signs for ALL
and when to
refer
Child Health, Environmental Sanitation, Nutrition, Vector,
Immunization, Social mobilization
Supervision of VHTs
Flip Charts for VHTs with Danger Signs, Key family Practices,
Diarrhoea, TB , Request all in picture format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Sanitation, HIV
VHTs (Peer Educators) assist to organise the queues at health
centre visited
Evidence for IMPACT of VHT
Implementation, best practices
VHTs follow up of discharged
patients?
With sustained MoH commitment and support, VHT Strategy
can work
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Actions Needed to Save Lives
Coordination of VHT by DHMT
VHT Implementation Kampala
TBAs & other former Community Medicine
distributors etc included in VHT?
Some
STATUS OF VHT IMPLEMENTATION
Current VHT Activities (during last 6 months)
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
CORPs trained by Environmental Alert, African Evangelistic Enterprise, CIDI Community Integrated Development Initiatives, Concern Worldwide
None
VHT Training
Other Background
Referrals
Demographics
Health Services
Under 5's
Women of reproductive age 304487 Births 2008-9 73107 Population Under 5 years 304487
Estimated number of pregnancies 2008-9 75368 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data
ANC 1 142% Any Postnatal Check? No Data
ANC 4 95% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women)
2+ doses
81804 % Low Birth Weight No Data
Number Pregnant women tested for HIV 147%
Number pregnant women positive for HIV 6% Newborns treated ARVs at Birth 4359 (123%) Population under 1 year 64816.609
Positive Pregnant women given ARVs for
prophylaxis
4823 (79%) Post Natal visit when? No Data DPT HEP HIB 3 <1y 87480
% deliveries at Health Facility 99% BCG <1y 114979 Measles <1y 99422
% skilled birth attendant ND
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 26% Perinatal Cases ND
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths ND
Malaria
ACTs available on day of Visit No
LLIN Hanging to protect pregnant women at
HCs Visited?
None LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without
net at home at HCs visited
None
IPT 2 0.53 Cases ND U5s treated with malaria inpatient
Malaria Cases pregnant women ND Deaths ND U5s treated with malaria outpatient 135564
Malaria Deaths ND Deaths ND
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
yes Cases Cases ND
Deaths Deaths ND
Diarrhoea
ORS Available on day of visit yes Cases ND Cases ND
Zinc available on day of visit Yes Deaths ND Deaths ND
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition ND
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 1648
Health workers as good examples
for key practices
Good, directed IEC
materials hanging in
patient waiting areas
Africa 2000 Network Care International in
Uganda
Forum for Women in Democracy MS Uganda Stromme Foundation Uganda National Health
Users/Consumers
Association
African Network For Prevention And
Protection Against Child Abuse And Neglect
(Anppcan)
CDRN FPAU National Association of
Women Organisations
in Uganda
The Agricultural Council of Uganda Uganda Project
Implementation and
Management Centre
Africare Child Fund Uganda Habitat for Humanity National Organisation
of Women with
Disabilities in Uganda
The East A frican Sub-regional Support Initiative for the Advancement of Women URCS
AFXB Orphan Program Uganda Community for
Development
Foundation Uganda
HORIZON 3000 NUDIPU Traditional and Modern Health
Practitioners
Uganda Society for
Disabled Children
Akina Mama Wa Afrika Compassion
International
Human Rights Network Oxfam GB in Uganda Transcultural Psychological Organisation Uganda Youth Forum
Aktion Afrika Hilfe Concern for the Girl
Child
Hunger Project PANOS Eastern Africa Uganda Change Agents Association UWESO
Alliance for African Assistance Concern Uganda Integrated Rural Development InitiativesPlan International Uganda Debt Network VSO
AMREF DED German Development Service International Aid Services Save the Children in Uganda Uganda Development Trust Volunteer Efforts for
Development Concerns
AT Uganda Ltd. Environmental Alert International Care and Relief Uganda Send a Cow Uganda Uganda Joint Christian Council World Vision Uganda
BUCADEF Feed the Children Life Ministry Uganda SNV Uganda Uganda Land Alliance Women and Children's
Crisis Centre
Straight Talk FoundationUganda National Farmer's Association
Kampala Health Situation
Women Newborn
Morbidity under 5 years
NGOs CBOS CSOs working at community level in the District
Estimated District LLIN Coverage
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? Some
ALL Registered at Community Development
Office?
Incomplete Partners Regularly Reporting Activities to DMT? Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 18 Number of Villages 1293
% SC Covered by VHT's 11% % Villages Covered VHT 2%
District has Register or List of VHTs ? No Number Active VHTs 46
Number VHTs 46
% VHTs female ND
Population 689001
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
46 Fertility Rate ND
Duration of Basic Health Promotion Training 21 days Ratio participants to facilitator 6
# VHTs basic Health Promotion trained AND
still active
Unknown Training Support MoH Health facilities 72 includes both govt.and
private; 2 Hospitals, 3 HCIV,
14 HCIII, 52 HCII
VHTs additional training modules Access to Functional Health Facilty ND
Average time spent volunteering per month (hours) 3-5 hours a day% Household owning a bicycle
0.533
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community level NTDs First Aid Access to Improved Water Source
59%
Contraceptives distributed by VHTs Condoms Latrine coverage
78%
IEC Available in Community Education-Gross Enrolment Rate
126
IEC needed in Community Female Literacy rate
55%
Main languages Lusoga
All VHTs attached to a Specified HC? Some List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the District NGOs - Plan,
Redcross
% of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Busoga People's Radio
(Empanga)
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
Yes
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How many? Yes, NTD registers Have VHTs been trained on who to
refer?
Some
Who Supervises? Incharges Any VHT data collated? By VHT No How are these done by VHTs? Standard letter
Standard Supervision Training? Yes By HCII No Are referrals recorded in VHT register? No
Supervision checklist? Yes By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Involvement, recognition,
allowance, T-Shirts
Is Any VHT data used? No What Motivates the VHTs? Recognition
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
Need to scale up training VHTs - Need to
Know danger
signs for ALL
and when to
refer
Supervision of VHTs Referrals
Motivation & Incentives Given in
District
Evidence for IMPACT of VHT
Implementation, best practices
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
No Data
VHT Reporting and District Data
Management
Other Background
Water & Sanitation, HIV/AIDS
Flip Charts for VHTs with Danger Signs, Key family Practices, Malaria,
NTDs,Water & Sanitation, HIV/AIDS, TB, Request all in picture format
Linkages between VHT, Health System and Other Sectors
Community volunteers of VEDCO, Redcross volunteers, 2069 CMDs,
23 Community volunteers trained by Nulife on integration of
nutrition in HIV, 78 Trained TBAs, 30 CHWs
None
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns NTD drug distribution -
Filariasis, Bilharzia, Trachoma, Surveillance NTD diseases
Family Planning Education and commodity distribution
Referrals
VHT Training
Health Services
Coordination of VHT by DHT
VHT Implementation Kamuli
Demographics
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine
distributors etc included in VHT?
Some
Other Community Health Workers NOT included in VHTs
Under 5's
Women of reproductive age 139178 Births 2008-9 33417 Population Under 5 years 139178
Estimated number of pregnancies 2008-9 34450 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 97% Any Postnatal Check? No Data
ANC 4 19% %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women
2+ doses)
15149 % Low Birth Weight No Data
Number Pregnant women tested for HIV 42%
Number pregnant women positive for HIV 5% Newborns treated ARVs at Birth 123 (99%) Population under 1 year 29627.043
Positive Pregnant women given ARVs for
prophylaxis
286 (42%) Post Natal visit when? DPT HEP HIB 3 <1y 23092
% deliveries at Health Facility 29% BCG <1y 33983 Measles <1y 21917
% skilled birth attendant ND
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 11% Perinatal Cases 545
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 16
Malaria
Estimated
District LLIN
Coverage
ND ACTs available on
day of Visit
Yes
LLIN Hanging to protect pregnant women
at HCs Visited?
None LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without
net at home at HCs visited
None
IPT 2 29% Cases ND U5s treated with malaria inpatient 5560
Malaria Cases pregnant women 628 Deaths ND U5s treated with malaria outpatient 87590
Malaria Deaths 1 Deaths 104
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
yes Cases ND Cases 636
Deaths ND Deaths 104
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 108
Zinc available on day of visit None Deaths ND Deaths 7
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 177
VHTs can Read MUAC? Some VHTs Have MUACs? Some Cases Low weight for Age 748
VHTs follow up of discharged patients? Yes
Aids Education Group For Youth Christian
Agricultural
Rural Youth
Movement
Integrated Rural Development
Initiatives
Kamuli Lutheran
Church Aids
Fighters Assoc
Send A Cow Uganda Twisakirala
Aloevera
Growers
Assoc
Africa 2000 Network Uganda Citizens Link
Development
Project
Kaliro Development Foundation Kamuli Network
Of Non-
Government
Organisation
Strengthening Decetralisation In Uganda Uganda
Developmen
t Services
Buzaya Rural Savings Scheme Environmental
Alert
Kamuli Community Development
Foundation
Kamuli Parish
Intergral
Dev.Assoc
Sustainable Agricultural Farmers Assoc Uganda Red
Cross-
Kamuli
Branch
Caring For Orphans Widows And Eldery Family Keduabi
World Peace
Kamuli District Womens Development
Assoc
Plan
International
Traditional And Modern Health
Practitioners
UPACLED
NGOs CBOS CSOs working at community level in the District
Kamuli Health Situation
Women Newborn
27%
29%
2%
3%
1%
22%
1%
4%
4%
1%
1%
5%
Kamuli Cause of Deaths Under 5's (n=386)
Malaria
Pneumonia
Diarrhoea
Malnutrition
AIDS
Anaemia
Trauma
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 12 Number of Villages 607
% SC Covered by VHT's 100% % Villages Covered VHT 95%
District has Register or or List of
VHTs ?
Yes Number Active VHTs 1535
Number VHTs 1535
% VHTs female 50% Demographics
Population 308715
Crude Mortality Rate CMR ND
District has training record for
VHTs
Yes Number of VHTs trained Health
Promotion and Education
1535
Duration of Basic Health
Promotion Training
5 days Ratio participants to facilitator 20 Health Services
# VHTs basic Health Promotion
trained AND still active
unknown Training Support MoH UNICEF Health facilities 33; 2 HCIV 9
HCIII 22 HCII
VHTs additionional training
modules
Other Background
Average time spent volunteering
per month (hours)
unknown % Household owning a bicycle 31%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level
Diarrhoea,
Onchocerciasis
, Helminths
Access to Improved Water Source 81%
Contraceptives distributed by
VHTs
Condoms Latrine coverage 1
IEC Available in Community Education-Gross Enrolment Rate10900%
IEC needed in Community Female Literacy rate 0.56
Main languages Rukiga, Rutagwenda, Rutooro
All VHTs attached to a Specified
HC?
Some List of VHTs available on day of
visit
No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the
District
Community
Development
% of District covered by
mobile phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Radio Kamwenge FM Ltd., Western Broadcasting Services Ltd.
Content of outreach EPI alone
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
None Have VHTs been trained on
who to refer?
All
Who Supervises? no information Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives Given
in District
Meetings
Is Any VHT data used? No What Motivates the VHTs? Supervision,
Stationary,
Community
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet
VHTs
Factors affecting
implementationVHTs
need basic tools to enable them
work effectively
VHTs - Need to
Know danger
signs for ALL
Fertility Rate
Access to Functional Health
Facilty
Coordination of VHT by DHMT
VHT Implementation Kamwenge
Some
Supervision of VHTs
Actions Needed to Save Lives Evidence for IMPACT of VHT
Implementation, best
practices
STATUS OF VHT IMPLEMENTATION
Social Mobilisation for Campaigns NTD drug
distribution Surveillance NTD diseases Family
Planning Education and commodity distribution
Referrals Mosquito net distribution during child
days
None
TBAs & other former Community
Medicine distributors etc included
in VHT?
Other Community Health Workers NOT included in
VHTs
None
Current VHT Activities (during last 6 months)
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Importance of ANC, Family Planning uses, HIV
prevention, adherence, Behavioural Change
Communication - new messages, Community
dialogue Request all in picture format
Motivation & Incentives
Given in District
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District
Data Management
VHT Training
ND
Referrals
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
- Frequency of dysentry attacks reduced and eventually stopped after 2004 when
VHTs started mobilising for sanitation improvement - Volunteers of
CRS mobilise clients for HCT for PMTCT and give out drapes of cloth (Bitenge) to
pregnant women to increase the numbers who deliver in health facilities
Under 5's
Women of reproductive age 62,360 Births 2008-9 14973 Population Under 5 years
62,360
Estimated number of pregnancies
2008-9
15436 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 16456 (107%) Any Postnatal Check? No Data
ANC 4 5651 (37%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
5132 % Low Birth Weight
Number Pregnant women tested for
HIV
12059 (78%)
Number pregnant women positive
for HIV
520 (4%) Newborns treated ARVs at
Birth
152 (94%)
Positive Pregnant women given ARVs
for prophylaxis
352 (68%) Population under 1 year 13274.745
% deliveries at Health Facility 16% BCG <1y 16959 DPT HEP HIB 3 <1y 15816
% skilled birth attendant ND Measles <1y 13010
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 1242 (8%) Perinatal Cases 4
Post Natal visit when? Day 42 Perinatal Deaths 1
Malaria
ACTs available on day of Visit Some
LLIN Hanging to protect at pregnant
women at HCs Visited?
Some LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for
u5s without net at home at
HCs visited
None
IPT 2 5228 (34%) Cases No Data U5s treated with malaria inpatient 4142
Malaria Cases pregnant women 280 Deaths No Data U5s treated with malaria
outpatient
35442
MalariaDeaths 0 Deaths 37
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
Yes Cases No Data Cases 480
Deaths No Data Deaths 9
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 166
Zinc available on day of visit None Deaths No Data Deaths 0
Nutrition
Health Centres visited have
MUACs?
None Cases Severe Malnutrition 20
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age 228
Lessons Learned Cases of
complicated
malaria have
gone up since
NGOs CBOS CSOs working at
community level in the District
Baylor Uganda GTZ Kamwenge Catholic
Development Agengy
Kitagwenda
Sustainable
Agriculture
Nganiko Turinamwe Coop
Credit
STRIDES
CRS Joy For Children Kamwenge Foundation For
Community Empowerement
MANYORO
PROMOTION
Nyabani Women Micro
Finance Assoc
Tech.For Rural
Animal Power
District Eco.Development Ass. Kabarole.Ilbale
Kitagwenda
Progressive
Farm And Ranch
Kamwenge Zibumbe
Microfinance
Manyoro Youth
Control Group
Parents Concern For Young
People, Peace
Foundation
UNICEF
EGPAF Kaduido Ngo
Network
Kitagwenda Community
Iniative Development
Agency
Mildmay Rural Initiative Development
Agency
Youth Alliance To
Combat Aids
Kamwenge Health Situation
Women Newborn
Estimated District LLIN Coverage
VHTs follow up of discharged patients?
42%
10% 7%
23%
7%
11%
Kamwenge Cause of Deaths
Under 5's (n=88)
Malaria Pneumonia
Malnutrition Anaemia
Trauma Other
List of CBO CSO and NGOs operating
in District Available at DHO?
No Joint Review with all partners ? No
ALL Registered at Community
Development Office?
Incomplete Partners Regularly Reporting Activities to
DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting irregular
Joint Planning? Incomplete
Number of Sub Counties 11 Number of Villages 508
% SC Covered by VHT's 73% % Villages Covered VHT 68%
District has Register or or List of VHTs
?
No Number Active VHTs 600
Number VHTs 1575
% VHTs female no data
Population 204732
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion
and Education
1575 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 13
# VHTs basic Health Promotion trained
AND still active
600 Training Support MoH Health facilities 46; 1 Hospital 2 HCIV 8
HCIII 35 HCII
VHTs additionional training modules Access to Functional Health
Facilty
ND
Average time spent volunteering per month
(hours)
unknown % Household owning a bicycle
0.14
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community level (List) NTDs Access to Improved Water
Source
81%
Contraceptives distributed by VHTs depo pills cds Latrine coverage
87%
IEC Available in Community Education-Gross Enrolment Rate
117
IEC needed in Community Female Literacy rate
65%
Main languages Rukiga, Runyankore,
Rutooro
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the District Education % of District covered by mobile
phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Kinkizi FM Ltd., Radio
West
Content of outreach EPI Growth monitoring VHTs Record and Report Diseases
of Epidemic Potential?
Some
VHTs have VHT Village Register? Some
Any Supervision activity of VHTs
during past 6 months ?
Yes Other Registers??If Yes How many? no Have VHTs been trained on who
to refer?
Some
Who Supervises? Incharges Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? Yes By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? Yes By HSD No
Any Supervision Reports Available? Yes By DMT No Motivation & Incentives Given in
District
Recognition Involvement
in health activities
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? Theoretically What for? NA Why do they volunteer? No Data
Factors affecting
implementation
Support supervision requires funding
especially in districts with few / no partners
because PHC funds are inadequate
VHTs - Need
to Know
danger signs
for ALL and
when to
refer needs
to be
incorporated
into training
Coordination of VHT by DHMT
120 community depo providers
Evidence for IMPACT of VHT
Implementation, best practices
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both
mother and baby Nutritional assessment of all children and
pregnant women.
Health facility deliveries went up from 17% to 25%
due to assisted refferals and education on radio spots
by VHTs; DPT3 coverage also went up from 81% to
87%; after IRS through VHT mobilisation outpatients
reduced from 16337 to 4909
Actions Needed to Save Lives
Supervision of VHTs
Other Background
VHT Implementation Kanungu
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine
distributors etc included in VHT?
environmental health - tree planting Malaria Medical male circumcision Reproductive Health
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma First Aid Male
involvement in health Prevention of communicable diseases
Request all in picture format
Linkages between VHT and Health System and Other Sectors
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns Family Planning
Education and commodity distribution Referrals Health
education through drama and on radio spots NTD
medicine distribution
Other Community Health Workers NOT included in
VHTs
Demographics
Health Services
VHT Reporting and District Data
Management
All
Referrals
Motivation & Incentives Given in
District
VHT Training
none
Under 5's
Women of reproductive age 46803 Births 2008-9 11237 Population Under 5 years 46803
Estimated number of pregnancies 2008-
9
11585 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 13042 (113%) Any Postnatal Check? No Data
ANC 4 5436 (47%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
5618 % Low Birth Weight No Data
Number Pregnant women tested for HIV 8295 (72%)
Number pregnant women positive for
HIV
440 (5%) Newborns treated ARVs at Birth 166 (91%)
Positive Pregnant women given ARVs for
prophylaxis
304 (69%) Population under 1 year
9963
% deliveries at Health Facility 34% BCG <1y 8624 DPT HEP HIB 3 <1y 8447
% skilled birth attendant Measles <1y 8955
Did VHTs interviewed know danger
signs pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 1243 (11%) Perinatal Cases 77
Post Natal visit when? Day 42 Perinatal Deaths 11
Malaria
Estimated District
LLIN Coverage
ND ACTs available on
day of Visit
Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to protect under 5 at
HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 4750 (41%) Cases ND U5s treated with malaria inpatient 2021
Malaria Cases pregnant women 306 Deaths ND U5s treated with malaria
outpatient
19799
MalariaDeaths 2 Deaths 29
Pneumonia
Pneumonia 1st line antibiotics available
on day of Visit
yes Cases ND Cases 507
Deaths ND Deaths 9
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 195
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres v sited have
MUACs?
None Cases Severe Malnutrition 105
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age 265
VHTs follow up of discharged patients? none
Lessons Learned and cultural practices IEC materials for
use at community
level should be
developed and
AIC Kinkizi Diocese The Child Family Community
Development Organisation
Bugongi Rukukuru Women's
Development Association
Malaria Consortium UNFPA
FHI NTD Program
Integrated Rural Development
Initiatives
TASO
Kanungu Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
62%
4%
6%
4%
24%
Kanungu Cause of Deaths Under 5's
(n=47)
Malaria Pneumonia Malnutrition
Anaemia Other
List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Yes Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 14 Number of Villages 711
% SC Covered by VHT's 86% % Villages Covered VHT 76%
District has Register or List of
VHTs ?
No Number Active VHTs 1903
Number VHTs 1903
% VHTs female No Data
Population 181200
Crude Mortality Rate CMR ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
1903 Fertility Rate ND
Duration of Basic Health
Promotion Training
3 days Ratio participants to facilitator 32
# VHTs basic Health Promotion
trained AND still active
unknown Training Support MoH Health facilities 31; 1 Hospital 1
HCIV 10 HCIII 19
HCII
VHTs additional training modules
(List and numbers)
Access to Functional Health
Facilty
ND
Average time spent volunteering
per month (hours)
20 - 40 % Household owning a bicycle
0.04
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level (List)
Malaria Access to Improved Water
Source
68%
Contraceptives distributed by
VHTs
Condoms Latrine coverage
58%
IEC Available in Community Education-Gross Enrolment
Rate
119
IEC needed in Community Female Literacy rate
52%
Main languages Kuksabin
All VHTs attached to a Specified
HC?
Yes All List of VHTs available on day of
visit
No Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
Education
Agriculture
Local
Government
% of District covered by
mobile phone network
ND
VHTs Assist Outreach Activities No Operational Radio Stations Kapchorwa
Trinity Radio
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
No Have VHTs been trained on
who to refer?
Some
Who Supervises? Incharges Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives Given
in District
Certificates,
Record books,
pens, handbags,
ITNs. Lunch
allowance
Is Any VHT data used? No What Motivates the VHTs? Monetary Token, Recognition, Quarterly Meetings
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
Supervision, M&E, follow up VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be
incorporated
into training
VHT Reporting and District
Data Management
Referrals
Motivation & Incentives
Given in District
Actions Needed to Save Lives
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby
Nutritional assessment of all children and
pregnant women.
Supervision of VHTs
Demographics
Reproductive Health - UNFPA
Current VHT Activities (during last 6 months)
TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
Other Community Health Workers NOT included in
VHTs
216 CHWs, 1422 CMDs
VHT Training
IEC, health promotion, home- visiting, refferals,
HBMF Family Planning education and commodity
distribution
Other Background
None
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Filariasis,
Request all in picture format
Linkages between VHT and Health System and Other Sectors
Coordination of VHT by DMT
VHT Implementation Kapchorwa
STATUS OF VHT IMPLEMENTATION
ANC 1increased from 60%- 80%; Latrine coverage
from 50% to 58%; Health Centre delivery from
11% -19%
Evidence for IMPACT of VHT
Implementation, best
practices
Health Services
Under 5's
Women of reproductive age 36602 Births 2008-9 8788 Population Under 5 years 36602
Estimated number of pregnancies
2008-9
9060 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 66% Any Postnatal Check? No Data
ANC 4 16% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
4596 % Low Birth Weight No Data
Number Pregnant women tested for
HIV
49%
Number pregnant women positive
for HIV
2% Newborns treated ARVs at
Birth
29
Positive Pregnant women given ARVs
for prophylaxis
67 Post Natal visit when? Population under 1 year 7792
% deliveries at Health Facility 24% BCG <1y 6775 DPT HEP HIB 3 <1y 4951
% skilled birth attendant ND Measles <1y 4450
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 17% Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
Estimated
District LLIN
Coverage
ND ACTs available
on day of Visit
No visit
LLIN Hanging to protect pregnant
women at HCs Visited?
no visit LLIN Hanging to protect
newborns at HF Visited?
no visit LLIN Hanging to protect
under 5 at HF Visited?
no visit
LLIN s for ANC distribution at HCs
visited
no visit LLIN s for NB distribution at
HC visited
no visit LLIN s for distribution for
u5s without net at home at
HCs visited
no visit
IPT 2 29% Cases ND U5s treated with malaria inpatient 1633
Malaria Cases pregnant women 147 Deaths ND U5s treated with malaria
outpatient
23147
Malaria Deaths 0 Deaths 16
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
no visit Cases ND Cases 81
Deaths ND Deaths 5
Diarrhoea
ORS Available on day of visit no visit Cases ND Cases 121
Zinc available on day of visit no visit Deaths ND Deaths 0
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition 12
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 37
VHTs follow up of discharged
patients?
none
Action Aid Project Kapchorwa Kapchorwa Rural
Development
Association
Safeguard Integrated
Development Foundation
World Vision
Peace Building
Project
Family Planning Association Of
Uganda
National
Committee On
Traditional
The Youth Sports
Organsiation Of Uganda
Islamic Medical Association Of
Uganda
Reproductive
Educative And
Community
Health
Programme
Uganda Redcross Society
Kapchorwa Human Rights Initiative Sabiny Elders
Association
UNFPA
NGOs CBOS CSOs working at community level in the District
Kapchorwa Health Situation
Women Newborn
76%
24%
Kapchorwa Cause of Deaths Under
5's (n=21)
Malaria Pneumonia
List of CBO CSO and NGOs
operating in District Available at
DHO?
Incomplete Joint Review with all partners ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? No
Number of Sub Counties 24 Number of Villages 748
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of
VHTs ?
No Number Active VHTs 3720
Number VHTs 3720 (5/village)
% VHTs female ND Population 646,678
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
Incomplete Number of VHTs trained Health
Promotion and Education
3720
Duration of Basic Health
Promotion Training
5 days Ratio participants to facilitator 8 Health facilities 97
# VHTs basic Health Promotion
trained AND still active
3720 just completed training Access to Functional Health
Facilty
ND
VHTs additional training modules
% Household owning a bicycle 20%
Average time spent volunteering
per month (hours)
unknown Access to Improved Water
Source
77%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at community
level+C21
Onchocerciasis, Helminths Latrine coverage 74%
Contraceptives distributed by
VHTs
Condoms Education-Gross Enrolment
Rate
110
IEC Available in Community Female Literacy rate 63%
IEC needed in Community Main languages Rukonjo, Rutooro
Access to mass media ND
All VHTs attached to a Specified
HC?
Some List of VHTs available on day of
visit
No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the
District
Community Development Operational Radio Stations Lion of Juda,
Diocese of South
Rwenzori
VHTs Assist Outreach Activities Some
Content of outreach Integrated
Outreach
VHTs Record and Report
Diseases of Epidemic
Potential?
Yes
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
Yes, one BDR Have VHTs been trained on
who to refer?
All
Who Supervises? Health Asst,
Incharges
Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives Given
in District
Meetings, given
priority and
involved in any
community based
activity
Is Any VHT data used? No What Motivates the VHTs? Supervision
Village Mortality Data available? No What for? NA Why do they volunteer? Just want to help
Factors affecting
implementation
Maliba s/c, only one with VHTs is
among those with the best EPI
coverage in district; also used to
have frequent cholera outbreaks (3)
but for the last 7 years has had
none; disease surveillance coverage
here is 100%
VHTs attend
clinic, rotated
weekly, are
supervised and
gain new skills
they also stay
and help
No village registers, no reporting
format
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
VHT Implementation Kasese
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Evidence for IMPACT of VHT
Implementation, best
practices
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns NTD drug
distribution Surveillance NTD diseases Family
Planning Education Referrals Hygiene & Sanitation
campaigns Latrine coverage documentation Health
Education at Parish meetings
None
VHT Reporting and District
Data Management
Actions Needed to Save Lives
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Onchocerciasis, First Aid Request all in picture
format
TBAs & other former Community
Medicine distributors etc included
in VHT?
Some
Other Background
Other Community Health Workers NOT included in
VHTs
Peer Educators, CORPs, Watsan committees in
each village
VHT Training
Demographics
Referrals
Motivation & Incentives
Given in District
Health Services
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Under 5's
Women of reproductive age
130,629
Births 2008-9
31,364
Population Under 5 years
130,629
Estimated number of pregnancies
2008-9
32,334
% Births registered No Data Morbidity under 5 years
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
ANC 1 30000 (93%) Any Postnatal Check? No Data
ANC 4 14787 (46%) %Infants weighed at Birth No Data Infant Mortality
Tetanus Toxoid coverage (pregnant
women 2+ doses)
11293 % Low Birth Weight
Number Pregnant women tested for
HIV
19354 (60%)
Number pregnant women positive
for HIV
461 (2%)
Newborns treated ARVs at
Birth
212 (85%)
Positive Pregnant women given ARVs
for prophylaxis
234 (51%)
Population under 1 year 27,807
% deliveries at Health Facility
31%
BCG <1y 26503 DPT HEP HIB 3 <1y 26043
% skilled birth attendant Measles <1y 25314
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 2761 (9%) Perinatal Cases 0
Post Natal visit when? Day 42 Perinatal Deaths 0 U5's slept under net survey night 46%
Malaria
Estimated
District LLIN
Coverage (HH
22% ACTs available
on day of Visit
Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for
u5s without net at home at
HCs visited
None
IPT 2 12915 (40%) Cases ND U5s treated with malaria inpatient 9567
Malaria Cases pregnant women 567 Deaths ND U5s treated with malaria
outpatient
71405
MalariaDeaths 12 Deaths 150
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
None Cases ND Cases 1032
Deaths ND Deaths 18
Diarrhoea
ORS Available on day of visit None Cases ND Cases 1206
Zinc available on day of visit None Deaths ND Deaths 42
Nutrition
Health Centres v sited have
MUACs?
Some Cases Severe Malnutrition 0
VHTs can Read MUAC? Some VHTs Have MUACs? Some CasesLow weight for Age 331
VHTs follow up of discharged
patients?
None
ANPPACAN UNICEF
Ikongo Rural Development
Association
Banyo Development Foundation
Kasese Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
71%
9%
20%
Kasese Cause of Deaths Under 5's
(n=210)
Malaria Pneumonia Diarrhoea
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review with all partners ? No
ALL Registered at Communiy Development
Office?
Yes Partners Regularly Reporting Activities to DMT? Yes
Partners have MoUs with DMT? No Frequency of reporting quarterly
Joint Planning? No
Number of Sub Counties 9 Number of Villages 264
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs ? No Number Active VHTs less than 600
Number VHTs 1584
% VHTs female ni
Population 153706
Crude Mortality Rate CMR ND
District has training record for VHTs Incomplete Number of VHTs trained Health Promotion and
Education
1584 Fertility Rate ND
Duration of Basic Health Promotion Training 5 Ratio participants to facilitator 30 to 1
# VHTs basic Health Promotion trained AND
still active
600 Training Support MoH Health facilities 18
VHTs additionional training modules (List
and numbers)
Access to Functional Health Facilty ND
Average time spent volunteering per month (hours) varies few
hours to
almost full
time
% Household owning a bicycle
42%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level (List) ntds Diarrhoea Access to Improved Water Source
94%
Contraceptives distributed by VHTs Condoms pills Latrine coverage
48%
IEC Available in Community Gross Enrolment Rate
IEC needed in Community Female Literacy rate
45%
Main languages Ateso
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Some % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations
Radio Joshua Katakwi
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
NO
VHTs Currently have VHT Village Register? No
Any Supervision activity of VHTs during past
6 months ?
Yes Other Registers??If Yes How many? Family
Planning only
some VHTs
Have VHTs been trained on who to
refer?
Some
Who Supervises? HC Any VHT data collated? By VHT Yes How are these done by VHTs? verbal
Standard Supervision Training? No By HCII No Information Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No Information
Any Supervision Reports Available? No By DMT Yes Motivation & Incentives Given in
District
Meetings quarterly teeshirt
Is Any VHT data used? Yes What Motivates the VHTs? regular meetings recognition
money
Village Mortality Data available? No What for? Family
Planning for
reports and
planning
HBMF when
drugs available
Why do they volunteer? Varying: want to serve,
monetary benefits
Factors affecting
implementation
homapak introduction fp uptake increased hc immunisation and outreach VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be
incorporated
Linkages between VHT and Health System and Other Sectors
Katakwi
Other Background
Linkages with other sectors in the District Other NGOs
working in
District IntHIV
18 network
support agents
Alliance
UNICEF (EPI
Nutrition
/Growth
monitoring
IMCI ANC)
Health sector
Current VHT Activities (during last 6 months)
VHT Training
depends on program
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation Filariasis Request all in picture format
Coordination of VHT by DHMT
Some
Katakwi
Evidence for IMPACT of VHT
Implementation, best practices
VHT Reporting and District Data
Management
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine
distributors etc included in VHT? Trad healers and
some tbas excluded
Demographics
Social Mobilisation for Campaigns Family Planning Education
Health Promotion, EPI RH HIV PMTCT TB DOTS
FP
Supervision of VHTs
Other Community Health Workers NOT included in VHTs CBDAs 60; Dots TB 43; Network support Agents 18, 26 vaccinators
100community counsellors PMTCT
Health Services
Referrals
Motivation & Incentives Given in
District
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Under 5's
Women of reproductive age 31049 Births 2008-9 7455 Population Under 5 years 31049
Estimated number of pregnancies 2008-9 7685 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1
104%
Any Postnatal Check? No Data
ANC 4
11%
%Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
2487 % Low Birth Weight No Data
Number Pregnant women tested for HIV 114%
Number pregnant women positive for HIV 5% Newborns treated ARVs at Birth 110 (100%)
Positive Pregnant women given ARVs for
prophylaxis
371 (85%) Population under 1 year 6609.358
% deliveries at Health Facility
28%
BCG <1y 5808 DPT HEP HIB 3 <1y 6332
% skilled birth attendant No Data Measles <1y 5607
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number)
21%
Perinatal Cases 1
Post Natal visit when? Day 42 Perinatal Deaths 0 U5's slept under net survey night 82%
Malaria
Estimated District
LLIN Coverage (HH
with 2+ nets)
56% ACTs available on day
of Visit
Yes
LLIN Hanging to protect at pregnant women at
HCs Visited?
None LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without
net at home at HCs visited
None
IPT 2
57%
Cases ND U5s treated with malaria inpatient 4099
Malaria Cases pregnant women 401 Deaths ND U5s treated with malaria outpatient 26588
MalariaDeaths 0 Deaths 10
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
ND Cases ND Cases 257
Deaths ND Deaths 4
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 314
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres visited have MUACs? None Cases Severe Malnutrition 3
VHTs can Read MUAC? Some VHTs Have MUACs? None CasesLow weight for Age 54
VHTs follow up of discharged patients? Some Village Health Teams
NA
Katakwi Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
List of CBO CSO and NGOs
operating in District Available at
DHO?
Yes Joint Review ? No
ALL Registered at Community
Development Office?
No Partners Regularly Reporting
Activities to DMT?
some
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? No
Number of Sub Counties 9 Number of Villages 477
% SC Covered by VHT's 11% % Villages Covered VHT 10%
District has Register or List of
VHTs ?
No Number Active VHTs 20
Number VHTs 210
% VHTs female No data Population 338,034
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
210
Duration of Basic Health
Promotion Training
5 days Ratio participants to facilitator 6 Health facilities 23; 1 Hospital, 2
HCIV, 8 HCIII, 12
HCII
# VHTs basic Health Promotion
trained AND still active
20 Access to Functional Health
Facilty
ND
VHTs additional training modules
% Household owning a bicycle 42%
Average time spent volunteering
per month (hours)
unknown Access to Improved Water
Source
55%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level (List)
NA Latrine coverage 75%
Contraceptives distributed by
VHTs
No Education-Gross Enrolment
Rate
126
IEC Available in Community Female Literacy rate 62%
IEC needed in Community Main languages Luganda
Access to mass media ND
All VHTs attached to a Specified
HC?
Yes All List of VHTs available on day of
visit
No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 No Operational Radio Stations ND
VHTs Assist Outreach Activities Some VHTs Record and Report
Diseases of Epidemic
Potential?
No
Content of outreach EPI alone
VHTs have VHT Village Register? No Have VHTs been trained on
who to refer?
Some
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
Yes, One How are these done by VHTs? Standard letter
Who Supervises? Projects, DHE Any VHT data collated? By VHT No Are referrals recorded in VHT
register?
Yes
Standard Supervision Training? Yes By HCII No VHTs follow up of discharged
patients?
Yes
Supervision checklist? No By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives Given
in District
Recognition
Is Any VHT data used? No What Motivates the VHTs? Umbrella instead
of Cap, gumboots
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
VHTs need work aides, Lack of
recognition in community and at
HC; VHT refferals need to be
honoured
VHTs - Need to
Know danger
signs for ALL
and when to
refer
Agriculture
VHT Implementation Kayunga
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Linkages between VHT and Health System and Other Sectors
STATUS OF VHT IMPLEMENTATION
Referrals VHT Reporting and District
Data Management
Linkages with other sectors in the
District
Coordination of VHT by DHMT
None
VHT Training
Some
50 Community Counselling Aides of PREFA; Asst
Community Advisors of MUWRP; Community
Health Educators of Self Help Africa; CDAs, 28
Community volunteers trained by Nulife on
integrating nutrition in HIV/AIDs care, 122 trained
TBAs, 244 CHWs
None
Other Community Health Workers NOT included in
VHTs
Demographics
Health Services
Other Background
TBAs & other former Community
Medicine distributors etc included
in VHT?
Current VHT Activities (during last 6 months)
Malaria control and prevention, sanitation and
personal hygiene, immunisation, mobilisation of
the general community for health
Supervision of VHTs
Evidence for IMPACT of VHT
Implementation, best
practices
No Data HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby
Nutritional assessment of all children and
pregnant women.
Motivation & Incentives
Given in District
Actions Needed to Save Lives
Women of reproductive age 68283 Births 2008-9 16395 Population Under 5 years 68283
Estimated number of pregnancies
2008-9
16902 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 94% Any Postnatal Check? No Data
ANC 4 22% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
10305 % Low Birth Weight No Data
Number Pregnant women tested for
HIV
94%
Number pregnant women positive for
HIV
5% Newborns treated ARVs at
Birth
220 (86%)
Positive Pregnant women given ARVs
for prophylaxis
550 (72%) Post Natal visit when?
% deliveries at Health Facility 29% BCG <1y 16113 Population under 1 year 14535.462
% skilled birth attendant No Data DPT HEP HIB 3 <1y 12336
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None Measles <1y 10774
Any PNC visit? (Number) 10% Perinatal Cases 10 VHTs interviewed know
danger signs?
For malaria
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
Estimated
District LLIN
Coverage
ND ACTs available
on day of Visit
No
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
None LLIN s for NB distribution at
HC visited
None LLIN s for distribution for
u5s without net at home at
HCs visited
None
IPT 2 34% Cases No Data U5s treated with malaria inpatient 3022
Malaria Cases pregnant women 324 Deaths No Data U5s treated with malaria
outpatient
50839
Malaria Deaths 0 Deaths 59
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases No Data Cases 470
Deaths No Data Deaths 5
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 232
Zinc available on day of visit None Deaths No Data Deaths 0
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 43
VHTs can Read MUAC? Some VHTs Have MUACs? Some Cases Low weight for Age 325
Health workers as good
examples for key practices
Handwashing facilities available for use in all wards and consultation rooms of health centre visited
Action for Human Rights and Civil
Awareness
Kayunga
Information
Bureau
PREFA
Child Advocacy International MAPLAY RYDA
Feed the Children MUWRP Straight Talk Foundation
Integrated Rural Development
Initiatives
Nulife TB CAP
Kayunga Child Development Centre Peer AIDS and
Counselling
Organisation
THETA
Kayunga Health Situation
Women Newborn Under 5's
NGOs CBOS CSOs working at community level in the District
57%
5%
1%
7%
11%
19%
Kayunga Cause of Deaths Under 5's
(n=103)
Malaria
Pneumonia
Malnutrition
Anaemia
Infection Sepsis Septicaemia
Other
List of CBO CSO and NGOs operating in District
Available at DHO?
Yes Joint Review ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting Activities to DMT? Yes All
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Yes
Number of Sub Counties 19 Number of Villages 925
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs ? No Number Active VHTs NA
Number VHTs NA
% VHTs female NA Population 581,400
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
NA
Duration of Basic Health Promotion Training NA Ratio participants to facilitator NA Health facilities 51; 1 Hospital 4 HCIV (1 NGO)
21 HCIII (6 NGO) 25 HCII (10
NGO)
# VHTs basic Health Promotion trained AND
still active
NA Training Support MoH WHO Access to Functional Health Facilty No Data
VHTs additional training modules
% Household owning a bicycle 35%
Average time spent volunteering per month (hours) unknown Access to Improved Water Source 73%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community level (List) CMDs treat Onchocersiasis, Schistosomiasis, Intestinal worms Latrine coverage 65%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate 109
IEC Available in Community Female Literacy rate 61%
IEC needed in Community Main languages Runyoro, Rutooro
Access to mass media ND
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No % of District covered by mobile phone
network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the District Education Extension Workers Operational Radio Stations Kagadi Kibaale Community
Radio, Uganda Rural Develop
and Training Programme
VHTs Assist Outreach Activities No
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
Some CMDs
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past 6
months ?
No Other Registers??If Yes How many? None Have VHTs been trained on who to refer? None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District training, quarterly meetings,
bicycles
Is Any VHT data used? No What Motivates the VHTs? Recognition, Regular
Supervision, Meetings,
Appreciation
Village Mortality Data available? No What for? NA Why do they volunteer? CMDs have volunterism spirit
Factors affecting
implementation
In 1989, CHWs contained a cholera outbreak
through training, mobilisation education in the
community, recording of deaths and distribution of
supplies - evidence that when given adequate
support VHTs can make a difference in community
health
Selecting the right VHTs is crucial; VHTs having necessary
logistics in time,to enable them to do their work
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to be
incorporated into
training
Health Services
None
Current VHT Activities (during last 6 months)
Other Background
VHT Training
Evidence for IMPACT of VHT
Implementation, best practices
Motivation & Incentives Given in District
Supervision of VHTs Referrals
CMDs do mobilisation for health, water & sanitation activities,
immunisation, epidemics control and disease surveillance, NTD
medicine distribution
Immunisation, HIV/AIDS, Reproductive Health
Flip Charts for VHTs with Danger Signs, TBs, Key family Practices.Water
and Sanitation, Malaria, Trauma, Onchocerciasis, Schistosomiasis,
Intestinal Worms Request all in picture format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
HW - Danger signs for newborns and how to manage LBW infants .Content and
timing of post natal checks for both mother and baby Nutritional assessment
of all children and pregnant women.
Actions Needed to Save Lives
Coordination of VHT by DHMT
608 CHWs, 618 TBAs, 1008 CMDs, 20 TB Volunteers, 82 Community
Counselling Aides, 80 Immunisers
VHT Implementation Kibaale
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine distributors
etc included in VHT?
None
Demographics
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
Under 5's
Women of reproductive age
117,443
Births 2008-9
28,198
Population Under 5 years
117,443
Estimated number of pregnancies 2008-9
29,070
% Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live
births)
No Data
ANC 1 0.96 Any Postnatal Check? No Data
ANC 4 0.15 %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
7412 % Low Birth Weight No Data
Number Pregnant women tested for HIV
0.38
Number pregnant women positive for HIV
0.05
Newborns treated ARVs at Birth 643 (242%)
Positive Pregnant women given ARVs for
prophylaxis
61 (11%)
Post Natal visit when? Population under 1 year 25,000
% deliveries at Health Facility
18%
BCG <1y 23759 DPT HEP HIB 3 <1y 16234
% skilled birth attendant ND Measles <1y 15774
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born danger
signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 0 Perinatal Cases 5
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day of
Visit
Yes
LLIN Hanging to protect pregnant women at HCs
Visited?
None LLIN Hanging to protect newborns at HF
Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net
at home at HCs visited
None
IPT 2 0.33 Cases No Data U5s treated with malaria inpatient 7727
Malaria Cases pregnant women 736 Deaths No Data U5s treated with malaria outpatient
Malaria Deaths 2 Deaths 26
Pneumonia
Pneumonia 1st line antibiotics available on day
of Visit
yes Cases No Data Cases 267
Deaths No Data Deaths 6
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 666
Zinc available on day of visit None Deaths ND Deaths 3
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 109
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 147
VHTs follow up of discharged patients? None
Lessons Learned and cultural practices Political commitment is essential to making VHTs work
NGOs CBOS CSOs working at community level in
the District
VSO Uganda
AMREF
Kibaale Health Situation
Women Newborn
46%
10%
5%
7%
7%
25%
Kibaale Cause of Deaths Under 5's (n=57)
Malaria Pneumonia Diarrhoea Malnutrition Anaemia Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting never
Joint Planning? No
Number of Sub Counties 14 Number of Villages 548
% SC Covered by VHT's 43% % Villages Covered VHT 45%
District has Register or List of VHTs ? Yes Number Active VHTs unknown
Number VHTs 1524
Demographics
% VHTs female 44%
Population 300800
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
1524
Duration of Basic Health Promotion
Training
10 days Ratio participants to facilitator 7 Health Services
# VHTs basic Health Promotion trained
AND still active
unknown Training Support MoH AMREF Health facilities 41(32 Govt. 9 NGO); Govt - 1 Hospital 2 HCIV 12 HCIII 17 HCII
VHTs additional training modules (List
and numbers)
Other Background
Average time spent volunteering
per month (hours)
20 % Household owning a bicycle 44%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community
level (List)
Malaria Access to Improved Water Source 58%
Contraceptives distributed by VHTs Condoms Latrine coverage 1
IEC Available in Community Education-Gross Enrolment Rate 10000%
IEC needed in Community Female Literacy rate 0.621
Main languages Luganda
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of
visit
No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in
the District
Community Development (Adult literacy), Local government % of District covered by mobile
phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Radio Kiboga
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
Yes
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How
many?
no Have VHTs been trained on who to
refer?
All
Who Supervises? Incharges, DHT Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Quarterly meetings
during which
allowances are given,
involving them in
Is Any VHT data used? No What Motivates the VHTs? Supervision, Recognition
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
In 2007/8, 174,492 children were treated by
CMDs 62% (108,771) of which within 24
hours
Supervision, Logistics VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Evidence for IMPACT of VHT
Implementation, best practices
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
1056 CMDs trained by Malaria Consortium to treat
malaria in community
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc
included in VHT?
All
Coordination of VHT by DHMT
VHT Implementation Kiboga
VHT Training
none
Current VHT Activities (during last 6 months)
Community mobilisation, awareness and sensitisation for
immunisation, Maternal health - monitoring and refferals for
pregnancy, Condom distribution, home visits
Referrals
Fertility Rate
Access to Functional Health Facilty
Motivation & Incentives Given in
District
VHT Reporting and District Data
Management
Malaria, Immunisation, Water and Sanitation, HIV/AIDS
Flip Charts for VHTs with Danger Signs, Key family
Practices, Trauma Trypanosomiasis Request all in
picture format
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
Under 5's
Women of reproductive age
60,762
Births 2008-9
14,589
Population Under 5 years
60,762
Estimated number of pregnancies 2008-9
15,040
% Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 0.9 Any Postnatal Check? No Data
ANC 4 0.37 %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
6595 % Low Birth Weight No Data
Number Pregnant women tested for HIV
0.69
Number pregnant women positive for
HIV
0.06
Newborns treated ARVs at Birth 134 (89%)
Positive Pregnant women given ARVs for
prophylaxis
321 (50%)
Post Natal visit when? No Data Population under 1 year
12,934
% deliveries at Health Facility
29%
BCG <1y 15008 DPT HEP HIB 3 <1y 11915
% skilled birth attendant ND Measles <1y 9856
Did VHTs interviewed know danger
signs pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 0 Perinatal Cases 19
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day
of Visit
Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
yes LLIN Hanging to protect under 5
at HF Visited?
yes
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 0.46 Cases ND U5s treated with malaria inpatient4588
Malaria Cases pregnant women 1602 Deaths ND U5s treated with malaria
outpatient
37894
Malaria Deaths 1 Deaths 39
Pneumonia
Pneumonia 1st line antibiotics available
on day of Visit
yes Cases ND Cases 1807
Deaths ND Deaths 15
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 235
Zinc available on day of visit None Deaths ND Deaths 220
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 69
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 118
VHTs follow up of discharged patients? yes
NGOs CBOS CSOs working at community
level in the District
AMREF Traditional and Modern
Health Practitioners
THETA
Kiboga Development Association UWESO
Kiboga Youth Drop-in Centre
Wattuba Youth Development Association
Masodde Project CCF
World Vision Uganda
Kiboga AIDS Awareness and Support Organisation
Kiboga Health Situation
Women Newborn
51%
21%
3%
5%
19%
1%
Kiboga Cause of Deaths Under 5's (n=76)
Malaria
Pneumonia
Infection Sepsis Septicaemia
Malnutrition
Anaemia
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review with all partners ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? No Frequency of reporting monthly
Joint Planning? No
Number of Sub Counties 13 Number of Villages 495
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or or List of
VHTs ?
No Number Active VHTs 0, selected 1041 not yet trained
Number VHTs 0
% VHTs female 0% Population 260,794
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
0
Duration of Basic Health Promotion
Training
NA Ratio participants to facilitator NA Health facilities 34; 1 Hospital 1 HCIV 13 HCIII 19
HCII
# VHTs basic Health Promotion
trained AND still active
0 Access to Functional Health Facilty ND
VHTs additionional training
modules (List and numbers)
% Household owning a bicycle 40%
Average time spent volunteering
per month (hours)
NA Access to Improved Water Source 36%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level (List)
NA Latrine coverage 83%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate 116
IEC Available in Community Female Literacy rate ND
IEC needed in Community Main languages Runyankore
Access to mass media ND
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by mobile
phone network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
None Operational Radio Stations Radio West
VHTs Assist Outreach Activities No Adult Literacy 0.64
Content of outreach EPI alone VHTs Record and Report Diseases
of Epidemic Potential?
None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
None Have VHTs been trained on who to
refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
CMDs used to get bicycles, T-shirts
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
VHT Implementation Kiruhura
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Demographics
Health Services
Other Background
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
None
TBAs & other former Community
Medicine distributors etc included
in VHT?
None
VHT Training
None
Evidence for IMPACT of VHT
Implementation, best practices
Current VHT Activities (during last 6 months)
CHWs do DOTs for TB
none
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs Referrals
Motivation & Incentives Given in District
VHT Reporting and District Data
Management
Actions Needed to Save Lives
Flip Charts for VHTs with Danger Signs, Key family Practices.Water
and Sanitation, Trauma Disease surveillance, First Aid, STIs signs and
symptoms, Request all in picture format
Under 5's
Women of reproductive age
52,680
Births 2008-9
12,649
Population Under 5 years
52,680
Estimated number of pregnancies
2008-9
13,040
% Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 0.7 Any Postnatal Check? No Data
ANC 4 0.16 %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
4244 % Low Birth Weight No Data
Number Pregnant women tested
for HIV
0.58
Number pregnant women positive
for HIV
0.06
Newborns treated ARVs at Birth 70 (85%)
Positive Pregnant women given
ARVs for prophylaxis
265 (62%)
Population under 1 year
11,214
% deliveries at Health Facility
12%
BCG <1y 13948 DPT HEP HIB 3 <1y 10200
% skilled birth attendant No Data Measles <1y 9930
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 0 Perinatal Cases 15
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN Coverage ND ACTs available on day of Visit Some
LLIN Hanging to protect at
pregnant women at HCs Visited?
Some LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to protect under 5 at
HF Visited?
Some
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 0.18 Cases ND U5s treated with malaria inpatient 1561
Malaria Cases pregnant women 284 Deaths ND U5s treated with malaria
outpatient
29642
MalariaDeaths 0 Deaths 1
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
None Cases ND Cases 73
Deaths ND Deaths 0
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 39
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres v sited have
MUACs?
None Cases Severe Malnutrition 1
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age 266
VHTs follow up of discharged
patients?
None
NGOs CBOS CSOs working at
community level in the District
ACCORD PACE
ADRICA UWESO
EGPAF Mayanja Memorial Injection Safety Project
Kiruhura Health Situation
Women Newborn
100
%
Kiruhura Cause of
Deaths Under 5's (n=1)
Malaria
List of CBO CSO and NGOs
operating in District Available at
DHO?
No Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 14 Number of Villages 399
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or or List of
VHTs ?
No Number Active VHTs 0
Number VHTs 0
% VHTs female 0% Population 240,000
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for
VHTs
No Number of VHTs trained Health
Promotion and Education
0
Duration of Basic Health
Promotion Training
NA Ratio participants to facilitator NA Health facilities 32
# VHTs basic Health Promotion
trained AND still active
0 Training Support MoH, Doctors of Global Health through Mutolere Hospital Access to Functional Health
Facilty
ND
VHTs additionional training
modules (List and numbers)
% Household owning a bicycle 15%
Average time spent volunteering
per month (hours)
unknown Access to Improved Water
Source
42%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community
level (List)
Onchocerciasis Latrine coverage 70%
Contraceptives distributed by
VHTs
No Education-Gross Enrolment
Rate
118
IEC Available in Community Female Literacy rate 45%
IEC needed in Community Main languages Rukiga, Runyarwanda
Access to mass media ND
All VHTs attached to a Specified
HC?
No List of VHTs available on day of
visit
No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the
District
Community Development, Agriculture (NAADS) Operational Radio Stations Voice of
Muhavura FM,
Radio Muhabura
VHTs Assist Outreach Activities No VHTs Record and Report Diseases of Epidemic Potential? Yes
Content of outreach EPI ANC Referrals
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
Yes, one How are these done by VHTs? No Information
Who Supervises? NA Any VHT data collated? By VHT No Are referrals recorded in VHT
register?
No
Standard Supervision Training? No By HCII No VHTs follow up of discharged
patients?
None
Supervision checklist? No By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives Given
in District
None
Is Any VHT data used? No What Motivates the VHTs? NA
Village Mortality Data available? No What for? NA Why do they volunteer? NA
Factors affecting
implementation
I - n 2001 health facility deliveries
increased from 32% to 56%
- Community traditional institutions
(Ngobyi groups) started long before
VHT concept where burial groups
Need political goodwill and support;
regular meetings, follow-up; training
and refresher training / Nulife
project not owned by health
workers, looked at as a separate
VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
Actions Needed to Save Lives VHT Need to Know danger signs for
ALL and when to refer needs to be
incorporated into training
HW Danger signs for newborns
and how to manage LBW
infants .Content and timing of
Have VHTs been trained on who to refer?
Current VHT Activities (during last 6 months)
CHWs carry out Social Mobilisation for Campaigns
NTD drug distribution Disease Surveillance Family
Planning Education Referrals Health Talks
Family Planning, HIV, Malaria
VHT Training
None
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
VHT Reporting and District
Data Management
None
Other Community Health Workers NOT included in
VHTs (List and estimate numbers)
HW - Danger signs for newborns and how to
manage LBW infants .Content and timing of post
natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Demographics
Health Services
Other Background
1623 CHWs of which 21 are Community Health
Educators, 20 CHWs trained by Nulife; 605 CMDs
Evidence for IMPACT of VHT
Implementation, best
Actions Needed to Save Lives
Kisoro
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc included
in VHT?
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Onchocerciasis Awareness on Dangers of local
Coordination of VHT by DHMT
VHT Implementation
Motivation & Incentives
Given in District
Under 5's
Women of reproductive age
48,480
Births 2008-9
11,640
Population Under 5 years
48,480
Estimated number of pregnancies
2008-9
12,000
% Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 0.63 Any Postnatal Check? No Data
ANC 4 0.28 %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
5105 % Low Birth Weight No Data
Number Pregnant women tested for
HIV 0.58
Number pregnant women positive for
HIV 0.01
Newborns treated ARVs at
Birth
90 (95%)
Positive Pregnant women given ARVs
for prophylaxis 102 (63%)
Population under 1 year
10,320
% deliveries at Health Facility
27%
BCG <1y 10356 DPT HEP HIB 3 <1y 9534
% skilled birth attendant ND Measles <1y 8124
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 0 Perinatal Cases 0
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
Estimated
District LLIN
Coverage
ND ACTs available
on day of Visit
Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
None LLIN s for NB distribution at
HC visited
None LLIN s for distribution for
u5s without net at home at
HCs visited
None
IPT 2 0.08 Cases ND U5s treated with malaria inpatient 1600
Malaria Cases pregnant women 91 Deaths ND U5s treated with malaria
outpatient
35760
MalariaDeaths 2 Deaths 11
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases ND Cases 514
Deaths ND Deaths 15
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 1104
Zinc available on day of visit None Deaths ND Deaths 3
Nutrition
Health Centres visited have
MUACs?
Some Cases Severe Malnutrition
VHTs / CHWs can Read MUAC? Some VHTs / CHWs Have MUACs? Some CasesLow weight for Age 80
Health workers as good examples for
key practices
Handwashing facilities available and used by health workers and patients
NGOs CBOS CSOs working at
community level in the District
Adra Uganda - Kisoro Combat Child
Mortality Among
Batwa
Kisoro Combined Efforts Organisation MSF PACE UPMB
Africare (U)-Kisoro Compassion International Kisoro Laos Orphanage Support Organisation Mutolere Public Health Programme- Gasasangutiya UCMB Urwasamabuye Multipurpose Group
AMREF
Doctors For Global Health Linkages Nyakabingo Women Health Group Uganda Change Agent Asociation Virunga Allied Actors For Dynamic Health Society Vaadhs
Buntu Peace Foundation
Good Samaritan Community Development Programme Microcare Organisation Of
Batwa People In
Uganda Obpu
UNHCR
Africa 2000 Network Kisoro
Kisoro Health Situation
Women Newborn
11%
29%
3%
7%
3%
3%
2%
42%
Kisoro Cause of Deaths Under 5's
(n=147)
Malaria
Pneumonia
Diarrhoea
Malnutrition
Infection Sepsis Septicaemia
Anaemia
Trauma
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review ? Some
ALL Registered at Community Development
Office?
No Partners Regularly Reporting Activities to DMT? No
Partners have MoUs with DMT? Yes Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 19 Number of Villages 761
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs ? Yes Number Active VHTs Unknown
Number VHTs 1872
% VHTs female ND Population 353,222
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs Yes Number of VHTs trained Health Promotion and
Education
1872
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 13 Health facilities 35
# VHTs basic Health Promotion trained AND
still active
Unknown Access to Functional Health Facilty ND
VHTs additional training modules (List and
numbers)
% Household owning a bicycle 37%
Average time spent volunteering per month (hours) 56 Access to Improved Water Source 66%
Are VHTs treating diseases at Community
level? (Currently)
Yes All Diseases Treated at community level (List) Onchocerciasis, Malaria, Schistosomiasis Latrine coverage 32%
Contraceptives distributed by VHTs Condoms and Oral Contraceptives Education-Gross Enrolment Rate 146
IEC Available in Community Female Literacy rate 45%
IEC needed in Community Main languages Luo, Acholi
Access to mass media ND
All VHTs attached to a Specified HC? Some List of VHTs available on day of visit No % of District covered by mobile
phone network
ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the District Water, Environmental Health, TB Leprosy; Reproductive Health;Intergrated Disease Surveilance;Immunisation Operational Radio Stations 1, Child Care International
VHTs Assist Outreach Activities No
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
No
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How many? No Have VHTs been trained on who to
refer?
Some
Who Supervises? Incharges Any VHT data collated? By VHT Yes How are these done by VHTs? Standard letter
Standard Supervision Training? No By HCII Yes Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Involving them in
campaigns such as polio,
Indoor residual
spraying,hepatitis E
mobilisation. Allowance.
Soap, Gumboots, quarterly
meetings
Is Any VHT data used? Yes What Motivates the VHTs? Quarterly Meetings
Village Mortality Data available? No What for? Replenishment
of medicines
Why do they volunteer? Want to help community and
their children in order to
reduce morbidity and
Factors affecting
implementation
Referrals
Motivation & Incentives Given in
District
Flip Charts for VHTs with Danger Signs, Key family Practices.Water
and Sanitation, Trauma Trypanosomiasis Request all in picture format
CMDs, CBDS, Mobilisation for Polio, HIV, Family Planning, IMCI, Hepatitis E sensitisation 1446 Epidemic Preparedness Response plus Hep E
Actions Needed to Save Lives
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
VHT Reporting and District Data
Management
Evidence for IMPACT of VHT
Implementation, best practices
None
VHT Training
Current VHT Activities (during last 6 months)
Monitoring sanitation in the community,providing treatment
for malaria to under 5s,mobilising for ANC,for
immunisation,health education in community,collection of data
on community deaths, births and morbidity
Water and Sanitation
STATUS OF VHT IMPLEMENTATION
Coordination of VHT by DHT
VHT Implementation Kitgum
TBAs & other former Community Medicine
distributors etc included in VHT?
All
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
Demographics
Health Services
Other Background
Under 5's
Women of reproductive age
71,351
Births 2008-9
13,131
Population Under 5 years
71,351
Estimated number of pregnancies 2008-9
17,661
% Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data
ANC 1 12750 (72%) Any Postnatal Check? No Data
ANC 4 6407 (36%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
11628 % Low Birth Weight No Data
Number Pregnant women tested for HIV
12094 (68%)
Number pregnant women positive for HIV
918 (8%)
Newborns treated ARVs at Birth 478 (92%)
Positive Pregnant women given ARVs for
prophylaxis
623 (68%)
Post Natal visit when? No Data Population under 1 year
15,189
% deliveries at Health Facility
45%
BCG <1y 12540 DPT HEP HIB 3 <1y 12024
% skilled birth attendant No Data Measles <1y 12198
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 3307 (19%) Perinatal Cases 75
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 16 U5's slept under net survey night 62%
Malaria
Estimated District
LLIN Coverage (HH
with 2+ nets)
32% ACTs available on day
of Visit
No
LLIN Hanging to protect pregnant women at
HCs Visited?
Yes LLIN Hanging to protect newborns at
HF Visited?
Yes LLIN Hanging to protect under 5 at HF
Visited?
Yes
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without
net at home at HCs visited
None
IPT 2 8576 (49%) Cases ND U5s treated with malaria inpatient 17919
Malaria Cases pregnant women 1525 Deaths ND U5s treated with malaria outpatient 85770
Malaria Deaths 1 Deaths 139
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
Cases ND Cases 1543
Deaths ND Deaths 29
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 759
Zinc available on day of visit None Deaths ND Deaths 15
Nutrition
Health Centres Have MUACs? Some Cases Severe Malnutrition 476
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 741
VHTs follow up of discharged patients? None
NGOs CBOS CSOs working at community level
in the District
Actionaid Uganda Bear Care Project Kitgum Concerned Womens Assoc Oxfam Gb Watwero Rights Focus Initive
Agoro Community Development Assoc Concerned Parents Assocition Kitgum Private Sector Promotion Centre Traditional/Cultural Institution Youth Out Of Poverty And Aids
AMREF Guu Foundation Community Based Rehabilitation Meeting Point UNFPA
Kitgum Health Situation
Newborn Women
Agency For Cooperation In Research & Development
45%
9%
5%
4%
2%
9%
26%
Kitgum Cause of Deaths Under 5's (n=309)
Malaria Pneumonia Diarrhoea Malnutrition
AIDS Anaemia Other
List of CBO CSO and
NGOs operating in
District Available at
DHO?
No Joint Review with all
partners ?
Some
ALL Registered at
Community
Development Office?
Incomplete Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs
with DMT?
Yes Frequency of reporting Irregular
Joint Planning? Incomplete
Number of Sub
Counties
7 Number of Villages 389
% SC Covered by VHT's 100% % Villages Covered VHT 92%
District has Register or
or List of VHTs ?
Yes Number Active VHTs 862 Demographics
Number VHTs 862
% VHTs female ND Crude Mortality Rate CMRNo Data
Fertility Rate No Data
District has training
record for VHTs
No Number of VHTs trained
Health Promotion and
Education
862 Access to Functional
Health Facilty
ND
Duration of Basic
Health Promotion
Training
5 days Ratio participants to
facilitator
20 Other Background
# VHTs basic Health
Promotion trained AND
still active
862 Training Support MoH WHO
VHTs additionional
training modules (List
and numbers)
Access to Improved
Water Source
0.63
Latrine coverage
64%
Average time spent
volunteering per month
(hours)
unknown Education-Gross Enrolment Rate 147
Are VHTs treating
diseases at Community
level? (Currently)
Some Diseases Treated at
community level (List)
Onchocerciasis,
Schistosomiasis,
Filariasis
Female Literacy rate No Data
Contraceptives
distributed by VHTs
No Main languages Alur, Lugbara, Kakwa,
Madi
IEC Available in
Community
Access to mass media No Data
IEC needed in
Community
% of District covered
by mobile phone
network
No Data
Operational Radio
Stations
Radio Spirit Koboko
All VHTs attached to a
Specified HC?
No List of VHTs available on day
of visit
No Adult Literacy 62%
Established Links to HC
2, 3, 4
No Linkages with other sectors
in the District
Education VHTs Record and
Report Diseases of
Epidemic Potential?
yes
VHTs Assist Outreach
Activities
Some
Content of outreach EPI alone Have VHTs been
trained on who to
refer?
All
VHTs have VHT Village
Register?
No How are these done by
VHTs?
Verbal
Any Supervision
activity of VHTs during
past 6 months ?
Yes Other Registers??If Yes How
many?
none Are referrals recorded
in VHT register?
No
Who Supervises? Health Assistants Any VHT data collated? By
VHT
No
Standard Supervision
Training?
No By HCII No Motivation &
Incentives Given in
District
involvement in health
and related activities,
paid 2500= for
mobilisation per month
Supervision checklist? No By HSD No What Motivates the
VHTs?
Refresher training
Any Supervision
Reports Available?
No By DMT No Why do they volunteer? ND
Is Any VHT data used? No
Village Mortality Data
available?
No What for? NA
Factors
affecting
implementation
Meningitis - Malteser
Population
Health facilities
% Household owning a
bicycle
Evidence for IMPACT of VHT
Implementation, best
practices
Motivation & Incentives
Given in District
Actions Needed to Save Lives
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Koboko VHT Implementation
Linkages between VHT and Health System and Other Sectors
Current VHT Activities (during last 6 months)
mobilisation for EPI and child days, Sanitation,
ITN distribution, community based disease
surveillance, IEC, NTDs - schisto, bilharzia, data
collection refferals
TBAs & other former
Community Medicine
distributors etc included in
VHT?
Some
Supervision of VHTs
Referrals
VHT Reporting and District
Data Management
Other Community Health Workers NOT included in
VHTs (List and estimate numbers)
Community Vaccinators
none
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma NTDs HIV TB
Request all in picture format
VHT Training
Under 5's
Women of reproductive
age
37390 Births 2008-9 8977 Population Under 5
years
37390
Estimated number of
pregnancies 2008-9
9255 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality
(deaths per 1000 live
births)
No Data
ANC 1 85% Any Postnatal Check? No Data
ANC 4 22% %Infants weighed at
Birth
No Data
Tetanus Toxoid
coverage (pregnant
women 2+ doses)
5179 % Low Birth Weight No Data
Number Pregnant
women tested for HIV
45%
Number pregnant
women positive for
HIV
3% Newborns treated
ARVs at Birth
49 (92%)
Positive Pregnant
women given ARVs for
prophylaxis
47 (36%) Population under 1
year
7959
% deliveries at Health
Facility
25% BCG <1y 8167 DPT HEP HIB 3 <1y 8917
% skilled birth
attendant
ND Measles <1y 6741
Did VHTs interviewed
know danger signs
pregnant or postparum
women?
