Dr. Jane Ruth Aceng, Minister of Health, flagging off the CHEWS after their commissioning. 

Hon. Dr. Jane Ruth Aceng, Minister of Health, has commissioned 181 Community Health Extension Workers (CHEWs) in Maracha District after completing  a 6-month training program in August last year.  Dr. Aceng said CHEWs play a crucial role in strengthening primary health care stating all health challenges start from the community.

“Primary health care looks at care that is easily accessible that is why you move door to door so that people can access you. That is affordable, that is why you give free services when you go to the people. That is culturally accessible, that is why you were chosen from your villages,” she said during the commissioning ceremony held in the district on Tuesday, April 15.

Dr. Aceng appealed to the CHEWs not to be motivated by money because it puts lives of communities at risk. “I am talking from experience, many at times when we have passed you like this, the community health extension workers focus on the money and not on the work and that is not a unique situation, medical work is a calling.”  

Dr. Aceng said the new malaria vaccine had been proven to be effective and the CHEWs are instrumental in its roll out. She observed that CHEWs tend to undermine Village Health Teams (VHTs) which causes tension and derails teamwork between the two groups.  

 “When we train community health extension workers they feel so powerful they start belittling my village health teams. The VHTs are a very important structure that link the community health extension workers to the village,” Dr. Aceng stated.

“The way we designed this program is that we move door to door, the parish might have five villages, you cannot move to the five villages so your duty is to empower the village health teams, work with them, supervise them, make those reports together.” 

Hon. Jennifer Driwaru, Maracha District Woman MP, called upon the district to support the CHEWs to deliver on their mandate,

“Lets us support our team to do the needful in the field because if we don’t support them they will not do the work,” she said.

Hon. Driwaru emphasized the need to upgrade Maracha Health Centre IV to a general hospital when resources are available in order to meet the ever increasing health demands.

Hon. Obitre Stephen, Maracha District Chairperson, commended government for investing Shs 7.4b to upgrade 6 health centers under the Uganda Intergovernmental Fiscal Transfers (UgIFT) program.

Hon. Obitre decried the poor health seeking behavior among local residents, however, is optimistic this is bound to improve with the deployment of CHEWs.

“You know the kind of community we have, they really  have poor healthcare  seeking attitude, there has been that information gap, now that the CHEWs are introduced, trained we are very sure the health seeking behavior of our people is going to improve,” he said.

Mr. Patrick Olila, Maracha District Chief Administrative Officer made a plea to the Ministry of Health to support the district in filling vacant staffing positions in the health sector.

Dr. Charles Olaro, acting Director General of Health Services in the Ministry of Health, said that the computer tablets given to the CHEWs will enhance health electronic data management.  Dr. Olaro said that the CHEWs should be role models in their communities to build confidence in their work.

“Lead by example. We request that you really remain our foot soldiers, you lead in good hygiene in your homes, sanitation, good nutrition,” he counseled.  

Ms. Monica Kotevu Koliba, Deputy Maracha Resident District Commissioner (RDC), said the CHEWs will support awareness creation on government programs and addressing poor socio-economic indicators.

“You have increased on the number of my mobilisers. I am receiving on top of the LC1s, LC2s, LC3s, VHTs. On top of the normal work that you will do, you know that we have issues of teenage pregnancy, early pregnancy, school dropout, I want you to reach the schools,” she directed.

 At the district level, CHEWs are managed and supervised through the existing local government structures; the District Health Officer has the overall responsibility but may assign relevant officers to oversee the operations of the CHEW strategy at even lower levels.

Dr. Paul Onzubo, Maracha District Health Officer, revealed 63 VHTs had been picked to become CHEWs as a way of rewarding them for their hard work. Dr. Onzubo pledged the district’s backing of the CHEW strategy.

Mr. Letia Jimmy, a CHEW, who spoke on behalf of the CHEWs, said the CHEWs were committed to cascade the malaria smart strategy and will soon start a malaria repellant garden.  

Dr. Gift Patrick Asibo, the deputy lead trainer, advised Ministry of Health to develop a career path growth for the CHEWs since most of them would wish to grow professionally.

The CHEWs underwent classroom learning and field placement, ensuring they gain the necessary knowledge and skills to effectively serve their communities. The training program was funded by Global Fund channeled through The AIDS Support Organization (TASO).

Dr. Richard Kabanda, Commissioner Health Promotion at the Ministry of Health, told the gathering the review of the curriculum for the CHEWs is underway to include “mindset change” because they had noticed some “CHEWs are not well aligned.”  

The CHEWs’ structure underscores government’s commitment to strengthening the community health system and improving health outcomes in underserved areas. The CHEWs will be deployed in the 91 parishes of Maracha District.