Adult learning in community healthcare : experiences of village health teams in Kampala District, Uganda

Abstract

Village Health Teams (VHTs) serve as a critical link between communities and the formal health system, providing basic health education, promoting preventive health measures, and facilitating access to healthcare services. The study explored the role of adult learning in equipping Village Health Team members in Kampala District to address community healthcare needs. The study employed a phenomenological-qualitative descriptive design to capture the lived experiences of the Village Health Team (VHT) members from 41 participants in Bwaise III Parish, Kawempe division, located in the northwest corner of Kampala district, Uganda between December 2024- December 2025. The study revealed that Village Health Teams (VHTs) in Kampala District play a multifaceted role in community healthcare, serving as educators, mobilizers, first-line care providers, and vital links between communities and health facilities. Their learning experiences are shaped by on-the-job practice, refresher trainings, peer-to-peer sharing, and mentorship, which build confidence and enhance service delivery, though training remains irregular and heavily dependent on NGOs. Guided by adult learning principles such as experiential and participatory learning, VHTs value practical, relevant, and continuous training that addresses real community health challenges. Despite persistent obstacles including lack of supplies, political interference, and reduced facilitation VHTs demonstrate empowered resilience, drawing strength from community trust, adaptability during health crises, and the confidence gained through continuous learning. The study confirmed that andragogy provides a powerful lens for understanding and improving VHT training and practice in Kampala. VHTs’ self-directed engagement, reliance on prior experience, and preference for problem-centered, relevant learning reflected the core elements of Andragogy theory. Through experiential and continuous learning, VHTs gain confidence, adaptability, and community trust, which enables them to respond effectively to diverse health challenges. However, systemic barriers such as inadequate facilitation, political interference, and limited government commitment undermine their potential. Strengthening community healthcare therefore requires a deliberate investment in sustainable adult learning frameworks, regular training, mentorship, provision of essential supplies, and policy reforms that prioritize VHT capacity-building. By addressing these gaps, both government and development partners can empower VHTs to deliver more effective and sustainable primary healthcare services.