Review of the village health worker pilot scheme in Tonga.

The village health worker (VHW) pilot scheme in Tonga was reviewed three months after implementation. The scheme was acceptable to the regional health workers and the communities the VHW were serving. There were demands from most for the VHW for the community to have more than one VHW, build a clinic, and to increase the emphasis on curative medicine. There was no demand for a health prevention or promotional role. The rate of recorded illnesses has increased but health seeking behaviour remained unchanged. This scheme has provided an opening for the Ministry of Health to implement equalizing strategies to merge the practice and the political rhetoric of primary health care and community participation.