{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:17:46Z","timestamp":1789769866227,"version":"4.0.1"},"reference-count":49,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003637","name":"Korea Foundation for International Health Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003637","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,12,9]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Empowering communities through identifying and unlocking community capacities and capabilities is vital for improving community health systems. This study assessed the community health system\u2019s status quo and readiness for implementing a government-led, partner-supported community health worker project.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A mixed methods cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two districts and one city in central Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>21 key informants (KIIs) with district leaders, 4 focus group discussions (FGDs) with community health workers (CHWs) termed as village health teams in the Ugandan setting and a survey of 487 CHWs and 419 pregnant women who had childbirth 12 months before.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study measures<\/jats:title>\n                    <jats:p>KIIs and FGDs explored community health system resources using the WHO health systems building blocks and the UNICEF health system strengthening maturation model. However, the surveys explored the work-related attributes and services delivered by the CHWs and to the community, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>A framework analysis was used for qualitative data in NVivo 14. While descriptive and stratified analyses were conducted for quantitative data in Stata I\/C 15.0: proportions for the varied geographical entities were compared using the t-test with p values &lt;0.05 considered significant, one-way ANOVA was used to compare means.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, all sites had relatively strong governance of community health only challenged by multiple implementing partners that were weakly coordinated. There was an exclusive paper-based information management system that linked to the national DHIS-2 software. Community reporting rates varied between 20% and 80%. Community health financing was weak, similarly to commodities availability. The mean age of the community health workforce was high at 50.9 (SD 11.9); the majority reported adequate skills in service delivery except for community first aid, Kangaroo mother care and noncommunicable diseases. Households\u2019 most received CHW services included home visits, treatment for sick under-five children and child immunisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The existing CHW system has governance and reporting strengths but could be enhanced through revitalization, enhanced coordination of stakeholders, providing appropriate training, work tools, supervision and engaging the community for accountability of results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-082085","type":"journal-article","created":{"date-parts":[[2025,1,12]],"date-time":"2025-01-12T00:05:38Z","timestamp":1736640338000},"page":"e082085","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Community health system capacities and capabilities within an evolving community health policy framework: mixed methods study of stakeholders in central Uganda"],"prefix":"10.1136","volume":"15","author":[{"given":"Richard","family":"Kabanda","sequence":"first","affiliation":[{"name":"Republic of Uganda Ministry of Health, Kampala, Uganda"},{"name":"Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald Miria","family":"Ocaatre","sequence":"additional","affiliation":[{"name":"Department of Health Education and Promotion, Ministry of Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Atwine","sequence":"additional","affiliation":[{"name":"Senior Top Management, Ministry of Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bounggui","family":"Kim","sequence":"additional","affiliation":[{"name":"Korea Foundation for International Healthcare, Gwangjin-gu, Seoul, Korea (the Republic of)"},{"name":"Korea Foundation 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Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solyi","family":"Kim","sequence":"additional","affiliation":[{"name":"Korea Foundation for International Healthcare, Gwangjin-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yein","family":"Park","sequence":"additional","affiliation":[{"name":"Korea Foundation for International Healthcare, Gwangjin-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Okuga","sequence":"additional","affiliation":[{"name":"Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8347-9699","authenticated-orcid":false,"given":"Raymond","family":"Tweheyo","sequence":"additional","affiliation":[{"name":"Department of Health Policy Planning and Management, Makerere 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