None VHTs interviewed know
New Born danger
signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 8% Perinatal Cases 0
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day
of Visit
Yes
LLIN Hanging to
protect at pregnant
women at HCs Visited?
None LLIN Hanging to
protect newborns at
HF Visited?
None LLIN Hanging to
protect under 5 at HF
Visited?
None
LLIN s for ANC
distribution at HCs
visited
Some LLIN s for NB
distribution at HC
visited
None LLIN s for distribution
for u5s without net at
home at HCs visited
None
IPT 2 33% Cases ND U5s treated with malaria inpatient 2578
Malaria Cases pregnant women 14 Deaths ND U5s treated with
malaria outpatient
27277
MalariaDeaths 0 Deaths 51
Pneumonia
Pneumonia 1st line
antibiotics available on
day of Visit
yes Cases ND Cases 579
Deaths ND Deaths 36
Diarrhoea
ORS Available on day
of visit
yes Cases ND Cases 321
Zinc available on day of
visit
None Deaths ND Deaths 6
Nutrition
Health Centres v sited
have MUACs?
None Cases Severe
Malnutrition
35
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for
Age
111
VHTs follow up of
discharged patients?
yes
Lessons Learned and
cultural practices
VHTs need to educate communities on importance of immunisation in order to allay fears about vaccines harming their women and children
Same as Arua
Koboko Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
41%
29%
5%
8%
17%
Koboko Cause of Deaths Under 5's
(n=125)
Malaria Pneumonia Diarrhoea
Anaemia Other
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review with all partners ? Some
ALL Registered at Communiy Development
Office?
Incomplete Partners Regularly Reporting Activities to DMT? No
Partners have MoUs with DMT? Yes Frequency of reporting annually
Joint Planning? Yes
Number of Sub Counties 6 Number of Villages 173
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs ? Yes
Number VHTs 33000%
Population 188100
Crude Mortality Rate CMR ND
VHT Training ND
District has training record for VHTs Yes Number of VHTs trained Health Promotion and
Education
330
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 25 to 1 Health Services
# VHTs basic Health Promotion trained AND
still active
Health facilities 17
Other Background
Social Mobilisation for Campaigns, NTD
drug distribution ,nutrition monitoring,
Average time spent volunteering per month (hours) n/a % Household owning a bicycle
ND
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level (List) NTDs Access to Improved Water Source
36%
Contraceptives distributed by VHTs Latrine coverage
0
IEC Available in Community Education-Gross Enrolment Rate
13400%
Female Literacy rate ND
Linkages between VHT and Health System
and Other Sectors
Main languages Akarimojong,Luo
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit Yes Access to mass media None
Established Links to HC 2, 3, 4 Yes All Linkages with other sectors in the District Yes % of District covered by mobile phone
network
Not Known
VHTs Assist Outreach Activities Yes All Operational Radio Stations Radio Karamoja
VHT Reporting and District Data Management
Supervision of VHTs VHTs have VHT Village Register? Yes All Referrals
Any Supervision activity of VHTs during past 6 months ? No Other Registers??If Yes How many? no Have VHTs been trained on who to
refer?
None
Who Supervises? No Data Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No
Supervision checklist? No By HSD No Motivation & Incentives Given in
District
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Non monetary include T-shirts,bicycles
Village Mortality Data available? Is Any VHT data used?What for? Mass
immunisation campaigns
Yes What Motivates the VHTs? Helping out at HC and learning
Factors affecting
implementation
Actions
Needed to
Save Lives
Why do they
volunteer?
No Data
selection, motivation
VHTs attend clinic once per month are supervised and gain new skills they also stay and help; have 230 marked bicycles that are sometimes used for assisted refferals VHTs - Need to Know danger signs for ALL and when to refer needs to be incorporated into training
Content of outreach Adult Literacy
Are referrals recorded in VHT register?
Evidence for IMPACT of VHT
Implementation, best practices
eradication of guinea worm; mobilise and
help young women to get TT shots because
coverage of the latter was very low
Access to Functional Health Facilty
Current VHT Activities (during last 6 months)
No
IEC needed in Community
list
VHTs additionional training modules (List and numbers)
% VHTs female
Other Community Health Workers NOT included in VHTs (List and estimate numbers)
Fertility Rate
330
Number Active VHTs 33000%
Demographics
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
STATUS OF VHT IMPLEMENTATION
VHT Implementation Kotido
Coordination of VHT by DHMT
Under 5's
Women of reproductive age 37996 Births 2008-9 1280 Population Under 5 years 38561
Estimated number of pregnancies 2008-9 8965 % Births registered No Data Morbidity under 5 years Malaria 60% Diarrhoea 11.6% ARI No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
26/1000 (UDHS 2006 Regional data) U5MR (deaths per 1000 live births) 174/1000 (UDHS 2006 Regional data)
ANC 1 71% Any Postnatal Check? No Data
ANC 4 30% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
0.846
TT 2-5 WCBA 29% % Low Birth Weight No Data
Number Pregnant women tested for HIV 6036 (68%)
Number pregnant women positive for HIV 130 (2%) Newborns treated ARVs at Birth 105 (269%) Infant Mortality
105/1000 (UDHS 2006 Regional data)
Positive Pregnant women given ARVs for
prophylaxis
56 (37%) Post Natal visit when? No Data Population under 1 year 8088
% deliveries at Health Facility 13% BCG <1y 0.8529 DPT HEP HIB 3 <1y 0.8661
% skilled traditional birth attendant 0.1112 Measles <1y 1.1387
Did VHTs interviewed know danger signs pregnant or postparum women? None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 0.43 Perinatal Cases 1
Post Natal visit when?
Day 1 and Day 42 Perinatal Deaths 0
Malaria Estimated District LLIN Coverage 98 ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant women at
HCs Visited?
None LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home at HCs visited None
IPT 2 0.35 Cases ND U5s treated with malaria inpatient 5058
Malaria Cases pregnant women 399 Deaths ND U5s treated with malaria outpatient 46180
MalariaDeaths
0 Deaths 13
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit yes Cases ND Cases 1114
Deaths ND Deaths 6
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 1033
Zinc available on day of visit
None Deaths ND Deaths 0
Nutrition Health Centres v sited have MUACs? Some Cases Severe Malnutrition 1288
VHTs can Read MUAC? Some VHTs Have MUACs? Some CasesLow weight for Age 2804
VHTs follow up of discharged patients? some
NGOs CBOS CSOs working at community level
in the District
AMREF UNICEF
Oxfam GB
SNV Uganda
UNFPA
Lessons Learned and cultural practices
Kotido Health Situation
Women Newborn
36%
3%
8%
22%
6%
25%
Kotido Cause of Deaths Under 5's (n=36)

Malaria Pneumonia
AIDS Anaemia
Infection Sepsis Septicaemia Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 11 Number of Villages 381
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs ? Incomplete Number Active VHTs NA
Number VHTs NA
% VHTs female NA Population 358,400
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
NA
Duration of Basic Health Promotion Training None Ratio participants to facilitator NA Health facilities 27; 3 Hospitals (I Govt 2
NGO) 12 HCIII 12 HCII
# VHTs basic Health Promotion trained AND
still active
NA Access to Functional Health Facilty ND
VHTs additional training modules
% Household owning a bicycle 52%
Average time spent volunteering per month (hours) 4 hrs for immunisers Access to Improved Water Source 73%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community level (List) NA Latrine coverage 56%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate 120
IEC Available in Community Female Literacy rate 52%
IEC needed in Community Main languages Ateso
Access to mass media ND
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No % of District covered by mobile phone
network
ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the District Water and Sanitation, Planning Unit Operational Radio Stations Continental FM Station Ltd.
VHTs Assist Outreach Activities Some
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How many? Yes, one Have VHTs been trained on who to
refer?
None
Who Supervises? Health Asst. at
HCs, Incharge
Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Is Any VHT data used? No Motivation & Incentives Given in
District
Prioritise and involve them in CBAs, Bags
Village Mortality Data available? Yes What for? NA What Motivates the VHTs? NA
Actions Needed to Save Lives
VHTs (trained by WHO) help out at health
centres to immunise
Volunterism is
dying; lack of
support
supervision at all
levels
VHTs - Need to Know danger signs for ALL and when
to refer needs to be incorporated into training
Current VHT Activities (during last 6 months)
Other Background
Supervision of VHTs
Mobilisation for health activites, sanitation
None
Flip Charts for VHTs with Danger Signs, Key family Practices.Water
and Sanitation, Trauma Trypanosomiasis Request all in picture format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Health Services
water and sanitation, PMTCT
VHT Training
Other Community Health Workers NOT included in VHTs
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine
distributors etc included in VHT?
All
Demographics
434 CLPs of Theta, 198 VHTs of WHO on water and Sanitation when
there were floods, 434 CMDs, Peer Educators; no VHTs trained
basic health promotion, Data Collectors, Community Mobilisers for
Health (1/parish), PMTCT mobilisers of THETA
Coordination of VHT by DMT
VHT Implementation Kumi
Referrals
VHTs follow up of discharged
patients?
Evidence for IMPACT of VHT
Implementation, best practices
HW - Danger signs for newborns and how to manage LBW infants .Content and timing of
post natal checks for both mother and baby Nutritional assessment of all children and
pregnant women.
Under 5's
Women of reproductive age
72,397
Births 2008-9
17,382
Population Under 5 years
72,397
Estimated number of pregnancies 2008-9
17,920
% Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 16324 (91%) Any Postnatal Check? No Data
ANC 4 2546 (14%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
7614 % Low Birth Weight No Data
Number Pregnant women tested for HIV
14341 (80%)
Number pregnant women positive for HIV
525 (4%)
Newborns treated ARVs at Birth 251 (82%)
Positive Pregnant women given ARVs for
prophylaxis
317 (60%)
Post Natal visit when? No Data Population under 1 year
15,411
% deliveries at Health Facility
54%
BCG <1y 14809 DPT HEP HIB 3 <1y 15549
% skilled birth attendant No Data Measles <1y 13849
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 5399 (31%) Perinatal Cases 30
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 1
Malaria
Estimated District
LLIN Coverage
ND ACTs available on day
of Visit
Yes
LLIN Hanging to protect pregnant women at
HCs Visited?
None LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without
net at home at HCs visited
None
IPT 2 9584 (53%) Cases ND U5s treated with malaria inpatient 11120
Malaria Cases pregnant women 360 Deaths ND U5s treated with malaria outpatient 104899
Malaria Deaths 0 Deaths 33
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
Cases ND Cases 1190
Deaths ND Deaths 33
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 223
Zinc available on day of visit None Deaths ND Deaths 4
Nutrition
Health Centres Have MUACs? Some Cases Severe Malnutrition 158
VHTs can Read MUAC? Some VHTs Have MUACs? Some Cases Low weight for Age 397
Lessons Learned and cultural practices Political leadership is key in making VHT concept work
Health workers as good examples
for key practices
Health workers practice handwashing between patients.
Actionaid Uganda Church Of Uganda-Teso Dioceses Planning And Dev't Office Kumi Aids Support Organsiation Ngora Pentecoastal Assemblies Of God Community Development Organsiation Pamo Volunteers Mukungoro The Centre For Recreation Educationand Appropriate Training For Everyone
AMREF Faith Action Ltd Kumi Network Of Development Organisations Ongino Community Development Association Save The Children Denmark-Kumi Children's Programme UWESO
Baptist Union Of Uganda Kumi Dev't Project
Kachumbala War Against Poverty Alleviation Kumi Human Rights Iniative & Good Governance Ongino Subcounty Association Of People With Disabilities Send A Cow Uganda Uganda Womens Finance Trust
Bukedea Women Strugglers Association Karev Youth And Orphans Link Iniative For Rural Development Malera Kakungur Aipecitoi Dev't Project Ongino Women In
Development Initiative
Soroti Catholic Diocese Organisation
Integrated Organisation
Vision Terudo
Kumi Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
31%
32%
4%
32%
1%
Kumi Cause of Deaths Under 5's (n=104)
Malaria Pneumonia Malnutrition Anaemia Other
List of CBO CSO and NGOs operating
in District Available at DHO?
Yes Joint Review ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DHT? No Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 14 Number of Villages 727
% SC Covered by VHT's 50% % Villages Covered VHT 44%
District has Register or List of VHTs ? Yes Number Active VHTs 415
Number VHTs 1383
% VHTs female No data
Population
469,041
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained
Health Promotion and
Education
1383 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to
facilitator
13
# VHTs basic Health Promotion
trained AND still active
415 Training Support MoH, Canadian
Public Health
Assoc.
Health facilities 40
VHTs additional training modules
(List and numbers)
Access to Functional Health
Facilty
ND
Average time spent
volunteering per month
(hours)
24 % Household owning a bicycle 31%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at
community level (List)
Helminths, DiarrhoeaAccess to Improved Water
Source
70%
Contraceptives distributed by VHTs No Latrine coverage 62%
IEC Available in Community Education-Gross Enrolment Rate 104
IEC needed in Community Female Literacy rate 60%
Main languages Rutooro,Rukiga
All VHTs attached to a Specified HC? Yes All List of VHTs available on day
of visit
No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in
the District
Agriculture - NAADS% of District covered by mobile
phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Kyenjojo
Development Radio
Content of outreach EPI alone VHTs Record and Report Diseases
of Epidemic Potential?
Yes
VHTs have VHT Village
Register?
No
Any Supervision activity of VHTs
during past 6 months ?
Yes Other Registers??If Yes How
many?
None Have VHTs been trained on who
to refer?
All
Who Supervises? Incharges,
Environmental
Health Staff,
Community
Development
Officers at s/c
level
Any VHT data collated? By
VHT
No How are these done by VHTs? Verbal
Standard Supervision Training? Yes By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? Yes By DMT No Motivation & Incentives Given in
District
Involvement,
Recognition,
Quarterly meetings,
Is Any VHT data used? Yes What Motivates the VHTs? Supervisory Meetings
Monthly & Quarterly,
Training VHTs in
remaining, Transport,
Village Mortality Data available? Theoretically What for? Basis for planning
and allocating
resources such as
medicines to
community, and
identifying active
VHTs
Why do they volunteer? Improve health of the
community, Sets
them apart from
others, Bridge the gap
between community
and public service
Factors affecting
implementation
Lack of supervision and
inadequate monthly report
forms and village registers.
Lack of transport to distant
health facilities
VHTs - Need to
Know danger signs
for ALL and when
to refer needs to
be incorporated
into training
VHT Training
Health Services
Demographics
Some
STATUS OF VHT IMPLEMENTATION
TBAs & other former
Community Medicine
distributors etc included in
VHT?
Other Community Health Workers NOT included in VHTs
(List and estimate numbers)
Community HIV/AIDS Counsellors, Parish
Development Committee Members
Coordination of VHT by DHT
VHT Implementation Kyenjojo
Supervision of VHTs
Child Days Oriented 80%, 40 VHTs Male Involvement in HIV/AIDS care
Current VHT Activities (during last 6 months)
health data collection, mobilisation for EPI, Water and
Sanitation Activities
Child Days, Malaria Prevention, Diarrhoeal
Diseases Control, HIV/AIDS
Flip Charts for VHTs with Danger Signs, Key
family Practices, Water and Sanitation,
Onchocerciasis, Trauma, HIV/AIDS, BCC,
Request all in picture format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District
Data Management
Referrals
Motivation & Incentives Given
in District
Other Background
Evidence for IMPACT of VHT
Implementation, best practices
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage
LBW infants .Content and timing of post natal checks for
both mother and baby Nutritional assessment of all
children and pregnant women.
In Kyaka HSD Child days coverage rose from 50% to
100% after VHT intervention / mobilisation.
Women of reproductive age 94746 Births 2008-9 22748 Population Under 5 years 94746
Estimated number of pregnancies
2008-9
23452 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 22438 (96%) Any Postnatal Check? No Data
ANC 4 8214 (35%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women) 2+ doses
7697 % Low Birth Weight No Data
Number Pregnant women tested for
HIV
14334 (61%)
Number pregnant women positive for
HIV
919 (6%) Newborns treated ARVs at
Birth
334 (84%)
Positive Pregnant women given ARVs
for prophylaxis
432 (47%) Post Natal visit when? No Data Population under 1 year 20168.763
% deliveries at Health Facility 20% BCG <1y 18153 DPT HEP HIB 3 <1y 21800
% skilled birth attendant No Data Measles <1y 13819
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 1530 (7%) Perinatal Cases 25
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 1
Malaria
Estimated District
LLIN Coverage
ND ACTs available on
day of Visit
Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
None LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 7883 (34%) Cases ND U5s treated with malaria inpatient 3252
Malaria Cases pregnant women 140 Deaths ND U5s treated with malaria
outpatient
42986
Malaria Deaths 0 Deaths 5
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases ND Cases 64
Deaths ND Deaths 0
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 391
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 7
VHTs can Read MUAC? All VHTs Have MUACs? None Cases Low weight for Age 417
VHTs follow up of discharged
patients?
ND
Lessons Learned and
cultural practices
VHT strategy can work given sustained support from MoH and partners
Integrated Rural Development
Initiatives
Canadian Public Health Association
UNICEF
Kyenjojo Health Situation
Women Newborn Under 5's
NGOs CBOS CSOs working at community level in the District
46%
36%
18%
Kyenjojo Cause of Deaths Under 5's
(n=11)
Malaria AIDS Other
List of CBO CSO and NGOs operating in District
Available at DHO?
No Joint Review ? Yes All Women of reproductive age 126533 Births 2008-9
ALL Registered at Community Development
Office?
No Partners Regularly Reporting Activities to DMT? No Estimated number of pregnancies 2008-9 31320 % Births registered
Partners have MoUs with DMT? Yes Frequency of reporting never Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live
births)
Joint Planning? No
Number of Sub Counties 19 Number of Villages 1198 ANC 1 109% Any Postnatal Check?
% SC Covered by VHT's 100% % Villages Covered VHT 100% ANC 4 27% %Infants weighed at Birth
District has Register or List of VHTs ? No Number Active VHTs 4998 Tetanus Toxoid coverage (pregnant women 2+
doses)
19354 % Low Birth Weight
Number VHTs 4998 Number Pregnant women tested for HIV 87%
% VHTs female No Data Number pregnant women positive for HIV 7% Newborns treated ARVs at Birth
Population
626,400
Positive Pregnant women given ARVs for
prophylaxis
906 (45%) Post Natal visit when?
Crude Mortality Rate CMR ND % deliveries at Health Facility 28% BCG <1y
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
4998 Fertility Rate ND % skilled birth attendant No Data
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator No Information Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born danger
signs?
# VHTs basic Health Promotion trained AND
still active
4998 Training Support MoH WHO UNICEF NUMAT Health facilities 48 Any PNC visit? (Number) 20% Perinatal Cases
VHTs additional training modules (List and
numbers)
Access to Functional Health Facilty ND Post Natal visit when? Day 1 and Day 42 Perinatal Deaths
Other Background Malaria
Estimated District LLIN
Coverage
ND
Average time spent volunteering per month (hours) Unknown % Household owning a bicycle 49% LLIN Hanging to protect pregnant women at HCs
Visited?
Some LLIN Hanging to protect newborns at HF
Visited?
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level (List) Malaria Access to Improved Water Source 67% LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited
Contraceptives distributed by VHTs Latrine coverage 62% IPT 2 50% Cases
IEC Available in Community Education-Gross Enrolment Rate 134 Malaria Cases pregnant women 1708 Deaths
IEC needed in Community Female Literacy rate 52% Malaria Deaths 6
Main languages Luo, Lango
Pneumonia
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No Access to mass media ND Pneumonia 1st line antibiotics available on day
of Visit
yes Cases
Established Links to HC 2, 3, 4 No Linkages with other sectors in the District Water and Sanitation % of District covered by mobile phone
network
ND Deaths
VHTs Assist Outreach Activities No Operational Radio Stations 8, Voice of Lango Radio, Radio
Apac, UBC Radio, Unity
Investments, Rhino FM, Radio
Management Services (U) Ltd,
Radio Wa-Lira Diocese,
Diarrhoea
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
No ORS Available on day of visit yes Cases
VHTs have VHT Village Register? No Zinc available on day of visit None Deaths
Any Supervision activity of VHTs during past 6
months ?
No Other Registers??If Yes How many? None Have VHTs been trained on who to refer? None
Nutrition
Health Centres Have MUACs?
Who Supervises? In-charges Any VHT data collated? By VHT No How are these done by VHTs? Verbal VHTs can Read MUAC? None VHTs Have MUACs?
Standard Supervision Training? Yes By HCII No Are referrals recorded in VHT register? No VHTs follow up of discharged patients? No
Supervision checklist? No By HSD No
Health workers as good
examples for key practices
Health Centres visited were very clean. They had soap and water for handwashing both in the consultation rooms and in the wards for the patients
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District Training, T-Shirts, Bicycles,
Transport and Lunch money
Ushs 3000-5000
Is Any VHT data used? No What Motivates the VHTs? Recognition, Appreciation,
Uniform, Meetings
Aboa Care For Children With Hiv/Aids Faith Vocational And
Technical Training
Institute
Send A Cow Uganda
Village Mortality Data available? No What for? n/a Why do they volunteer? Did not meet VHTs ACF North East Chili
Producers Association
Uganda Project Implementation And
Management Centre
Factors affecting implementation
Christian Renewal Church Women NUMAT Uganda Shelter Programme
No Data VHTs - Need to
Know danger
signs for ALL
and when to
refer needs to
be incorporated
into training
CPAR Rural Facilities
Development
Foundation
UNFPA
VHT Implementation Lira Lira Health Situation
Coordination of VHT by DHMT Women Newborn
Health Services
Demographics
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine distributors
etc included in VHT?
No Information
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
3102 CMDs
VHT Training
None
Current VHT Activities (during last 6 months)
Mobilisation for Immunisation, Sanitation and Hygiene, Education
and Distribution of Family Planning methods, Distribution of
Malaria drugs
No Information
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation, Trauma Trypanosomiasis Request all in picture format
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs Referrals
Motivation & Incentives Given in District
VHT Reporting and District Data
Management
NGOs CBOS CSOs working at community level in the District
Evidence for IMPACT of VHT
Implementation, best practices
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
No Data
Under 5's
Women of reproductive age 126533 Births 2008-9 30380 Population Under 5 years 126533
Estimated number of pregnancies 2008-9 31320 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data
ANC 1 109% Any Postnatal Check? No Data
ANC 4 27% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women
2+ doses)
19354 % Low Birth Weight No Data
Number Pregnant women tested for HIV 87%
Number pregnant women positive for HIV 7% Newborns treated ARVs at Birth 528 (88%)
Positive Pregnant women given ARVs for
prophylaxis
906 (45%) Post Natal visit when? No Data Population under 1 year 26935
% deliveries at Health Facility 28% BCG <1y 32230 DPT HEP HIB 3 <1y 22469
% skilled birth attendant No Data Measles <1y 19998
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 20% Perinatal Cases 18
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 7
Malaria
Estimated District
LLIN Coverage
ND ACTs available on day
of Visit
Yes
LLIN Hanging to protect pregnant women at
HCs Visited?
Some LLIN Hanging to protect newborns at
HF Visited?
All LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s without
net at home at HCs visited
None
IPT 2 50% Cases ND U5s treated with malaria inpatient 8900
Malaria Cases pregnant women 1708 Deaths ND U5s treated with malaria outpatient 123787
Malaria Deaths 6 Deaths 137
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
yes Cases ND Cases 1535
Deaths ND Deaths 44
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 2470
Zinc available on day of visit None Deaths ND Deaths 13
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 822
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 467
VHTs follow up of discharged patients? No
Health workers as good
examples for key
practices
Health Centres visited were very clean. They had soap and water for handwashing both in the consultation rooms and in the wards for the patients
Aboa Care For Children With Hiv/Aids Faith Vocational And
Technical Training
Institute
Send A Cow Uganda UNICEF
ACF North East Chili
Producers
Association
Uganda Project Implementation And
Management Centre
UWESO
Christian Renewal Church Women NUMAT Uganda Shelter Programme WHO
CPAR Rural Facilities
Development
Foundation
UNFPA
Lira Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
47%
19%
17%
17%
Lira Cause of Deaths Under 5's (n=288)
Malaria Pneumonia Diarrhoea Anaemia
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Yes Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 13 Number of Villages 598
% SC Covered by VHT's 23% % Villages Covered VHT 25%
District has Register or List of VHTs ? No Number Active VHTs 295
Number VHTs 147 (511 members)
% VHTs female no data
Population
396,664
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
511 Fertility Rate ND
Duration of Basic Health Promotion Training unknown Ratio participants to facilitator unknown
# VHTs basic Health Promotion trained AND
still active
295 Health facilities 55; 1 Military Hospital 3
HCIV 14 HCIII 22 HCII
Private / NGO 1 Hospital
9 HCIII 15 HCII
VHTs additional training modules (List and
numbers)
Access to Functional Health Facilty ND
Average time spent volunteering
per month (hours)
unknown % Household owning a bicycle 42%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community
level (List)
NA Access to Improved Water Source 71%
Contraceptives distributed by VHTs No Latrine coverage 78%
IEC Available in Community Education-Gross Enrolment Rate 143
IEC needed in Community Female Literacy rate 74%
Main languages Luganda
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of
visit
No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the
District
Education, Agriculture % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations
Radio Simba,
CBS
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
No
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How
many?
None Have VHTs been trained on who to
refer?
Some
Who Supervises? District and Sub-
county trainers
Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Quarterly meetings, T-
shirts, Badges,
Is Any VHT data used? No What Motivates the VHTs? Supervision
Village Mortality Data available? No What for? NA Why do they volunteer? No information
Factors affecting implementation
- Lack of funds for support
supervision - Non-
availability / intermittent supply
of routine immunisation cards
affects the accuracy of records of
children immunised
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Coordination of VHT by DHMT
VHT Implementation Luweero
Other Background
None
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Request all in
picture format
Linkages between VHT and Health System and Other Sectors
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc included
in VHT?
All
Current VHT Activities (during last 6 months)
Sanitation, Maternal health, child health, Community based
integrated disease surveillance
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
None
90 Immunisation mobilisers
VHT Training
Health Services
Demographics
VHT Reporting and District Data
Management
Supervision of VHTs Referrals
Motivation & Incentives Given in
District
Evidence for IMPACT of VHT
Implementation, best practices
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both mother
and baby Nutritional assessment of all children and pregnant
women.
Under 5's
Women of reproductive age 80126 Births 2008-9 19238 Population Under 5 years 80126
Estimated number of pregnancies 2008-9 19833 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 61% Any Postnatal Check? No Data
ANC 4 27% %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
6794 % Low Birth Weight No Data
Number Pregnant women tested for HIV 44%
Number pregnant women positive for HIV 7% Newborns treated ARVs at Birth 215 (69%)
Positive Pregnant women given ARVs for
prophylaxis
318 (51%) Post Natal visit when? No Data Population under 1 year 17056.552
% deliveries at Health Facility 29% BCG <1y 11061 DPT HEP HIB 3 <1y 9435
% skilled birth attendant No Data Measles <1y 10264
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 15% Perinatal Cases ND
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 6
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day of
Visit
No
LLIN Hanging to protect pregnant women
at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to protect under 5 at
HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 30% Cases ND U5s treated with malaria inpatient 597
Malaria Cases pregnant women 81 Deaths ND U5s treated with malaria
outpatient
51551
Malaria Deaths 0 Deaths 5
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
yes Cases ND Cases 99
Deaths ND Deaths 1
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 72
Zinc available on day of visit None Deaths ND Deaths 1
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 4
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 205
VHTs follow up of discharged patients? None
AMREF FPAU Traditional And Modern Health
Practitioners THETA
Association Francois-Xavier Bagnoud Plan International Uganda Society For Disabled
Children
Community Development And Child
Welfare Initaive
Promoting Moringa In
Uganda
Uganda Microfinance Union
Concern For The Girl Child SCiU VEDCO
Environmental Alert Send A Cow Uganda World Vision Uganda
Luweero Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
38%
8%
8%
46%
Luweero Cause of Deaths Under 5's (n=13)
Malaria Pneumonia Diarrhoea Perinatal Conditions
List of CBO CSO and NGOs operating
in District Available at DHO?
Incomplete Joint Review with all partners ? Some
ALL Registered at Communiy
Development Office?
Yes Partners Regularly Reporting Activities
to DMT?
Some
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 6 Number of Villages 201
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or or List of
VHTs ?
No Number Active VHTs NA
Number VHTs 0
% VHTs female 0% Population
74300
Crude Mortality Rate
CMR
ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
0
Duration of Basic Health Promotion
Training
NA Ratio participants to facilitator NA Health facilities 12; 1 Hospital 4 HCIII 5 HCII Private / NGO
2 HCII; all have midwives
# VHTs basic Health Promotion
trained AND still active
NA Access to Functional
Health Facilty
ND
VHTs additionional training modules
(List and numbers)
% Household owning
a bicycle
35%
Average time spent volunteering per
month (hours)
NA Access to Improved
Water Source
46%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community level
(List)
NA Latrine coverage 80%
Contraceptives distributed by VHTs No Education-Gross
Enrolment Rate
103
IEC Available in Community Female Literacy rate ND
IEC needed in Community Main languages Luganda
Access to mass media ND
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No % of District covered
by mobile phone
network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
Agriculture,
Education, water
department,
community
development
Operational Radio
Stations
ND
VHTs Assist Outreach Activities No Adult Literacy 70%
Content of outreach EPI alone VHTs Record and
Report Diseases of
Epidemic Potential?
None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been
trained on who to
refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done
by VHTs?
No Information
Standard Supervision Training? No By HCII No Are referrals recorded
in VHT register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation &
Incentives Given in
District
NA
Is Any VHT data used? No What Motivates the
VHTs?
No Information
Village Mortality Data available? No What for? NA Why do they volunteer?No Information
Factors affecting
implementation
Lyantonde is 4th in country in latrine
coverage rising from 46% - 85%
through work with CHWs
VHTs need training, meetings and
allowances
VHTs - Need to
Know danger
signs for ALL and
when to refer
needs to be
incorporated into
training
Demographics
Health Services
Other Background
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
STATUS OF VHT IMPLEMENTATION
Actions Needed to Save Lives
none
Coordination of VHT by DHMT
VHT Implementation
none
Current VHT Activities (during last 6 months)
Lyantonde
TBAs & other former Community
Medicine distributors etc included in
VHT?
None
NA
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Linkages between VHT, Health System and Other Sectors
Supervision of VHTs
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation,
Trauma, HIV/AIDS and TB - symptoms, community responsibilty, where to go for
treatment, adherence,Brucellosis prevention, Rabies - treatment in hospital, Rape and
Defilement - sensitisation, school health for OVC especially on dental, skin hygiene
and treatment for jiggers Request all in picture format
VHT Training
VHT Reporting and District Data
Management
Referrals
Motivation & Incentives Given in
District
804 CMDs
Evidence for IMPACT of VHT
Implementation, best practices
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review ? No
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? No Frequency of reporting never
Joint Planning? No
Number of Sub Counties 28 Number of Villages 1043
% SC Covered by VHT's 7% % Villages Covered VHT 4%
District has Register or List of VHTs ? Yes Number Active VHTs unknown
Number VHTs 160
% VHTs female No data Population
317,500
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
160
Duration of Basic Health Promotion Training 4 days Ratio participants to facilitator 20 Health facilities 23; 2 HCIV 12 HCIII 9
HCII
# VHTs basic Health Promotion trained AND
still active
unknown Access to Functional Health Facilty ND
VHTs additional training modules (List and
numbers)
% Household owning a bicycle 21%
Average time spent volunteering
per month (hours)
unknown Access to Improved Water Source 57%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community
level (List)
NA Latrine coverage 62%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate 137
IEC Available in Community Female Literacy rate ND
IEC needed in Community Main languages Lumasaba
Access to mass media ND
All VHTs attached to a Specified HC? Some List of VHTs available on day of
visit
No % of District covered by mobile phone
network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
Watsan Community
Development
Operational Radio Stations ND
VHTs Assist Outreach Activities Some Adult Literacy 60%
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
yes
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during past
6 months ?
Yes Other Registers??If Yes How
many?
none Have VHTs been trained on who to
refer?
All
Who Supervises? Health Assistants Any VHT data collated? By VHT Yes How are these done by VHTs? Verbal
Standard Supervision Training? Yes By HCII Yes Are referrals recorded in VHT register? No
Supervision checklist? Yes By HSD Yes
Any Supervision Reports Available? Yes By DMT Yes Motivation & Incentives Given in
District
Bags donated by Global
Fund
Is Any VHT data used? Yes What Motivates the VHTs? Certificate, Uniform
Village Mortality Data available? No What for? Baseline surveys,
Water and Sanitation
Coverage, Disease
Surveillance Reports
Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
In Kaato s/c pit latrine coverage increased
from 59.7% in 2007/8 before VHTs to 71%
in 2008/9 after VHTs mobilised and
sensitised communities on importance of
good pit latrines
lack of protective wear, incentives
and transport
Community mobilisation and sensitisation, refferals
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma Ochocerciasis
Request all in picture format
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
Coordination of VHT by DMT
Demographics
TBAs & other former Community
Medicine distributors etc included
in VHT?
STATUS OF VHT IMPLEMENTATION
Some
VHT Implementation Manafwa
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both mother
and baby Nutritional assessment of all children and pregnant
women.
