Reflecting on One Health in Action During the COVID-19 Response

The COVID-19 pandemic, a singular disruptive event in recent human history, has required rapid, innovative, coordinated and collaborative approaches to manage and ameliorate its worst impacts. However, the threat remains, and learning from initial efforts may benefit the response management in the future. One Health approaches to managing health challenges through multi-stakeholder engagement are underscored by an enabling environment. Here we describe three case studies from state (New South Wales, Australia), national (Ireland), and international (sub-Saharan Africa) scales which illustrate different aspects of One Health in action in response to the COVID-19 pandemic. In Ireland, a One Health team was assembled to help parameterise complex mathematical and resource models. In New South Wales, state authorities engaged collaboratively with animal health veterinarians and epidemiologists to leverage disease outbreak knowledge, expertise and technical and support structures for application to the COVID-19 emergency. The African One Health University Network linked members from health institutions and universities from eight countries to provide a virtual platform knowledge exchange on COVID-19 to support the response. Themes common to successful experiences included a shared resource base, interdisciplinary engagement, communication network strategies, and looking global to address local need. The One Health approaches used, particularly shared responsibility and knowledge integration, are benefiting the management of this pandemic and future One Health global challenges

Reflecting on One Health in Action During the COVID-19 Response

The COVID-19 pandemic, a singular disruptive event in recent human history, has required rapid, innovative, coordinated and collaborative approaches to manage and ameliorate its worst impacts. However, the threat remains, and learning from initial efforts may benefit the response management in the future. One Health approaches to managing health challenges through multi-stakeholder engagement are underscored by an enabling environment. Here we describe three case studies from state (New South Wales, Australia), national (Ireland), and international (sub-Saharan Africa) scales which illustrate different aspects of One Health in action in response to the COVID-19 pandemic. In Ireland, a One Health team was assembled to help parameterise complex mathematical and resource models. In New South Wales, state authorities engaged collaboratively with animal health veterinarians and epidemiologists to leverage disease outbreak knowledge, expertise and technical and support structures for application to the COVID-19 emergency. The African One Health University Network linked members from health institutions and universities from eight countries to provide a virtual platform knowledge exchange on COVID-19 to support the response. Themes common to successful experiences included a shared resource base, interdisciplinary engagement, communication network strategies, and looking global to address local need. The One Health approaches used, particularly shared responsibility and knowledge integration, are benefiting the management of this pandemic and future One Health global challenges

Performance of District Disaster Management Teams after Undergoing an Operational Level Planners’ Training in Uganda

Introduction: Uganda is vulnerable to several natural, man-made and a hybrid of disasters including drought, famine, floods, warfare, and disease outbreaks. We assessed the district disaster team’s performance, roles and experiences following the training. Findings: The disasters most commonly experienced by the district teams were epidemics of diseases in humans (7 of 12), animals (epizoonotics) (3 of 12) and crops (3 of 12); hailstorms and floods (3 of 12). The capabilities viewed most useful for management of disasters were provision of health care services (9/12) and response management (8 of 12). The capability domains most often consulted during the disasters were general response management (31%), health services (29%) and water and sanitation (17%). The skills areas perceived to be vital following the training were response to epidemics 10/12, disaster management planning 8/12, hazards and vulnerability analysis 7/12 and principles of disaster planning 7/12 respectively. Main challenges mentioned by district teams were inadequacy of finance and logistics, lack of commitment by key partners towards disaster preparedness and response. Conclusions: The most common disaster experienced disasters related to outbreaks of diseases in man, animals and crops. The most frequently applied capabilities were response management and provision of emergency health services. The activities most frequently implemented following disaster management teams training were conducting planning meetings, refinement of plans and dissemination of skills gained. The main challenges were related to limited budget allocations and legal frameworks for disaster management that should be addressed by both central and local governments.Keywords: Performance, disaster management, evaluation, operational level, Ugand

A Descriptive Overview of the Burden, Distribution and Characteristics of Epidemics in Uganda

Background: Although Uganda is a high burden country for epidemics of infectious diseases, the pattern of epidemics has not yet been adequately documented. The purpose of this study was to describe the distribution, magnitude and characteristics of recent epidemics in Uganda, as a basis for informing policy on priorities for targeted prevention of epidemics. Methods: Qualitative and quantitative data was collected from the Epidemiological Surveillance Division of the Ministry of Health and the African Field Epidemiology Network through key informant interviews and a documents review. Results: Acute outbreaks that have occurred since 2002 are: Cholera, Meningitis, Malaria, Viral Hemorrhagic Fevers (Ebola, Marburg), arboviruses (yellow-fever), Anthrax, Hepatitis E, Measles, Polio, Influenza A viruses, dysentery and other diarrheal diseases. Chronic outbreaks include: Propagated epidemics of cholera, head nodding disease, Hepatitis B, Hepatitis E, HIV and Typhoid Fever. Thirty-one districts had a high incidence of cholera. Most of the epidemic prone diseases are preventable through appropriate behavior change and sanitation measures. However, current focus is mainly on prevention, low focus on prevention. Community involvement in resilience and early detection is inadequate. Conclusion: Uganda has a high burden of preventable epidemic prone diseases. There is need to invest in surveillance, early detection and sustainable prevention through appropriate technology and behavior change involving individuals, families, communities and policy makers.Keywords: Epidemic, outbreak, surveillance

