It is a public health fact that in Uganda, the war against COVID-19 will be won or lost in the community. Presently, communities have the panacea on how the response progresses simply because COVID-19 infections are increasingly being detected in communities across the country.
Current figures indicate that as of 8th June 2020, a total of 646 people had been confirmed to have contracted the diseases and of these, 425 are imported while 221 are locally transmitted. A cursory look at the distribution of local cases indicates that almost all regions of the country have reported some cases. While this trend can't be characterized yet as consistent community transmission, but the fact that sporadic cases have been detected in many places is indeed worrying.
Therefore, the Ministry of health with support from the World Health Organization (WHO) and partners has intensified community engagement interventions to stop the outbreak in the communities. In other words, people must know about COVID-19 and to do practice the right behaviours to stop the outbreak. In Rakai and Kyotera districts, for instance, some of the most COVID-19 affected, the response has necessitated taking COVID-19 action to sub-county levels - composed of parishes and villages.
Already, District Task Forces (DTF) with clear composition and terms of reference have been set up in all districts and are spearheading the response at that level. Chaired by the Resident District Commissioners, DTFs have embraced COVID-19 work with utmost commitment and zeal.
The DTFs have developed or updated risk communication plans in a considerably short period of time. Although most of these plans are not yet funded, they chart the way the district would like to take on the response. The plans are an indication of serious intent and are handy for resource mobilization and partner support.
In Rakia district, for instance, members of the DTFs have gone a step further and conducted social mobilization activities at the sub-county level, participated in radio talk shows and supervised the translation of IEC materials into the local language. Most importantly, DTFs have oriented lower-level structures on COVID-19, participated in community dialogue sessions and supervised sub-county COVID-19 community engagement activities.
In a few districts, DTF members have supported and participate in Knowledge Attitude and Practices (KAP) studies aimed at exposing the drivers of the epidemic in the communities. Findings from some of these KAPs are informing response activities in districts where they have been conducted.
In the sub-counties of Kyotera and Rakai districts, community engagement structures have been set up comprising of public servants from all sectors signifying the importance of multi-sectoral collaboration in COVID-19 response. These sub-county teams have organized and participated in community engagement activities such as community dialogues, distribution of IEC materials, contact tracing and followed up implementation of community action plans.
Sub counties have also mobilized individuals, households and communities for COVID-19 and are conducting home visits, distributing IEC materials as well as strengthening WASH activities at household and community levels. They are also advising people on physical distancing and organizing or conducting regular community meetings as needed.
Community engagement has also brought on board LC1 executives supported by Village Health Teams into the action. Boda Boda riders, market vendors, restaurant and lodge owners and many more are all undertaking roles in this response as seen in Rakai and Kyotera districts.
Community action is also at the centre of Community Based Disease Surveillance (CBDS) and contact tracing. While border surveillance and detection of cases have been strengthened, CBDS is taken as a game-changer in this response. In Rakai district, the first four community cases were detected through the vigilance of VHTs and local councils using CBDS guidelines. More positive cases and contacts have been detected not only at the border posts such as Mutukula and Kansesero in Kyotera but also in communities in several districts using CBDS.
Community COVID-19 alerts through the Alert Desks have also been verified and responded to on time. This is central to the response and several people who came into contact with sick people have been detected and quarantined in centres for quick and daily follow.
A lot of work is being done to establish and functionalize the key response pillars. However, it is the community-based work done through community engagement and CBDS that will determine how soon and where the war against COVID-19 is won or lost.