Referrals
Motivation & Incentives Given in
District
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
Evidence for IMPACT of VHT
Implementation, best practices
None
Current VHT Activities (during last 6 months)
360 Community Change Agents CCAs (160 trained by
Save an Opportunity SAO and 200 by PREFA), 39
Community Health Promoters CHPs trained by Women
Concern Ministry
VHT Training
VHT Reporting and District Data
Management
Actions Needed to Save Lives
Health Services
Other Background
Women of reproductive age 64135 Births 2008-9 15399 Population Under 5 years 64135
Estimated number of pregnancies 2008-9 15875 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data
ANC 1 13790 (87%) Any Postnatal Check? No Data
ANC 4 6029 (38%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (Pregnant
women 2+ doses)
18579 % Low Birth Weight 2%
Number Pregnant women tested for HIV 12493 (79%)
Number pregnant women positive for HIV 256 (2%) Newborns treated ARVs at Birth 53 (72%)
Positive Pregnant women given ARVs for
prophylaxis
110 (43%) Post Natal visit when? Population under 1 year 13652.5
% deliveries at Health Facility 22% BCG <1y 17367 DPT HEP HIB 3 <1y 4819
% skilled birth attendant Measles <1y 7960
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 2505 (16%) Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day of
Visit
Yes
LLIN Hanging to protect pregnant women
at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to protect under 5 at
HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 5752 (36%) Cases ND U5s treated with malaria inpatient 4401
Malaria Cases pregnant women 377 Deaths ND U5s treated with malaria
outpatient
52306
Malaria Deaths 0 Deaths 40
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
yes Cases ND Cases 587
Deaths ND Deaths 3
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 481
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres Have MUACs? Some Cases Severe Malnutrition 213
VHTs can Read MUAC? All VHTs Have MUACs? None Cases Low weight for Age 175
VHTs follow up of discharged patients? yes
Lessons Learned and
cultural practices
VHT concept can work with sustained support and incentives
Health workers as good
examples for key
Health workers practice handwashing between patients.
AMREF FDNC PREFA USAID
Baylor Uganda Malaria Control TB-Cap UWCN
Carter Center NGO-SAO UHIN
NGOs CBOS CSOs working at community level in the District
Manafwa Health Situation
Women Newborn Under 5's
40%
1%
5%
30%
6%
18%
Manafwa Cause of Deaths Under 5's
Malaria
Pneumonia
Malnutrition
Anaemia
Infection Sepsis Septicaemia
Other
List of CBO CSO and NGOs operating in District
Available at DHO?
No Joint Review with all partners ? No
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? No Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 13 Number of Villages 791
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs ? Yes Number Active VHTs 1733
Number VHTs 2349 Population 369200
% VHTs female ND Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs Incomplete Number of VHTs trained Health
Promotion and Education
2349 Health facilities 28
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 14 Access to Functional Health Facilty ND
# VHTs basic Health Promotion trained AND
still active
1733 Training Support ADB through SHSSP I
VHTs additionional training modules (List and
numbers)
% Household owning a bicycle 42%
Access to Improved Water Source 68%
Average time spent volunteering per
month (hours)
4 Latrine coverage 57%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community
level (List)
Onchocerciasis, Malaria Education-Gross Enrolment Rate 174
Contraceptives distributed by VHTs Condoms 2349 coartem distributors Female Literacy rate ND
IEC Available in Community Main languages Alur, Lugbara, Kakwa,
Madi
IEC needed in Community Access to mass media ND
% of District covered by mobile phone
network
ND
All VHTs attached to a Specified HC? Some List of VHTs available on day of visit No Operational Radio Stations Radio Pacis, Voice of Life,
Arua Nile F.M
Established Links to HC 2, 3, 4 Some Adult Literacy 62.10%
VHTs Assist Outreach Activities Yes All
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
some for outbreaks
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during past 6
months ?
No Other Registers??If Yes How many? none Have VHTs been trained on who to refer? All
Who Supervises? no one Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District
Bicycles, ITNs, Fuel
Is Any VHT data used? No What Motivates the VHTs? Supervision
Village Mortality Data available? No What for? NA Why do they volunteer? ND
Factors affecting
implementation
Using VHTs coartem distribution rose from 44-
60% VHT members (former TBAs) help out in
ANC, supervised by health assistant
Lack of supervision. VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Head of household is fined 5000= by LC1 if partner does not give birth in health facility
VHT Implementation Maracha-Terego
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Demographics
Evidence for IMPACT of VHT
Implementation, best practices
Other Background
20 VHTs trained palliative care in HIV
Current VHT Activities (during last 6 months)
Community mobilisation for health, refferal for ANC, health
information management, watsan, FP education and commodity
distribution
Supervision of VHTs
VHT Reporting and District Data
Management
Linkages with other sectors in the
District
community
development, water
and sanitation
TBAs & other former Community
Medicine distributors etc included
in VHT?
All
Referrals
Motivation & Incentives Given in District
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
yes, Community Distributing Agents for FP, Parish
Mobilisers for EPI, Parish Development Committee
members, Popular Opinion Leaders who market products of
UHMG 88 CHWs 15 trained TBAs
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Actions Needed to Save Lives
VHT Training
none
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma NTDs Meningitis
Plague request all in picture format
Linkages between VHT and Health System and Other Sectors
Health Services
Under 5's
Women of reproductive age 74578 Births 2008-9 17906 Population Under 5 years 74578
Estimated number of pregnancies 2008-9 18460 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000
live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 15726 (85%) Any Postnatal Check? No Data
ANC 4 5613 (30%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women
2+ doses)
4318 % Low Birth Weight No Data
Number Pregnant women tested for HIV 2772 (15%)
Number pregnant women positive for HIV 27 (1%) Newborns treated ARVs at Birth 22 (81%)
Positive Pregnant women given ARVs for
prophylaxis
18 (67%) Population under 1 year 15876
% deliveries at Health Facility 29% BCG <1y 13523 DPT HEP HIB 3 <1y 9535
% skilled birth attendant No Data Measles <1y 7655
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 2097 (12%) Perinatal Cases 0
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day of
Visit
Yes
LLIN Hanging to protect at pregnant women
at HCs Visited?
some LLIN Hanging to protect newborns at
HF Visited?
None LLIN Hanging to protect under 5 at
HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 9430 (51%) Cases ND U5s treated with malaria inpatient 3433
Malaria Cases pregnant women 81 Deaths ND U5s treated with malaria outpatient 52884
MalariaDeaths 0 Deaths 178
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
yes Cases ND Cases 869
Deaths ND Deaths 81
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 197
Zinc available on day of visit None Deaths ND Deaths 26
Nutrition
Health Centres v sited have MUACs? Some Cases Severe Malnutrition 218
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 287
VHTs follow up of discharged patients? No
African Childcare Foundation Arua District Farmers
Association (Arudifa)
Caritas Maddor Here Is Life Ms Uganda Tukaliri Multi Purpose
Association (Tma)
African Network For Prevention And
Protection Against Child Abuse And Neglect
(ANPPCAN)
Assozione Centro Auti
Volentare (A.C.A.V.)
Community Empowerment For Rural
Dev't
Koboko United Womens
Association
National Community Of People Living
With Hiv/Aids (Nacwola-Arua)
UHMG
AIC Bileafe Rural
Development
Organisation
Consultancy For Rural Enterprise
Management
Liberal Misery Concern
League
Rwer Oli Division Youth Association United Humanitarian
Development Association
Ajai Rural Development Forum (Arcodofo) Cafidco Rural Finance
Development Ltd
FPAU Lugbara Literature
Association
Rural Initiative Community
Empowerment Rice Under Mihv
Vurra Patriotic
Entertainment Group
(Vupeg)
Aripezu Rural Development Association Care International In
Uganda
German Development Service Maracha Action For
Development
Snv Uganda Wenwa West Nile
Women Association
Transcultural Phychosocial
Organisation
World Vision Kati
Maracha-Terego Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
37%
7%
6%
4%
0%
10%
6%
4%
0%
1% 25%
Maracha-Terego Cause of Deaths
Under 5's (n=482)

Malaria
Pneumonia
Diarrhoea
Malnutrition
AIDS
Anaemia
Trauma
Infection Sepsis Septicaemia
Perinatal Conditions
Meningitis
Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting irregular
Joint Planning? Incomplete
Number of Sub Counties 23 Number of Villages 1384
% SC Covered by VHT's 35% % Villages Covered VHT 19%
District has Register or or List of VHTs ? No Number Active VHTs 1225
Number VHTs about 5/village
% VHTs female ND
Population
887972
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
1225 Fertility Rate ND
Duration of Basic Health Promotion
Training
10 days Ratio participants to facilitator 10
# VHTs basic Health Promotion trained
AND still active
1225 Training Support World Vision
International,
CARITAS MADDOR
Health facilities 80
VHTs additionional training modules (List
and numbers)
Access to Functional Health Facilty ND
Average time spent volunteering
per month (hours)
20 % Household owning a bicycle 34%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community
level (List)
NA Access to Improved Water Source 85%
Contraceptives distributed by VHTs Condoms Latrine coverage 95%
IEC Available in Community Education-Gross Enrolment Rate 121
IEC needed in Community Female Literacy rate 80%
Main languages Luganda
All VHTs attached to a Specified HC? No List of VHTs available on day of
visit
Yes Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in
the District
Community
Development,
Education
% of District covered by mobile
phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations CBS, Star Radio, Bwala
Hill 88.0FM, Radio West,
Equator Radio, Buddu
Broadcasting Services,
Kalung Foundation Ltd.,
Radio Maria Uganda
Association, Christian
Life Ministries, UBC
Radio, Christian Radio
Network, Baptist
International Mission
(U), Voice of Africa
(MMC for EC and SA)
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
Yes Other Registers??If Yes How
many?
None Have VHTs been trained on who to
refer?
All
Who Supervises? DHT Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII Yes Are referrals recorded in VHT
register?
No
Supervision checklist? Yes By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
Bicycles, ITNs, Fuel
Is Any VHT data used? No What Motivates the VHTs? Supervision
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
Lack of supervision and no
linkages between VHTs and
health centres
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Demographics
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Masaka
Social Mobilisation for Campaigns EPI / TT Family Planning
Education Referrals Homevisiting Identifying Latrine Coverage
Household Sanitation TB DOTS
Other Background
Health Services
Some
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
CHWs, PDCs, 77 popular opinion leaders of UHMG
distribute contraceptives
TBAs & other former Community
Medicine distributors etc
included in VHT?
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both
mother and baby Nutritional assessment of all children and
pregnant women.
Baseline health indicators available in Kitanda sub-county that
will inform any impact that VHT interventions may be having.
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
VHT Reporting and District Data
Management
Referrals
Motivation & Incentives Given in
District
Evidence for IMPACT of VHT
Implementation, best practices
HIV Malaria Ebola
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, HIV/AIDs Prevention
and Treatment, PNC Basic First Aid TB adherence
Request all in picture format
VHT Training
None
Current VHT Activities (during last 6 months)
Women of reproductive age 179370 Births 2008-9 43067 Population Under 5 years 179370
Estimated number of pregnancies 2008-9 44399 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data
ANC 1 76% Any Postnatal Check? No Data
ANC 4 35% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
26198 % Low Birth Weight No Data
Number Pregnant women tested for HIV 48%
Number pregnant women positive for
HIV
9% Newborns treated ARVs at Birth 761 (91%)
Positive Pregnant women given ARVs for
prophylaxis
1239 (72%) Population under 1 year 38182.796
% deliveries at Health Facility 32% BCG <1y 42886 DPT HEP HIB 3 <1y 32861
% skilled birth attendant No Data Measles <1y 32403
Did VHTs interviewed know danger
signs pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 11% Perinatal Cases 71
Post Natal visit when? Day 42 Perinatal Deaths 28
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day
of Visit
Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to protect under 5
at HF Visited?
None
LLIN s for ANC distribution at HCs visited None LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 23% Cases ND U5s treated with malaria inpatient9900
Malaria Cases pregnant women 1129 Deaths ND U5s treated with malaria
outpatient
97777
MalariaDeaths 2 Deaths 218
Pneumonia
Pneumonia 1st line antibiotics available
on day of Visit
none Cases ND Cases 2624
Deaths ND Deaths 120
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 1384
Zinc available on day of visit None Deaths ND Deaths 23
Nutrition
Health Centres visited have
MUACs?
None Cases Severe Malnutrition 997
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 1920
VHTs follow up of discharged patients? yes Village Health Teams
Health workers as good
examples for key
practices
Health workers have emergency algorithms pasted on wall in labour suite in one health centre visited
Child Restoration Outreach Nulife UWESO
Kitenga Development Foundation Send a Cow Uganda World Vision Uganda
Masaka Diocese Development
Association MADDO
UHMG
Masaka Health Situation
Women Newborn Under 5's
NGOs CBOS CSOs working at community level in the District
29%
17%
7%
11%
8%
28%
Masaka Cause of Deaths Under 5's (n=763)
Malaria
Pneumonia
AIDS
Anaemia
Infection Sepsis Septicaemia
Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting irregular
Joint Planning? No
Number of Sub Counties 12 Number of Villages 598
% SC Covered by VHT's 17% % Villages Covered VHT 23%
District has Register or List of VHTs ? No Number Active VHTs 360
Number VHTs 720
% VHTs female ND
Population
571,000
Crude Mortality Rate CMR ND
District has training record for VHTs Incomplete Number of VHTs trained Health
Promotion and Education
720 Fertility Rate ND
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 13
# VHTs basic Health Promotion trained AND
still active
360 Training Support MoH UNHCR Health facilities 54, 2 Hospitals 1 HCIV
14 HCIII 37HCII
VHTs additional training modules (List and
numbers)
Access to Functional Health Facilty ND
Average time spent volunteering
per month (hours)
1 day a week % Household owning a bicycle 52%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community
level (List)
Onchocerciasis Access to Improved Water Source 64%
Contraceptives distributed by VHTs Condoms Latrine coverage 59%
IEC Available in Community Education-Gross Enrolment Rate 95
IEC needed in Community Female Literacy rate 49%
Main languages Runyoro
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of
visit
Incomplete Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
% of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations Christian Life Ministries,
UBC Radio, Masindi
Broadcasting Service,
Earnest Publishers,
Bunyoro broadcasting
radio, Kitara Radio,
Kings Radio
Content of outreach EPI Growth monitoring VHTs Record and Report Diseases of
Epidemic Potential?
Yes
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during
past 6 months ?
Yes Other Registers??If Yes How
many?
None Have VHTs been trained on who to
refer?
All
Who Supervises? HSD Supervisors,
Parish Coordinators
Any VHT data collated? By VHT Yes How are these done by VHTs? Verbal
Standard Supervision Training? Yes By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
None
Is Any VHT data used? Yes What Motivates the VHTs? Recognition,
Village Mortality Data available? Theoretically What for? Identify main
problems in their
villages
Why do they volunteer? To serve their
community to reduce
morbidity and mortality
Factors affecting
implementation
Improved refferal system, HIV testing went
up
VHT concept is good
provided partners
avoid parallel
programs
Vertical VHT implementation
demotivates VHTs in areas that
are not covered by that project
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc included
in VHT?
All
Coordination of VHT by DHMT
VHT Implementation Masindi
Evidence for IMPACT of VHT
Implementation, best practices+A18
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
80 Community Reproductive Health Workers, Condom
Distributors, 60 Community Counselling Aides CCAs of
PREFA, 30 Network Support Agents (link HIV positive
cases to HCs), 100 CORPs
VHT Training
Current VHT Activities (during last 6 months)
immunisation, nutrition, hygiene & sanitation at household level,
malaria, HIV/AIDS, Onchocerciasis
Supervision of VHTs
Actions Needed to Save Lives
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation,
Trauma,Onchocerciasis, Malaria Trypanosomiasis
Request all in picture format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Reproductive Health and Family Planning
Reproductive Health and Family Planningunder UNFPA, Participatory Rural
appraisal under District Livelihood Support Program, Malaria Prevention
Community
Development,
Probation
Department, CBOs,
Faith-based
Organisations,
Agriculture-NAADS
Motivation & Incentives Given in
District
Health Services
Other Background
Referrals
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both mother
and baby Nutritional assessment of all children and pregnant
women.
Demographics
n
Under 5's
Women of reproductive age 115342 Births 2008-9 27694 Population Under 5 years 115342
Estimated number of pregnancies 2008-9 28550 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 22561 (79%) Any Postnatal Check? No Data
ANC 4 6288 (22%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
11806 % Low Birth Weight No Data
Number Pregnant women tested for HIV 14828 (52%)
Number pregnant women positive for HIV 739 (5%) Newborns treated ARVs at Birth 311 (142%)
Positive Pregnant women given ARVs for
prophylaxis
467 (63%) Post Natal visit when? No Data Population under 1 year 24553
% deliveries at Health Facility 24% BCG <1y 22568 DPT HEP HIB 3 <1y 16467
% skilled birth attendant No Data Measles <1y 14144
Did VHTs interviewed know danger signs
pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 1937 (7%) Perinatal Cases ND
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths ND
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day
of Visit
No visit
LLIN Hanging to protect pregnant women
at HCs Visited?
No visit LLIN Hanging to protect newborns
at HF Visited?
no visit LLIN Hanging to protect under 5 at
HF Visited?
no visit
LLIN s for ANC distribution at HCs visited No visit LLIN s for NB distribution at HC
visited
no visit LLIN s for distribution for u5s
without net at home at HCs visited
no visit
IPT 2 12482 (44%) Cases ND U5s treated with malaria inpatient ND
Malaria Cases pregnant women ND Deaths ND U5s treated with malaria outpatient 85897
Malaria Deaths ND Deaths ND
Pneumonia
Pneumonia 1st line antibiotics available
on day of Visit
No visit Cases ND Cases ND
Deaths ND Deaths ND
Diarrhoea
ORS Available on day of visit No visit Cases ND Cases ND
Zinc available on day of visit No visit Deaths ND Deaths ND
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition ND
VHTs can Read MUAC? Some VHTs Have MUACs? None Cases Low weight for Age 275
VHTs follow up of discharged patients? Some Village Health Teams
Abagamba Kamu Joint Group (Ajg) Highway Of Holiness
Evangelical Foundation
MS Uganda Rural Development
Crusaders Association
UNFPA Youth
Effort
Against
STDs/AIDS
Action For Children - Masindi Masindi Seed &Grain
Growers Association
Nature Conservation And Promotion
Association (Nacopra)
The Development Of
The Rural Community
UNHCR
Actionaid Uganda Masindi District Farmers
Association
Nutrifarm Services Uganda Uganda Change Agent
Association
UWESO
Budongo Forests Community Dev't
Organisation
Masindi Small Scale
Industries Association
Participatory Rural Development
Organisation
Uganda Fisheries &Fish
Conservation
Association
Vision For Rural Development
Initiatives
Gukwasamanzi Farmer's Association Ltd Mission Masindi Poverty Alleviation Credit Trust Uganda Society For
Disabled Children
VSO Uganda
Masindi Health Situation
Women Newborn
Pie chart for Mortality u5's
NGOs CBOS CSOs working at community level in the District
No Data
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? Yes All
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting Activities
to DMT?
Some
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Yes
Number of Sub Counties 13 Number of Villages 497
% SC Covered by VHT's 8% % Villages Covered VHT 14%
District has Register or List of VHTs ? No Number Active VHTs unknown
Number VHTs 370
% VHTs female no data
Population 416,089
Crude Mortality Rate
CMR
ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
370 Fertility Rate ND
Duration of Basic Health Promotion
Training
6 days Ratio participants to facilitator 15
# VHTs basic Health Promotion trained
AND still active
unknown Health facilities 32; 1 Hospital (NGO) 2 HCIV 4 HCIII 25
HCII
VHTs additional training modules (List
and numbers)
Access to Functional
Health Facilty
ND
Average time spent volunteering per
month (hours)
16 % Household owning a
bicycle
40%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community level
(List)
Malaria, Bilharzia Access to Improved
Water Source
61%
Contraceptives distributed by VHTs Condoms Latrine coverage 62%
IEC Available in Community Education-Gross
Enrolment Rate
108
IEC needed in Community Female Literacy rate 54%
Main languages Lusoga
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
None % of District covered by
mobile phone network
ND
VHTs Assist Outreach Activities Some Operational Radio
Stations
ND
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained
on who to refer?
All
Who Supervises? PDCs, S/c trainers,
Incharges
Any VHT data collated? By VHT No How are these done by
VHTs?
Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in
VHT register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives
Given in District
Safary Day Allowances (SDA)ranges
from 2000/= to 12000/= depending on
card-community Volunteer to the officer,
Is Any VHT data used? No What Motivates the
VHTs?
Follow-up, Supervision
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
None
VHT Training
NBC
Current VHT Activities (during last 6 months)
Community sensitization on health issues,data collection,follow up
of patients,refferals, home visiting, Treat NTDs - bilharzia
Supervision of VHTs
Health Services
Other Background
none
Flip Charts for VHTs with Danger Signs, Key family Practices.Water
and Sanitation, Trauma Trypanosomiasis Request all in picture
format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Referrals
Motivation & Incentives Given in
District
Actions Needed to Save Lives
Immunisation coverage increased from 55% to over 100% due to
VHT mobilisation and sensitisation.
lack of follow up VHTs - Need to
Know danger signs
for ALL and when
to refer needs to be
incorporated into
training
HW - Danger signs for newborns and how to manage LBW infants
.Content and timing of post natal checks for both mother and baby
Nutritional assessment of all children and pregnant women.
Evidence for IMPACT of VHT
Implementation, best practices
VHT Implementation Mayuge
Coordination of VHT by DMT
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc included in
VHT?
Some
Demographics
Women of reproductive age 84050 Births 2008-9 20180 Population Under 5 years 84050
Estimated number of pregnancies 2008-9 20804 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data U5MR (deaths per 1000 live births) No Data
ANC 1 15716 (76%) Any Postnatal Check? No Data
ANC 4 3721 (18%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 9237 % Low Birth Weight No Data
Number Pregnant women tested for HIV 11241 (54%)
Number pregnant women positive for HIV 533 (5%) Newborns treated ARVs at Birth 76 (78%)
Positive Pregnant women given ARVs for prophylaxis 228 (43%) Post Natal visit when? No Data Population under 1 year 17891.83
% deliveries at Health Facility 20% BCG <1y 15804 DPT HEP HIB 3 <1y 10236
% skilled birth attendant No Data Measles <1y 10130
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 3742 (19%) Perinatal Cases 79
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 2
Malaria
Estimated
District LLIN
ND ACTs available on
day of Visit
No
LLIN Hanging to protect pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF
Visited?
None LLIN Hanging to protect under 5 at
HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s
without net at home at HCs visited
None
IPT 2 6446 (31%) Cases ND U5s treated with malaria inpatient 2477
Malaria Cases pregnant women 44 Deaths ND U5s treated with malaria
outpatient
42742
Malaria Deaths 0 Deaths 28
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit yes Cases ND Cases 341
Deaths ND Deaths 15
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 168
Zinc available on day of visit None Deaths ND Deaths 23
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 140
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 174
VHTs follow up of discharged patients?
Adventist Development and Relief Agency ADRA Busoga
Family Life
Education
Ghakuwebwa Mwino Kyebando Women's
Development Assoc
Intergrated
Development
Activities and
Ndese Basima Boda Kyebando Sustainabl
e
Intergrate
Africa 2000 Network (U) Community
Association
For Rural
Hope Women's Group Kavule
Development
Assoc
Original Rural Action For
Community Development
Uganda
Communit
y
Alikula Women's Organisation Group Community
Aid Scheme
Idudi Development Assoc Kigandalo
Twekebeze Post
Club
SCiU URCS
Bidhampola Community Development Assoc Community
Integrated
Development
Inter Farmer Participatory Research Centre
Buyemba
Kyebatakobana's
Women's Assoc
Kyete
Send A Cow Uganda Wabuluwg
u Pwds
Union
Bulyangada Orphan Widow's Sub-Project Eastern
Coffee
Farmers
Inter Rural Link Farmers and Health Activities Mpatesobola
Disabled Person
Assoc
Sustainable Development Agency Yotaliga
Intergrate
d
NGOs CBOS CSOs working at community level in the District
Mayuge Health Situation
Women Newborn Under 5's
25%
15%
21%
12%
2%
11%
4%
2%
8%
Mayuge Cause of Deaths Under 5's
(n=150)
Malaria Pneumonia Malnutrition
Anaemia Other
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 21 Number of Villages 565
% SC Covered by VHT's 24% % Villages Covered VHT 9%
District has Register or List of VHTs ? No Number Active VHTs 100
Number VHTs 100
% VHTs female NA
Population
392,901
Crude Mortality Rate CMR ND
District has training record for VHTs Number of VHTs trained Health Promotion and
Education
None Fertility Rate ND
Duration of Basic Health Promotion Training 2 days Ratio participants to facilitator 5
# VHTs basic Health Promotion trained AND
still active
NA Training Support MoH PREFA Health facilities 40; 2 Hospitals 2 HCIV 18 HCIII 18 HCII
VHTs additional training modules (List and
numbers)
Access to Functional Health
Facilty
ND
Average time spent volunteering per month
(hours)
% Household owning a
bicycle
17%
Are VHTs treating diseases at Community
level? (Currently)
Yes All Diseases Treated at community level (List) Onchocerciasis,
Intestinal worms
Access to Improved Water
Source
57%
Contraceptives distributed by VHTs No Latrine coverage 65%
IEC Available in Community Education-Gross Enrolment
Rate
121
IEC needed in Community Female Literacy rate 63%
Main languages Lumasaba
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No % of District covered by
mobile phone network
ND
VHTs Assist Outreach Activities Yes All Operational Radio Stations Capital FM, Open Gate FM, BBC World Service FM,
Radio France International, Buwalasi Hill FM, Radio
Ssanyu Ltd., Haustrs Ltd., Katinvuma Broadcasts,
Ddembe FM Ltd., UBC Radio, Christian Radio Network,
Voice of Africa (UMC for EC and SA), Radio Maria
Content of outreach Integrated Outreach VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during past
6 months ?
Yes Other Registers??If Yes How many? Yes, 3 Have VHTs been trained on
who to refer?
All
Who Supervises? Health Asst. Any VHT data collated? By VHT No How are these done by
VHTs?
Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in
VHT register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? Yes By DMT No Motivation & Incentives
Given in District
Bicycles, Handbags, Recognition, Transport T-shirts,
Cup of Tea
Is Any VHT data used? No What Motivates the VHTs? No Data
Village Mortality Data available? Yes What for? NA Why do they volunteer? Did not meet VHTs
Evidence for IMPACT of
VHT Implementation, best
practices
Other Community Health Workers NOT included in VHTs (List and estimate
numbers)
250 CCAs
VHT Training
Emergency Cholera Training
Current VHT Activities (during last 6 months)
Supervision of VHTs
Health Services
Other Background
No Data
Linkages with other sectors in the District none
Home-based Counselling for HIV/AIDS, Community mobilisation and
sensitisation, information dissemination, home visiting
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation, Cholera, Dysentry, Dental Health in Children,Trauma, Onchocerciasis,
Request all in picture format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Factors affecting implementation
lack of funds for training; lack of logistics to enable VHTs do their work; attitude
of health workers is key to making VHT concept work;
- intereference during selection process begets uncommitteed VHTs
Referrals
Motivation & Incentives Given in District
Actions Needed to Save Lives
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
HW - Danger signs for newborns and how to manage LBW infants .Content and
timing of post natal checks for both mother and baby Nutritional assessment of
all children and pregnant women.
VHT Implementation Mbale
Coordination of VHT by DMT
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine
distributors etc included in VHT?
None
Demographics
Women of reproductive age
79366
Births 2008-9
19056
Population Under 5 years
Estimated number of pregnancies 2008-9
19645
% Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data
ANC 1 104% Any Postnatal Check? No Data
ANC 4 67% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 12877 % Low Birth Weight No Data
Number Pregnant women tested for HIV 83%
Number pregnant women positive for HIV 5% Newborns treated ARVs at Birth 213 (103%)
Positive Pregnant women given ARVs for prophylaxis 437 (54%) Post Natal visit when? Population under 1 year
% deliveries at Health Facility 41% BCG <1y 21769 DPT HEP HIB 3 <1y
% skilled birth attendant ND Measles <1y
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger signs?
Any PNC visit? (Number) 50% Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
Estimated
District LLIN
Coverage
ND ACTs available on
day of Visit
no visit
LLIN Hanging to protect pregnant women at HCs Visited? no visit LLIN Hanging to protect newborns at HF Visited? No Visit LLIN Hanging to protect under 5 at HF Visited?
LLIN s for ANC distribution at HCs visited no visit LLIN s for NB distribution at HC visited No Visit LLIN s for distribution for u5s without net at home at
HCs visited
IPT 2 21% Cases ND U5s treated with malaria inpatient
Malaria Cases pregnant women 538 Deaths ND U5s treated with malaria outpatient
Malaria Deaths 5 Deaths
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit no visit Cases ND Cases
Deaths ND Deaths
Diarrhoea
ORS Available on day of visit no visit Cases ND Cases
Zinc available on day of visit no visit Deaths ND Deaths
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age
VHTs follow up of discharged patients? None
Health workers as good examples for key
practices
Handwashing facilities available in consultation rooms.
AIC Environmental
Alert
Mt. Elgon Baptist Ind. Mission Namanda
Development
Foundation
Send A Cow Uganda
Africa 2000 Network Uganda FPAU Mulosi Inyukha Assi Women Group Namisindwa Yetana
Assoc.
Shunya
Bumityero Tubaana Women Group Integrated
Rural
Development
Initiatives
Mutoto Tubaana Association Poverty Alleviation &
Community
Development
Foundation
Sironko Valley Integrated Projects
Child Restoration Outreach International
Care & Relief
Naiku Mixed Group PREFA U.P.D.F. Widows & Orphans Assoc.
Community Innovation In Development Uganda Ms Uganda Nalondo Butta Orphans Care & Family Support Project Private Sector
Promotion Centre
Mbale
Uganda Project Implementation And Management Centre
NGOs CBOS CSOs working at community level in the District
Mbale Health Situation
Women Newborn Under 5's
45%
8%
21%
5%
21%
Mbale Cause of Deaths Under 5's (n=316)
Malaria
Pneumonia
Anaemia
Infection Sepsis Septicaemia
Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting Activities to
DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 17 Number of Villages 742
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or or List of VHTs ? No Number Active VHTs 0
Number VHTs 0
% VHTs female 0%
Population
418,200
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion
and Education
0 Fertility Rate ND
Duration of Basic Health Promotion
Training
NA Ratio participants to facilitator NA
# VHTs basic Health Promotion trained
AND still active
0 Training Support MoH Health facilities 53; 4 Hospitals 4 HCIV 11 HCIII 34 HCII. 20%
health units have midwives
VHTs additionional training modules (List
and numbers)
Access to Functional
Health Facilty
ND
Average time spent volunteering per month
(hours)
NA % Household owning a
bicycle
34%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level (List) Malaria by Coartem
distributors,
Diarrhoea by CMDs
Access to Improved
Water Source
63%
Contraceptives distributed by VHTs Condoms have coartem distributors Latrine coverage 91%
IEC Available in Community Education-Gross
Enrolment Rate
108
IEC needed in Community Female Literacy rate 68%
Main languages Ruyankore
All VHTs attached to a Specified HC? Some List of VHTs available on day of visit No Access to mass media 70%
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the District Agriculture NAADS,
Water and
Sanitation, Religious
NGOs
% of District covered by
mobile phone network
ND
VHTs Assist Outreach Activities Some Operational Radio
Stations
Capital Radio, BBC World Service, Life Radio, UBC
Radio, Radio West, Voice of Africa (UMC for EC and
SA), Radio Maria, Christian Life Ministries, Greater
Afrikan Radio, Voice of Tooro, Radio Vision Empire,
Baptist International Mission (U) .
Content of outreach EPI Growth monitoring VHTs Record and Report
Diseases of Epidemic
Potential?
None
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained
on who to refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by
VHTs?
Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in
VHT register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives
Given in District
Bags, Bicycles, nametags, 2000= / month, T-
shirts, recognition, encouraged to form their own
income generating activities
Is Any VHT data used? No What Motivates the VHTs? no information
Village Mortality Data available? No What for? NA Why do they volunteer? no information
immunisation
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation, poisons, nutrition - breastfeeding, OVCs - care and support,
HIV/AIDS, Trauma, Request all in picture format
VHT Training
Peer Educators, Social Support Groups for HIV positive mothers
VHT Reporting and District Data
Management
Current VHT Activities (during last 6 months)
CORPs carry out refferals, mobilisation for health activities,family
planning, Coartem distribution and health education
Health Services
Other Background
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs Referrals
Motivation & Incentives Given in District
None
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
2 CMDs / village, CORPs of HCU being trained to become VHTs,
PDCs, Community Vaccinators of GAVI
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Mbarara
TBAs & other former Community Medicine
distributors etc included in VHT?
Demographics
Under 5's
Women of reproductive age 84476 Births 2008-9 20283 Population Under 5 years
Estimated number of pregnancies 2008-9 20910 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data
ANC 1 21474 (103%) Any Postnatal Check? No Data
ANC 4 12703 (61%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 9913 % Low Birth Weight No Data
Number Pregnant women tested for HIV 15053 (72%)
Number pregnant women positive for HIV 1436 (10%) Newborns treated ARVs at Birth 757 (89%)
Positive Pregnant women given ARVs for prophylaxis 1143 (80%)
% deliveries at Health Facility 48% BCG <1y 21816
% skilled birth attendant No Data Population under 1 year
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None DPT HEP HIB 3 <1y
Any PNC visit? (Number) 1946 (10%) Perinatal Cases 0 Measles <1y
Post Natal visit when? Day 42 Perinatal Deaths 0 VHTs interviewed know danger signs?
