Covid funding for study on healthcare in Uganda

Rapid response Covid funding has been secured for a project aiming to improve the understanding and uptake of health guidelines in ‘hard-to-reach’ communities in Uganda.

The project, led by Professor Han Dorussen from the Department of Government, will explore how Covid-19 guidelines can be made more compatible with local cultural practices, and practical and economic constraints. It has the potential to inform public health policy and communications across the developing world.

Professor Dorussen, who is collaborating with the Uganda Reach the Aged Association, has received £525,000 for the study from UK Research and Innovation through the UK Government’s Global Challenges Research Fund (GCRF) and the Newton Fund.

The study will target refugees, animal herding communities, truck drivers and urban slum dwellers, paying particular attention to the role of women in the distribution, communication and uptake of health advice. It will also explore how trust in health organisations can be improved by working with local community groups.

Professor Dorussen explained some of the reasons why it’s hard to reach these communities: “Uganda hosts more than one million refugees, mainly from South Sudan and the Democratic Republic of Congo (DRC) and they use a number of different languages, from French to a host of indigenous languages.

“Language can also be a barrier for truck drivers, while the remoteness of animal herding communities hinders dissemination, and tensions between groups make some hard to reach. Practical constraints such as the availability of soap and clean water make the uptake of healthcare guidelines practically difficult to implement too.”

The research team will support a number of local initiatives, such as the translation and broadcast of health advice in various indigenous languages, and projects training people to make liquid soap. They will explore the effectiveness of initiatives through focus groups and surveys. They will also look at whether targeting advice at particular settings, such as where women gather to collect water, can improve uptake.

Professor Dorussen has previously studied external interventions and their impact on post-conflict situations, including the local perception of and trust in these various interveners. Trust will also be a focus of this study.

“We are interested to explore how trust in the various local, national and foreign organisations that provide health guidelines matters. In particular we will look at whether involving local organisations in ‘spreading the news’ helps to get people to follow advice,” Professor Dorussen said.

Despite Africa, and Uganda, having experience of managing infectious diseases, such as malaria and Ebola, and being well organised for the current Covid-19 crisis, Professor Dorussen believes much can be learnt: “The Ugandan government has imposed quite strict measures but there are infections and people are dying. Our research is focused on Uganda and Covid in the first instance, however, it would surprise me if some of our findings would not apply more generally. For instance in the DRC there is a lot of distrust against health officials in their efforts to contain Ebola.”

The project is funded for 18 months. It is one of two Essex projects funded by the UKRI's rapid response Covid fund. Read about Professor Ileana Steccolini's project supporting vulnerable communities in Brazil.