Why We Need Primary Health Care (PHC) and CBHC

There are several reasons why PHC and CBHC are important:

(a) Many illnesses can be prevented. The most common health problems can often be stopped or managed through actions taken by individuals, communities, and with the support of the government or other organizations. For example, malaria can be prevented.

(b) Death and illness rates can be lowered. To reduce suffering from illnesses, people need to be encouraged and supported to adopt healthy habits and work together to improve their local environment, rather than just waiting to go to hospitals or clinics. This encouragement needs to happen in villages and homes, not just within healthcare facilities.

(c) Health services don’t reach everyone. Even if healthcare facilities were fully equipped, there are still not enough of them, especially for services like dental and mental health. These are often located in cities, making it difficult for people in rural areas to get the essential health care they need.

Goals of CBHC

The main goal of CBHC is to empower communities to take charge of their own health and well-being. This means helping communities to:

• Identify their own health problems.
• Find solutions to those problems.
• Make their own decisions about their health.
• Seek out resources from outside their community when needed.
• Evaluate what they are doing and make changes if necessary.
• Work together and individually to make healthy behaviors normal practices.

What CBHC Does

CBHC involves several activities, including:

• Providing information, education, and training about common health problems in the community and how to prevent and control them.
• Promoting good nutrition.
• Providing care for mothers and children.
• Giving vaccinations against major infectious diseases.
• Preventing and controlling diseases that are common in the area, like diarrhea, respiratory infections, and malaria.
• Offering reproductive health services, including family planning and preventing and controlling sexually transmitted infections, especially HIV/AIDS.
• Providing appropriate treatment for common illnesses and injuries.
• Addressing community mental health.
• Helping people with disabilities through rehabilitation.
• Conducting health activities in schools.

Benefits of CBHC

 A) CBHC has several advantages:

• Communities take responsibility for managing their own health problems.
• It empowers communities to systematically care for their health using affordable resources they have.
• It helps community members plan, decide on, implement, and evaluate health care approaches in their community.
• Communities develop a sense of ownership and belonging in the health care system.
• It reduces the cost of delivering health care.
• It lessens reliance on the government and outside donors.
• It helps health workers gain knowledge about families, communication, group dynamics, and cultural differences when caring for people at the community level.
• CBHC makes services more accessible by bringing them closer to where people live.
• It raises awareness within the community about various health issues.
• Individuals, families, and communities become actively involved in health activities.
• It promotes care that considers physical, mental, spiritual, and cultural aspects of health.
• It connects communities with workers from other sectors, like agriculture.
• It encourages unity within the community.
• It helps in taking appropriate action on health issues.
• It improves the overall quality of life.
• It contributes to community development.
• It allows for early identification of health problems in individuals.
• It fosters interaction and support among community members.
• It raises the standard of living.

B) Disadvantages of CBHC

There are also some disadvantages to CBHC:

 (a) Diagnoses are often based on assumptions because there may be no access to medical tests.

(b) It can sometimes increase stigma around certain health conditions.

Where CBHC Services Come From

In some areas, CBHC services are provided by organizations like:

(1) TASO (The AIDS Support Organization)

(2) UWESO (Uganda Women’s Effort To Save Orphans)

(3) CGC (Concern for the Girl Child)

(4) Hospices that offer palliative care.

Village Health Teams (VHTs) or Community-Based Workers

A Village Health Team (VHT) is a non-political group that helps with the health of people in a community at the household level. They are set up to help communities get organized, empowered, and involved in providing, managing, and carrying out health services at the household level. The main goal of VHTs is to improve the quality of life by making health services stronger at the household level.

What Village Health Teams Do

VHTs have several roles:

• They help the community identify and understand their health problems.
• They encourage community participation in health programs like vaccinations and malaria control.
• They collect information and keep records of household members, which is used for planning and other programs.
• They act as a link between the community and healthcare providers.
• They follow up with patients or clients.
• They visit people in their homes.
• They identify people who need care at home or elsewhere and make appropriate referrals.
• They share basic health information to encourage healthy behaviors.
• They distribute medicines, supplies, and information materials, including insecticide-treated bed nets.
• They act as role models in the community and work with other community groups and government departments.

Basic Health Services Provided by VHTs

VHTs provide advice and information on:

• Diseases:

• • Treating and managing simple illnesses at home.
  • Sexually transmitted diseases (including HIV/AIDS).
  • Tuberculosis (TB).

• Family:

• • Family planning (child spacing).
  • Pregnancy, childbirth, and newborn care.
  • Adolescent sexual and reproductive health.
  • Breastfeeding.
  • Food and nutrition.
  • Abuse and violence.
  • Immunization.
  • Mental health.

The Home:

• • Water and sanitation.
  • Hygiene.
  • First Aid.

How VHTs Provide Services:

• • Creating community maps.
  • Keeping community registers.
  • Conducting home visits.
  • Talking with neighbors about identified health issues.

What Community Members Should Do:

• • Select and support VHT members.
  • Attend village health events.
  • Use health services.
  • Improve their personal and family health.

What Local Leaders Should Do:

• • Inform communities about VHTs.
  • Advocate for health at home.
  • Encourage community involvement in health.
  • Supervise VHT activities.
  • Provide financial support.
  • Include VHTs in district and village health plans.
  • Attend and support health events.

Selecting and Training Village Health Teams

VHT members are usually chosen through a popular vote after the community has been informed and consulted. The following criteria are used to guide the selection process:

• Being at least 18 years old.
• Being a resident of the village.
• Being able to read and write (at least in the local language).
• Having good communication skills.
• Being a dependable and trustworthy person.
• Being interested in health and development issues.
• Being a resource person in the community.

Who Makes Up a Village Health Team:

• Community Own Resource Persons (CORPs).
• Local leaders.
• Any other helpful individuals in the community.

Community Own Resource Persons (CORPs)

A Community Own Resource Person (CORP) is a community member selected and trained to help improve the health of their community and support development. Their role goes beyond just health care and includes other aspects of development, like food production and income-generating activities.

Types of CORPs:

• Community Health Workers.
• Traditional Birth Attendants (TBAs).
• Traditional healers.
• Community Drug Distributors (CDDs).
• Community HIV/AIDS counselors.
• Community reproductive health workers.
• Community DOTS providers (for tuberculosis treatment).
• Peer educators, and others.

Responsibilities of a CORP

A CORP has the following duties:

• Visiting homes and providing advice on personal hygiene and environmental sanitation.

• Advising and educating communities on topics related to:

(i) Food production and nutrition.

(ii) Disease prevention.

(iii) Using safe water.

• Identifying health problems and setting priorities together with community members.
• Keeping records and using them for planning, organizing, implementing, monitoring, and evaluating health services.
• Identifying individuals and families at risk and referring them for further care.

Techniques Used to Start Community Health Activities

The steps taken to establish community health activities include:

• Community approach.
• Community entry.
• Community assessment.
• Community situation analysis (diagnosis).
• Community mobilization.
• Community participation.
• Community organization.
• Community empowerment.
• Community-based rehabilitative services for disabled and disadvantaged groups.