Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Interventions for Continuity of Essential Health Service Delivery during the COVID-19 Response in Uganda, between March 2020 and April 2021

Version 1 : Received: 30 August 2022 / Approved: 30 August 2022 / Online: 30 August 2022 (08:23:26 CEST)

A peer-reviewed article of this Preprint also exists.

Kabwama, S.N.; Wanyenze, R.K.; Kiwanuka, S.N.; Namale, A.; Ndejjo, R.; Monje, F.; Wang, W.; Lazenby, S.; Kizito, S.; Troeger, C.; Liu, A.; Lindgren, H.; Razaz, N.; Ssenkusu, J.; Sambisa, W.; Bartlein, R.; Alfvén, T. Interventions for Maintenance of Essential Health Service Delivery during the COVID-19 Response in Uganda, between March 2020 and April 2021. Int. J. Environ. Res. Public Health 2022, 19, 12522. Kabwama, S.N.; Wanyenze, R.K.; Kiwanuka, S.N.; Namale, A.; Ndejjo, R.; Monje, F.; Wang, W.; Lazenby, S.; Kizito, S.; Troeger, C.; Liu, A.; Lindgren, H.; Razaz, N.; Ssenkusu, J.; Sambisa, W.; Bartlein, R.; Alfvén, T. Interventions for Maintenance of Essential Health Service Delivery during the COVID-19 Response in Uganda, between March 2020 and April 2021. Int. J. Environ. Res. Public Health 2022, 19, 12522.

Journal reference: Int. J. Environ. Res. Public Health 2022, 19, 12522
DOI: 10.3390/ijerph191912522

Abstract

Introduction: The COVID-19 pandemic overwhelmed health systems globally, and affected delivery of other health services. We conducted a study in Uganda to describe interventions for continuity of access to other health services. Methods: We reviewed documents and interviewed 21 key informants. Thematic analysis was conducted to identify themes using the World Health Organization health system building blocks as a guiding framework. Results: Governance strategies included establishment of coordination committees and development and dissemination of guidelines. Infrastructure and commodities strategies included review of drug supply plans and allowing emergency orders. Workforce strategies included provision of infection prevention and control equipment, recruitment and provision of incentives. Service delivery modifications included designation of facilities for COVID-19 management, patient self-management, dispensing drugs for longer periods and leveraging community patient networks to distribute medicines. However, multi-month drug dispensing led to drug stock-outs while community drug distribution was associated with stigma concerns. Conclusions: Health service maintenance during emergencies requires coordination to harness existing health system investments. The service continuity committee coordinated efforts to maintain services and should remain a critical element of emergency response. Self-management and leveraging patient networks should address stigma to support service continuity in similar settings and strengthen service delivery beyond the pandemic.

Keywords

COVID-19; health care; learning health systems; health serives; public health

Subject

MEDICINE & PHARMACOLOGY, Nursing & Health Studies

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