The village health worker programme in primary health care in the Maseru health service area: a case study

[摘要] English: Health in Lesotho is similar to many developing countries, where healthcare facilities are poor. The delivery of health care services is especiallypoor in the rural villages. The aim of this study was to find out whetherthe implementation of the Village Health Worker Programme hasimproved the provision of health care services and the health status inthe Maseru Health Service Area. The Village Health Workers' support inthe villages and the problems, which may have resulted in poor deliveryof services, were also investigated.In the empirical phase a qualitative survey was undertaken using FocusGroup Discussions for three categories of respondents, namely thetrainers, Village Health Workers (VHWs) and villagers. The interviews inthe villages were arranged with the consent of the chiefs in Ha Foso andHa Thamae. The interviews with the respondents were conducted inEnglish and Sesotho. The reason was that the respondents in the villagescould only communicate in Sesotho, while the VHW staff was proficientin English.The following factors can be highlighted regarding the Village HealthWorker Programme in the Maseru Health Service Area:+ Firstly, the greater percentage of Lesotho's population resides in therural villages. The findings of this study reveal that many people inthese villages are old, poor and unemployed. This situation results inpoor health status in the villages.+ Secondly, the delivery of health care services in the villages is poor.The researcher found that where the Programme was implementedproperly, it was accepted and supported by the communities involvedfor example Ha Foso. Here the Programme also managed to improvethe delivery of health care services, which resulted in a good healthstatus within the community. On the other hand, the opposite wasfound in the villages that did not support the Programme, for examplein Ha Thamae.Thirdly, the problems in the VHW Programme have affected itsimplementation in the villages. The respondents asserted that if theaim of the Government is to improve health in the villages, incentivesto the VHWs must be a priority.In the light of the data obtained from the .literature study and from therespondents, one may conclude that unless the structure and policies ofthe VHW Programme are changed to suit the interests of all the peopleinvolved, it has no future in the Maseru HSA.

[发布机构] University of the Free State