The logic model for Uganda’s health sector preparedness for public health threats and emergencies

ABSTRACT

Background: Uganda is an ecological hot-spot with infectious disease transmission belts which exacerbates its vulnerability to epidemics. Its proximity to the Congo Basin, climate change pressure on eco-systems, increased international travel and globalization, and influx of refugees due to porous borders, has compounded the problem. Public Health Events are a major challenge in the region with significant impact on Global Health Security.

Objective: The country developed a multi-hazard plan with the purpose of harmonizing processes and guiding stakeholders on strengthening emergency preparedness and response.

Method: Comprehensive risk profiling, identification of preparedness gaps and capacities were developed using a preparedness logic model, which is a step by step process. A multidisciplinary team was constituted; the Strategic Tool for Analysis of Risks was used for risk profiling and identification of hazards; a desk review of relevant documents informed the process and finally, approval was sought from the National Task Force for public health emergencies.

Results: Target users and key public health preparedness and response functions of the multi-hazard plan were identified. The key capabilities identified were: coordination; epidemiology and surveillance; laboratory; risk communication and social mobilization. In each of these capabilities, key players were identified. Risk profiling classified road traffic accident, cholera, malaria and typhoid as very high risk. Meningitis, VHF, drought, industrial accidents, terrorism, floods and landslides were high risk. Hepatitis E, avian influenza and measles were low risk and the only plague fell into the category of very low risk. Risk profiling using STAR yielded good results. All risk categories required additional preparedness activities, and very high and high-risk categories required improved operational response capacity and risk mitigation measures.

Conclusion: Uganda successfully developed a national multi-hazard emergency preparedness and response plan using the preparedness logic model. The plan is now ready for implementation by the Uganda MoH and partners.

KEYWORDS:

• Emergencies
• multi-hazard
• logic model
• preparedness
• Uganda

Responsible Editor Stig Wall, Umeå University, Sweden

Responsible Editor Stig Wall, Umeå University, Sweden

Acknowledgments

We give special thanks to the Ministry of Health for providing leadership which enabled the development of the multi-hazard plan. We thank the WHO for technical and financial support for the planning process. We are highly indebted to all subject matter experts and Partners who made invaluable contributions to the plan. We would like to thank the African Centres for Disease Control and Prevention and African Field Epidemiology Network for availing us a scientific writing workshop opportunity that shaped this paper.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics and consent

The MoH Uganda through the office of the Director General of Health Services gave the directive and approval for documentation of the process of developing the multi-hazard plan. The Office of the Associate Director for Science, CDC/Uganda, also determined that this activity was not human subject research, and its primary intent was public health practice and policy.

Paper context

Uganda has been able to successfully develop a national multi-hazard emergency preparedness and response plan using the preparedness logic model. Using the STAR tool, risks were categorized.

Additional information

Funding

Funding is by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention Cooperative Agreement number GH001353-01 through Makerere University School of Public Health to the Uganda Public Health Fellowship Program, Ministry of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the US Centers for Disease Control and Prevention/the Agency for Toxic Substances and Disease Registry, the Department of Health and Human Services, Makerere University School of Public Health, or the Ministry of Health.

Notes on contributors

Alex Riolexus Ario

ARA - Led the writing process after reviewing the planning process and collating information, drafted and coordinated manuscript writing and wrote the first draft; IM, LB, AM, SK, JK, MW, JNK, FO, PT, HGM participated in writing and revision of many drafts; ARA and HGM revisited the first draft critically for key intellectual content, read and gave approval of the final manuscript.