Community-based management and care of people with dementia: A training needs assessment among village health teams in Uganda based on WHO guidelines

Abstract

Background: Dementia is a public health problem worldwide with approximately 47 million people living with the disease. Although the symptoms are known and named, dementia remains a hidden problem in low and middle income countries (LMICs) as most people perceive it be a normal aging process. In a bid to improve healthcare, the Uganda government adopted a model of recruiting community-based health assistants known as village health teams (VHTs). These individuals helped in linking the community health units with community members with a goal of promoting health services. However, there is paucity of information about how the VHTs provide community-based management and care for people with dementia and their ability to perform the task. The purpose of this study was to identify the training needs of the VHTs in caring for people with dementia in rural communities of southwestern Uganda. Methods: This study utilized a cross-sectional qualitative design conducted with the help of semi-structured interview guide. The WHO guide was adopted in developing interviews on dementia care and management in LMICs. Results: From the study, VHTs reported the need for training with specific to dementia care to equip them with knowledge and skills on early detection and management, care and referral system. Results also show that VHTs were not able to detect dementia early since they perceive it as normal aging process. There was no community engagement in helping people with dementia since most people in the community do not take dementia to be a medical condition. Also there was little support for dementia in these areas as VHTs only referred people with dementia to health facilities in an event of physical ailment. Other organizations like churches only offered prayers only to the aged persons who are very close to the church. Conclusions: The study found that there is an urgent need for training VHTs on caring for individuals with dementia in rural communities of southwestern Uganda. The identified gaps helped in designing the strategies for capacity building through training of VHTs on dementia care in rural communities of southwestern Uganda.