Uganda Mountain Community Health System—Perspectives and Capacities towards Emerging Infectious Disease Surveillance

Abstract

In mountain communities like Sebei, Uganda, which are highly vulnerable to emerging and re-emerging infectious diseases, community-based surveillance plays an important role in the monitoring of public health hazards. In this survey, we explored capacities of village health teams (VHTs) in Sebei communities of Mount Elgon in undertaking surveillance tasks for emerging and re-emerging infectious diseases in the context of a changing climate. We used participatory epidemiology techniques to elucidate VHTs’ perceptions on climate change and public health and assessed their capacities to conduct surveillance for emerging and re-emerging infectious diseases. Overall, VHTs perceived climate change to be occurring with wider impacts on public health. However, they had inadequate capacities in collecting surveillance data. The VHTs lacked transport to navigate through their communities and had insufficient capacities in using mobile phones for sending alerts. They did not engage in reporting other hazards related to the environment, wildlife, and domestic livestock that would accelerate infectious disease outbreaks. Records were not maintained for disease surveillance activities and the abilities of VHTs to analyze data were also limited. However, VHTs had access to platforms that could enable them to disseminate public health information. The VHTs thus need to be retooled to conduct their work effectively and efficiently through equipping them with adequate logistics and knowledge on collecting, storing, analyzing, and relaying data, which will improve infectious disease response and mitigation efforts.

Household satisfaction with health services and choice of response strategies to malaria occurrence: The case of mountain communities of Elgon in Uganda

“…These are important factors that relate with health service access. This result is similar to that in other studies that have shown community health care workers within this area to perceive climate change to undermine their activities [9]. Although the target population are different, similar results have been…”

“…This result can be linked to the results of the current study as the study area is a hard-to-reach area with limited opportunities for ensuring sustained health systems. This has been demonstrated in other studies that indicate limited surveillance capacities partly because of the terrain and limited infrastructure and communication channels [9].…”

“…It is even worse in mountain communities where access to social services is limited [8]. Indeed, the hotspots for malaria in mountain communities like in Elgon have been shown to be highly variable [3] and yet the area has limited surveillance and response capacities for such diseases [9].…”

A proposed One Health approach to control yellow fever outbreaks in Uganda

“…However, the existing surveillance systems (both YF passive and sentinel surveillance systems) for human population in Uganda face significant challenges such as inadequate laboratory diagnostic capabilities, a shortage of skilled public health professionals such as those needed for data analysis and interpretation of surveillance data, leading to the underreporting of YF cases, and slower outbreak response [48]. Moreover, health workers and community-based surveillance volunteers often lack awareness of the YF case definition, leading to ineffective and irregular reporting of cases at both community and health facility levels [49]. Consequently, only few healthcare units report YF cases [17].…”

How Should a One Health Perspective Promote Cross-Disciplinary Research About Bat-Associated Viruses in Uganda?

“…Despite having a village health team (VHT) network for community disease surveillance, volunteers are challenged by inadequate access to transportation for surveillance data collection; lack of data analysis and storage capacity; no coordination among environmental, wildlife, or livestock surveillance; and inability to use mobile phones for data reporting. 24 Experts' engagement with communities is essential for early recognition and response to emerging infectious disease events. While Uganda has formalized a National One Health Platform for advising government agencies and coordinating their responses to zoonotic diseases, this endeavor lacks financial backing and actual intersectoral coordination.…”