Monday, March 6, 2017

Village Health Worker Supervision Visit

Scott Nabity, MD, MPH
Resident in Medicine-Pediatrics at MGH
Pediatric Hospital Care in Uganda

January 18, 2017 

A village health workers prepares a child for examination of his respiratory rate in her home while district health workers supervise the visit. The village health worker’s medication kit lies in the foreground.
In collaboration with MGH researchers, a team at Mbarara University of Science and Technology (MUST) has fostered an innovative village health worker program in one of the local health districts near Mbarara. In this area of Uganda, villages are spread on the sloping farming terrain of the Rwenzori foothills and traveling to a health center with a sick child is a significant burden. This can lead to delaying medical attention until the child is severely ill. The program aims to improve early diagnosis and intervention in treatable infectious diseases that are common to the region, namely malaria, pneumonia, and diarrheal illnesses. Village health workers are unpaid servants to their communities, kind of like volunteer firemen in the rural US. They are lay people elected by their village who receive special training and access to rapid malaria tests and a limited assortment of medications, including oral rehydration solution. The local health district works with the MUST team to provide periodic supervisory support visits with the goal of ensuring quality and standardization of practice. Today I was invited to tag along for one such supervisory visit.
The village health worker offers us bananas at the end of the visit as her children look on.

Following the visit, supervising health workers descend the hill back to the main road in the foothills of the Rwenzori Mountains.
I take a break to get schooled by village kids in an impromptu game of “rocks” at another village health worker supervision visit.

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