GCRF_NF138: Uptake of Public Health Practices for Prevention of COVID-19 among Refugees, Pastoralist Communities, Truck Drivers, Slum Dwellers: Uganda

Lead Research Organisation: University of Essex
Department Name: Government

Abstract

How can the uptake and acceptance of health guidelines regarding COVID-19 be improved among 'hard-to-reach' communities in Uganda, specifically among refugees, pastoralist communities, truck drivers and urban slum dwellers? Specifically, the project will consider how guidelines can be made more compatible with local cultural practices, and practical and economic constraints, and whether this indeed improves the distribution and uptake of information. Since in many communities women are central to preventive activities, the project pays specific attention to the gendered aspects of the distribution, communication and uptake of health guidelines. It further considers how trust in health organisations can be improved by means of including local community organisations in developing and implementing health guidelines. The main objectives are:
1) To establish how culture, information, attitudes and practices unique to targeted
communities influence the risk of COVID-19 transmission.
2) To promote culturally sensitive radio and mobile phone communication to enhance
awareness of the COVID-19 prevention; specifically, the relevance and the importance of
community engagement and local solutions.
3) To examine the role of trust in health organisation with the aim to build local community capacity to respond to pandemics, and to gather local evidence that can inform health policy and humanitarian response.
 
Description The survey UPTAKE OF PUBLIC HEALTH PRACTICES FOR PREVENTION OF COVID 19 AMONG REFUGEES, PASTORAL COMMUNITIES, TRUCK DRIVERS AND SLUM DWELLERS IN UGANDA, alongside information provide by key informants and focus group meetings provides a wealth of information on the knowledge about and impact of COVID-19, awareness of health guidelines and willingness to follow these guidelines, and the perception of the role of government and health officials, as well as community leaders in handling COVID-19. A unique aspect of the research that it has targeted (over-sampled) specific communities that are commonly underrepresented in nationally representative surveys. The research has shown that knowledge about COVID was generally widespread also in these communities, that there was largely a positive perception of the role played by officials in containing COVID, but with notable variation. Trust in their community matters most to understand following COVID guideline in refugee and pastoralist communities, while trust in the government is more important for urban and trucking communities. Radio is the key communication mechanism for most communities where communication in local languages is important. Especially for pastoralist communities, cultural practices and traditional beliefs are seen as important barriers to the uptake of health guidelines (and vaccines). Women are more worried about the impact of COVID, and rely more on community leaders for information about COVID. Concern about the impact of COVID on schooling of girls (and increased risks of pregnancy and forced marriages) of young adolescent girls was mentioned across the communities.
Exploitation Route In the months following the completion the project we developed a limited amount of impact activities will continue in the upcoming months. Even though funding was abruptly removed, the research team volunteered to share our findings more widely with the policy and health care community in Uganda. It remains our intention to share our key findings via an academic publication which will hopefully inspire other academics to explore communication of health guidelines to 'hard to reach communities' and, in particular refugee communities. The survey data have been made publicly available to be used by others.
Sectors Healthcare,Government, Democracy and Justice
 