Malaria
Estimated
District LLIN
Coverage
ND ACTs available on
day of Visit
No
LLIN Hanging to protect at pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF Visited? None LLIN Hanging to protect under 5 at HF Visited?
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home at
HCs visited
IPT 2 5696 (27%) Cases ND U5s treated with malaria inpatient
Malaria Cases pregnant women 233 Deaths ND U5s treated with malaria outpatient
MalariaDeaths 0 Deaths
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit No Cases ND Cases
Deaths ND Deaths
Diarrhoea
ORS Available on day of visit yes Cases ND Cases
Zinc available on day of visit None Deaths ND Deaths
Nutrition
Health Centres v sited have MUACs? None Cases Severe Malnutrition
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age
VHTs follow up of discharged patients? none
Lessons Learned and cultural practices
structure exists that can be used as learning experience to set up VHTs (CORPs of HCU)
ACORD Conservation
Effort
Community
Development
ICOBI Mbarara ArchdioceseResources Management Foundation
Agency for Integrated Development Training Services FPAU Integrated Rural Development Initiatives Mbarara District
Women's
Development
Association
TASO
NGOs CBOS CSOs working at community level in the District
Mbarara Health Situation
Women Newborn
47%
7%
4%
Mbarara Cause of Deaths Under 5's (n=81)
Malaria Pneumonia
Malnutrition Anaemia
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review ? Yes All
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting Activities
to DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting monthly
Joint Planning? Yes
Number of Sub Counties 9 Number of Villages 606
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs ? No Number Active VHTs n/a
Number VHTs n/a
% VHTs female n/a Population
291,900
Crude Mortality Rate
CMR
ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
NA
Duration of Basic Health Promotion
Training
NA Ratio participants to facilitator NA Health facilities 55; 1 Hospital, 2 HCIV, 18 HCIII, 34
HCII
# VHTs basic Health Promotion trained
AND still active
NA Training Support MoH PREFA Access to Functional
Health Facilty
ND
VHTs additional training modules (List
and numbers)
% Household owning a
bicycle
33%
Average time spent volunteering per
month (hours)
NA Access to Improved
Water Source
74%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community level
(List)
NTDs by CMDs Latrine coverage 76%
Contraceptives distributed by VHTs No Education-Gross
Enrolment Rate
100
IEC Available in Community Female Literacy rate ND
IEC needed in Community Main languages Luganda
Access to mass media ND
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the
District
International HIV
Alliance, Advocacy,
Operational Radio
Stations
Radio Skynet Ltd.
VHTs Assist Outreach Activities No Adult Literacy 72%
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? No Have VHTs been trained
on who to refer?
None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by
VHTs?
No Information
Standard Supervision Training? No By HCII No Are referrals recorded in
VHT register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives
Given in District
Involving CMDs in health activites that
have funding, quarterly meetings
Is Any VHT data used? No What Motivates the
VHTs?
NA
Village Mortality Data available? Theoretically What for? NA Why do they volunteer? CMDs volunteer for Recognition,
Learning new skills, Support
Factors affecting
implementation
Need training VHTs - Need to
Know danger signs
for ALL and when
to refer needs to be
incorporated into
training
No Data
Evidence for IMPACT of VHT
Implementation, best practices
Supervision of VHTs
Actions Needed to Save Lives
Demographics
Health Services
Flip Charts for VHTs with Danger Signs, Key family Practices.Water
and Sanitation, Trauma, Malaria, Bilharzia, Request all in picture
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Other Background
None
Current VHT Activities (during last 6 months)
Referrals
Motivation & Incentives Given in
District
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both mother
and baby Nutritional assessment of all children and pregnant
women.
CMDs distribute drugs for Bilharzia, couselling aides for HIV/AIDS,
IPT in Pregnancy, HIV/AIDS
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
1170 CMDs, PHAs
VHT Training
TBAs & other former Community
Medicine distributors etc included in
VHT?
None
VHT Implementation Mityana
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Women of reproductive age 58964 Births 2008-9 14157 Population Under 5 years 58964
Estimated number of pregnancies 2008-9 14595 % Births registered
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live
births)
ANC 1 13958 (96%) Any Postnatal Check? No Data
ANC 4 4864 (33%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women) 2+ doses 8287 % Low Birth Weight
Number Pregnant women tested for HIV 7888 (54%)
Number pregnant women positive for HIV 734 (9%) Newborns treated ARVs at Birth 368 (100%)
Positive Pregnant women given ARVs for prophylaxis 818 (111%) Post Natal visit when? Population under 1 year 12551.7
% deliveries at Health Facility 43% BCG <1y 13590 DPT HEP HIB 3 <1y 11950
% skilled birth attendant Measles <1y 11128
Did VHTs interviewed know danger signs pregnant or
postparum women?
None VHTs interviewed know New Born danger
signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 3845 (27%) Perinatal Cases 11
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
Estimated
District LLIN
ND ACTs available
on day of Visit
Yes
LLIN Hanging to protect pregnant women at HCs Visited? yes LLIN Hanging to protect newborns at HF
Visited?
Yes LLIN Hanging to protect under 5 at HF Visited? Yes
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home
at HCs visited
None
IPT 2 6615 (45%) Cases ND U5s treated with malaria inpatient 4146
Malaria Cases pregnant women 625 Deaths ND U5s treated with malaria outpatient 53043
Malaria Deaths 0 Deaths 92
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit yes Cases ND Cases 515
Deaths ND Deaths 17
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 1336
Zinc available on day of visit None Deaths ND Deaths 3
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 90
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 585
VHTs follow up of discharged patients? n/a
In Maanyi HCIII staff used a donation from HE in 2000 to purchase and hang ITNs in maternity and children's wards.
ICOBI PREFA
Mildmay RTI
MMIS
NAPHOFANU
Under 5's
Health workers as good examples for key
practices
NGOs CBOS CSOs working at community level in the District
Mityana Health Situation
Women Newborn
63%
13%
2%
19%
3%
Mityana Cause of Deaths Under 5's (n=146)
Malaria Pneumonia Diarrhoea Anaemia Other
List of CBO CSO and
NGOs operating in
District Available at
DHO?
Yes Joint Review with all
partners ?
Yes All
ALL Registered at
Community
Development Office?
Yes Partners Regularly
Reporting Activities to
DMT?
Yes
Partners have MoUs with
DMT?
Yes Frequency of reporting monthly
Joint Planning? Yes
Number of Sub Counties 13 Number of Villages 382
% SC Covered by VHT's 31% % Villages Covered VHT 30%
District has Register or
or List of VHTs ?
Yes Number Active VHTs 110
Number VHTs 423
% VHTs female 30%
Population 265300
Crude Mortality Rate
CMR
0.87%
District has training
record for VHTs
Yes Number of VHTs trained
Health Promotion and
Education
423
Duration of Basic Health
Promotion Training
5 Ratio participants to
facilitator
1:20 Fertility Rate 7.1 (UDHS 2006)
# VHTs basic Health
Promotion trained AND
still active
110 Training Support MoH
VHTs additional training
modules (List and
numbers)
Health facilities 19
Access to Functional
Health Facility
64%
Average time spent
volunteering per month
(hours)
8 hours
Are VHTs treating
diseases at Community
level? (Currently)
Some Diseases Treated at
community level (List)
Malaria
Diarrhoea
% Household owning a
bicycle
6% (2002)
Contraceptives
distributed by VHTs
Condoms Access to Improved
Water Source
84%
IEC Available in
Community
Latrine coverage 6%
IEC needed in
Community
Education-Gross
Enrolment Rate
37
Female Literacy rate 6%
All VHTs attached to a
Specified HC?
Yes All List of VHTs available on
day of visit
Yes Main languages Ngakarimojong, English
& Kiswahili
Established Links to HC
2, 3, 4
Yes All Linkages with other
sectors in the District
poor Access to mass media poor
VHTs Assist Outreach
Activities
Yes All % of District covered by
mobile phone network
ND
Content of outreach Integrated Outreach Operational Radio
Stations
2 (Two) Radio
Management Services
VHTs have VHT Village
Register?
Some
Any Supervision activity
of VHTs during past 6
months ?
Yes Other Registers? If Yes
How many?
No Have VHTs been trained
on who to refer?
All
Who Supervises? HSD Any VHT data collated?
By VHT
Yes How are these done by
VHTs?
Standard letter
Standard Supervision
Training?
Yes By HCII Yes Are referrals recorded in
VHT register?
Yes
Supervision checklist? Yes By HSD Yes
Any Supervision Reports
Available?
Yes By DMT Yes Motivation & Incentives
Given in District
Transport refund & lunch
during meetings &
trainings, soon some are
getting bicycles
Is Any VHT data used? No Information What Motivates the
VHTs?
Continuous & sustained
utilisation of their
services
Village Mortality Data
available?
No What for? N/A Why do they volunteer? The spirit to serve their
communities
Factors
affecting
implementati
on
Other Background
Evidence for IMPACT of VHT
Implementation, best
practices
Actions Needed to Save Lives
Supervision of VHTs Referrals
Motivation & Incentives
Given in District
VHT Reporting and District
Data Management
Demographics
VHT Implementation Moroto
Other Community Health Workers NOT included in
VHTs (List and estimate numbers)
None
VHT Training
Health Services
Linkages between VHT and Health System and Other Sectors
None
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns Family Planning
Education and commodity distribution Referrals
Treatment of common childhood illnesses
Yes e.g. leaflets
Yes
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
TBAs & other former
Community Medicine
distributors etc included
in VHT?
Some
Under 5's
Women of reproductive
age
61019 Births 2008-9 11407 Population Under 5
years
53590
Estimated number of
pregnancies 2008-9
13265 % Births registered 39% Morbidity under 5 years Malaria 40.3%
RTI 28.2%
Diarrhoea 5.2%
Malnutrition 1.4%
Others 24.9%
Maternal Mortality Rate 82.9/100,000 Neonatal Mortality
(deaths per 1000 live
births)
26/1000 (UDHS 2006
Regional data)
U5MR (deaths per 1000
live births)
174/1000 (UDHS 2006
Regional data)
ANC 1 65.39% Any Postnatal Check? No Data
ANC 4 42.53% %Infants weighed at
Birth
No Data Infant Mortality 105/1000 (UDHS 2006 Regional data)
Tetanus Toxoid coverage
(pregnant women 2+
doses)
79.90% Population under 1 year 11407
TT2-5 WCBA 30.55% % Low Birth Weight 1%
Number Pregnant
women tested for HIV
7111 (53.61%)
Number pregnant
women positive for HIV
179 (1.35%) Newborns treated ARVs
at Birth
89.20%
Positive Pregnant
women given ARVs for
prophylaxis
78
% deliveries at Health
Facility
17% BCG <1y 73.17% DPT HEP HIB 3 <1y 91.78%
% skilled Traditional
birth attendant
29% Measles <1y 88.29%
Did VHTs interviewed
know danger signs
pregnant or postparum
women?
Few VHTs interviewed know
New Born danger signs?
Few VHTs interviewed know
danger signs for
malaria?
yes
Any PNC visit? (Number) No data Perinatal Cases
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths yes U5's slept under net survey night 17%
Malaria
Estimated District LLIN
Coverage (HH with 2+
nets)
6% ACTs available on day of
Visit
Yes
LLIN Hanging to protect
at pregnant women at
HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC
distribution at HCs
visited
Some LLIN s for NB
distribution at HC visited
None LLIN s for distribution
for u5s without net at
home at HCs visited
None
IPT 2 38.91% Cases N/A U5s treated with malaria inpatient No data
Malaria Cases pregnant women 3593 Deaths N/A U5s treated with
malaria outpatient
47642
Malaria Deaths No data Deaths No data
Pneumonia
Pneumonia 1st line
antibiotics available on
day of Visit
Septrin Cases 3593 Cases N/A
Deaths No data Deaths N/A
Diarrhoea
ORS Available on day of
visit
yes Cases 6192 Cases N/A
Zinc available on day of
visit
None Deaths No data Deaths N/A
Nutrition
Health Centres visited
have MUACs?
Some Cases Severe
Malnutrition
1691
VHTs can Read MUAC? some VHTs Have MUACs? None Cases Low weight for
Age
988
VHTs follow up of
discharged patients?
some Village Health Teams
Need to incorporate information from VHTs reports in the HMIS
yes, e.g. having latrines at home.
ACF C & D IRC Moroto Diocese UNFPA WFP
AFLI CLIDE ISP SCiU UNICEF WHO
No Data
NGOs CBOS CSOs working at community level in the District
Lessons Learned and
cultural practices
Health workers as good
examples for key practices
Moroto Health Situation
Women Newborn
List of CBO CSO and NGOs operating in
District Available at DHO?
Incomplete Joint Review ? Yes All
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting Activities to DMT? Yes
Partners have MoUs with DMT? Yes Frequency of reporting irregular
Joint Planning? Yes
Number of Sub Counties 8 Number of Villages 188
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs ? Yes Number Active VHTs 750
Number VHTs 1300
% VHTs female No data
Population 304721
Crude Mortality Rate CMR 188*
District has training record for VHTs Incomplete Number of VHTs trained Health Promotion and
Education
1300 Fertility Rate ND
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator
12
# VHTs basic Health Promotion trained AND
still active
750 Health facilities
44; 1Hospital 1 HCIV 10 HCIII 25 HCII Private and
NGO 4 HCIIs/Dispensaries 3 HCIIIs
VHTs additional training modules (List and
numbers)
Access to Functional Health
Facilty
ND
Average time spent volunteering per month
(hours)
2 % Household owning a
bicycle
36%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community level (List) NA Access to Improved Water
Source
49%
Contraceptives distributed by VHTs Condoms and Injectables Latrine coverage
73%
IEC Available in Community Education-Gross Enrolment
Rate
17
IEC needed in Community Female Literacy rate
55%
Main languages Madi
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in the District Education % of District covered by
mobile phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations ND
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How many? yes, 1, BDR Have VHTs been trained on
who to refer?
Some
Who Supervises? In-charge Any VHT data collated? By VHT Yes How are these done by
VHTs?
Verbal
Standard Supervision Training? No By HCII Yes Are referrals recorded in
VHT register?
No
Supervision checklist? No By HSD Yes
Any Supervision Reports Available? No By DMT Yes Motivation & Incentives
Given in District
Involvement in mass campaign mobilisation;
Quarterly meetings at health units; Lunch Allowance
Ushs.2000= / 3000=, drug boxes, torches
Is Any VHT data used? Yes What Motivates the VHTs? Uniform, Recognition, Refresher trainings,
Village Mortality Data available? Theoretically What for? update births and
deaths register at
Planning unit
Why do they volunteer? To help our communities; to improve the health of our
communities; inform other women to take their sick
children quickly for care at HC;Enjoy treating
neighbours at home
Factors affecting
implementation
Latrine coverage increased fron 54% to 73%
after initial training of VHTs
Community members purchase
torches and make medicine
boxes with padlocks for the
VHTs.
Lack of community ACTs has demotivated some
VHTs and Some have lost respect and trust of
the community. VHTs require more practical
sessions during training.
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants .Content and
timing of post natal checks for both mother and baby Nutritional assessment of
all children and pregnant women.
Social mobilisation for campaigns; NTD drug distribution; Surveillance NTD
diseases; Family Planning Education and Commodity Distribution; Refferals
Health Services
Other Background
Referrals
Motivation & Incentives Given in District
Other Community Health Workers NOT included in VHTs (List and estimate
numbers)
None
VHT Training
TBAs & other former Community Medicine
distributors etc included in VHT?
Use of ITNs
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation, Trauma Trypanosomiasis Request all in picture format
Supervision of VHTs
VHT Reporting and District Data
Management
Linkages between VHT and Health System and Other Sectors
Evidence for IMPACT of VHT Implementation,
best practices
None
Current VHT Activities (during last 6 months)
Moyo
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
No Information
Demographics
VHT Implementation
Women of reproductive age 61,554 Births 2008-9 14,779 Population Under 5 years
Estimated number of pregnancies 2008-9 15,236 % Births registered No Data Morbidity under 5 years
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data U5MR (deaths per 1000 live births)
ANC 1 6621 (47%) Any Postnatal Check? No Data
ANC 4 4266 (30%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 2756 % Low Birth Weight No Data Infant Mortality
Number Pregnant women tested for HIV 2599 (18%)
Number pregnant women positive for HIV 92 (4%) Newborns treated ARVs at Birth 48 (112%)
Positive Pregnant women given ARVs for prophylaxis 26 (28%) Post Natal visit when? Day 42
% deliveries at Health Facility 25% BCG <1y 4,711 Population under 1 year
% skilled birth attendant No Data DPT HEP HIB 3 <1y
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None Measles <1y
Any PNC visit? (Number) 2985 (22%) Perinatal Cases 6 VHTs interviewed know danger signs?
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 3
Malaria
Estimated
District LLIN
Coverage
ND ACTs available on
day of Visit
Yes
LLIN Hanging to protect pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF Visited? None LLIN Hanging to protect under 5 at HF Visited?
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home at
HCs visited
IPT 2 4293 (30%)+H9Cases ND U5s treated with malaria inpatient
Malaria Cases pregnant women 319 Deaths ND U5s treated with malaria outpatient
MalariaDeaths 0 Deaths
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit Yes Cases ND Cases
Deaths ND Deaths
Diarrhoea
ORS Available on day of visit yes Cases ND Cases
Zinc available on day of visit None Deaths ND Deaths
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age
VHTs follow up of discharged patients? No
Lessons Learned and cultural practices
Harvesting
season
negatively
affects the
Health workers as
good examples for
key practices
Action Against Domestic Violence (Adaps) Aktion Afrika
Hilfe .E.V
Consultancy For Rural Enterprise Activity
Management
Jusice And Peace
Commission
Moyo Development Agency
Action Against Hunger (Acf-Usa) CEPAP,
Child Salvage
Initiative
FPAU Madi Women
Development
Association
Moyo District Diary Farmers Association
African Development And Emergency Organisation (Adeo) Community
Empowerment
Forrural
Development
International Aid (Sweden) Moyo District
Farmers Association
Ms Uganda
Agency For Cooperation And Research In Development (Acord) Community
Management
Agency
Jesuit Refugee Service (Jrs) Moyo Bee Keepers
Association
NIDEF
NGOs CBOS CSOs working at community level in the District
Health facilities visited had good, simple and pictorial IEC materials translated in local
language for patients to read as they wait to see the health workers
Moyo Health Situation
Women Newborn Under 5's
36%
13%
16%
2%
9%
2%
9%
11%
2%
Moyo Cause of Deaths Under 5's (N=45)
Malaria Pneumonia
Malnutrition AIDS
Anaemia Trauma
Infection Sepsis Septicaemia Meningitis
Other
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review with all partners ? Some
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 17 Number of Villages 829
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs ? Yes Number Active VHTs 2400
Number VHTs 3019
% VHTs female 60% Population 441300
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
3019
Duration of Basic Health Promotion Training 3 days Ratio participants to facilitator 10 Health facilities 64
# VHTs basic Health Promotion trained AND
still active
2400 Access to Functional Health
Facilty
ND
VHTs additionional training modules
% Household owning a
bicycle
32%
Average time spent volunteering per month
(hours)
ND Access to Improved Water
Source
82%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community level (List) Schistosomiasis
Worms
Latrine coverage
58%
Contraceptives distributed by VHTs Condoms Education-Gross Enrolment
Rate
127
IEC Available in Community Female Literacy rate
78%
IEC needed in Community Main languages Luganda
Access to mass media ND
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit Yes % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 Yes All Linkages with other sectors in the District Agriculture; encouraged all departments to use VHT structure Operational Radio Stations
Radio Buwama
VHTs Assist Outreach Activities Yes All
Content of outreach Integrated Outreach VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during past
6 months ?
No Other Registers??If Yes How many? one, Malaria register
for drug distributors
Have VHTs been trained on
who to refer?
All
Who Supervises? Incharges / DHI / CDAs Any VHT data collated? By VHT No How are these done by
VHTs?
Standard letter
Standard Supervision Training? No By HCII No Are referrals recorded in
VHT register?
Yes
Supervision checklist? No By HSD No
Any Supervision Reports Available? Yes By DMT Yes Motivation & Incentives
Given in District
Don't queue up at health centres,T-shirts, Badges,
Recognition, Involvement, 2500= for transport,
bicycles to some
Is Any VHT data used? Yes What Motivates the VHTs? umbrellas, torches, community medicines and
supplies
Village Mortality Data available? No What for? Planning and
Monitoring
Why do they volunteer? ND
Factors affecting
implementation
funds for support supervision; lack of translated
IEC materials for use by VHTs; transport and
mobilisation activitites in hard to reach areas
e.g Buniako islands remains a challenge
VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
TBAs & other former Community Medicine
distributors etc included in VHT?
Some
STATUS OF VHT IMPLEMENTATION
Evidence for IMPACT of VHT Implementation,
best practices
Other Community Health Workers NOT included in VHTs about 700 CHWs
VHT Training
Eyecare, dental, disease surveillance, Acute Flacid Paralysis
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns NTD drug distribution Surveillance NTD
diseases Family Planning Education Referrals Home visiting for Sanitation
Improvement ITN distribution Followup
Demographics
Health Services
Other Background
Referrals
Motivation & Incentives Given in District
Coordination of VHT by DHMT
VHT Implementation Mpigi
Key Family Practices, HIV, TB
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation, Trauma Schistosomiasis Fistulas Consequences of not seeking
healthcare First Aid Request all in picture format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Actions Needed to Save Lives
Mpigi Deaths identified by one VHT who had details of ALL (list of all names
and ages addresses dates) unusual deaths facilitating outbreak investigation
and cause from contaminated alcohol to be identified
HW - Danger signs for newborns and how to manage LBW infants .Content and
timing of post natal checks for both mother and baby Nutritional assessment of
all children and pregnant women.
Supervision of VHTs
Women of reproductive age 89143 Births 2008-9 21403 Population Under 5 years
Estimated number of pregnancies 2008-9 22065 % Births registered No Data Morbidity under 5 years
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data U5MR (deaths per 1000 live births)
ANC 1 101% Any Postnatal Check? No Data
ANC 4 27% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 14498 % Low Birth Weight No Data Infant Mortality
Number Pregnant women tested for HIV 77%
Number pregnant women positive for HIV 7% Newborns treated ARVs at Birth 368 (89%)
Positive Pregnant women given ARVs for prophylaxis 785 (62%)
% deliveries at Health Facility 42% BCG <1y 22357 Population under 1 year
% skilled birth attendant No Data DPT HEP HIB 3 <1y
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None Measles <1y
Any PNC visit? (Number) 17% Perinatal Cases 168 VHTs interviewed know danger signs?
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
ND ACTs available on day of Visit
LLIN Hanging to protect at pregnant women at HCs Visited? Some LLIN Hanging to protect newborns at HF Visited? None LLIN Hanging to protect under 5 at HF Visited?
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home at
HCs visited
IPT 2 40% Cases ND U5s treated with malaria inpatient
Malaria Cases pregnant women 519 Deaths ND U5s treated with malaria outpatient
MalariaDeaths 0 Deaths
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit No Cases ND Cases
Deaths ND Deaths
Diarrhoea
ORS Available on day of visit yes Cases ND Cases
Zinc available on day of visit None Deaths ND Deaths
Nutrition
Health Centres visited have MUACs? None Cases Severe Malnutrition
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age
VHTs follow up of discharged patients? None
ANPPACAN Gomba Aids
Support And
Counselling
Organisation
Nkozi Aids Project Upma/Mpigi Branch
Community Based Health Care Organisation CBHC Integrated
Rural
Development
Initiatives
Nulife Vedco
Concern Uganda Kibibi
Women's
Assoc
Omega Women's Group Waggumbulizi
Foundation
Dutch Uganda Orphans Project Mpigi District
Disabled Union
Send A Cow Uganda World Vision Uganda
Eldery Welfare Mission Mpingof Uganda Red Cross Society
NGOs CBOS CSOs working at community level in the District
Under 5's
Estimated District LLIN Coverage
Mpigi Health Situation
Women Newborn
35%
Mpigi Cause of Deaths Under 5's (n=63)
Malaria Pneumonia
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review ? No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting Activities to
DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? No
Number of Sub Counties 15 Number of Villages 800
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs ? No Number Active VHTs 0
Number VHTs 0
% VHTs female 0%
Population
522,160
Crude Mortality Rate
CMR
ND
District has training record for VHTs No Number of VHTs trained Health Promotion
and Education
None Fertility Rate ND
Duration of Basic Health Promotion
Training
No training yet Ratio participants to facilitator 0
# VHTs basic Health Promotion trained
AND still active
None Training Support UPHOLD MIHV Health facilities 54 Health Units; 1 Hospital, 2 HCIV, 13 HCIII, 40
HCII
VHTs additional training modules (List
and numbers)
Access to Functional
Health Facilty
No Data
Average time spent volunteering per month
(hours)
NA % Household owning a
bicycle
36%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community level (List) NA Access to Improved
Water Source
46%
Contraceptives distributed by VHTs Condoms, Injectables and
Oral Contraceptives
Latrine coverage 76%
IEC Available in Community Education-Gross
Enrolment Rate
91
IEC needed in Community Female Literacy rate 71%
Main languages Luganda
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No % of District covered by
mobile phone network
ND
VHTs Assist Outreach Activities No Operational Radio
Stations
Voice of Tooro, Sun Radio, Mubende Radio
Content of outreach EPI alone VHTs Record and Report
Diseases of Epidemic
Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained
on who to refer?
None
Who Supervises? No VHTs yet Any VHT data collated? By VHT No How are these done by
VHTs?
No Information
Standard Supervision Training? No By HCII No Are referrals recorded in
VHT register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives
Given in District
None
Is Any VHT data used? No What Motivates the
VHTs?
No VHTs
Village Mortality Data available? No What for? NA Why do they volunteer? NA
Factors affecting
implementation
Need to select and train VHTs VHTs - Need to
Know danger signs
for ALL and when
to refer needs to be
incorporated into
training
No Data
Linkages with other sectors in the District Agriculture -
NAADS, Water &
Sanitation
Evidence for IMPACT of VHT
Implementation, best practices
1600 CMDs
VHT Training
None
Actions Needed to Save Lives
Mubende
Coordination of VHT by DHMT
VHT Implementation
Health Services
Demographics
STATUS OF VHT IMPLEMENTATION
Other Community Health Workers NOT included in VHTs
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation, Trauma, Request all in picture format
Linkages between VHT and Health System and Other Sectors
Referrals
VHT Reporting and District Data
Management
Current VHT Activities (during last 6 months)
CMDs do distribution of FP pills, depo provera; mobilisation for EPI,
HIV Counselling, HBMF - homapak,not yet trained for ACTs
Supervision of VHTs
HIV, Water & Sanitation, Malaria, Family Planning
None TBAs & other former Community Medicine
distributors etc included in VHT?
Other Background
Motivation & Incentives Given in District
HW - Danger signs for newborns and how to manage LBW infants .Content
and timing of post natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
Women of reproductive age 105476 Births 2008-9 25325 Population Under 5 years 105476
Estimated number of pregnancies 2008-9 26108 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data U5MR (deaths per 1000 live births) No Data
ANC 1 113% Any Postnatal Check? No Data
ANC 4 48% %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women) 2+ doses 18082 % Low Birth Weight No Data
Number Pregnant women tested for HIV 60%
Number pregnant women positive for HIV 6% Newborns treated ARVs at Birth 160 (46%)
Positive Pregnant women given ARVs for prophylaxis 1371 (150%) Post Natal visit when? No Data Population under 1 year 22452.88
% deliveries at Health Facility 20% BCG <1y 29199 DPT HEP HIB 3 <1y 18984
% skilled birth attendant ND Measles <1y 17548
Did VHTs interviewed know danger signs pregnant or postpartum
women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 15% Perinatal Cases 0
Post Natal visit when? Day 1 and
Day 42
Perinatal Deaths 0
Malaria
ND ACTs available on day of Visit Yes
LLIN Hanging to protect pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF
Visited?
None LLIN Hanging to protect under 5 at HF Visited? None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home
at HCs visited
None
IPT 2 64% Cases ND U5s treated with malaria inpatient 2828
Malaria Cases pregnant women 446 Deaths ND U5s treated with malaria outpatient 33384
Malaria Deaths 0 Deaths 105
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit Yes Cases ND Cases 563
Deaths ND Deaths 40
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 326
Zinc available on day of visit None Deaths ND Deaths 5
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 131
VHTs can Read MUAC? None VHTs Have MUACs? Cases Low weight for Age 378
VHTs follow up of discharged patients? None
High migration of people affect health indicators
Mubende District Farmers Association (Mudfa) Send A Cow Uganda
Actionaid Bulera Vanila
Spices And
Horticultural
Kasaazi P.W.D. Group Kiwamirembe
Bwavu Mpologoma
Farmers'
Mubende District Forum Setuka Foundation /
Sserinya Brick Makers
Akwata Empola Namago Womens Group Butoloogo
Rural
Development
Kasalaga Women Group Kolping House
Mityana Womens'
Project
Nabingoola Ddembe Womens Group Uganda Agali Awamu
Members Group
Balikyewunya Development Organisation Ezra Kibuuka
Foundation
Kassanda Cornerstone Foundation Link Rural Based
Organsation
NAWOU Mubende Branch Uganda Change Agent
Association Kiyuni Branch
Barandiza Kimeze Youth Group FPAU Kibaale Development Minnesota
International
Health Volunteers
MIHV
Obwavu Ngo Nakiragala United Organsation Zigoti Women Group
Bukuya Twekembe Group Kabbo
Women's
Association
Kiteredde / Kisekende Womens Group Mitytana
Foundation Of
Disadvantaged
Groups
Rural Education Development & Child Welfare
Scheme
Under 5's
Lessons Learned and cultural practices
Mubende Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
Estimated District LLIN Coverage
55%
2%
3%
3%
3%
29%
4%
0% 1%
Mubende Cause of Deaths Under 5's (n=191)
Malaria Pneumonia Diarrhoea
Malnutrition AIDS Anaemia
Trauma Perinatal Conditions Other
List of CBO CSO and NGOs operating in
District Available at DHO?
Incomplete Joint Review ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting Activities to
DMT?
Yes
Partners have MoUs with DMT? No Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 28 Number of Villages 1382
% SC Covered by VHT's 11% % Villages Covered VHT 4%
District has Register or List of VHTs ? Yes Number Active VHTs Unknown
Number VHTs 52
% VHTs female ND Population
929,200
Crude Mortality Rate
CMR
ND
Fertility Rate ND
District has training record for VHTs Yes Number of VHTs trained Health Promotion
and Education
52
Duration of Basic Health Promotion
Training
6 days Ratio participants to facilitator 11.25 Health facilities 87; 6 Hospitals, 4 HCIV, 23 HCIII, 54 HCII
# VHTs basic Health Promotion trained
AND still active
unknown Training Support MoH Bujagali Energy Ltd. Access to Functional
Health Facilty
ND
VHTs additional training modules (List
and numbers)
% Household owning a
bicycle
27%
Average time spent volunteering per month
(hours)
Unknown Access to Improved
Water Source
58%
Are VHTs treating diseases at
Community level? (Currently)
No Diseases Treated at community level (List) NA Latrine coverage
73%
Contraceptives distributed by VHTs Condoms Education-Gross
Enrolment Rate
101
IEC Available in Community Female Literacy rate
76%
IEC needed in Community Main languages Luganda
Access to mass media ND
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No % of District covered by
mobile phone network
ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in the District Operational Radio
Stations
Radio Dunamis, Dynamic Broadcasting, Prayer
Palace Ministries
VHTs Assist Outreach Activities Yes All VHTs Record and Report
Diseases of Epidemic
Potential?
Yes
Content of outreach Integrated Outreach
VHTs have VHT Village Register? No Have VHTs been trained
on who to refer?
All
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? Yes, one How are these done by
VHTs?
Verbal
Who Supervises? Incharges Any VHT data collated? By VHT Yes Are referrals recorded in
VHT register?
No
Standard Supervision Training? Yes By HCII Yes
Supervision checklist? No By HSD Yes
Any Supervision Reports Available? No By DMT Yes Motivation & Incentives
Given in District
performance allowance 5000= a day when
involved in activity
Is Any VHT data used? Yes What Motivates the
VHTs?
Meetings, Certificates, Recognition
Village Mortality Data available? No What for? community
diagnosis in
planning,
monitoring VHT
activities
Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
Coverage is very low, lack of support
supervision, transport and review
meetings.
VHTs - Need to
Know danger signs
for ALL and when
to refer needs to be
incorporated into
training
Motivation & Incentives Given in District
Referrals
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Actions Needed to Save Lives
None
VHT Training
HW - Danger signs for newborns and how to manage LBW infants .Content
and timing of post natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
- A project within the district constructs sanitary platforms (at a
subsidised price) on which to develop pit latrines, VHTs guide the
community on where to purchase them -
project - go door to door; no data demonstrating/measuring impact,
using volunteers and peace corps workers documenting interventions -
prospective trial -
Community Counsellors / volunteers of World Vision, Sengas
and Kojjas of Theta
Evidence for IMPACT of VHT
Implementation, best practices
Current VHT Activities (during last 6 months)
community mobilisation, IEC, drug & condom distribution, health
promotion for sanitation, refferals, immunisation
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and
Sanitation, Trauma, Bilharzia, Request all in picture format
Supervision of VHTs
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
None
Health Services
Other Background
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine
distributors etc included in VHT?
