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Village Health Workers helping build the Public Health system in Zim

September 28th, 2012 by Posted in Countries, English, Health, Zimbabwe
 A five day training of village health workers

A five day training of village health workers. Picture: Rumbidzai Mtetwa: MEL Officer

Story By:

Alford Garikayi: WASH Manager

Rumbidzai Mtetwa: MEL Officer

Tariro Mavi: Public Health Promoter

Village Health Workers (VHW’s) have been a part of the Zimbabwe’s Ministry of Health sector for decades now and are the link between the community, the health centres and other organisations working in the communities. They are the first to know and raise the flag in any case of disease outbreaks or any health scares in the communities and as such have in most cases taken the role and sometimes burden of helping to sustain the health system at grassroots levels. In some areas these individuals are known to be the ‘earth angel centres’ where people can turn to for support in other areas other than health.

Roles of VHWs in the communities

The main role of VHW’s is information dissemination and they are the custodians of health in the communities they work and live in. They are a medium for cascading information on hygiene, HIV/AIDS awareness, child protection and gender based violence among other issues. VHW’s usually give out this information through household visits, community health clubs and public addressees’ at ward or health meetings. Village Health workers also distribute condoms and HIV/AIDS awareness material (IEC), give out initial care for malaria patients, assist in mobilising communities for immunisations and during the cholera crisis were the first point of oral rehydration.

VHWs also take part in monitoring activities being carried out by both government and non-governmental organisations (NGOs). They monitor and encourage households to construct hygiene enabling structures as evidence of practicing what they would have learnt during hygiene messaging forums. In this role they also carry out disease surveillance and make alerts to their local rural health centres of any increases in certain diseases or developing trends of certain diseases. VHWs also take part in other activities like distribution of non-food items (NFIs), food distributions, post distribution monitoring, baseline surveys and assessments.

Challenges faced by VHWs

In their roles they face a number of challenges and the major challenge is mode of transport as they carry out their work. The area one VHW has to cover in most cases is an entire ward and they travel an estimated 30kilometeres to cover the entire ward, and as in most cases on foot. This takes up a lot of their ‘personal’ time leaving them with inadequate time for carrying out their own household chores. In most communities no clothing, in the form of uniforms, shoes, bags, hats for the sun, t-shirts, raincoats with promotional messages in line with their work is provided to them, such materials are usually donated by NGO’s working in those areas.

Incentives that are supposed to be due to them from government rarely come on time, and are very inconsistent hence most of them are doing work out of their own passion. One might stop and say, ‘yes’, that is the way to go to encourage voluntarism in them, but one should stop and realise the great burden these individuals carry. People should note that most are not even able to turn to look for other sources of income as the work they have to carry out on a day to day basis overwhelms them leaving no time for any other activities. These same people have families that need to be fed, taken to school, and clothed as well. And yet in that same breathe they are the reason why so many other cases in the 2008-2009 cholera epidemics were curbed through their effortless service to their communities.

What can be done to make their work easier?

  • They can be offered free medical services as an incentive.
  • More VHWs can be trained per ward to reduce distances covered by the current VHWs.

  • Some with adequate qualifications and experience can be promoted upwards in the health care system, for example, promoting them to be primary health workers.
  • NGO’s when developing their projects should be encouraged to think of ways if incorporating incentives in their budgets that can go a long way in ensuring that their work is made easier, for example, purchasing of bicycles for the VHW’s.
  • It could be encouraged that when NGO’s carry out their projects they turn the homes, of at least one, of these VHW’s into ideal homesteads and ensure that all the VHW’s preach on a day to day basis is also present at their homes. Hence they will not only talk the mile but they will be walking the mile.

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