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Insider
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Caregiver/friend
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Rapport-building with clients and community; development of clients’ sense of social connection. Altruistic motivation
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Work within community structures
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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
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Client and community member mistrust
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Addressing clients’ concealment of HIV status by lying about own HIV status to increase relatability
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Outsider
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Professional
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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
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Representatives of government
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Feeling a sense of helplessness when faced with community members’ frustration about the lack of public resources
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Intermediary
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Advocate
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Notifying hospital of disease outbreaks; working to ensure accountable hospital care; advocacy for client needs
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Bridge
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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
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Gatekeeper
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Referring clients for services; arbitration of which clients are referred
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Not fully a health professional
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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
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