VHT Implementation Mukono
Coordination of VHT by DHMT
Some
Demographics
Women of reproductive age 187698 Births 2008-9 45066 Population Under 5 years 187698
Estimated number of pregnancies 2008-9 46460 % Births registered No Data Morbidity under 5 years
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data U5MR (deaths per 1000 live births)
ANC 1 79% Any Postnatal Check? No Data
ANC 4 27% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women) 2+ doses 28300 % Low Birth Weight No Data
Number Pregnant women tested for HIV 63%
Number pregnant women positive for HIV 7% Newborns treated ARVs at Birth 740 (82%)
Positive Pregnant women given ARVs for prophylaxis 1613 (80%) Post Natal visit when? No Data Population under 1 year 39955.6
% deliveries at Health Facility 36% BCG <1y 36469 DPT HEP HIB 3 <1y 28089
% skilled birth attendant No Data Measles <1y 28023
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 24% Perinatal Cases 161
Post Natal visit when? Day 1 and
Day 42
Perinatal Deaths 47
Malaria
ND ACTs available on day of Visit Yes
LLIN Hanging to protect pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF
Visited?
None LLIN Hanging to protect under 5 at HF Visited? None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home
at HCs visited
None
IPT 2 42% Cases ND U5s treated with malaria inpatient 9745
Malaria Cases pregnant women 876 Deaths ND U5s treated with malaria outpatient 114424
Malaria Deaths 2 Deaths 198
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit Cases ND Cases 1459
Deaths ND Deaths 60
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 353
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 151
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 362
VHTs follow up of discharged patients? Yes
African Network For Prevention And Protection Against Child
Abuse And Neglect (ANPPCAN)
Integrated
Rural
Development
Initiatives
Mukono Multi Purpose Youth Organisation THETA (Traditional
And Modern
Health
Practitioners)
World Vision Uganda
Aids Action Uganda Literacy Aid
Uganda
Mukono Womens Aids Task Force (Mwatf) Uganda
Environmental
Education
Foundation (Ueef)
Youth Alert Mukono
Cape Of Good Hope Orphan Care & Family Support Project Mukono
Gatsby Club
Pat The Child UWESO
Christ The King Bulumagi Mukono
Harmonious
Group
Send A Cow Uganda VEDCO
NGOs CBOS CSOs working at community level in the District
Lessons Learned and cultural practices
VHTs are appreciated more in rural settings than in urban ones
Estimated District LLIN Coverage
Mukono Health Situation
Women Newborn Under 5's
45%
14%
6%
3%
12%
0%
2%
11%
7%
Mukono Cause of Deaths Under 5's (n=443)
Malaria Pneumonia
Malnutrition AIDS
Anaemia Trauma
Infection Sepsis Septicaemia Perinatal Conditions
Other
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review with all partners ? Yes All
ALL Registered at Communiy
Development Office?
Incomplete Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting never
Joint Planning? Yes
Number of Sub Counties 10 Number of Villages 180
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs ? No Number Active VHTs 540
Number VHTs 540
% VHTs female 10% Population 217500
Crude Mortality Rate CMR 1.09%
District has training record for VHTs Incomplete Number of VHTs trained Health
Promotion and Education
540 Fertility Rate 7.20%
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 11.25
# VHTs basic Health Promotion trained
AND still active
540 Health facilities 18
VHTs additionional training modules (List
and numbers)
Access to Functional Health Facilty 72.50%
Average time spent volunteering
per month (hours)
ND % Household owning a bicycle
7%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community
level (List)
children given
plumpy nut but
project winding up
Access to Improved Water Source
45%
Contraceptives distributed by VHTs No Latrine coverage
1%
IEC Available in Community Education-Gross Enrolment Rate
46
IEC needed in Community Female Literacy rate
9%
Main languages Ng'akarimojong, Kiswahili
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of
visit
No Access to mass media ND
Established Links to HC 2, 3, 4 Some % of District covered by mobile
phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations ND
Content of outreach EPI Growth
monitoring
Referrals
VHTs have VHT Village Register? Yes All Have VHTs been trained on who to
refer?
All
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How
many?
None How are these done by VHTs? Standard letter
Who Supervises? Health Assts. At
HCIII
Any VHT data collated? By VHT No Are referrals recorded in VHT
register?
No
Standard Supervision Training? No By HCII No
Supervision checklist? No By HSD No Motivation & Incentives Given in
District
meetings, 2000 lunch
Any Supervision Reports Available? No By DMT No What Motivates the VHTs? ND
Is Any VHT data used? No Why do they volunteer? ND
Village Mortality Data available? No What for? NA
Factors affecting
implementation
No Data VHTs - Need to Know
danger signs for ALL
and when to refer
needs to be
incorporated into
training
VHT Reporting and District Data
Management
Linkages with other sectors in
the District
Community,
Planning, Finance
depts and others
Linkages between VHT and Health System and Other Sectors
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both
mother and baby Nutritional assessment of all children and
pregnant women.
Supervision of VHTs
Evidence for IMPACT of VHT
Implementation, best practices
No Data
Motivation & Incentives Given in
District
Actions Needed to Save Lives
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma Request all
in picture format
Other Community Health Workers NOT included in VHTs (List
and estimate numbers)
Other Background
Nutrition MUAC screening
Guinea worm monitors
VHT Training
Current VHT Activities (during last 6 months)
Social Mobilisation and registration for child days Referrals
Nutrition activities Sanitation
None
Coordination of VHT by DHMT
VHT Implementation Nakapiripirit
Demographics
Health Services
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc
included in VHT?
Some
Women of reproductive age 50025 Births 2008-9 10500 Population Under 5 years 44587
Estimated number of pregnancies 2008-9 10875 % Births registered No Data Morbidity under 5 years Malaria 31.45%
Diarrhoea 5.76%
ARI No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
26/1000 (UDHS 2006
Regional data)
U5MR (deaths per 1000 live
births)
174/1000 (UDHS 2006
Regional data)
ANC 1 41.14% Any Postnatal Check? No Data
ANC 4 14.80% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
121.18%
TT2-5 WCBA 25.03% % Low Birth Weight No Data
Number Pregnant women tested for HIV 3840
Number pregnant women positive for
HIV
3% Newborns treated ARVs at Birth 34
Positive Pregnant women given ARVs for
prophylaxis
35 Post Natal visit when? Population under 1 year 9352
% deliveries at Health Facility 6% BCG <1y 62.29% Infant Mortality 105/1000 (UDHS 2006
Regional data)
% skilled traditional birth attendant 17% DPT HEP HIB 3 <1y 55.09%
Did VHTs interviewed know danger
signs pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None Measles <1y 118.23%
Any PNC visit? (Number) 28% Perinatal Cases 0 VHTs interviewed know danger
signs?
For malaria
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
ND ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to protect under 5
at HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 24.07% Cases ND U5s treated with malaria
inpatient
246
Malaria Cases pregnant women 4 Deaths ND U5s treated with malaria
outpatient
32229
MalariaDeaths 0 Deaths 0
Pneumonia
Pneumonia 1st line antibiotics available
on day of Visit
ND Cases ND Cases 11
Deaths ND Deaths 1
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 246
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres v sited have
MUACs?
Some Cases Severe Malnutrition 415
VHTs can Read MUAC? All VHTs Have MUACs? All CasesLow weight for Age 702
VHTs follow up of discharged patients? ND
SNV Uganda
UNICEF
NGOs CBOS CSOs working at community level in the District
Estimated District LLIN Coverage
Nakapiripirit Health Situation
Women Newborn Under 5's
34%
33%
33%
Nakapiripirit Cause of Deaths Under 5's
(n=3)
Malaria
Pneumonia
Anaemia
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting irregular
Joint Planning? Incomplete
Number of Sub Counties 9 Number of Villages 360
% SC Covered by VHT's 11% % Villages Covered VHT 14%
District has Register or List of VHTs ? No Number Active VHTs unknown
Number VHTs 100
% VHTs female 50% Population
172,100
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
100
Duration of Basic Health Promotion
Training
no data Ratio participants to facilitator 17 Health facilities 23; 2 Hospitals (1 Govt.
1 Private) 2 HCIV 6
HCIII 13 HCII
# VHTs basic Health Promotion trained
AND still active
unknown Access to Functional Health Facility ND
VHTs additional training modules
% Household owning a bicycle
66%
Average time spent volunteering
per month (hours)
unknown Access to Improved Water Source
85%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community
level (List)
Malaria Latrine coverage
80%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate
142
IEC Available in Community Female Literacy rate
ND
IEC needed in Community Main languages Luganda
Access to mass media ND
All VHTs attached to a Specified HC? No List of VHTs available on day of
visit
No % of District covered by mobile
phone network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in
the District
Community
Development
Operational Radio Stations ND
VHTs Assist Outreach Activities No Adult Literacy 82%
Content of outreach EPI alone VHTs Record and Report Diseases of
Epidemic Potential?
Some
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How
many?
None Have VHTs been trained on who to
refer?
All
Who Supervises? Health Assts. Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No
Motivation &
Incentives Given in
None
Is Any VHT data used? No What Motivates the VHTs? Quarterly Meetings
Village Mortality Data available? No What for? NA Why do they volunteer? ND
Factors affecting
implementation
lack of consistent supply of
logistics / medicines for VHTs
affects the trust that the
community has in VHTs
VHT Training
Demographics
Evidence for IMPACT of VHT
Implementation, best practices and
factors affecting implementation
162 CHWs 403 trained TBAs 630 coartem distributors
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc
included in VHT?
Health Services
Some
Other Community Health Workers NOT included in VHTs
No Data
Other Background
None
Current VHT Activities (during last 6 months)
Community mobilisation and sensitisation, refferals
VHT Reporting and District Data
Management
Actions Needed to Save Lives
Supervision of VHTs
none
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Linkages between VHT and Health System and Other Sectors
Coordination of VHT by DMT
VHT Implementation Nakaseke
Referrals
Women of reproductive age 34764 Births 2008-9 8347 Population Under 5 years 34764
Estimated number of pregnancies 2008-9 8605 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data
ANC 1 72% Any Postnatal Check? No Data
ANC 4 14% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
2705 % Low Birth Weight ND
Number Pregnant women tested for HIV 44%
Number pregnant women positive for
HIV
7% Newborns treated ARVs at Birth 219 (109%)
Positive Pregnant women given ARVs for
prophylaxis
167 (61%) Post Natal visit when? Population under 1 year 7400.3
% deliveries at Health Facility 43% BCG <1y 5639 DPT HEP HIB 3 <1y 3744
% skilled birth attendant ND Measles <1y 4008
Did VHTs interviewed know danger
signs pregnant or postparum women?
None VHTs interviewed know New Born
danger signs?
None VHTs interviewed know danger
signs?
For malaria
Any PNC visit? (Number) 6% Perinatal Cases 463
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 77
Malaria
ND ACTs available on day of Visit no visit
LLIN Hanging to protect pregnant
women at HCs Visited?
no visit LLIN Hanging to protect newborns
at HF Visited?
no visit LLIN Hanging to protect under 5
at HF Visited?
no visit
LLIN s for ANC distribution at HCs visited no visit LLIN s for NB distribution at HC
visited
no visit LLIN s for distribution for u5s
without net at home at HCs
visited
no visit
IPT 2 40% Cases ND U5s treated with malaria inpatient2533
Malaria Cases pregnant women 204 Deaths ND U5s treated with malaria
outpatient
22947
Malaria Deaths 0 Deaths 54
Pneumonia
Pneumonia 1st line antibiotics available
on day of Visit
no visit Cases ND Cases 476
Deaths ND Deaths 10
Diarrhoea
ORS Available on day of visit no visit Cases ND Cases 74
Zinc available on day of visit no visit Deaths ND Deaths 5
Nutrition
Health Centres Have MUACs? No Visit Cases Severe Malnutrition 96
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 20
VHTs follow up of discharged patients? No
PREFA Uganda National
Health Consumers
Organisation
Save for Health World Vision Uganda
Save the Children in Uganda
Stop Malaria
Nakaseke Health Situation
Women Newborn Under 5's
Estimated District LLIN Coverage
NGOs CBOS CSOs working at community level in the District
Lessons learned
Data collected by VHTs needs to be collated and integrated
into HMIS for effective district planning to occur
37%
7%
3%
53%
Nakaseke Cause of Deaths Under 5's (n=146)
Malaria
Pneumonia
Diarrhoea
Perinatal Conditions
List of CBO CSO and NGOs operating in
District Available at DHO?
No Joint Review ? Some
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 9 + 1 military
barracks
Number of Villages 306
% SC Covered by VHT's 50% % Villages Covered VHT 50%
District has Register or List of VHTs ? No Number Active VHTs 788
Number VHTs 1078
% VHTs female no data Population
141,428
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
Duration of Basic Health Promotion
Training
6 days Ratio participants to facilitator 7.5 Health facilities 31; 1 Hospital 2 HCIV 8
HCIII 20 HCII
# VHTs basic Health Promotion trained
AND still active
Training Support MoH AMREF SCiU Access to Functional Health Facilty ND
VHTs additional training modules (List
and numbers)
% Household owning a bicycle
59%
Average time spent volunteering
per month (hours)
unknown Access to Improved Water Source
69%
Are VHTs treating diseases at Community
level? (Currently)
Some Diseases Treated at community
level (List)
Malaria Latrine coverage
73%
Contraceptives distributed by VHTs No Education-Gross Enrolment Rate
134
IEC Available in Community Female Literacy rate
66%
IEC needed in Community Main languages Luruli, Luganda
Access to mass media ND
All VHTs attached to a Specified HC? Some List of VHTs available on day of
visit
No % of District covered by mobile
phone network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in
the District
Community Services,
Education, Local
Government
Operational Radio Stations
Radio Kitara, Masindi
broad-casting services
VHTs Assist Outreach Activities Some VHTs Record and Report Diseases of
Epidemic Potential?
Yes
Content of outreach EPI ANC
VHTs have VHT Village Register? Yes All Have VHTs been trained on who to
refer?
All
Any Supervision activity of VHTs during
past 6 months ?
Yes Other Registers??If Yes How
many?
None How are these done by VHTs? Verbal
Who Supervises? DHT, Trainers at
HSD
Any VHT data collated? By VHT Yes Are referrals recorded in VHT
register?
No
Standard Supervision Training? Yes By HCII No
Supervision checklist? No By HSD Yes
Motivation &
Incentives Given in
District
Quarterly meetings,
involving them in
activities where
allowances are given
Any Supervision Reports Available? Yes By DMT Yes What Motivates the VHTs? Recognition
Is Any VHT data used? Yes Why do they volunteer? To improve health of
neighbours and family
Village Mortality Data available? No What for? (Specify) Community planning
and soliciting for
assistance
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both
mother and baby Nutritional assessment of all children and
pregnant women.
Evidence for IMPACT of VHT
Implementation, best practices
Supervision of VHTs
IEC, community mobilisation, immunisation, maternal & child
health, nutrition, environmental health, disease surveillance,
refferals
Linkages between VHT and Health System and Other Sectors
None
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, bilharzia
Request all in picture format
Other Background
VHT Reporting and District Data
Management
Other Community Health Workers NOT included in VHTs
Coordination of VHT by DMT
VHT Training
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc
included in VHT?
All
79 coatem distributors
Referrals
None
Current VHT Activities (during last 6 months)
Demographics
Health Services
Nakasongola
By-laws can be set
up to enforce key
messages VHTs give
in the community
e.g. in Nakasongola,
a household without
a pit latrine within 2
months of
notification may be
Contraceptive usage rose from 9% to
25.6% as a result of VHT community
sensitisation and distribution of
contraceptives
DHT works very
closely with local
government
structures such as
LC chairpersons to
supervise the VHTs
Lack of logistics, supervision,
review meetings and motivation
for VHTs;
VHT Implementation
Women of reproductive age 28568 Births 2008-9 6859 Population Under 5 years 28568
Estimated number of pregnancies 2008-9 7071 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data
ANC 1 105% Any Postnatal Check? No Data
ANC 4 41% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
2938 % Low Birth Weight No Data
Number Pregnant women tested for HIV 52%
Number pregnant women positive for
HIV
6% Newborns treated ARVs at Birth 58 (89%)
Positive Pregnant women given ARVs for
prophylaxis
157 (70%) Post Natal visit when?
% deliveries at Health Facility 31% BCG <1y 5919 Population under 1 year 6081.404
% skilled birth attendant ND DPT HEP HIB 3 <1y 5204
Did VHTs interviewed know danger
signs pregnant or postpartum women?
None VHTs interviewed know New Born
danger signs?
None Measles <1y 4351
Any PNC visit? (Number) 11% Perinatal Cases 7 VHTs interviewed know danger
signs?
For malaria
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 3
Malaria
ND ACTs available on day of Visit Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect newborns
at HF Visited?
None LLIN Hanging to protect under 5
at HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 49% Cases ND U5s treated with malaria
inpatient
2124
Malaria Cases pregnant women 327 Deaths ND U5s treated with malaria
outpatient
40627
Malaria Deaths 0 Deaths 7
Pneumonia
Pneumonia 1st line antibiotics available
on day of Visit
yes Cases ND Cases 273
Deaths ND Deaths 11
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 144
Zinc available on day of visit None Deaths ND Deaths 1
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 2
VHTs can Read MUAC? All VHTs Have MUACs? None Cases Low weight for Age 50
VHTs follow up of discharged patients? Yes
AMREF Lwampanga Water
Supply Project
Nakasongola District Farmers
Association (Nadifa0
Strengthening
Decentralisation In
Uganda (Sdu)
Wabinyanyi Tweboyoke Group
Concern Uganda Lwampanga Women
Xtian Association
Nakasongola District Women
Development Association (Nawda)
Suubi Nyababaseeka
Mixed Group
World Vision Wabinyonyi Area
Dev't Program
Kazwama Disabled Association Nakasongola Boda-
Boda Transport Saving
And Credit
Nakasongola Womens Guild Uganda Society For
Disabled Children
(Usoc)
Kyabataika Development Association Nakasongola District
Change Agents
Association
SCiU VEDCO
NGOs CBOS CSOs working at community level in the District
Health workers as good examples for
key practices
DHT and the VHT supervisers at all levels (s/c, parish) hold regular support supervision meetings to forge way forward
Estimated District LLIN Coverage
Nakasongola Health Situation
Women Newborn Under 5's
11%
18%
13%
5%
53%
Nakasongola Cause of Deaths Under 5's
(n=62)
Malaria
Pneumonia
Infection Sepsis
Septicaemia
Perinatal
Conditions
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Incomplete Partners Regularly Reporting Activities to
DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 11 Number of Villages 825
% SC Covered by VHT's 18% % Villages Covered VHT 17%
District has Register or List of VHTs ? Yes Number Active VHTs 426
Number VHTs 426
% VHTs female 65%
Population 300800
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion
and Education
426 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 10
# VHTs basic Health Promotion trained
AND still active
unknown Training Support MoH Health facilities 65 (28 have midwives)
VHTs additionional training modules (List
and numbers)
Access to Functional Health Facilty ND
Average time spent volunteering per
month (hours)
no data % Household owning a bicycle
16%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community level (List) NA Access to Improved Water Source
95%
Contraceptives distributed by VHTs Condoms Latrine coverage
99%
IEC Available in Community Education-Gross Enrolment Rate
118
IEC needed in Community Female Literacy rate
73%
Main languages Ruyankore Rukiga Ruhororo
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Yes All % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities No Operational Radio Stations Voice of Development Rukungiri, Radio Rukungiri, Maendeleo Company Ltd.
Content of outreach Integrated Outreach VHTs Record and Report Diseases of
Epidemic Potential?
some
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on who to refer? All
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? Standard letter
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District Recognition, Appreciation,Meetings where
transport is given, priority dont queue at
HC, badge
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? Have volunterism spirit and want to serve their communities
Factors affecting
implementation
Proper selection Lack of village registers
Data collection tool needs to be translated
into local language
VHTs - Need to Know danger signs for
ALL and when to refer needs to be
incorporated into training
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Rukungiri
VHT Training
No
Demographics
Some
Other Community Health Workers NOT included in VHTs (List and estimate numbers) Community based contraceptive distributors 2 per parish, CMDs 2 per village, CHWs
Health Services
TBAs & other former Community Medicine
distributors etc included in VHT?
Other Background
HW - Danger signs for newborns and how to manage LBW infants .Content and timing
of post natal checks for both mother and baby Nutritional assessment of all children
and pregnant women.
Actions Needed to Save Lives
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
VHT Reporting and District Data Management
Referrals
Current VHT Activities (during last 6 months)
none
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation,
HIV / TB treatment and adherence Request all in picture format
Linkages with other sectors in the District Community Development
training ongoing but plan to do health
Evidence for IMPACT of VHT Implementation,
best practices
VHTs follow up of discharged patients?
Delivery in HCs increased from 19% - 53% over 10 years due to health education and
refferals by CHWs / VHTs; ITN use increased from 4% to over 60%
Women of reproductive age 60762 Births 2008-9 14589 Population Under 5 years 60762
Estimated number of pregnancies 2008-9 15040 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live
births)
No Data
ANC 1 108% Any Postnatal Check? No Data
ANC 4 50% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
7403 % Low Birth Weight No Data
Number Pregnant women tested for HIV 81%
Number pregnant women positive for HIV 6% Newborns treated ARVs at Birth 259 (97%)
Positive Pregnant women given ARVs for
prophylaxis
485 (68%) Population under 1 year 12934.4
% deliveries at Health Facility 53% BCG <1y 12984 DPT HEP HIB 3 <1y 11928
% skilled birth attendant No Data Measles <1y 10203
Did VHTs interviewed know danger signs
pregnant or postparum women?
Few VHTs interviewed know New Born danger
signs?
Few VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 8% Perinatal Cases ND
Post Natal visit when? Day 42 Perinatal Deaths ND
Malaria
Estimated District LLIN Coverage ND ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
some LLIN Hanging to protect newborns at HF
Visited?
None LLIN Hanging to protect under 5 at HF
Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net
at home at HCs visited
None
IPT 2 46% Cases ND U5s treated with malaria inpatient 1417
Malaria Cases pregnant women 291 Deaths ND U5s treated with malaria outpatient 31389
MalariaDeaths 1 Deaths 9
Pneumonia
Pneumonia 1st line antibiotics available on
day of Visit
none Cases ND Cases 454
Deaths ND Deaths 14
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 99
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres v sited have MUACs? None Cases Severe Malnutrition 48
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age 118
Lessons Learned and cultural practices Trainers use a mixture of english and local language during VHT training
AMREF Kityaza Fish Pond Development Group Rubabo Community Initiative To Promote Health
Kadiudo Network Mabanga Primary Health Care Unit Rukungiri Functional Literacy Resource
Centre
Kagunga Environment Conservation Assoc Mabanga Women Literacy Group Twimmukye Group
Kamwenge Boda Boda Group Nulife Wildlife Clubs Of Uganda
Karujumbura Womens Group Nyamizi Womens Assoc
Rukungiri Health Situation
Women Newborn Under 5's
NGOs CBOS CSOs working at community level in
the District
27%
43%
27%
3%
Rukungiri Cause of Deaths Under 5's
(n=33)
Malaria
Pneumonia
Malnutrition
Anaemia
List of CBO CSO and NGOs operating
in District Available at DHO?
No Joint Review with all partners
?
No
ALL Registered at Community
Development Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting annually
Joint Planning? No
Number of Sub Counties 19 Number of Villages 1321
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs
?
Incomplete Number Active VHTs 3963
Number VHTs 11889
% VHTs female ND Population 521978
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained
Health Promotion and
Education
11889
Duration of Basic Health Promotion
Training
5 days Ratio participants to
facilitator
20 Health facilities 57
# VHTs basic Health Promotion
trained AND still active
3963 Access to Functional Health
Facilty
ND
VHTs additionional training modules
(List and numbers)
% Household owning a bicycle
30%
Average time spent
volunteering per month
(hours)
unknown Access to Improved Water
Source
84%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at
community level (List)
Malaria
Onchocerciasis
Filariasis
Latrine coverage
83%
Contraceptives distributed by VHTs Other 2596 coartem distributors Education-Gross Enrolment Rate
136
IEC Available in Community Female Literacy rate
44%
IEC needed in Community Main languages Alur, Jonam
Access to mass media ND
All VHTs attached to a Specified HC? Some List of VHTs available on day
of visit
No % of District covered by mobile
phone network
ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in
the District
Community
Development,
Education,
Operational Radio Stations Radio Paidha FM
VHTs Assist Outreach Activities Yes All
Content of outreach EPI alone VHTs Record and Report Diseases
of Epidemic Potential?
Yes
VHTs have VHT Village
Register?
Yes All
Any Supervision activity of VHTs
during past 6 months ?
No Other Registers??If Yes How
many?
Yes, 4 Have VHTs been trained on who
to refer?
All
Who Supervises? PDCs, Incharges,
HSD supervisor
Any VHT data collated? By
VHT
No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD No VHTs follow up of discharged
patients?
NO
Any Supervision Reports Available? No By DMT No
Motivation &
Incentives Given
in District
none
Is Any VHT data used? No What Motivates the VHTs? Supervision,
Stationary, Bag,
Uniform
Village Mortality Data available? No What for? NA
Evidence for IMPACT
of VHT
Factors
affecting
Why do they volunteer? ND
VHTs - Need to Know about
Plague control and prevention
and be actively involved in
HW - Danger signs
for newborns and
how to manage
Demographics
Other Background
Health Services
TBAs & other former
Community Medicine
distributors etc included in
VHT?
All
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns NTD drug distribution
Surveillance NTD diseases Family Planning Education
and commodity disrtibution Referrals
none
Flip Charts for VHTs with Danger Signs, Key
family Practices.Water and Sanitation, Trauma
NTDs Nutrition HIV/AIDS Request all in picture
VHT Reporting and District
Data Management
Linkages between VHT and Health System and Other Sectors
Other Community Health Workers NOT included in VHTs
(List and estimate numbers)
None
VHT Training
24 VHTs trained by PACE in 2009 in long term family planning
methods; Redcross retrained TBAs in 2007/8 gave them gloves for
use in emergency deliveries only
Coordination of VHT by DHMT
VHT Implementation Nebbi
STATUS OF VHT IMPLEMENTATION
Referrals Supervision of VHTs
Actions Needed to Save
Lives
In 2007 cholera outbreak was stopped
in 3 parishes due to VHT sensitisation
in community on use of chlorine to
sterilise water, handwashing, how to
mix homemade ORS, and importance
of fluid replenishments; in 2004
deaths due to malaria in children
dropped from 447 to 350 due to
homapak treatment by VHTs
lack of support
supervision and
basic logistics
Women of reproductive age 105440 Births 2008-9 25316 Population Under 5 years 105440
Estimated number of pregnancies
2008-9
26099 % Births registered
Maternal Mortality Rate calculate from HMIS Neonatal Mortality (deaths per
1000 live births)
ANC 1 108% Any Postnatal Check? No Data
ANC 4 34% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
12282 % Low Birth Weight
Number Pregnant women tested for
HIV
27%
Number pregnant women positive for
HIV
7% Newborns treated ARVs at
Birth
145 (96%)
Positive Pregnant women given ARVs
for prophylaxis
266 (52%) Population under 1 year 22445
% deliveries at Health Facility 51% BCG <1y 27825 DPT HEP HIB 3 <1y 20603
% skilled birth attendant ND Measles <1y 16973
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 19% Perinatal Cases 110
Post Natal visit when? Day 42 Perinatal Deaths 11
Malaria
Estimated District
LLIN Coverage
ND ACTs available on
day of Visit
Yes
LLIN Hanging to protect at pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 54% Cases ND U5s treated with malaria inpatient 10666
Malaria Cases pregnant women 858 Deaths ND U5s treated with malaria
outpatient
105596
MalariaDeaths 9 Deaths 376
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
yes Cases ND Cases 1846
Deaths ND Deaths 94
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 1588
Zinc available on day of visit None Deaths ND Deaths 76
Nutrition
Health Centres v sited have
MUACs?
None Cases Severe Malnutrition 145
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 496
Lessons Learned and
cultural practices
Actionaid Uganda CUAMM Kubbi Community Development
Project
Nebbi District
Muslim
Dev.Association
Pilot Projects For Dev't
Forum
Uganda Society
For Disabled
Children
Action For Socio Economic Dev't
(Ased)
Dafam Enterprises,
Rajom (Coffee)
Nursery Project,
Lim Welo Farmer Field Group Nebbi District Ngo
Forum
Send a Cow Uganda Ukuru Arc-
Deaconary
Planning
AFARD Ggp Project
(Embassy Of Japan)
Mer Ber Women Group Nyapea Safe
Motherhood &
Childcare Assoc.
Snv Uganda Unity Is Strenght
Association
AIC Indigenous
Voluntary Effort For
Rural Emancipation
Merlonyo Waketemo Women
Group
Orussi Women
Initiative To
Eliminate Poverty
World Vision
Uganda
Caritas -Nebbi Jonam Initiative For
Youth Dev't
MSF Paidha Starr Welfare
Association
Techoserve Nebbi (Usaid) Youth Young
Womens Group
Community Empowerment For Rural
Development
Kisa Women Group Ms Uganda Parombo Akworo
Aids Control
Assoc.(Paaca Ngo)
URCS
NGOs CBOS CSOs working at community level in the District
Initially trained 9VHTs per village but only 3 per
village are active - big numbers are difficult to
supervise and retain
Nebbi Health Situation
Women Newborn Under 5's
67%
17%
14%
2%
Nebbi Cause of Deaths Under 5's
(n=557)
Malaria
Pneumonia
Diarrhoea
Perinatal Conditions
List of CBO CSO and NGOs operating in District
Available at DHO?
No Joint Review with all partners ? No
ALL Registered at Community Development
Office?
Yes Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? No Frequency of reporting never
Joint Planning? Yes
Number of Sub Counties 16 Number of Villages 921
% SC Covered by VHT's 69% % Villages Covered VHT 68%
District has Register or or List of VHTs ? No Number Active VHTs just completed training
Number VHTs 2708
% VHTs female no data
Population 434087
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
2708 Fertility Rate ND
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 11
# VHTs basic Health Promotion trained AND
still active
just completed trainingTraining Support MoH Health facilities 37; 1 Hospital 3 HCIV 10
HCIII 23 HCII
VHTs additionional training modules (List and
numbers)
Access to Functional Health Facilty ND
Average time spent volunteering per
month (hours)
NA % Household owning a bicycle
29%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community
level (List)
NA Access to Improved Water Source
67%
Contraceptives distributed by VHTs No Latrine coverage
91%
IEC Available in Community Education-Gross Enrolment Rate
121
IEC needed in Community Female Literacy rate
64%
Main languages Ruyankore, Runyarwanda,
Rukiga
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Yes All Linkages with other sectors in the
District
Water and Sanitation % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities No Operational Radio Stations Radio Ankole, Radio West
Content of outreach Integrated Outreach VHTs Record and Report Diseases of
Epidemic Potential?
No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past 6
months ?
No Other Registers??If Yes How many? none Have VHTs been trained on who to refer? None
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? No Information
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District recognition, given first
priority at community
functions, tree planting
scheme
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting
implementation
Other Community Health Workers NOT included in VHTs (List and
estimate numbers)
none
Demographics
Health Services
Other Background
VHT Reporting and District Data
Management
HIV/AIDS
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Prevention of HIV
adherence to treatment, first aid, post natal care Request
all in picture format
TBAs & other former Community
Medicine distributors etc included
in VHT?
Linkages between VHT and Health System and Other Sectors
Mobilisation for EPI, water and sanitation
VHT Training
none
Current VHT Activities (during last 6 months)
Coordination of VHT by DHMT
VHT Implementation Ntungamo
All
STATUS OF VHT IMPLEMENTATION
Evidence for IMPACT of VHT
Implementation, best practices
Supervision of VHTs Referrals
Motivation & Incentives Given in District
Actions Needed to Save Lives
List of CBO CSO and NGOs operating
in District Available at DHO?
No Joint Review ? Some
ALL Registered at Community
Development Office?
No Partners Regularly Reporting
Activities to DMT?
No
Partners have MoUs with DMT? Incomplete Frequency of reporting never
Joint Planning? Incomplete
Number of Sub Counties 8 Number of Villages 897
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs
?
Yes Number Active VHTs 1794
Number VHTs 3588
% VHTs female No data
Population
343,643
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained
Health Promotion and
Education
3588 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to
facilitator
30
# VHTs basic Health Promotion
trained AND still active
1794 Training Support MoH Health facilities 16; 1 HCIV 5 HCIII 5
HCII Private and NGO
1 Hospital 3 HCIII 1
HCII
VHTs additional training modules
(List and numbers)
Access to Functional Health
Facilty
ND
Average time spent
volunteering per month
(hours)
Unknown % Household owning a bicycle
56%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at
community level (List)
NTDs Access to Improved Water
Source
60%
Contraceptives distributed by VHTs Condoms Latrine coverage
66%
IEC Available in Community Education-Gross Enrolment Rate
139
IEC needed in Community Female Literacy rate
ND
Main languages Luo, Lango
All VHTs attached to a Specified HC? Yes All List of VHTs available on day
of visit
No Access to mass media ND
Established Links to HC 2, 3, 4 Some Linkages with other sectors in
the District
Water and
Sanitation. VHTs
transport vaccines
from a
refridgerator that
is not working to
one that is
working.
% of District covered by mobile
phone network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations 1, Radio Apac
Content of outreach EPI alone VHTs Record and Report Diseases
of Epidemic Potential?
No
VHTs have VHT Village
Register?
Yes All
Any Supervision activity of VHTs
during past 6 months ?
No Information Other Registers??If Yes How
many?
Yes 2 Have VHTs been trained on who
to refer?
