TY - JOUR T1 - Panacea or pitfall? The introduction of community health extension workers in Uganda JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2020-002445 VL - 5 IS - 8 SP - e002445 AU - David Musoke AU - Rawlance Ndejjo AU - Edwinah Atusingwize AU - Charles Ssemugabo AU - Amanda Ottosson AU - Linda Gibson AU - Peter Waiswa Y1 - 2020/08/01 UR - http://gh.bmj.com/content/5/8/e002445.abstract N2 - Summary boxThe Uganda Ministry of Health is planning to introduce new Community Health Extension Workers (CHEWs) who would be institutionalised, paid a monthly allowance, and work closely with existing Village Health Teams (VHTs) who are community volunteers.The introduction of CHEWs is likely to have several benefits to the country’s health system, including availability of another health cadre offering majorly preventive and selected curative services, and supporting the work of VHTs including supervision.But there are foreseeable concerns that could affect the CHEW programme. Just like VHTs, CHEWs would require support systems: performance management, regular refresher trainings, supervision from health practitioners, and availability of necessities and supplies.Given that two CHEWs would be employed per parish (the sub-counties of Uganda are divided into parishes, which are further divided into villages) in comparison with four VHTs per village, VHTs would remain crucial in supporting the community health system.However, there is a likelihood that with the introduction of CHEWs, VHTs would be further neglected hence affecting community health outcomes. Hence, there is need for a holistic approach to introduce and adequately support the CHEWs.Even with the introduction of CHEWs, deliberate effort to strengthen the existing VHT programme is necessary to improve community health.In 2018, the world commemorated 40 years of the Alma Ata Declaration on primary health care (PHC) which emphasised the importance of Community Health Workers (CHWs) in ensuring its vision of health for all. In line with the declaration, Uganda launched a CHW programme in 2001 in an effort to address the high disease burden and critical shortage of health professionals, as well as improve equitable access to health services.1The programme established a cadre of volunteers charged with the responsibility of empowering communities to take control of their own health and well-being, and actively participate in … ER -