Strategies for sustainability and equity of prepayment health schemes in Uganda

Background: Despite the long existence of community health insurance schemes (CHI) in Uganda, their numbers and coverage levels have remained small with limited accessibility by the poor. Objectives: To examine issues of equity and sustainability in CHI schemes, which are prerequisites to health sector financing. Methods: We carried out a descriptive cross-sectional study employing qualitative techniques. Eight focus group discussions (FGDs) with CHI scheme members and seven FGDs with non-members were held. Twelve Key informant interviews (KIs) were held with scheme managers, officials from Ministry of Health and one health financing organisation. We reviewed relevant documents and records of schemes. Results: Respondents' perceptions of unfairness in schemes were: non-members were treated better in hospital than members; some members pay premiums continuously without falling sick and schemes refused to cover illnesses like diabetes and hypertension. Fairness was related with the very little payment for the services received, members paying less than non-members but both getting the same treatment and no patient discrimination based on gender, age or social status. Schemes are not sustainable because they operate on small budgets, have low enrolment and lack government support. Effect of abolition of user fees on scheme enrolment was minimal.. Conclusion Government should ensure that quality of health care does not deteriorate in the context of increased utilisation after user fees removal, schemes need substantial support to build their sustainability and there is need for technical and policy considerations about whether or not CHI has a role to play in Ugandan health system

Opportunities for Strategic Use of E-Learning in Scaling Up Disaster Management Capacity in Eastern Africa: A Descriptive Analysis

Background: The growing need for disaster management skills at all levels in Eastern Africa requires innovative approaches to training planners at all levels. While information technology tools provide a viable option, few studies have assessed the capacity for training institutions to use technology for cascading disaster management skills. Methods: The design was an explorative survey. A pre-training survey was conducted among 16 faculty members (9 academic staff and 7 information technology (IT) staff) from 7 schools of public health in Eastern Africa. Key informant interviews with 4 students and 4 staff members were conducted at the school of public health in Makerere. IT staff also conducted observations on trends of use of information technology infrastructure. Results: Current levels of use of ICT among teaching and IT staff is variable. On-site use of the internet is high, but off-site access is low. Personal computers, e-mail, discussion forums and other web-based learning management platforms and open education resources (OERs) have been variably used by faculty and students to facilitate learning. On the other hand, videos, web-conferencing, social media, web-based document management tools, and mobile telephone applications were much less frequently used. A disaster management short course produced by the Health Emergencies Management Project (HEMP) has been adapted to a web-based open education resource and an interactive CD-ROM. Challenges included low levels of awareness and skills in technology options among students and faculty and access to reliable internet. Conclusions: Despite the existing challenges, technology tools are a viable platform for cascading disaster management skills in Eastern Africa.Keywords: Information and Communication technology, e-learnin

Hiv Risk Behavior And Work In Uganda: A Cross-Sectional Study

Objective: The study assessed the prevalence of factors associated with HIV risky behaviour among employees of a Sugar Factory in Jinja District, Uganda. Methods: A cross-sectional study of 321 participants was carried out in a Sugar Factory where several workers were migrants. Using an interviewer-administered questionnaire, information on socio-demographic characteristics, work factors and sexual behaviours was obtained. Results: Fifty-one percent of the men and 32% of the women reported having multiple sex partners in the past year. Thirty-six percent of the respondents reported using condoms during the last casual sex. Twenty-four percent of men and 15% women reported sexually transmitted infection-related symptoms in the last one-year. Having multiple sex partners was associated with being a contract worker (OR= 2.1, 95%CI= 1.10-3.79) and being married but not living with spouse (OR= 2.1, 95%CI= 1.16-4.00). Conclusion: HIV risk behaviour among Sugar Factory workers is associated with separation from partner. HIV intervention strategies should include work related factors of this type. Keywords: HIV, Sexual, Risk behaviour, Factory, Workplace, Uganda East African Journal of Public Health Vol. 5 (1) 2008 pp. 43-4

Effect of HIV/AIDS on household welfare in Uganda rural communities: a review

No Abstract. East African Medical Journal Vol. 85 (4) 2008: pp. 187-19