Some
Who Supervises? Subcounty
Supervisors
Any VHT data collated? By
VHT
Yes How are these done by VHTs? Standard letter
Standard Supervision Training? No By HCII Yes Are referrals recorded in VHT
register?
No
Supervision checklist? No By HSD Yes
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in
District
T-Shirts, Bags
Is Any VHT data used? Yes What Motivates the VHTs? Community lends
bicycles to some
VHTs to enable them
to do their work.
Training motivates
VHTs.
Village Mortality Data available? Theoretically What for? Documenting
numbers of people
referred for HCT;
PMTCT;
Documenting
numbers of
children less than
Why do they volunteer? To improve the health
of their families and
neighbours.
Factors affecting
implementation
Lack of transport for follow-
up of pregnant women and
post-partum mothers.
VHTs - Need to
Know danger signs
for ALL and when
to refer needs to
be incorporated
into training
Demographics
Health Services
Other Background
897 CMDs; 188 Community-based PMTCT; 2366 HBMF; 1794
Condom distribution; Indoor Residual Spraying; Sanitation;
Current VHT Activities (during last 6 months)
Refferals; Community sensitisation and mobilisation for
mass campaigns; Community Vaccination; Distribution of
drugs for NTDs; Condom Distribution Methods; Health
Education
None
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District
Data Management
Other Community Health Workers NOT included in VHTs
(List and estimate numbers)
CUAMM uses Social Workers for mobilisation and
sensitisation for PMTCT, ANC and Immunisation
VHT Training
TBAs & other former
Community Medicine
distributors etc included in
VHT?
Some
Flip Charts for VHTs with Danger Signs, Key
family Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Supervision of VHTs Referrals
Motivation & Incentives Given
in District
Evidence for IMPACT of VHT
Implementation, best practices
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage
LBW infants .Content and timing of post natal checks for
both mother and baby Nutritional assessment of all
children and pregnant women.
Community vaccinator moves around the wards in
Anyeke HCIV immunising all children who have missed
any vaccination
VHT Implementation Oyam
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Women of reproductive age 69,416 Births 2008-9 16,667 Population Under 5 years
75,601
Estimated number of pregnancies
2008-9
17,182 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data U5MR (deaths per 1000 live
births)
No Data
ANC 1 15285 (89%) Any Postnatal Check? No Data
ANC 4 3719 (22%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
13647 % Low Birth Weight No Data
Number Pregnant women tested for
HIV
14675 (85%)
Number pregnant women positive for
HIV
831 (6%) Newborns treated ARVs at
Birth
215 (86%)
Positive Pregnant women given ARVs
for prophylaxis
435 (52%) Post Natal visit when? No Data Population under 1 year
14,777
% deliveries at Health Facility 29% BCG <1y 26994 DPT HEP HIB 3 <1y 15989
% skilled birth attendant No Data Measles <1y 14355
Did VHTs interviewed know danger
signs pregnant or postparum
women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 2453 (15%) Perinatal Cases 18
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 2
Malaria
Estimated District
LLIN Coverage
ND ACTs available on
day of Visit
Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
Yes LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 9144 (53%) Cases ND U5s treated with malaria inpatient 3264
Malaria Cases pregnant women 501 Deaths ND U5s treated with malaria
outpatient
35203
MalariaDeaths 0 Deaths 29
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
Yes Cases ND Cases 320
Deaths ND Deaths 18
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 164
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 76
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 473
VHTs follow up of discharged
patients?
No
ACF Apac District Scouts
Council
Concerned Parents Association -
Apac Branch
Mimisa / Lightforce Orgyanisation For Socio
Economic Change And
Advancement
Uganda Pioneers
Association
Action Aid Uganda Apac Dev't
Initiative
Apac Under Privilege
Development
Organisation
COOPI Minakulu Wildlife
Club
Send A Cow Uganda UNFPA
Agency For Performing Sustainable
Development Initiatives
Campaign Against
Domestic Violence In
The Community
(Cadovic Network
Apac)
CUAMM Ms Uganda Strengthening Dcentralisation
In Uganda (Sdu) Project
UNICEF
Apac Development Foundation
Limited
Care International In
Uganda
Golgotha Orphanage Care Natoinal Guidence
For Empowerment
For People Living
With Hiv/Aids
THETA WACANE
Apac Disabled Persons Union / Apac
District Farmers' Assoc.
Christian Charity
Centre Uganda
Joint Women Restoration And
Welfare Uganda
Noto Tam Kelo Kuc
Development
Association
Uganda National Students
Association
Youth Aids
Association
Chawente
NGOs CBOS CSOs working at community level in the District
Oyam Health Situation
Women Newborn Under 5's
30%
24%
4%
9%
15%
2%
5%
11%
Oyam Cause of Deaths Under 5's (n=98)
Malaria
Pneumonia
AIDS
Anaemia
Infection Sepsis Septicaemia
Perinatal Conditions
Meningitis
Other
List of CBO CSO and NGOs operating
in District Available at DHO?
Yes Joint Review ? Yes All
ALL Registered at Community
Development Office?
No Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DMT? Yes Frequency of reporting quarterly
Joint Planning? Yes
Number of Sub Counties 19 Number of Villages 1197
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List of VHTs ? Yes Number Active VHTs 1436
Number VHTs 2394
% VHTs female ND Population 436480
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs Incomplete Number of VHTs trained
Health Promotion and
Education
2394
Duration of Basic Health Promotion
Training
10 days Ratio participants to
facilitator
25 Health facilities 53
# VHTs basic Health Promotion
trained AND still active
1436 Training Support MoH WHO UNICEF Medair Access to Functional Health
Facilty
ND
VHTs additional training modules
(List and numbers)
% Household owning a bicycle 35%
Average time spent
volunteering per month
(hours)
Unknown Access to Improved Water
Source
51%
Are VHTs treating diseases at
Community level? (Currently)
Some Diseases Treated at
community level (List)
Malaria, Diarrhoea,
Pneumonia,
Onchocerciasis
Latrine coverage 35%
Contraceptives distributed by VHTs Oral
Contraceptives
and Condoms
Education-Gross Enrolment Rate 166
IEC Available in Community Female Literacy rate 41%
IEC needed in Community Main languages
Luo, Acholi
Access to mass media
ND
All VHTs attached to a Specified HC? Yes All List of VHTs available on day
of visit
Yes % of District covered by mobile
phone network
ND
Established Links to HC 2, 3, 4 Yes All Operational Radio Stations
ND
VHTs Assist Outreach Activities Some
Content of outreach EPI alone VHTs Record and Report Diseases
of Epidemic Potential?
Yes
VHTs have VHT Village
Register?
Yes All
Any Supervision activity of VHTs
during past 6 months ?
Yes Other Registers??If Yes How
many?
No Have VHTs been trained on who
to refer?
Some
Who Supervises? Peer supervisors,
Incharges
Any VHT data collated? By
VHT
Yes How are these done by VHTs? Standard letter
Standard Supervision Training? Yes By HCII Yes Are referrals recorded in VHT
register?
Yes
Supervision checklist? Yes By HSD Yes
Motivation &
Incentives Given
in District
Soap, T-shirts,
Gumboots, Bicycles
for the parish
supervisor / 2 per
parish, Lunch
Allowance
Any Supervision Reports Available? Yes By DMT Yes What Motivates the VHTs? Community
ownership, Training,
Self-motivated
Is Any VHT data used? No Information Why do they volunteer? No Information
Village Mortality Data available? Yes What for? n/a
Factors affecting
implementation
- Community sensitisation and
education on Hepatitis E by VHTs
contained the outbreak in one parish
- VHT monthly education activity
reports are signed by local council
chairpersons who also assist with
community mobilisation. Bicycles
belong to the village and are labelled
with the word "VHT"
Frequent stock outs of
community medicines;
Different reporting formats;
Sustainability after partners
leave
VHTs - Need to
Know danger signs
for ALL and when
to refer needs to
be incorporated
into training
Linkages between VHT and Health System and Other Sectors
None Other Community Health Workers NOT included in VHTs
(List and estimate numbers)
Coordination of VHT by DHMT
VHT Implementation Pader
STATUS OF VHT IMPLEMENTATION
VHT Reporting and District
Data Management
Flip Charts for VHTs with Danger Signs, Key
family Practices.Water and Sanitation, Trauma
Trypanosomiasis Request all in picture format
Local Government
Structures,
Community
Development,
Agriculture,
Education
74 VHTs trained on how to do MUAC, 190 VHTs trained to do disease
surveillance in 10 subcounties, 1122 posts have community
vaccinators, 90 VHTs trained to distribute contraceptives
Other Background
Management of common illnesses, IEC, Community
Mobilisation for immunisation, Disease surveillance,
Family Planning education and distribution of supplies
None
Linkages with other sectors in
the District
Current VHT Activities (during last 6 months)
Health Services
TBAs & other former
Community Medicine
distributors etc included in
VHT?
All
Demographics
VHT Training
HW - Danger signs for newborns and how to manage
LBW infants .Content and timing of post natal checks for
both mother and baby Nutritional assessment of all
children and pregnant women.
Evidence for IMPACT of VHT
Implementation, best practices
Referrals
Actions Needed to Save Lives
Supervision of VHTs
Health Centres
have a list of
VHTs attached to
it and monthly
meetings are held
between the
VHTs and the
incharges.
Supervision of
VHTs by
incharges of
HCIIs is done via
return
demonstration
Women of reproductive age 88169 Births 2008-9 21169 Population Under 5 years 88169
Estimated number of pregnancies
2008-9
21824 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per
1000 live births)
No Data
ANC 1
18104 (83%)
Any Postnatal Check? No Data
ANC 4
10701 (49%)
%Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant
women 2+ doses)
11978
% Low Birth Weight No Data
Number Pregnant women tested for
HIV
11971 (55%)
Number pregnant women positive for
HIV
782 (7%) Newborns treated ARVs at
Birth
283 (80%)
Positive Pregnant women given ARVs
for prophylaxis
443 (57%) Post Natal visit when? No Data Population under 1 year 18769
% deliveries at Health Facility 34% BCG <1y 15684 DPT HEP HIB 3 <1y 15373
% skilled birth attendant No Data Measles <1y 13877
Did VHTs interviewed know danger
signs pregnant or postparum
women?
Few VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 3465 (16%) Perinatal Cases ND
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths ND
Malaria
Estimated District
LLIN Coverage
ND ACTs available on
day of Visit
Yes
LLIN Hanging to protect pregnant
women at HCs Visited?
None LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs
visited
Some LLIN s for NB distribution at HC
visited
None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 8551 (39%) Cases ND U5s treated with malaria inpatient 5916
Malaria Cases pregnant women 440 Deaths ND U5s treated with malaria
outpatient
90429
Malaria Deaths ND Deaths 55
Pneumonia
Pneumonia 1st line antibiotics
available on day of Visit
ND Cases ND Cases 1970
Deaths ND Deaths 28
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 160
Zinc available on day of visit None Deaths ND Deaths 4
Nutrition
Health Centres Have MUACs? Some Cases Severe Malnutrition 402
VHTs can Read MUAC? Some VHTs Have MUACs? Some Cases Low weight for Age 420
VHTs follow up of discharged
patients?
None
Lessons Learned and
cultural practices
Use of the VHTs in health service delivery can succeed when DHTs, local government structures and all partners are involved in their coordination
AMREF Lutheran
Federation(LWF)
PACE WVI
AVSI Medair Pathfinder
GOAL Medical Team
International (MTI)
UNICEF
ICRC NUMAT WHO
Under 5's
Pader Health Situation
Newborn Women
NGOs CBOS CSOs working at community level in the District
40%
22%
4%
17%
2%
10%
1%
1%
1%
1%
1%
Pader Cause of Deaths Under 5's
(n=139)
Malaria
Pneumonia
Diarrhoea
Malnutrition
AIDS
Anaemia
Trauma
Infection Sepsis Septicaemia
Meningitis
Tuberculosis
Other
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List of CBO CSO and NGOs operating in District Available at
DHO?
Yes Joint Review with all partners ? Some
ALL Registered at Communiy Development Office? Incomplete Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 21 Number of Villages 796
% SC Covered by VHT's 5% % Villages Covered VHT 2%
District has Register or or List of VHTs ? Incomplete Number Active VHTs 480
Number VHTs 480
% VHTs female 40%
Population 449,600
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion and Education 480 Fertility Rate ND
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 20
# VHTs basic Health Promotion trained AND still active 480 Training Support MoH Health facilities 91 ; 2 Hospitals 1 HCIV 19 HCIII
43 HCII 26 NGO units
VHTs additionional training modules (List and numbers) Access to Functional Health Facilty ND
Average time spent volunteering per month (hours) unknown % Household owning a bicycle
37%
Are VHTs treating diseases at Community level? (Currently) No Diseases Treated at community level (List) NA Access to Improved Water Source
62%
Contraceptives distributed by VHTs Condoms Latrine coverage
84%
IEC Available in Community Education-Gross Enrolment Rate
110
IEC needed in Community Female Literacy rate
71%
Main languages Luganda
All VHTs attached to a Specified HC? Some List of VHTs available on day of visit No Access to mass media
Established Links to HC 2, 3, 4 Some % of District covered by mobile phone network
VHTs Assist Outreach Activities Yes All Operational Radio Stations ND
Content of outreach EPI alone VHTs Record and Report Diseases of Epidemic Potential? none
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past 6 months ? No Other Registers??If Yes How many? none Have VHTs been trained on who to refer? None
Who Supervises? HSD supervisor Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No VHTs follow up of discharged patients? none
Any Supervision Reports Available? No By DMT No
Motivation & Incentives Given in
District
allowances
Is Any VHT data used? No What Motivates the VHTs? no information
Village Mortality Data available? Theoretically What for? NA Why do they volunteer? no information
Factors affecting implementation
12 model villages were set up where communities working via
VHTs agreed to improve the health situation of their villages
through immunisation, cleaning, use of ITNs, proper nutrition
and setting up of improved latrines, as a result latrine coverage
increased from 54% to 86%
VHTs attend clinic once per month
are supervised and gain new skills
they also stay and help
lack of VHT training VHTs - Need to Know danger signs for ALL
and when to refer needs to be incorporated
into training
VHT Reporting and District Data Management
Other Community Health Workers NOT included in VHTs (List and estimate numbers) 2 CMDs / village, 28 CLPs of Theta, 2 Mobilisers / parish, Community Care Coalitions 4 / area of operation of
WVU
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine distributors etc
included in VHT?
Linkages with other sectors in the District Agriculture NAADS, Education FAL
Referrals
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants .Content and timing of post natal
checks for both mother and baby Nutritional assessment of all children and pregnant women.
Coordination of VHT by DHMT
VHT Implementation Rakai
All
Demographics
Other Background
Health Services
VHT Training
ND
Current VHT Activities (during last 6 months)
Evidence for IMPACT of VHT Implementation, best
practices
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation, Infected bites,
HIV/AIDS, Filariasis, Request all in picture format
Linkages between VHT and Health System and Other Sectors
Social Mobilisation for Campaigns, Homevisiting, Referrals,
none
Supervision of VHTs
List of CBO CSO and NGOs operating in District Available at
DHO?
Yes Joint Review with all partners ? Some
ALL Registered at Communiy Development Office? Incomplete Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 21 Number of Villages 796
% SC Covered by VHT's 5% % Villages Covered VHT 2%
District has Register or or List of VHTs ? Incomplete Number Active VHTs 480
Number VHTs 480
% VHTs female 40%
Population 449,600
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion and Education 480 Fertility Rate ND
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 20
# VHTs basic Health Promotion trained AND still active 480 Training Support MoH Health facilities 91 ; 2 Hospitals 1 HCIV 19 HCIII
43 HCII 26 NGO units
VHTs additionional training modules (List and numbers) Access to Functional Health Facilty ND
Average time spent volunteering per month (hours) unknown % Household owning a bicycle
37%
Are VHTs treating diseases at Community level? (Currently) No Diseases Treated at community level (List) NA Access to Improved Water Source
62%
Contraceptives distributed by VHTs Condoms Latrine coverage
84%
IEC Available in Community Education-Gross Enrolment Rate
110
IEC needed in Community Female Literacy rate
71%
Main languages Luganda
All VHTs attached to a Specified HC? Some List of VHTs available on day of visit No Access to mass media
Established Links to HC 2, 3, 4 Some % of District covered by mobile phone network
VHTs Assist Outreach Activities Yes All Operational Radio Stations ND
Content of outreach EPI alone VHTs Record and Report Diseases of Epidemic Potential? none
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past 6 months ? No Other Registers??If Yes How many? none Have VHTs been trained on who to refer? None
Who Supervises? HSD supervisor Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No VHTs follow up of discharged patients? none
Any Supervision Reports Available? No By DMT No
Motivation & Incentives Given in
District
allowances
Is Any VHT data used? No What Motivates the VHTs? no information
Village Mortality Data available? Theoretically What for? NA Why do they volunteer? no information
Factors affecting implementation
12 model villages were set up where communities working via
VHTs agreed to improve the health situation of their villages
through immunisation, cleaning, use of ITNs, proper nutrition
and setting up of improved latrines, as a result latrine coverage
increased from 54% to 86%
VHTs attend clinic once per month
are supervised and gain new skills
they also stay and help
lack of VHT training VHTs - Need to Know danger signs for ALL
and when to refer needs to be incorporated
into training
VHT Reporting and District Data Management
Other Community Health Workers NOT included in VHTs (List and estimate numbers) 2 CMDs / village, 28 CLPs of Theta, 2 Mobilisers / parish, Community Care Coalitions 4 / area of operation of
WVU
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine distributors etc
included in VHT?
Linkages with other sectors in the District Agriculture NAADS, Education FAL
Referrals
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants .Content and timing of post natal
checks for both mother and baby Nutritional assessment of all children and pregnant women.
Coordination of VHT by DHMT
VHT Implementation Rakai
All
Demographics
Other Background
Health Services
VHT Training
ND
Current VHT Activities (during last 6 months)
Evidence for IMPACT of VHT Implementation, best
practices
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation, Infected bites,
HIV/AIDS, Filariasis, Request all in picture format
Linkages between VHT and Health System and Other Sectors
Social Mobilisation for Campaigns, Homevisiting, Referrals,
none
Supervision of VHTs
Women of reproductive age 90,819 Births 2008-9 21,805 Population Under 5 years 90,819
Estimated number of pregnancies 2008-9 22,480 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data
ANC 1 19269 (86%) Any Postnatal Check? No Data
ANC 4 8688 (39%) %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 10,460 % Low Birth Weight 2%
Number Pregnant women tested for HIV 8420 (37%)
Number pregnant women positive for HIV 865 (10%) Newborns treated ARVs at Birth 310 (85%)
Positive Pregnant women given ARVs for prophylaxis 539 (62%) Population under 1 year 19,333
% deliveries at Health Facility 27% BCG <1y 97% DPT HEP HIB 3 <1y 78%
% skilled birth attendant No Data Measles <1y 72%
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 2792 (13%) Perinatal Cases 21
Post Natal visit when? Day 42 Perinatal Deaths 4
Malaria
Estimated District LLIN Coverage ND ACTs available on day of Visit No
LLIN Hanging to protect at pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF Visited? None LLIN Hanging to protect under 5 at HF Visited? None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home at
HCs visited
None
IPT 2 9247 (41%) Cases ND U5s treated with malaria inpatient 3181
Malaria Cases pregnant women 195 Deaths ND U5s treated with malaria outpatient 61156
MalariaDeaths 0 Deaths 31
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit No Cases ND Cases 491
Deaths ND Deaths 13
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 303
Zinc available on day of visit None Deaths ND Deaths 1
Nutrition
Health Centres visited have MUACs? None Cases Severe Malnutrition 56
VHTs can Read MUAC? None VHTs Have MUACs? None CasesLow weight for Age 323
Lessons Learned and cultural practices
Outreaches fail due to lack of logistics such
as RDTs for HIV testing
Health workers as good examples for
key practices
use television to deliver prer-recorded
health messages at OPD
African Network For Prevention & Protection Against Child Abuse &
Neglect (Anppcan- Rakai)
Crusade For National Development Kauurito Community Development Developmet Project Rakai Aids Counselors Association Send A Cow Uganda UPHOLD
Community Enterprise Development Organisation DANIDA Kitovu Mobile Rakai Aids Information Network (Rain) St. Joseph Matale Youth Organisation World Vision Uganda
Community Initiative For Prevention Of Hiv/Aids (Cipa) EGPAF Lutheran World Federation Rakai Health Sciences Program Straight Talk Uganda
Community Welfare Services Integrated Rural Development Initiatives Medecins Du Monde Rakai Women Against Aids And Poverty THETA
Concern Rakai International Care & Relief Mukisa Health Services Rakai Tourism Development Association Uganda Cares
Cowser Open Palm Kakuuto Rural Development Foundation Orphans Community Based Organisation Rural Development Services Uganda Redcross Rakai Branch
Rakai Health Situation
Women Newborn Under 5's
NGOs CBOS CSOs working at community level in the District
52%
14%
2%
4%
3%
16%
7%
2%
Rakai Cause of Deaths Under 5's (n=94)
Malaria Pneumonia Diarrhoea
Malnutrition AIDS Anaemia
Trauma Perinatal Conditions
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Incomplete Partners Regularly Reporting Activities to
DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 11 Number of Villages 825
% SC Covered by VHT's 18% % Villages Covered VHT 17%
District has Register or List of VHTs ? Yes Number Active VHTs 426
Number VHTs 426
% VHTs female 65%
Population 300800
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion
and Education
426 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 10
# VHTs basic Health Promotion trained
AND still active
unknown Training Support MoH Health facilities 65 (28 have midwives)
VHTs additionional training modules (List
and numbers)
Access to Functional Health Facilty ND
Average time spent volunteering per
month (hours)
no data % Household owning a bicycle
16%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community level (List) NA Access to Improved Water Source
95%
Contraceptives distributed by VHTs Condoms Latrine coverage
99%
IEC Available in Community Education-Gross Enrolment Rate
118
IEC needed in Community Female Literacy rate
73%
Main languages Ruyankore Rukiga Ruhororo
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Yes All % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities No Operational Radio Stations Voice of Development Rukungiri, Radio Rukungiri, Maendeleo Company Ltd.
Content of outreach Integrated Outreach VHTs Record and Report Diseases of
Epidemic Potential?
some
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on who to refer? All
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? Standard letter
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District Recognition, Appreciation,Meetings where
transport is given, priority dont queue at
HC, badge
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? Have volunterism spirit and want to serve their communities
Factors affecting
implementation
Proper selection Lack of village registers
Data collection tool needs to be translated
into local language
VHTs - Need to Know danger signs for
ALL and when to refer needs to be
incorporated into training
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Rukungiri
VHT Training
No
Demographics
Some
Other Community Health Workers NOT included in VHTs (List and estimate numbers) Community based contraceptive distributors 2 per parish, CMDs 2 per village, CHWs
Health Services
TBAs & other former Community Medicine
distributors etc included in VHT?
Other Background
HW - Danger signs for newborns and how to manage LBW infants .Content and timing
of post natal checks for both mother and baby Nutritional assessment of all children
and pregnant women.
Actions Needed to Save Lives
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
VHT Reporting and District Data Management
Referrals
Current VHT Activities (during last 6 months)
none
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation,
HIV / TB treatment and adherence Request all in picture format
Linkages with other sectors in the District Community Development
training ongoing but plan to do health
Evidence for IMPACT of VHT Implementation,
best practices
VHTs follow up of discharged patients?
Delivery in HCs increased from 19% - 53% over 10 years due to health education and
refferals by CHWs / VHTs; ITN use increased from 4% to over 60%
List of CBO CSO and NGOs operating in
District Available at DHO?
Yes Joint Review with all partners ? Some
ALL Registered at Community
Development Office?
Incomplete Partners Regularly Reporting Activities to
DMT?
Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 11 Number of Villages 825
% SC Covered by VHT's 18% % Villages Covered VHT 17%
District has Register or List of VHTs ? Yes Number Active VHTs 426
Number VHTs 426
% VHTs female 65%
Population 300800
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion
and Education
426 Fertility Rate ND
Duration of Basic Health Promotion
Training
5 days Ratio participants to facilitator 10
# VHTs basic Health Promotion trained
AND still active
unknown Training Support MoH Health facilities 65 (28 have midwives)
VHTs additionional training modules (List
and numbers)
Access to Functional Health Facilty ND
Average time spent volunteering per
month (hours)
no data % Household owning a bicycle
16%
Are VHTs treating diseases at Community
level? (Currently)
No Diseases Treated at community level (List) NA Access to Improved Water Source
95%
Contraceptives distributed by VHTs Condoms Latrine coverage
99%
IEC Available in Community Education-Gross Enrolment Rate
118
IEC needed in Community Female Literacy rate
73%
Main languages Ruyankore Rukiga Ruhororo
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Yes All % of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities No Operational Radio Stations Voice of Development Rukungiri, Radio Rukungiri, Maendeleo Company Ltd.
Content of outreach Integrated Outreach VHTs Record and Report Diseases of
Epidemic Potential?
some
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during
past 6 months ?
No Other Registers??If Yes How many? None Have VHTs been trained on who to refer? All
Who Supervises? NA Any VHT data collated? By VHT No How are these done by VHTs? Standard letter
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District Recognition, Appreciation,Meetings where
transport is given, priority dont queue at
HC, badge
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? Have volunterism spirit and want to serve their communities
Factors affecting
implementation
Proper selection Lack of village registers
Data collection tool needs to be translated
into local language
VHTs - Need to Know danger signs for
ALL and when to refer needs to be
incorporated into training
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
VHT Implementation Rukungiri
VHT Training
No
Demographics
Some
Other Community Health Workers NOT included in VHTs (List and estimate numbers) Community based contraceptive distributors 2 per parish, CMDs 2 per village, CHWs
Health Services
TBAs & other former Community Medicine
distributors etc included in VHT?
Other Background
HW - Danger signs for newborns and how to manage LBW infants .Content and timing
of post natal checks for both mother and baby Nutritional assessment of all children
and pregnant women.
Actions Needed to Save Lives
Linkages between VHT and Health System and Other Sectors
Supervision of VHTs
VHT Reporting and District Data Management
Referrals
Current VHT Activities (during last 6 months)
none
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation,
HIV / TB treatment and adherence Request all in picture format
Linkages with other sectors in the District Community Development
training ongoing but plan to do health
Evidence for IMPACT of VHT Implementation,
best practices
VHTs follow up of discharged patients?
Delivery in HCs increased from 19% - 53% over 10 years due to health education and
refferals by CHWs / VHTs; ITN use increased from 4% to over 60%
List of CBO CSO and NGOs operating in District Available at DHO? Yes Joint Review with all partners ? No
ALL Registered at Community Development Office? Yes Partners Regularly Reporting Activities to DMT? No
Partners have MoUs with DMT? Yes Frequency of reporting never
Joint Planning? No
Number of Sub Counties 7 Number of Villages 390
% SC Covered by VHT's 14% % Villages Covered VHT 3%
District has Register or or List of VHTs ? Yes Number Active VHTs 40
Number VHTs 48
% VHTs female 60%
Population 214011
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion and Education 48 Fertility Rate ND
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 16
# VHTs basic Health Promotion trained AND still active 40 Training Support MoH Vector Control Health facilities 24
VHTs additionional training modules (List and numbers) Access to Functional Health Facilty ND
Average time spent volunteering per month (hours) unknown % Household owning a bicycle
39%
Are VHTs treating diseases at Community level? (Currently) Some Diseases Treated at community level (List) Worms Access to Improved Water Source
43%
Contraceptives distributed by VHTs Condoms Latrine coverage
57%
IEC Available in Community Education-Gross Enrolment Rate
173
IEC needed in Community Female Literacy rate
68%
Main languages Luganda, Runyankore
All VHTs attached to a Specified HC? No List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 No % of District covered by mobile phone network ND
VHTs Assist Outreach Activities No Operational Radio Stations ND
Content of outreach none VHTs Record and Report Diseases of Epidemic Potential? No
VHTs have VHT Village Register? No
Any Supervision activity of VHTs during past 6 months ? No Other Registers??If Yes How many? None Have VHTs been trained on who to refer? All
Who Supervises? Health Asst./ DHE Incharges Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District VHTs donot queue up in health
centres, are given priority
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting implementation
Need stationary, prioritise transport to go to VHTs who move in
sparsely populated areas
VHTs - Need to Know danger signs for
ALL and when to refer needs to be
incorporated into training
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation, Trauma,
Nutrition - Balanced diet, Healthy versus Malnourished children Request all in picture format
Linkages between VHT and Health System and Other Sectors
EPI coverage in Parish with VHTs is 80-100% Latrine coverage from 34% - 54%
Evidence for IMPACT of VHT Implementation, best
practices
Health Services
Other Background
HW - Danger signs for newborns and how to manage LBW infants .Content and timing of post natal
checks for both mother and baby Nutritional assessment of all children and pregnant women.
Actions Needed to Save Lives
none
Current VHT Activities (during last 6 months)
Social Mobilisation for Campaigns, SanitationFamily Planning Education and commodity distribution
Referrals Albendazole distribution Sensitisation on Early Health seeking behaviour
Malaria, Diarrhoea
Supervision of VHTs Referrals
Motivation & Incentives Given in District
VHT Reporting and District Data Management
Linkages with other sectors in the District NGOs
VHT Training
VHT Implementation
TBAs & other former Community Medicine distributors etc
included in VHT?
Some
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
Other Community Health Workers NOT included in VHTs (List and estimate numbers) 150 CHWs; 135 Trained TBAs; 114 CMDs
Sembabule
Demographics
Women of reproductive age 43230 Births 2008-9 10380 Population Under 5 years 43230
Estimated number of pregnancies 2008-9 10701 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data U5MR (deaths per 1000 live births) No Data
ANC 1 68% Any Postnatal Check? No Data
ANC 4 18% %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 3628 % Low Birth Weight No Data
Number Pregnant women tested for HIV 52%
Number pregnant women positive for HIV 8% Newborns treated ARVs at Birth 68 (93%)
Positive Pregnant women given ARVs for prophylaxis 325 (77%) Population under 1 year 9202.473
% deliveries at Health Facility 14% BCG <1y 9668 DPT HEP HIB 3 <1y 7217
% skilled birth attendant No Data Measles <1y 7682
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 17% Perinatal Cases 0
Post Natal visit when? Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN Coverage ND ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF Visited? None LLIN Hanging to protect under 5 at HF Visited? None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home at
HCs visited
None
IPT 2 19% Cases ND U5s treated with malaria inpatient 2044
Malaria Cases pregnant women 243 Deaths ND U5s treated with malaria outpatient 21647
MalariaDeaths 0 Deaths 3
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit Yes Cases ND Cases 541
Deaths ND Deaths 0
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 131
Zinc available on day of visit None Deaths ND Deaths 0
Nutrition
Health Centres visited have MUACs? None Cases Severe Malnutrition 16
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 71
VHTs follow up of discharged patients? No
Lessons Learned and cultural
practices
Have a problem of malnutrition yet nutrition was identified as a gap in VHT training
Health workers as good examples for
key practices
Handwashing facilities available and used in consultation rooms
Co-Care Uganda Lutheran World Federation Minnesota International Health Volunteers MIHV Ssembabule District Administration STRIDES
EGPAF Marie Stopes Paralegal Ssembabule District Ssembabule District Change Agent
Association
Stop Malaria
Financial Services Association International Uganda Limited Mawoda Mawogola Womens Development
Association
Send A Cow Uganda Ssembabule District Farmers Association Taso Mbarara
Kitovu Mobile Mawogola Movement Association For
Development
Ssembabule Aids Counselling Services Ssembabule Paralegal Association Uganda Change Agent Association
NGOs CBOS CSOs working at community level in the District
Sembabule Health Situation
Under 5's Women Newborn
75%
25%
Sembabule Cause of Deaths Under 5's (n=4)
Malaria Diarrhoea
List of CBO CSO and NGOs operating in District Available at DHO? Yes Joint Review ? Some
ALL Registered at Community Development Office? No Partners Regularly Reporting Activities to DMT? Yes All
Partners have MoUs with DMT? Yes Frequency of reporting monthly
Joint Planning? Incomplete
Number of Sub Counties 31 Number of Villages 2447
% SC Covered by VHT's 6% % Villages Covered VHT 5%
District has Register or List of VHTs ? Yes Number Active VHTs unknown
Number VHTs 253
% VHTs female ND
Population
347,500
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion and Education 253 Fertility Rate ND
Duration of Basic Health Promotion Training 5 days Ratio participants to facilitator 20
# VHTs basic Health Promotion trained AND still active unknown Training Support MoH WHO Bredley Presbyterian Church USA Health facilities 44; 3 HCIV 23 HCIII 18 HCII
VHTs additional training modules (List and numbers) Access to Functional Health Facilty ND
Average time spent volunteering per month (hours) unknown % Household owning a bicycle
10%
Are VHTs treating diseases at Community level? (Currently) Some Diseases Treated at community level (List) Onchocerciasis, DOTS-TB Access to Improved Water Source
72%
Contraceptives distributed by VHTs Condoms Latrine coverage
62%
IEC Available in Community Education-Gross Enrolment Rate
134
IEC needed in Community Female Literacy rate
56%
Main languages Lumasaba
All VHTs attached to a Specified HC? Yes All List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Yes All Linkages with other sectors in the District Community Development, Nutrition,
Agriculture
% of District covered by mobile phone network ND
VHTs Assist Outreach Activities Some Operational Radio Stations
Voice of Teso, Kyoga veritas
Content of outreach EPI alone VHTs Record and Report Diseases of Epidemic Potential? Some
VHTs have VHT Village Register? Yes All
Any Supervision activity of VHTs during past 6 months ? No Other Registers??If Yes How many? No Have VHTs been trained on who to refer? All
Who Supervises? VHT focal person Any VHT data collated? By VHT No How are these done by VHTs? Verbal
Standard Supervision Training? No By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD No
Any Supervision Reports Available? No By DMT No Motivation & Incentives Given in District allowances
Is Any VHT data used? No What Motivates the VHTs? ND
Village Mortality Data available? No What for? NA Why do they volunteer? Did not meet VHTs
Factors affecting implementation
Need training of trainers (TOTs), only have two who were
trained before Sironko became a district (was still part of
Mbale)
VHTs - Need to Know danger signs
for ALL and when to refer needs to be
incorporated into training
Evidence for IMPACT of VHT Implementation, best practices
VHT Implementation Sironko
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine distributors etc
included in VHT?
