Performance of community health workers and associated factors in responding to yellow fever and COVID-19 outbreaks: A case study of Masaka District, Uganda, 2022

Introduction: Community health workers (CHWs), also known as Village Health Teams (VHTs) in Uganda, play a crucial role in delivering healthcare to communities with limited access to formal health facilities. Their role in responding to yellow fever and COVID-19 outbreaks remains inadequately docume...

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Main Authors: Nicholas Muhumuza, Eric Segujja, Abel Wilson Walekhwa, Angela Kisakye, Brenda Nakazibwe, Prossy Nakito, Charity Mutesi, Carolyne Nyamar, Sarah Paige, Suzanne Kiwanuka
Format: Article
Language:English
Published: African Field Epidemiology Network 2025-06-01
Series:Journal of Interventional Epidemiology and Public Health
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Online Access:https://afenet-journal.org/performance-of-community-health-workers-and-associated-factors-in-responding-to-yellow-fever-and-covid-19-outbreaks-a-case-study-of-masaka-district-uganda-2022/
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Summary:Introduction: Community health workers (CHWs), also known as Village Health Teams (VHTs) in Uganda, play a crucial role in delivering healthcare to communities with limited access to formal health facilities. Their role in responding to yellow fever and COVID-19 outbreaks remains inadequately documented. This study examined the performance of Community Health Workers (CHWs) and associated factors in responding to the aforementioned outbreaks in Masaka District, Uganda. Methods: A cross-sectional study was conducted in Masaka District using quantitative methods. A total of 427 CHWs were selected using stratified random sampling. Performance was assessed using 10 key indicators based on CHWs’ roles in outbreak response, high performance was defined as scoring six or more. Data were analyzed using STATA version 14.0. Poisson regression with robust standard errors was employed to identify factors associated with CHW performance and to estimate crude and adjusted prevalence ratios (PRs) with 95% confidence intervals. Results: Most respondents 279(65.3%) were females, 325(76.1%) depended on agriculture and 337(78.9%) lived in rural areas. The majority, 320 (74.9%), demonstrated high performance in responding to yellow fever and COVID-19 outbreaks. Key facilitators of performance included provision of record books (APR= 1.23; 95% CI: [1.06-1.43]), support supervision (APR=1.43; 95% CI: [1.04-1.96]), recognition by health workers (APR= 1.37; 95% CI; [1.02-1.85]), and receipt of financial incentives (APR=1.16; 95% CI: [1.04-1.30]). Barriers included use of foot as means of transport (CPR=0.69; 95% CI: [0.58-0.84]), never refunded transport costs to attend supervision meeting (CPR=0.72; 95% CI: [0.64-0.81]) and shortage of PPE (CPR=0.78; 95% CI: [0.71-0.86]). Conclusion: CHWs demonstrated high performance in yellow fever and COVID-19 outbreak response, driven by training, recognition and case reporting tools. Both intrinsic (training, recognition) and extrinsic (financial incentives) motivators are essential for enhancing CHWs’ performance. The Ministry of Health and stakeholders should invest in sustainable incentives and continuous capacity-building for CHWs to strengthen disease outbreak responses in low-resource settings.
ISSN:2664-2824