NCD Research, 27 April 2022

Community health workers: Reviewing the Task-shifting of NCD screening

On a weekly basis, our project managers on the ground in Nakaseke conduct meetings with all community health workers to address opportunities and challenges faced throughout the screening process. As our first study on task-shifting non-communicable disease screening to CHWs is coming to an end, the project team faciliated an informal open group discussion to review key challenges, positive outcomes and recommendations for the implementation of a CHW-led screening program in rural Uganda.

Positive Outcomes

The project enabled the community members to learn about Balamu Project and ACCESS as an organization. In addtion, the project enabled to identify people with NCDs in the community and guided them on how to seek treatment. It helped CHWs learn how to screen for random blood sugar, blood pressure and chronic kidney disease and they can do the exercise without direct supervision of the project leaders. The project raised awareness towards CHWs in villages that were not reached before while reducing myths and misconceptions about NCDs in the community. Finally, it increased the number of NCD patients attending the NCD clinics especially at ACCESS lifecare clinic.

Key Challenges identified during the study

Our community health workers asked for further transportation and salary support. As CHWs need to stop any other work that may generate income for their families such as farming or selling, they asked for a higher compensation. Furthermore, community members and local leaders request the project to provide continuous screening of people for NCD in the community not for only specific period and not only for study participants. This is a consideration we are taking into account while scaling-up our program. Some CHWs faced challenges when addressing community members in their home. Lastly, the long distance for the referred patients to travel to attend the NCD clinics is a challenge when seeking care.

Recommendations

  • Building a sustainable transport mechanisms to reach remote communities
  • Provide motivational packages for CHWs at the end of the year/project
  • Equipping CHWSwith tools to continue screening community members for NCDs longitudinally
  • Establish community outreaches through e.g. mobile clinics in different villages so that referred patients do not have to walk long distances to the clinic.