A study was made of the training and performance of village health workers near Lagos, and of the management of the scheme to which they belonged. Among the deficiencies observed were inadequate drug control and poor record-keeping. Nevertheless, the scheme led to a significant extension of primary health care coverage.
PIP: In 1982, the Institute of Child Health and Primary Care (IHCPC) in Lagos, Nigeria, was asked to develop a primary health care (PHC) service for a rural population of about 35,000 people in 56 villages approximately 50 km. from Lagos. A core of volunteer village health workers (VVHW) would be established. A health care center was completed. The 1st step was to encourage village health committees to form. Then VVHS are nominated for training. Initial training lasts 3 weeks and takes place in the community. There have been 4 courses; 82 village health workers have been trained. The trainers are PHC workers connected to the ICHPC who have been trained. The courses cover promotional, curative, and preventive activities. Active learning is encouraged; song and dance are used. At graduation, a formal occasion, certificates and drug kits are given out. They contain essential drugs, which are donated. There are sufficient drugs for 3-6 months. The workers are advised to sell the drugs to the villagers at a small profit. They keep the profit, and get some pay. The rest of the selling price resupplies the drug fund. VVHWs are supervised by a midlevel PHC worker, the community health assistant. The ICHPC field research team interviewed 75 of the 82 VVHWs. The number of patients seen by VVHWs in a month ranged from none to 300; the average was 17.8. 91% of the villages have a VVHW service. The activities of 75 VVHWs during 1 month in relation to selected characteristics in rural Ogun State, 1987 are presented in tabular form. Of the 82 VVHWs who were trained, 10 became nonfunctioning over a period of 4 years. Service management should have attention paid to it. Drug stocks with VVHWs are shown in tabular form. Record keeping was not very good. Active village health committees were interfering with the VVHWs. The role of the village health committees in relation to the VVHWs has now changed, but it is difficult to provide supervision for the VVHWs.