Assessment of roles and challenges of community health workers in pandemic preparedness using lessons from the COVID-19 outbreak in rural Uganda

Abstract

Pandemics pose significant global threats, often causing panic due to poor preparedness and inadequate planning. Community Health Workers (CHWs) play a critical role in pandemic preparedness and response, especially in resource-limited settings like Uganda’s Bwindi-Mgahinga Conservation Area (BMCA), where human-wildlife coexistence heightens the risks of emerging and re-emerging infectious diseases. Unfortunately, CHWs face significant challenges exacerbated by limited resources. This study examined the roles and challenges of CHWs during the COVID-19 pandemic in BMCA-adjacent communities. The CHWs from sub-counties bordering BMCA were purposively selected and involved in 12 Focus Group Discussions in Kisoro, 8 in Rubanda, and 15 in Kanungu districts. The qualitative data obtained were analyzed using QDA Miner Lite to generate key themes. The findings revealed that CHWs ensured uninterrupted healthcare delivery by raising community awareness about COVID-19 transmission risks, facilitating contact tracing, promoting adherence to infection prevention guidelines, supporting vaccine awareness campaigns, and coordinating medical referrals to foster collaborative pandemic response networks. However, they faced challenges, including inadequate personal protective equipment (PPE), limited pandemic-specific training, community resistance, stigma, insufficient transportation, and inadequate incentives. Optimizing CHWs’ services through strategic deployment and resolving the challenges they face is essential to enhance pandemic preparedness and mitigate COVID-19 transmission risks to both human and wildlife populations. Integrating CHWs into the health system, developing streamlined policies, increasing recruitment, providing transportation and incentives, enhancing pandemic-focused training, conducting regular program evaluations, raising community awareness, and ensuring equitable resource allocation can boost management of disease outbreaks.