Description The project has collected unique data on how culture, information, attitudes, and practices unique to targeted communities in Uganda are relevant for the uptake of COVID-19 health guidance. The Final Report collates the information from desk reviews, key informants, and focus group discussions, while focusing on the results of the Survey "Uptake of public health practices for prevention of COVID 19 among refugees, pastoral communities, truck drivers and slum dwellers in Uganda" with 5400 respondents. The Final Report and the Dissemination Slides have been presented at a number of (virtual) events reaching audiences at the district and national level; the Report and Slides have also been posted at a number of websites. The project has promoted culturally sensitive radio and mobile phone communication to enhance awareness of the COVID-19 prevention; specifically, the relevance and the importance of community engagement and local solutions. The project organised 5 training workshops for Radio Broadcasters and Translators on WHO Guidelines for Journalists for broadcasting COVID-19 messages and the Core Research Team (CRT) developed a training manual. Short radio announcements were translated into 18 languages and used for weekly broadcasts by 5 FM radio stations. To explore the relevance of local initiates, the project organised, and provided seed funding, for 12 projects where 6 projects dealt with liquid soap making and 6 with the sewing of face masks. The experiences were evaluated in focus group discussions and key insights include in policy briefs and final report. Originally, the intention was to evaluate the impact of the local initiatives as quasi experiments, but the sudden reduction in GCRF funding meant that this was no longer possible. Similarly, the evaluation of the possible impact of radio programs via a survey of radio listeners had to be abandoned midway. The third objective of the project was to examine the role of trust in health organisations with the aim to build local community capacity to respond to pandemics, and to gather local evidence that can inform health policy and humanitarian response. The GCRF budget cuts have affected the attainment of this objective significantly. Regardless, the project supported capacity building via the provision of desktop computers to six District Health Offices. This also enabled the CRT to participate in 12 meetings of the COVID-19 task force at the district level. Furthermore, the survey contains the basic information which we expect will allow us to delve deeper into the role of trust in COVID-19 prevention. The analysis of the data is still on-going but researchers at the University of Essex (led by PI Dorussen) with the target of submitting academic publication in 2023. As already described above, the experiences with local initiatives have informed the policy briefs and the final report. The evidence collected so far (via the survey, focus group meetings, and key informants) has been collated in the final report and the dissemination slides which have been presented by Mr. Obot at two key (virtual) events: one for the six district health offices and one for the Uganda National COVID-19 Task Force, part of the Ministry of Health.
First Year Of Impact 2021
Sector Education,Healthcare
Impact Types Societal,Policy & public services
 
Description Measuring Trust and its Variance during the COVID-19 Pandemic Using Serial Surveys and Quantitative Text Analysis
Amount £355,804 (GBP)
Funding ID ES/W011913/1 
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 02/2022 
End 01/2025
 
Title SURVEY UPTAKE OF PUBLIC HEALTH PRACTICES FOR PREVENTION OF COVID 19 AMONG REFUGEES, PASTORAL COMMUNITIES, TRUCK DRIVERS AND SLUM DWELLERS IN UGANDA 
Description The dataset contains the responses of 5421 participants randomly selected from 6 district (N = 900 in each district) in Uganda. The target populations and research sites were a. Refugees - (1) Adjumani district - Pakele refugees' settlement; (2) Arua district (currently Terego) - Imvepi refugees' settlement; (3) Yumbe district - Bidibidi refugees' settlement; b. Pastoralists - (4) Kotido district - Panyagara subcounty; c. Truck drivers - Tororo district - Malaba Town Council; and d. Urban slum dwellers - Nakawa division, Kampala Capital City. The surveys attained ethical approval from the University of Essex (UK) and the Uganda National Council for Science and Technology (UNCST) Ethics Committee. They consisted of phone and face-to-face interview questionnaire fitted on the data collectors' phones using Open Data Kit (ODK) programme, focus group discussions guide, and key informant interviews questions. Questions cover awareness of COVID regulations, ability to follow regulation, impact of COVID on personal and family life, trust in authorities, perception of authorities following COVID rules. 
Type Of Material Database/Collection of data 
Year Produced 2022 
Provided To Others? No  
Impact Key findings have been presented to policy makers in Uganda at national and district level. They are the basis of a final report and policy briefs. Data will be made publicly available as soon as possible. 
 
Description Partnership between University of Essex and Uganda Reach the Aged Association (URAA) for GCRF / Newton Fund Agile COVID 19 Rapid Response 
Organisation Uganda Reach the Aged Association (URAA)
Country Uganda 
Sector Charity/Non Profit 
PI Contribution As the Principal Investigator on the project, I have contributed by leading the research and research design. I have also secured ethical approval for the project at the University of Essex.
Collaborator Contribution The partners have started implementing the research locally. In particular, via completing a desk review, starting engaging with key informants and stakeholder at the local, regional, and national level. The partners are also working on securing required local research permits.
Impact The partnership was formalised, and used to obtain ethics approval at the University of Essex (ETH-2020-0320). Completion of due diligence process. Acquired research permits in Uganda. The project has also completed initial engagement activities with district health officials. The collaboration is multi-disciplinary involving political scientists, (health) sociologists, cultural anthropologists and health professionals. In 2020-2021, the survey research was designed and implemented across communities in Uganda. Data were collected and compiled. Alongside, we developed a number of community engagement activities and focus groups to evaluate their impact. The key descriptive findings were summarised in a report that we presented (virtually) to stakeholders and directly to the Prime Minsters and Health Ministers offices in Kampala.
Start Year 2020
 
