Balancing Safety and Good Care during Infectious Disease Outbreaks in Uganda (BASYC)

Balancing safety and good care in the context of infectious disease outbreaks: learning health systems for infection prevention and control in Uganda (BASYC)

February 2021 – January 2023

This multi-disciplinary project examines infection prevention and control (IPC) practices in the context of care provision in Ugandan health facilities and communities facing recurrent epidemics.

Our analysis of distancing and personal protective measures for IPC is grounded in a broader mapping of geographic and social distance that characterise the material realities and practices of care in Uganda. Drawing on the experiences and institutional memory of health workers, lay caregivers and recipients of care, we aim to contribute to a ‘learning health system’ for epidemic preparedness during and beyond the COVID-19 crisis.

Dr Georgina Pearson is Principal Investigator and Dr Karina Kielmann is Co-Principal Investigator. Together, they are responsible for conceptualisation and oversight of the project work packages, as well as ensuring the timely delivery of high-quality outputs. In addition to academic publications, we hope that our findings will contribute to refining national guidelines on IPC in Uganda and health provider training materials for epidemic preparedness.

Gimenne Zwama and Dr Aaron Karat are Research Fellows supporting data collection, analysis, and dissemination activities within the project.

In resource-poor health systems experiencing infectious disease (ID) outbreaks including Coronavirus disease (COVID-19), health care workers (HCW) balance the need to provide good care for patients alongside safety measures to protect patients and themselves from infection. Set in Uganda, a country that has experienced multiple ID outbreaks in recent decades, this project examines how IPC measures are implemented in the context of care relations in health facilities and communities.

Our aim is to strengthen the health system’s capacity to draw on past and existing information and experiences of preparing for, and responding to, epidemic outbreaks, both during and beyond the COVID-19 crisis. We draw on methods from policy research, anthropology, and geography to examine the implementation of IPC measures within the broader context of historical, geographic, and social distances that characterise provision of care in two contrasting regions of Uganda (South-Central and West Nile).

Working with relevant stakeholders at national and regional level, we hope to deliver insights that can inform health protection practices and protocols for safe and compassionate care and strengthen capacity of the health system for future epidemic preparedness within and beyond Uganda's borders.

  1. To elucidate path-dependent influences of Uganda's recent history of infectious disease (ID) outbreaks on current IPC practice within health and community care.
  2. To examine how current implementation of IPC physical distancing measures and barrier methods relate to social, professional, and geographic hierarchies of care provision.
  3. To elicit how formal and informal caregivers attend to care needs and mitigate risk and safety in the context of ID outbreaks including COVID-19.
  4. To assess how institutional memory and individual experiences of providing care in the context of ID outbreaks can contribute to learning health systems.

Makerere University School of Public Health; London School of Hygiene & Tropical Medicine

This work is supported by a grant from the Health Systems Research Initiative with funding from the Foreign, Commonwealth and Development Office, the UK Medical Research Council and Wellcome, in collaboration with the UK Economic and Social Research Council (grant no. MR/V015192/1).

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Dr Karina Kielmann

Reader - IGHD