Table 2 Themes: Roles of Village Health Team Members

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