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Table 2 Themes: Roles of Village Health Team Members

From: Outsiders, insiders, and intermediaries: village health teams’ negotiation of roles to provide high quality sexual, reproductive and HIV care in Nakaseke, Uganda

Role Characteristics of Role Manifestations of Role
Insider Caregiver/friend Rapport-building with clients and community; development of clients’ sense of social connection. Altruistic motivation
Work within community structures Education of clients in churches, drinking places, pool halls; enhancement of clients’ family support systems; provision of ongoing and consistent follow-up care; reduction of community-level stigma
Client and community member mistrust Addressing clients’ concealment of HIV status by lying about own HIV status to increase relatability
Outsider Professional Possession of specialized training and knowledge; fulfillment of responsibilities including client education, counseling on medicine and family planning methods, participation in door-to-door community mobilization, aid with antenatal care, instruction on community sanitation, work to ensure client HIV medication adherence; collaboration with other VHTs and medical workers. Increased VHT self-esteem as a result of work
Representatives of government Feeling a sense of helplessness when faced with community members’ frustration about the lack of public resources
Intermediary Advocate Notifying hospital of disease outbreaks; working to ensure accountable hospital care; advocacy for client needs
Bridge Simplification of medical terms; assistance to clients in navigating health care system; use of hospital visits as way to bring clients for HIV testing; education of other community members
Gatekeeper Referring clients for services; arbitration of which clients are referred
Not fully a health professional Lack of personal respect from health facility medical workers: medical workers’ discarding of referrals forms and refusal to serve patients referred by VHTs. Resultant diminishment of client trust in VHT work and role