Village health workers – ‘Extended arm’ connecting healthcare system to local people

Village health workers (VHW) are considered the "extended arm" of the health sector in caring for people's health. They are an important "link" in the grassroots healthcare system, serving as a bridge between the healthcare system and the people.

Dieu De (Hai Can Hamlet, Phu Nghia Commune, Dong Nai province) assists commune health station staff in receiving and collecting information from people bringing their children for vaccination. Photo: Collaborator

With a low allowance (0.3 or 0.5 times the basic salary, depending on the area), VHW must be truly dedicated and responsible for caring for the people to stick with and commit to this "jack-of-all-trades" job.

Dedicated, enthusiastic, and responsible

On September 17, the Phu Nghia Commune Health Station sent health workers to Hai Can Hamlet to provide vaccinations for children. By around 5 p.m., Dieu De, a village health worker, was still going door to door, urging families with eligible children to bring them in for their shots.

Dieu De is one of three S'tieng village health workers in Phu Nghia Commune. Despite his age, he remains deeply committed to his work. As a respected figure in the S'tieng community, he is known for his enthusiasm, sense of responsibility, and deep understanding of village health work, qualities that allow him to carry out his duties with great effectiveness.

In addition to Dieu De, Phu Nghia Commune has two other S'tieng ethnic VHW: Dieu Chanh in Thac Dai Hamlet and Dieu Dong in Dak Khau Hamlet.

Nguyen Hoai Nam, a Bachelor of midwifery and Acting Head of the Phu Nghia Commune Health Station, shared: "In hamlets with a large S'tieng population, having S'tieng village health workers is more effective. They are respected members of the community, well-versed in local customs and traditions, and have a strong understanding of the area, which greatly facilitates health communication and education efforts."

In Loc Quang Commune, Le Thi Kim Dung, 68, is the longest-serving VHW, with 30 years of service. She is currently responsible for Hiep Hoan Hamlet, which has 430 households and more than 1,500 residents.

To effectively promote childhood vaccination and nutrition, Dung created a Zalo group for mothers with children under five. She regularly shares information in the group on vaccinations, vitamin A supplementation, disease prevention, and outbreak control. Thanks to this initiative, vaccination coverage in Hiep Hoan consistently meets the set targets. Her deep knowledge of the local area also enables her to support local health workers in verifying and responding to outbreaks promptly when diseases occur.

Dung shared: "Compared to decades ago, people's awareness of disease prevention and health care has improved significantly. For example, in vaccination, many people are willing to pay out of pocket for their children to receive service vaccinations if the commune health station has not been supplied or has run out of vaccines in the Expanded Program on Immunization. In the past, some mothers fed their babies porridge as early as three months old, hoping it would make them stronger. But now, the vast majority understand the benefits of breastfeeding. Seeing the impact of village health work brings me joy and gives me the motivation to stay committed to this job."

Awaiting new allowance levels

As the "extended arm" of commune and ward health stations, village health workers play a vital role in preventive health campaigns and disease control efforts, especially in remote, isolated areas and ethnic minority communities. With the advantage of being local and fluent in the native language and culture, they can effectively communicate messages about environmental hygiene, vaccination, and disease prevention to the community.

They also serve as a crucial "link" in the disease surveillance system. Because they know the households well, often by name, village health workers can quickly identify outbreak sites when disease occurs in the area, enabling the health sector to respond promptly.

Outside of epidemic periods, the work of village health workers is generally not physically demanding, yet it requires deep familiarity with the local area, close community engagement, a strong sense of responsibility, and dedication. In reality, without these qualities, it is difficult for them to stay committed to the job, especially given the currently very low allowance for village health workers.

Dieu De (Hai Can Hamlet, Phu Nghia Commune) talks with people, calling them to take their children for vaccination. Photo: Collaborator

Nguyen Thi Hoa, a village health worker in Trung Tam Hamlet, Bau Ham Commune, said she has been involved in health work for nearly eight years. She is responsible for the hamlet, which includes 24 residential groups with 860 households. Currently, she receives a monthly allowance of 702,000 VND.

"This allowance has increased compared to a few years ago. I agreed to become a village health worker because I enjoy taking part in community activities and social work, but the current allowance does not reflect the amount of work village health workers have to do," Hoa said.

According to Nguyen Hoai Nam, a Bachelor of Midwifery, Phu Nghia Commune was formed through the merger of three former communes of the old Bu Gia Map District: Phu Nghia, Phu Van, and Duc Hanh. The commune now has 23 hamlets, but currently only 11 village health workers. For hamlets without a VHW, the Commune Health Station relies on a team of population collaborators and assigns station-based health workers to oversee those areas.

The commune has 20 village health workers, one in each hamlet, with some also serving as population collaborators. Village health workers effectively carry out programs implemented by the Commune Health Station, such as calling children for vaccinations and vitamin A supplementation, and providing nutrition counseling to help reduce child malnutrition rates. Their key strength lies in their dedication, working for the cause, for the community.

Tran Van Thi, Specialist Doctor Level I, Head of Loc Quang Commune Health Station

"Village health workers are very dedicated, despite the low allowance. Both the commune and the Commune Health Station truly rely on them. Normally, when there are no outbreaks, the work is not too demanding. But now, with many types of epidemics, village health workers are working extremely hard. We hope the health sector will open more training courses for village health workers in the hamlets and increase the allowance to give them more motivation to continue their work," Nam said.

In reality, due to the low monthly allowance, which is not sufficient to truly motivate or encourage, many village health workers have quit. Meanwhile, others remain on the job but are no longer fully committed. Currently, the Ministry of Health is drafting a decree outlining specific allowance policies for civil servants, public employees, and workers at public health facilities, including epidemic prevention allowances and support schemes for village health workers, residential group health workers, and village midwives. The draft proposes a monthly support level equal to 0.7 and 0.5 times the basic salary for village health workers, residential group health workers, and village midwives, respectively.

By Hai Yen – Translated by Mai Nga, Minho