Govt sets age limits, minimum pay for community health workers and VHTs
Under the guidelines, new VHT recruits must be at least 22 years old and able to read and understand English, as well as demonstrate basic computer literacy.
Community health extension workers (CHEWs) are a recent gathering. (File)
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Uganda has introduced new standards governing the recruitment, age limits, education requirements and remuneration of village health teams (VHTs) and community health extension workers (CHEWs).
Dr Richard Kabanda, the commissioner for health promotion, education, and strategic communication at the Ministry of Health launched the new guidelines on Wednesday during the 4th Health Promotion and Disease Prevention Conference at Speke Resort, Munyonyo.
He said they are aimed at professionalising community-level healthcare and improving service delivery.
Under the guidelines, new VHT recruits must be at least 22 years old and able to read and understand English, as well as demonstrate basic computer literacy.
The maximum age for VHTs will be 65 years, providing a formal retirement threshold for volunteers who have continued serving their communities well into old age.
The guidelines also establish minimum requirements for CHEWs, who are being deployed to strengthen primary healthcare and connect households with formal health facilities.
New CHEW recruits must have completed Senior Four and be aged between 22 and 35 years. Those who have previously served as VHTs may qualify for an exception, allowing recruitment up to the age of 40. CHEWs will retire at 60 years.
The guidelines also require gender representation among community health workers. At least one VHT in a village must be female, while the CHEW arrangement requires at least one woman and one man at parish level.
The selection process must be community-based rather than driven by politicians or other individuals seeking to influence appointments.
Kabanda said the aim was to ensure that community health programmes are owned by the people they serve and that those selected can meet the changing demands of healthcare delivery.
The health ministry is also moving towards digital reporting, with districts implementing or expanding the CHEW programme expected to receive digital tools to support data collection and service delivery. This is intended to reduce dependence on paper-based reporting and enable community health workers to contribute more effectively to health surveillance and planning.
Under the framework, VHTs will be entitled to remuneration for up to 10 days, with a minimum rate of sh20,000 per day. The standards are intended to address differences in payments, with some partners previously providing more support than others.
Kabanda said community health workers are expected to prioritise maternal and child health while also supporting HIV and AIDS, tuberculosis, malaria, immunisation, nutrition, water, sanitation and hygiene, and the prevention of non-communicable diseases.
The guidelines come as Uganda seeks to shift more attention towards preventing illnesses before patients require hospital treatment.
Speaking at the conference, Vice-President Jessica Alupo said community structures should be treated as essential national health infrastructure and receive adequate investment, coordination, supervision and sustained support.
She said VHTs often worked with limited resources, sometimes requesting basic equipment such as gumboots and torches to carry out their duties effectively.
The United States has also committed about $5.9 million in foreign assistance to train more than 4,000 CHEWs in Uganda, with plans to support the training of nearly 14,000 by 2029.
Mary Borgman, the US Embassy Uganda's Office of Global Health Diplomacy director, said the US will support the graduation of more than 2,200 CHEWs in 22 districts in the coming weeks while training nearly 1,300 additional workers in nine districts.
She said CHEWs play an important role in identifying early signs of malaria, HIV, tuberculosis, sickle cell disease and infectious disease outbreaks before referring patients for treatment.
“Uganda's community health workers are the first line of defense. Under the Ministry of Health's leadership, they protect Ugandan families. They also protect Americans at home, our service members, and U.S. businesses abroad.
“The next step is ensuring effective implementation: deploying workers promptly, paying and supervising them consistently, and increasing domestic financing so Uganda carries a growing share of the cost."
Borgman said the next priority is ensuring that community health workers are deployed promptly, paid consistently, adequately supervised and supported by increased domestic financing.
The US government said its assistance was part of a five-year, $2.3 billion (sh9.29 trillion) bilateral Health Cooperation Memorandum of Understanding signed in December 2025 under the Trump administration's America First Global Health Strategy.
Borgman said studies estimated that every dollar invested in community health in Uganda generated $13 (sh52,500) in health and economic benefits, making prevention a potentially cost-effective way to strengthen the health system.
Other partners supporting Uganda's community health workforce include the World Bank, the Global Fund, UNICEF, the Mastercard Foundation, Living Goods and Nama Wellness.