Healthworker preparedness for COVID-19 management and implementation experiences: a mixed methods study in Uganda's...

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Systems Research

Background:

• COVID-19's impact highlights the need for health system resilience, particularly in resource-limited settings.
• This study assesses health worker preparedness and implementation experiences for COVID-19 management in Uganda's refugee-hosting districts.

Purpose of the Study:

• To evaluate health care worker (HCW) knowledge, attitude, and practices (KAP) regarding COVID-19 management.
• To explore HCW implementation experiences and stakeholder perspectives on COVID-19 response in Uganda.
• To identify gaps in health system preparedness and inform strategies for resource-limited settings.

Main Methods:

• Cross-sectional, mixed-method descriptive study involving 485 participants, including over 370 HCWs, across 17 health facilities in 7 Ugandan districts.
• Quantitative data collected via a pre-validated KAP questionnaire, analyzed using SPSS (p < 0.05 significance).
• Qualitative data from interviews explored implementation experiences and stakeholder opinions, analyzed thematically.

Main Results:

• 71% of HCWs demonstrated adequate COVID-19 knowledge, with significant variations observed (e.g., 95% awareness of symptoms vs. 35% on intubation criteria).
• Protective practices included ventilation and training; deficient practices involved psychosocial support and contingency planning.
• HCWs reported increased workload and moderate control but high supervisor and colleague support.

Conclusions:

• Health care worker preparedness for COVID-19 management is partially inadequate in Uganda.
• Implementation challenges stem from health system complexity, a top-down national response, and existing bottlenecks.
• Recommendations include continuous information sharing, capacity strengthening, and community-focused strategies.