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Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital

Overview of attention for article published in Human Resources for Health, January 2017
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  • Above-average Attention Score compared to outputs of the same age (62nd percentile)

Mentioned by

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5 tweeters

Citations

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13 Dimensions

Readers on

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82 Mendeley
Title
Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital
Published in
Human Resources for Health, January 2017
DOI 10.1186/s12960-016-0177-9
Pubmed ID
Authors

Laban Kashaija Musinguzi, Emmanueil Benon Turinawe, Jude T. Rwemisisi, Daniel H. de Vries, David K. Mafigiri, Denis Muhangi, Marije de Groot, Achilles Katamba, Robert Pool

Abstract

Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services. Data were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the data, we conducted an additional six in-depth interviews and three FGD with VHTs and four FGD with community members on the role of VHTs. Key informant interviews were conducted with local government staff, health workers, local leaders, and NGO staff with health programs in Luwero. Thematic analysis was used during data analysis. The ability of VHTs to link communities with formal health care was affected by the stakeholders' perception of their roles. Community members perceive VHTs as working for and under instructions of "others", which makes them powerless in the formal health care system. One of the challenges associated with VHTs' linking roles is support from the government and formal health care providers. Formal health care providers perceived VHTs as interested in special recognition for their services yet they are not "experts". For some health workers, the introduction of VHTs is seen as a ploy by the government to control people and hide its inability to provide health services. Having received training and initial support from an NGO, VHTs suffered transition failure from NGO to the formal public health care structure. As a result, VHTs are entangled in power relations that affect their role of linking community members with formal health care services. We also found that factors such as lack of money for treatment, poor transport networks, the attitudes of health workers and the existence of multiple health care systems, all factors that hinder access to formal health care, cannot be addressed by the VHTs. As linking social capital framework shows, for VHTs to effectively act as links between the community and formal health care and harness the resources that exist in institutions beyond the community, it is important to take into account the power relationships embedded in vertical relationships and forge a partnership between public health providers and the communities they serve. This will ensure strengthened partnerships and the improved capacity of local people to leverage resources embedded in vertical power networks.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 82 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Malaysia 1 1%
Netherlands 1 1%
Canada 1 1%
Unknown 79 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 18 22%
Student > Ph. D. Student 14 17%
Researcher 12 15%
Unspecified 9 11%
Student > Postgraduate 8 10%
Other 21 26%
Readers by discipline Count As %
Nursing and Health Professions 22 27%
Social Sciences 15 18%
Medicine and Dentistry 14 17%
Unspecified 12 15%
Psychology 6 7%
Other 13 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 January 2017.
All research outputs
#5,657,583
of 11,227,973 outputs
Outputs from Human Resources for Health
#441
of 609 outputs
Outputs of similar age
#116,899
of 316,290 outputs
Outputs of similar age from Human Resources for Health
#14
of 25 outputs
Altmetric has tracked 11,227,973 research outputs across all sources so far. This one is in the 49th percentile – i.e., 49% of other outputs scored the same or lower than it.
So far Altmetric has tracked 609 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.0. This one is in the 25th percentile – i.e., 25% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 316,290 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 62% of its contemporaries.
We're also able to compare this research output to 25 others from the same source and published within six weeks on either side of this one. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.