Some
Other Community Health Workers NOT included in VHTs (List and estimate numbers) 198 Parish Mobilisers (PMs) - Immunisation, 4894 community medicine distributors (CMDs) - HBMF,
4156 community drug distributors (CDDs) - Onchocerciasis
TB DOTs, Mobilisation, Onchocerciasis, Health Education
Other Background
Coordination of VHT by DMT
Health Services
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants .Content and timing of post natal
checks for both mother and baby Nutritional assessment of all children and pregnant women.
Demographics
No
Current VHT Activities (during last 6 months)
VHT Training
Work very closely with local government structures (Deputy CAO) who are committed to supporting VHTs
Motivation & Incentives Given in District
none
Flip Charts for VHTs with Danger Signs, STDs in Adolescents, Mental Health (Epilepsy) Key family
Practices.Water and Sanitation, Trauma, Onchocerciasis, Non-communicable diseases, Request all
in picture format
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data Management
Supervision of VHTs Referrals
Women of reproductive age 70195 Births 2008-9 16854 Population Under 5 years 70195
Estimated number of pregnancies 2008-9 17375 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data U5MR (deaths per 1000 live births) No Data
ANC 1 91% Any Postnatal Check? No Data
ANC 4 29% %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 13267 % Low Birth Weight ND
Number Pregnant women tested for HIV 128%
Number pregnant women positive for HIV 2% Newborns treated ARVs at Birth 92 (31%)
Positive Pregnant women given ARVs for prophylaxis 227 (43%) Post Natal visit when? No Data Population under 1 year 14942.5
% deliveries at Health Facility 25% BCG <1y 16430 DPT HEP HIB 3 <1y 16443
% skilled birth attendant ND Measles <1y 18000
Did VHTs interviewed know danger signs pregnant or postparum
women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 28% Perinatal Cases ND
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths ND
Malaria
Estimated District LLIN Coverage ND ACTs available on day of Visit Yes
LLIN Hanging to protect pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF Visited? None LLIN Hanging to protect under 5 at HF Visited? None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home at
HCs visited
None
IPT 2 32% Cases ND U5s treated with malaria inpatient 321
Malaria Cases pregnant women ND Deaths ND U5s treated with malaria outpatient 60919
Malaria Deaths ND Deaths 11
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit yes Cases ND Cases 210
Deaths ND Deaths 3
Diarrhoea
ORS Available on day of visit yes Cases ND Cases ND
Zinc available on day of visit None Deaths ND Deaths ND
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition ND
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 513
VHTs follow up of discharged patients? None
Health workers as good examples for
key practices
Handwashing facilities are provided in some health centres and used by health workers and patients
Baylor Uganda Environmental Alert PREFA Sironko Yetana Project
Bizibu Women's Association Gimunye Womens Association Send A Cow Uganda Uganda Christian Compassion Ministries
Bugitimwa Womens' Group Global Fund Sironko Beefarmers Association UWESO
Bundagala Women Group Nadisi Women Group Sironko Farmers Association Limited WHO
Carter Center National Association Of Women
Organsiations In Uganda
Sironko United Women's Group
Under 5's
Sironko Health Situation
Women Newborn
NGOs CBOS CSOs working at community level in the District
79%
21%
Sironko Cause of Deaths Under 5's (n=14)
Malaria Pneumonia
List of CBO CSO and NGOs operating in District Available at
DHO?
Yes Joint Review with all partners ? no
ALL Registered at Communiy Development Office? Yes Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? no
Number of Sub Counties 17 Number of Villages 538
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or or List of VHTs ? Yes Number Active VHTs 1093
Number VHTs 3220
% VHTs female No Data
Population 498391
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
all Fertility Rate ND
Duration of Basic Health Promotion Training 5 Ratio participants to facilitator 1:25
# VHTs basic Health Promotion trained AND still active most Training Support MoH Health facilities 88; 35 Govt., 53 NGO, 44 Private (
1 Hospital 3 HCIV 18 HCIII 66
HCIV)
VHTs additionional training modules (List and numbers) Access to Functional Health Facilty ND
Average time spent volunteering per month (hours) 14 % Household owning a bicycle
58%
Are VHTs treating diseases at Community level? (Currently) Some Diseases Treated at community level (List) NTDs diarrhoea First Aid Access to Improved Water Source
77%
Contraceptives distributed by VHTs Condoms Latrine coverage
55%
IEC Available in Community Gross enrolment rate 121.4
IEC needed in Community Female Literacy rate
54%
Main languages Ateso, Kumam, Kiswahili
All VHTs attached to a Specified HC? Some List of VHTs available on day of visit No Access to mass media ND
Established Links to HC 2, 3, 4 Some % of District covered by mobile phone network ND
VHTs Assist Outreach Activities Some Operational Radio Stations
Voice of Teso Ltd., Kyoga Veritas
Radio Ltd., UBC Radio, Baptist
International Mission (U)
Content of outreach EPI Growth monitoring VHTs Record and Report Diseases of Epidemic
Potential?
ND
VHTs have VHT Village Register? Some
Any Supervision activity of VHTs during past 6 months ? Yes Other Registers??If Yes How many? NI Have VHTs been trained on who to refer? Some
Who Supervises? Parish Coordinators Any VHT data collated? By VHT No How are these done by VHTs? Standard letter
Standard Supervision Training? No By HCII No Information Are referrals recorded in VHT register? Some
Supervision checklist? No By HSD No Information
Any Supervision Reports Available? No Information By DMT No Motivation & Incentives Given in District Refresher training, bicycles
selection for campaigns
Is Any VHT data used? No What Motivates the VHTs? NI
Village Mortality Data available? Theoretically What for? no Why do they volunteer? Did not meet vhts
Factors affecting
implementation follow up and motivation Close working with NGOs and
their constant support
VHTs - Need to Know danger signs
for ALL and when to refer needs to be
incorporated into training
Health Services
Other Background
Actions Needed to Save Lives
Referrals
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data Management
Linkages with other sectors in the District Agriculture Farmers groups Ed WS AG
Probation and welfare for IVC
Community development offices fro
community mobilisationh
malaria NTDs TB Nutrition
Current VHT Activities (during last 6 months)
Disaster relief, flooding, water and sanitation, mobilisation for campaigns, refferals
FP HIV PHC all flip charts
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation, New
born Request all in picture format
Motivation & Incentives Given in District
Supervision of VHTs
No Data HW - Danger signs for newborns and how to manage LBW infants .Content and timing of
post natal checks for both mother and baby Nutritional assessment of all children and
pregnant women.
Evidence for IMPACT of VHT Implementation, best
practices
VHT Implementation Soroti
Coordination of VHT by DHMT
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine distributors
etc included in VHT?
Some
CMD 176 Absorbed TBAs MPS, TH drug sellers sensitised Injection safer Logistics and drug
management HMIS Community Vaccinators
VHT Training
Demographics
Other Community Health Workers NOT included in VHTs
Women of reproductive age 100675 Births 2008-9 24172 Population Under 5 years 100675
Estimated number of pregnancies 2008-9 24920 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data U5MR (deaths per 1000 live births) No Data
ANC 1 102% Any Postnatal Check? No Data
ANC 4 33% %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+ doses) 11503 % Low Birth Weight No Data
Number Pregnant women tested for HIV 116%
Number pregnant women positive for HIV 2% Newborns treated ARVs at Birth 395 (85%)
Positive Pregnant women given ARVs for prophylaxis 499 (76%) Population under 1 year 21430.813
% deliveries at Health Facility 45% BCG <1y 185997 DPT HEP HIB 3 <1y 20883
% skilled birth attendant No Data Measles <1y 15707
Did VHTs interviewed know danger signs pregnant or
postpartum women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 23% Perinatal Cases 77
Post Natal visit when? Day 42 Perinatal Deaths 21
Malaria
Estimated District LLIN Coverage ND ACTs available on day of Visit Yes
LLIN Hanging to protect at pregnant women at HCs Visited? No Visit LLIN Hanging to protect newborns at HF Visited? None LLIN Hanging to protect under 5 at HF Visited? None
LLIN s for ANC distribution at HCs visited No Visit LLIN s for NB distribution at HC visited no visit LLIN s for distribution for u5s without net at home
at HCs visited
None
IPT 2 42% Cases ND U5s treated with malaria inpatient 20995
Malaria Cases pregnant women 2457 Deaths ND U5s treated with malaria outpatient ND
MalariaDeaths 3 Deaths 65
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit No Visit Cases nd Cases 1550
Deaths nd Deaths 58
Diarrhoea
ORS Available on day of visit No Visit Cases ND Cases 1201
Zinc available on day of visit No Visit Deaths ND Deaths 3
Nutrition
Health Centres v sited have MUACs? No Visit Cases Severe Malnutrition 203
VHTs can Read MUAC? Some VHTs Have MUACs? Some CasesLow weight for Age 114
VHTs follow up of discharged patients? Some
AIC Health Need Uganda SOCADIDO Uganda Cares
AMREF Kasiwo Community Based Association SODIPU Uganda Red Cross
Baylor Uganda PAG TASO UNICEF
Child Fund International (Former CCF) PREFA TB-CAP Marie Stopes
Child Health Advocacy International RTI TEDDO WHO / MoH
GFTAM /UAC SARUDA Uganda Assembly Of God World Vision
NGOs CBOS CSOs working at community level in the District
Soroti Health Situation
Women Newborn Under 5's
26%
24%
1%
12%
1%
16%
4%
8%
6%
2%
Soroti Cause of Deaths Under 5's (n=251)
Malaria Pneumonia
Diarrhoea Malnutrition
AIDS Anaemia
Infection Sepsis Septicaemia Perinatal Conditions
Meningitis Other
List of CBO CSO and NGOs operating in District Available at
DHO?
Incomplete Joint Review ? No
ALL Registered at Community Development Office? Yes Partners Regularly Reporting Activities to DMT? Some
Partners have MoUs with DMT? Incomplete Frequency of reporting irregular
Joint Planning? No
Number of Sub Counties 21 Number of Villages 683
% SC Covered by VHT's 48% % Villages Covered VHT 55%
District has Register or List of VHTs ? No Number Active VHTs less than 100
Number VHTs 500
% VHTs female 40% Population
455,115
Crude Mortality Rate CMR ND
Fertility Rate ND
District has training record for VHTs No Number of VHTs trained Health Promotion and
Education
500
Duration of Basic Health Promotion Training 10 days Ratio participants to facilitator 35 Health facilities 70; 5 Hospitals (2 govt, 1 NGO 2
Private) 3 HCIV 19 HCIII 43 HCII
# VHTs basic Health Promotion trained AND still active less than 100 Training Support MoH Plan International Access to Functional Health Facilty ND
VHTs additional training modules (List and numbers)
% Household owning a bicycle
41%
Average time spent volunteering per month (hours) 20% Access to Improved Water Source
61%
Are VHTs treating diseases at Community level? (Currently) Some Diseases Treated at community level (List) Malaria Latrine coverage
82%
Contraceptives distributed by VHTs No 1258 coartem distributors Education-Gross Enrolment Rate
137
IEC Available in Community Female Literacy rate
48%
IEC needed in Community Main languages Japadhola, Lusamia-Lugwe, Ateso,
Lugwere, Lunyoli
Access to mass media ND
All VHTs attached to a Specified HC? Some List of VHTs available on day of visit No % of District covered by mobile phone network ND
Established Links to HC 2, 3, 4 Some Water, Community Development,
Agriculture, Education, Probation and
Welfare
Operational Radio Stations Rock Mambo Radio Ltd.
VHTs Assist Outreach Activities Yes All
Content of outreach EPI alone VHTs Record and Report Diseases of Epidemic
Potential?
Yes
VHTs have VHT Village Register? Some
Any Supervision activity of VHTs during past 6 months ? No Other Registers??If Yes How many? None Have VHTs been trained on who to refer? Some
Who Supervises? Health Assistants at s/c
(Environmental assts.)
Any VHT data collated? By VHT Yes How are these done by VHTs? Verbal
Standard Supervision Training? Yes By HCII No Are referrals recorded in VHT register? No
Supervision checklist? No By HSD Yes
Any Supervision Reports Available? No By DMT Yes Motivation & Incentives Given in District Involve in activities where there is
allowance, given priority at HC
when they refer patients
Is Any VHT data used? Yes What Motivates the VHTs? Recognition, Involvement,
Training, Community trust,
Certificate
Village Mortality Data available? Yes What for? Planning and promotion of household
sanitation, allocation of water sources
Why do they volunteer? Volunteers at heart, Social
responsibility, Sacrifice,
Contribution to the nation
Factors affecting
implementation
Pit latrine coverage increased from 64% in 2003/4 to 85%
in 2008/9 due to community mobilisation and sensitisation
by VHTs; PMTCT uptake gone up
Different incentives given by different projects who
train them, volunterism has a limit, lack of transport and
logisitics to do work
VHTs - Need to Know danger signs
for ALL and when to refer needs to be
incorporated into training
Evidence for IMPACT of VHT Implementation, best
practices
Linkages with other sectors in the District
VHT Reporting and District Data Management
VHT identified a child with
paralysis at Malaba border point
and alerted the authorities; VHTs
together with health workers are
involved in screening for
influenza (H1N1) at the malaba
border post
Supervision of VHTs Referrals
Motivation & Incentives Given in District
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW infants .Content and timing of
post natal checks for both mother and baby Nutritional assessment of all children and
pregnant women.
Flip Charts for VHTs with Danger Signs, Key family Practices.Water and Sanitation,
Trauma, Intestinal worms, Trypanosomiasis Request all in picture format
Linkages between VHT and Health System and Other Sectors
Demographics
Health Services
Palliative care, sanitation, nutrition
Current VHT Activities (during last 6 months)
Mobilisation for child days, refferals, community sensitisation and response, Disease
surveillance, BDR, Community based rehabilitation, Screening at border posts for Influenza,
Retreatment of ITNs
None
VHT Training
Other Background
VHT Implementation
Other Community Health Workers NOT included in VHTs (List and estimate numbers) Community lay persons of Theta (are part of VHTs) trained TBAs 340
Coordination of VHT by DMT
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community Medicine distributors
etc included in VHT?
All
Tororo
Women of reproductive age 91933 Births 2008-9 22073 Population Under 5 years 91933
Estimated number of pregnancies 2008-9 22756 % Births registered No Data Morbidity under 5 years No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live
births)
No Data U5MR (deaths per 1000 live births) No Data
ANC 1 21709 (95%) Any Postnatal Check? No Data
ANC 4 5102 (22%) %Infants weighed at Birth No Data Infant Mortality No Data
Tetanus Toxoid coverage (pregnant women 2+
doses)
10318 % Low Birth Weight No Data
Number Pregnant women tested for HIV 22931 (101%)
Number pregnant women positive for HIV 811 (4%) Newborns treated ARVs at Birth 256 (90%)
Positive Pregnant women given ARVs for
prophylaxis
625 (77%) Post Natal visit when? No Data Population under 1 year 19569.945
% deliveries at Health Facility 27% BCG <1y 18876 DPT HEP HIB 3 <1y 16853
% skilled birth attendant No Data Measles <1y 14843
Did VHTs interviewed know danger signs pregnant
or postparum women?
None VHTs interviewed know New Born danger
signs?
None VHTs interviewed know danger signs? For malaria
Any PNC visit? (Number) 7025 (32%) Perinatal Cases 58
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 2
Malaria
Estimated District LLIN Coverage ND ACTs available on day of Visit No
LLIN Hanging to protect pregnant women at HCs
Visited?
None LLIN Hanging to protect newborns at HF
Visited?
None LLIN Hanging to protect under 5 at HF Visited? None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s without net at home
at HCs visited
None
IPT 2 10565 (46%) Cases ND U5s treated with malaria inpatient 11286
Malaria Cases pregnant women 485 Deaths ND U5s treated with malaria outpatient 129257
Malaria Deaths 1 Deaths 101
Pneumonia
Pneumonia 1st line antibiotics available on day of
Visit
yes Cases ND Cases 1207
Deaths ND Deaths 12
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 455
Zinc available on day of visit None Deaths ND Deaths 1
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 292
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 1084
VHTs follow up of discharged patients? Yes
Lessons Learned and cultural
practices
Selection process determines attrition rates (more educated VHTs are harder to retain)
Africa 2000 Network Uganda Global Fund Nagonga Youth Development Project Research And Development Tororo District Farmers Assoc
Youth Training Advisory
Mission
Asinge Joint Youths Assoc JCRC Obulala Bwa Banamda Send A Cow Uganda Uganda Change Agent Assoc
CDC Lions Club Of Tororo Osukuru Women's Network Taso Tororo Uganda Rural Communiity Development Program
Community Vision Mifumi Development Programme Plan International THETA UWESO
Development Rehabilitation Organisation Mulanda Women's Development
Assoc
PREFA Tororo Civil Society Of Network WVU
NGOs CBOS CSOs working at community level in the District
Tororo Health Situation
Women Newborn Under 5's
45%
6%
0%
7%
1%
18%
3%
2%
2% 16%
Tororo Cause of Deaths Under 5's (n=225)
Malaria Pneumonia
Diarrhoea Malnutrition
AIDS Anaemia
Infection Sepsis Septicaemia Perinatal Conditions
Meningitis Other
List of CBO CSO and NGOs operating in District Available at
DHO?
No Joint Review ? Some
ALL Registered at Community Development Office? Yes Partners Regularly Reporting
Activities to DMT?
Yes
Partners have MoUs with DMT? Incomplete Frequency of reporting quarterly
Joint Planning? Incomplete
Number of Sub Counties 19 Number of Villages 686
% SC Covered by VHT's 0% % Villages Covered VHT 0%
District has Register or List of VHTs ? Yes Number Active VHTs all
Number VHTs 555 VHTs with 3 day training
supported by UNFPA BIAS TO
rh
% VHTs female NA
Population
1,158,200
Crude Mortality Rate CMR ND
District has training record for VHTs No Number of VHTs trained Health
Promotion and Education
NA Fertility Rate ND
Duration of Basic Health Promotion Training 10 days Ratio participants to facilitator 17
# VHTs basic Health Promotion trained AND still active NA Training Support MoH, sensitisation and
selection ongoing 10 per
village
Health facilities 98
VHTs additional training modules (List and numbers) Access to Functional Health Facilty ND
Average time spent volunteering
per month (hours)
40 % Household owning a bicycle 21%
Are VHTs treating diseases at Community level? (Currently) No Diseases Treated at community
level (List)
NTDs by CMDs Access to Improved Water Source 67%
Contraceptives distributed by VHTs Condoms Latrine coverage 81%
IEC Available in Community Education-Gross Enrolment Rate 72
IEC needed in Community For Health Workers as well Female Literacy rate 90%
Main languages Luganda
All VHTs attached to a Specified HC? Some List of VHTs available on day of
visit
No Access to mass media ND
Established Links to HC 2, 3, 4 No Linkages with other sectors in
the District
gender - comm. Mob for
adolesct services, peer
educ.
% of District covered by mobile phone
network
ND
VHTs Assist Outreach Activities Some Operational Radio Stations ND
Content of outreach EPI Growth monitoring VHTs Record and Report Diseases of
Epidemic Potential?
No
VHTs have VHT Village Register? Some
Any Supervision activity of VHTs during past 6 months ? No Other Registers??If Yes How
many?
No Have VHTs been trained on who to refer? Some
Who Supervises? Incharges, Subcounty focal
persons
Any VHT data collated? By VHT Yes How are these done by VHTs? Verbal
Standard Supervision Training? Yes By HCII Yes Are referrals recorded in VHT register? Yes
Supervision checklist? Yes By HSD Yes
Any Supervision Reports Available? No By DMT Yes Motivation & Incentives Given in District involve in community
mobilisation
Is Any VHT data used? Yes What Motivates the VHTs? Quarterly Meetings, Support
Supervision, Equipment to help
to do their work, involvement
Village Mortality Data available? No What for? Monitoring trends of
service uptake and for
planning OPD services for
Why do they volunteer? Did not meet CMDs
Factors affecting
implementation
Actions Needed to Save Lives
Motivation & Incentives Given in District
Current VHT Activities (during last 6 months)
Share an Opportunity- CHWs in 3 s/cs; Safemotherhood Assts
under TB program - 72, mobilise for TB and refer, CMDs 1408,
Community Growth Promoters trained by UPHOLD 40 (10 per
parish in 4 parishes)
Health Services
VHT Reporting and District Data
Management
Coordination of VHT by DHMT
VHT Implementation Wakiso
STATUS OF VHT IMPLEMENTATION
TBAs & other former Community
Medicine distributors etc
included in VHT?
Some
Demographics
Other Community Health Workers NOT included in VHTs (List and estimate numbers)
Supervision of VHTs
Malaria, HIV, RH, Water snd Sanitation, Ebola, Meningitis
Flip Charts for VHTs with Danger Signs, Key family
Practices.Water and Sanitation, Trauma, Bilharzia Request all
in picture format
Linkages between VHT and Health System and Other Sectors
Activities performed by CMDs - Mobilisation for EPI, child days, ANC, Refferals, Bilharzia
Deworming, HBMF TB DOTs
Other Background
VHT Training
Referrals
Evidence for IMPACT of VHT Implementation, best
practices
HW - Danger signs for newborns and how to manage LBW infants .Content
and timing of post natal checks for both mother and baby Nutritional
assessment of all children and pregnant women.
VHTs - Need to Know
danger signs for ALL and
when to refer needs to be
incorporated into training
Frequent stockouts of community
medicines, sensitisation of
district leaders, health workers
and community on roles and
responsibilities of VHTs.
Not Yet, but when CMDs still had homapak, workload at health
facility reduces for common childhood illness, OPD attendance
for under 5's reduced by 9% and number of under 5's going to
CMDs for treatment was increasing
CMDs assist health workers
to pick up medicines from
district office on motorbikes
whenever there are stock
outs because HCs lack
sufficient vehicles, they also
stay and help out at HCs to
give health talks and
immunise children
Women of reproductive age 233956 Births 2008-9 56173 Population Under 5 years 233956
Estimated number of pregnancies 2008-9 57910 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths per 1000 live births) No Data
ANC 1 72% Any Postnatal Check? No Data
ANC 4 45% %Infants weighed at Birth No Data
Tetanus Toxoid coverage (pregnant women) 2+ doses 26404 % Low Birth Weight No Data
Number Pregnant women tested for HIV 53%
Number pregnant women positive for HIV 9% Newborns treated ARVs at Birth 755 (85%)
Positive Pregnant women given ARVs for prophylaxis 1388 (55%) Post Natal visit when? Population under 1 year 49803
% deliveries at Health Facility 30% BCG <1y 97% DPT HEP HIB 3 <1y 99%
% skilled birth attendant ND Measles <1y 106%
Did VHTs interviewed know danger signs pregnant or
postparum women?
None VHTs interviewed know New Born danger signs? None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 21% Perinatal Cases 190
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 5
Malaria
Estimated District LLIN
Coverage
ND ACTs available on
day of Visit
Yes
LLIN Hanging to protect pregnant women at HCs Visited? None LLIN Hanging to protect newborns at HF Visited? None LLIN Hanging to protect under
5 at HF Visited?
None
LLIN s for ANC distribution at HCs visited Some LLIN s for NB distribution at HC visited None LLIN s for distribution for u5s
without net at home at HCs
visited
None
IPT 2 30% Cases ND U5s treated with malaria inpatient 6412
Malaria Cases pregnant women 1192 Deaths ND U5s treated with malaria
outpatient
162129
Malaria Deaths 0 Deaths 38
Pneumonia
Pneumonia 1st line antibiotics available on day of Visit yes Cases ND Cases 1332
Deaths ND Deaths 27
Diarrhoea
ORS Available on day of visit yes Cases ND Cases 908
Zinc available on day of visit None Deaths ND Deaths 2
Nutrition
Health Centres Have MUACs? None Cases Severe Malnutrition 360
VHTs can Read MUAC? Some VHTs Have MUACs? None Cases Low weight for Age 1799
VHTs follow up of discharged patients? CMDs do
Lessons Learned and cultural
practices
CMDs are popular and get
elected as councillors
Health workers as good examples
for key practices
Handwashing facilities
available and being used
by both health workers
African Network For Prevention And Protection Against Child
Abuse And Neglect (ANPPCAN)
Community Efforts For
Integrated Development
(Ceide)
Integrated Rural Development Initiatives Uganda Red Cross
Society Entebbe
Branch
Voluntary Action For
Development
Agency For Integrated Rural Development (AFIRD) Compassionate Outreach
To East African Mission-
Uganda (Coteam-U)
Nulife UNFPA
Children And Life Mission Environmental Alert Send A Cow UWESO
Community Action For Development Hunger Free World Uganda The Hunger Project- Uganda VEDCO
Wakiso Health Situation
Women Newborn Under 5's
NGOs CBOS CSOs working at community level in the District
37%
26%
12%
19%
6%
Wakiso Cause of Deaths Under 5's
(n=102)
Malaria
Pneumonia
AIDS
Anaemia
List of CBO CSO and NGOs
operating in District
Available at DHO?
Yes Joint Review ? Some
ALL Registered at
Community Development
Office?
Yes Partners Regularly Reporting
Activities to DMT?
Some
Partners have MoUs with
DMT?
Incomplete Frequency of reporting irregular
Joint Planning? Incomplete
Number of Sub Counties 8 Number of Villages 321
% SC Covered by VHT's 100% % Villages Covered VHT 100%
District has Register or List
of VHTs ?
Incomplete Number Active VHTs unknown
Number VHTs 2093
% VHTs female No Data
Population 398100
Crude Mortality Rate CMR No Data
District has training record
for VHTs
No Number of VHTs trained
Health Promotion and
Education
2093 Fertility Rate No Data
Duration of Basic Health
Promotion Training
10 days Ratio participants to
facilitator
No Data
# VHTs basic Health
Promotion trained AND still
active
unknown Training Support MoH UNICEF; UPHOLD
supports quarterly meetings
Health facilities 17
VHTs additional training
modules (List and numbers)
Access to Functional Health
Facilty
No Data
Average time spent
volunteering per month
(hours)
unknown % Household owning a
bicycle
47
Are VHTs treating diseases
at Community level?
(Currently)
Some Diseases Treated at
community level (List)
NTDs Access to Improved Water
Source
38%
Contraceptives distributed
by VHTs
No Latrine coverage 75%
IEC Available in Community Education-Gross Enrolment
Rate
101
IEC needed in Community Female Literacy rate 45%
Main languages Alur, Lugbara, Kakwa, Madi
All VHTs attached to a
Specified HC?
Yes All List of VHTs available on day
of visit
Yes Access to mass media No Data
Established Links to HC 2, 3,
4
Yes All Linkages with other sectors
in the District
community Services,
Education
% of District covered by
mobile phone network
No Data
VHTs Assist Outreach
Activities
Some Operational Radio Stations Radio Pacis
Arua
Content of outreach EPI Growth monitoring VHTs Record and Report
Diseases of Epidemic
Potential?
Yes
VHTs have VHT Village
Register?
Yes All
Any Supervision activity of
VHTs during past 6 months ?
No Other Registers??If Yes How
many?
no Have VHTs been trained on
who to refer?
Some
Who Supervises? Health Assts. / CDAs Any VHT data collated? By
VHT
Yes How are these done by
VHTs?
Verbal
Standard Supervision
Training?
No By HCII Yes Are referrals recorded in VHT
register?
No
Supervision checklist? Yes By HSD No
Any Supervision Reports
Available?
No By DMT No Motivation & Incentives
Given in District
pens, certificates, T-shirts,
ITNs
Is Any VHT data used? No What Motivates the VHTs? Competitions, Recognition,
doing a good reports
Village Mortality Data
available?
No What for? NA Why do they volunteer? want to serve, help their
neighbours to improve their
health
Factors
affecting
implementation
Clean Village competitions
were organised and through
health promotion talks by
VHTs, cleanest village won a
plaque which hangs in the
office of the CAO plus a
borehole; also VHTs are
given priority for functional
adult literacy FAL classes;
VHT coordinator (super VHT)
receives all VHT members'
reports at nearest HC and
summarises their data
long distances to travel
without transport facilitation
VHTs - Need to Know danger
signs for ALL and when to
refer needs to be
incorporated into training
Supervision of VHTs
VHT Implementation Yumbe
Coordination of VHT by DMT
STATUS OF VHT IMPLEMENTATION
TBAs & other former
Community Medicine
distributors etc included in
VHT?
All
Demographics
Other Community Health Workers NOT included in VHTs
(List and estimate numbers)
Nutrition Scouts, Community Counselling Aides
Motivation & Incentives Given in
District
Referrals
VHT Training
Health Services
None
Current VHT Activities (during last 6 months) Other Background
community mobilisation for health, Bilharzia - Ivermectin
distribution, immunisation, sanitation, controlling
epidemics - cholera, meningitis, refferals, early detection
of disease
none
Flip Charts for VHTs with Danger Signs, Key family
Linkages between VHT and Health System and Other Sectors
VHT Reporting and District Data
Management
Evidence for IMPACT of VHT
Implementation, best practices
Actions Needed to Save Lives
HW - Danger signs for newborns and how to manage LBW
infants .Content and timing of post natal checks for both
mother and baby Nutritional assessment of all children
and pregnant women.
Women of reproductive age 80416 Births 2008-9 19308 Population Under 5 years 80416
Estimated number of
pregnancies 2008-9
19905 % Births registered No Data
Maternal Mortality Rate No Data Neonatal Mortality (deaths
per 1000 live births)
No Data
ANC 1 61% Any Postnatal Check? No Data
ANC 4 18% %Infants weighed at Birth No Data
Tetanus Toxoid coverage
(pregnant women) 2+ doses
7654 % Low Birth Weight No Data
Number Pregnant women
tested for HIV
37%
Number pregnant women
positive for HIV
1% Newborns treated ARVs at
Birth
39 (85%)
Positive Pregnant women
given ARVs for prophylaxis
21 (24%) Post Natal visit when? No Data Population under 1 year 17118.3
% deliveries at Health
Facility
34% BCG <1y 9655 DPT HEP HIB 3 <1y 9832
% skilled birth attendant No Data Measles <1y 7706
Did VHTs interviewed know
danger signs pregnant or
postparum women?
None VHTs interviewed know New
Born danger signs?
None VHTs interviewed know
danger signs?
For malaria
Any PNC visit? (Number) 21% Perinatal Cases 0
Post Natal visit when? Day 1 and Day 42 Perinatal Deaths 0
Malaria
Estimated District LLIN
Coverage
ND ACTs available on day of
Visit
Yes
LLIN Hanging to protect
pregnant women at HCs
Visited?
Some LLIN Hanging to protect
newborns at HF Visited?
None LLIN Hanging to protect
under 5 at HF Visited?
None
LLIN s for ANC distribution
at HCs visited
Some LLIN s for NB distribution at
HC visited
None LLIN s for distribution for
u5s without net at home at
HCs visited
None
IPT 2 39% Cases No Data U5s treated with malaria inpatient 1819
Malaria Cases pregnant women123 Deaths No Data U5s treated with malaria
outpatient
60241
Malaria Deaths 0 Deaths 49
Pneumonia
Pneumonia 1st line
antibiotics available on day
of Visit
yes Cases No Data Cases 325
Deaths No Data Deaths 11
Diarrhoea
ORS Available on day of visit yes Cases No Data Cases 14
Zinc available on day of visit None Deaths No Data Deaths 1
Nutrition
Health Centres Have MUACs? Some Cases Severe Malnutrition 114
VHTs can Read MUAC? None VHTs Have MUACs? None Cases Low weight for Age 1390
VHTs follow up of
discharged patients?
Some
practice handwashing
between patients
Access to HCs is a problem;
Predominantly muslim
community who marry off
their girls at an early age;
Women who deliver in HCs
are considered weaklings -
all factors may contribute
towards a high maternal
mortality
Aringa Association For
Development Programme
(AADP)
Dragon Agroforestry
Programme
Nasury Paticipatory Rural Action For
Development (PRAFORD)
Super Contractors / Produce
Dealers
Vocational Training Skill
Dev't Centre Yumbe
Aringa Disaster
Preparedness Forum
Earth Care Nkoscy Needy Kid
Orphanage Support Centre
Pelican Youth CBO Trans-Cultural Phychosocial
Organisation
Yumbe Aids Alleviation
Programme
Aringa General Purpose
Cooperatives Society
Islamic Medical Association
Of Uganda
Nudipu -Yumbe Branch SNV Uganda Uganda Change Agents
Association
Yumbe Women Network
Yumbe Health Situation
Women Newborn Under 5's
Health workers as good examples
for key practices
Lessons Learned and cultural
practices
NGOs CBOS CSOs working at community level in the District
43%
8%
7%
11%
21%
0%
1% 1% 8%
Yumbe Cause of Deaths Under 5's (n=168)
Malaria
Pneumonia
Diarrhoea
Malnutrition
Anaemia
Trauma