Assessment of the preparedness of the Ugandan health care system to tackle more COVID-19 cases

Healthworker preparedness for COVID-19 management and implementation experiences: a mixed methods study in Uganda’s refugee-hosting districts

“…education level, residence, location of work station, hygiene promotion or social distance management) and facility-related factors (e.g. poor information/communication, lack of safety plans, risk monitoring or work environmental threats).The need for infrastructural preparedness, responsive and resilient health systems cannot be overemphasized [ 29 , 68 ]. We recommend practical, bespoke and urgent strengthening of system capacity at all levels, especially in light of surging community transmission, a limited health workforce and congested higher-level facilities.…”

Healthworker Preparedness for COVID-19 Management and Implementation Experiences: A Mixed Methods Study in Uganda’s Refugee-Hosting Districts

“…A myriad of other factors including governance, leadership or stewardship shortfalls, changing population pro les with related needs and ine ciencies within the public sector have ampli ed the growth and prominence of the private health sector and out-of-pocket payments for healthcare [15][16][17][18]. In particular, the low funding for Uganda's healthcare system continues to create an ongoing challenge of insu cient health workforce numbers [18] estimated at 72% sta ng levels in public facilities with low HCW-patient ratios [19]. Uganda's doctor-patient and nurse-patient ratio is approximately 1:25 000 and 1:11 000 respectively which is way below the WHO recommended doctor-patient ratio of 1:1000 [19].…”

“…In particular, the low funding for Uganda's healthcare system continues to create an ongoing challenge of insu cient health workforce numbers [18] estimated at 72% sta ng levels in public facilities with low HCW-patient ratios [19]. Uganda's doctor-patient and nurse-patient ratio is approximately 1:25 000 and 1:11 000 respectively which is way below the WHO recommended doctor-patient ratio of 1:1000 [19]. This healthworker shortfall has sometimes been mitigated by task shifting which has existed in Uganda since 1918 [20] and which the evidence shows to have improved quality of care in the treatment of HIV/AIDS, tuberculosis, maternal, newborn and child health (MNCH) programs as well as malaria [21][22][23].…”

“…education level, residence or location of work station, hygiene promotion, social distance management etc) and facility-related factors (e.g. poor information/communication, lack of safety plans, risk monitoring and work environmental threats among others).The need for infrastructural preparedness, responsive and resilient health systems cannot be overemphasized [68,19]. We recommend practical and urgent support for system capacity at all levels, especially in light of surging community transmission, a limited health workforce and congested higher-level facilities.…”

“…The Ministry of Health also instituted several guidelines for the continuity of essential health services and clinical management of COVID-19 including screening, testing, isolation, and institutional quarantine among others. However, there are several challenges that would signi cantly undermine Uganda's health system preparedness to tackle the pandemic including the high HCW-patient ratios in addition to other existing sta ng gaps, porous borders which potentially let through infected people especially refugees from neighbouring countries, ineffective quarantine processes and low nancing for the health system [19,46,47]. COVID-19 is a highly contagious infectious disease with higher likelihood for infection among healthworkers compared to the general population [48].…”