281 Working through community health workers: how village health teams in Uganda ensure continuity of care for refugees with hypertension and diabetes

Abstract PTH 4: Mental Health and Refugees 2, B307 (FCSH), September 4, 2025, 14:00 - 14:48 Many refugees in Uganda struggle with continuity of chronic disease care. This study explores how community health workers assist refugees living with diabetes and hypertension in engaging with both formal health services and treatment as well as self- and social care. Drawing on semi-structured individual interviews with 10 community health workers from Bidibidi refugee settlement, we find that they, despite receiving little assistance and having limited resources, engage in three types of work that appear critical to maintaining care continuity for refugees with diabetes and hypertension. One, Relations Work: Community health workers establish contact with the community and facilitate communication between the community and health facility staff. They serve as intermediaries, and help patients re-engage with health services, advocate for patients, and act as “go-betweens”. Two, Care Work: Community health workers routinely monitor and screen for common illnesses, i.e. malaria. They also refer cases that cannot be managed within the community to the health center, including diabetes and hypertension. They also promote health, deliver prescribed medication to patients with chronic conditions, monitor adherence, and follow up with patients who discontinue treatment. Three, Community Engagement Work: Community health workers record and assess common illnesses within the community, engage in community sensitization, and mobilization. These three types of work are critical to the continuity of chronic condition care for refugees. Our findings indicate the importance of community health workers and of their integration community health workers into the formal health system. Hence, they need training, equipment, transport means and compensation for their time. To address community needs, community engagement should include dialogues, radio talk shows, outreaches, and integrated programs. Diabetes and hypertension care and follow-up need strengthening at other health system levels through added financing for programmes, health workforce trainings and continuous monitoring and evaluation and improved diagnostic equipment at referral levels.