Description Chairman URAA Board of Directors communication during the Annual General Meeting (AGM) that was held on December 10th 2022 at the URAA headquarters in Kampala City. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Third sector organisations
Results and Impact The research report formed part of the Chairman URAA Board of Directors communication to the over 100 members during the Annual General Meeting (AGM) that was held on December 10th 2022 at the URAA headquarters in Kampala City.
Year(s) Of Engagement Activity 2023
 
Description Disseminated of Final Report in the six districts through zoom on March 31, 2022, where all the six district stakeholders including the members of the District COVID-19 Task Force participated. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The purpose of the virtual event was to disseminate the key findings of our project to stakeholders in the six relevant health districts in Uganda including the District COVID-19 task forces. The presentation led to a brief discussion and participants expressed their appreciation of the research project and that they valued their opportunity to participate..
Year(s) Of Engagement Activity 2022
 
Description Dissemination by Mr. Obot of Final Report to Church of Uganda Higher Education Institutions (COU-HEI) Research Consortium 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact Dissemination of the research report by David Obot, CI, on 25.1.2023 through the Church of Uganda Higher Education Institutions (COU-HEI) Research Consortium. The 5 universities forming the consortium are: Uganda Christian University (UCU), Mukono; All Saints University Lango (ASUL), Lira City; Bishop Stuart University (BSU), Mbarara City; Ankole Western University, Kabwohe, Sheema Municipality; Ndejje University;
Year(s) Of Engagement Activity 2023
 
Description District Health Sector Committees: Handover of Personal Computers for Recording Covid Health Data 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact As part of the research project, personal computers are distributed to six District Health Sector Committees to facilitate the recording and administrating of Covid-19 related health statistics in the regions targeting in our research. The handover events were covered by local media generating interest in our research project; also to generate publicity so that it will maximise response rates to the planned survey. The handover event in Nakawa District, Kampala, Uganda was attended by Mr. Fred Were Wetaga (URAA Officer), Dr. Susan Namutesa (DHO, Nakawa Division, Kampala Capital City Authority), Mr. David Obot (Co-Investigator), and Dr. Henry Opondo (Core Research Team).
Year(s) Of Engagement Activity 2021
 
Description Participation of Core Research Team in twelve District Covid-19 Task Force meetings 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Participation of Core Research Team in District Covid-19 Task Force meetings. A total of 12 meetings attended by CRTs (Arua -2, Yumbe-2, Adjumani-2, Kotido-2, Tororo-2, Nakawa-2)
Year(s) Of Engagement Activity 2021
 
Description Presentation (virtual) of final research report by Mr. Obot with PI Dorussen in attendance to the Uganda National COVID-19 Task Force, Ministry of Health on April 5, 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation (virtual) on April 5, 2022 by Mr. Obot attended by PI (Dorussen). Approximately 300 attendees.
Institutions represented included: WHO, UNDP, UNHCR, Ministries of Health, Local Government, Office of the Prime Minister; academic institutions including Makerere Institute of Pubic Health, Mbarara University of Science and Technology (MUST) and Uganda Christian University among others; as well as individual researchers. The dissemination slides have been uploaded on several websites, while other institutions that requested the materials to upload on their websites are the African Leadership Institute (AFLI), and University of Cavendish
Year(s) Of Engagement Activity 2022
 
Description Presentation of the UKRI Research report by Mr. Obot to university students and youth representatives 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact David Obot presented the UKRI Research report to the 18 university students and youth representatives on 5th January 2023 at their venue, St. Gracious Primary School, Lira City, Northern Uganda.
Year(s) Of Engagement Activity 2023