Abstract
BackgroundThe level of preparedness of the health care workers, the health facility and the entire health system determines the magnitude of the impact of an Ebola Virus Disease (EVD) outbreak as demonstrated by the West African Ebola outbreak. The objective of the study was to assess preparedness of the health care facilities and identify appropriate preparedness measures for Ebola outbreak response in Kasese and Rubirizi districts in western Uganda.MethodsA cross sectional descriptive study was conducted by interviewing 189 health care workers using a structured questionnaire and visits to 22 health facilities to determine the level of health care system preparedness to EVD outbreak. District level infrastructure capabilities, existence of health facility logistics and supplies, and health care workers’ knowledge of EVD was assessed. EVD Preparedness was assessed on infrastructure and logistical capabilities and the level of knowledge of an individual health work about the etiology, control and prevention of EVD.ResultsTwelve out of the 22 of the health facilities, especially health center III’s and IV’s, did not have a line budget to respond to EVD when there was a threat of EVD in a nearby country. The majority (n = 13) of the facilities did not have the following: case definition books, rapid response teams and/or committees, burial teams, and simulation drills. There were no personal protective equipment that could be used within 8 h in case of an EVD outbreak in fourteen of the 22 health facilities. All facilities did not have Viral Hemorrhagic Fever (VHF) incident management centers, isolation units, guidelines for burial, and one-meter distance between a health care worker and a patient during triage. Overall, 54% (n = 102) of health care workers (HCWs) did not know the incubation period of EVD. HCWs who had tertiary education (aOR = 5.79; CI = 1.79–18.70; p = 0.003), and were Christian (aOR = 10.47; CI = 1.94–56.4; p = 0.006) were more likely to know about the biology, incubation period, causes and prevention of EVD.ConclusionsFeedback on the level of preparedness for the rural districts helps inform strategies for building capacity of these health centers in terms of infrastructure, logistics and improving knowledge of health care workers.
Highlights
The level of preparedness of the health care workers, the health facility and the entire health system determines the magnitude of the impact of an Ebola Virus Disease (EVD) outbreak as demonstrated by the West African Ebola outbreak
Socio-demographic characteristics of the health workers One hundred and eighty-seven (187) Health Care Workers (HCW) from both Kasese and Rubirizi districts participated in this study (Table 1)
Recruitment of health care workers was based on names provided by the District Health officers. We addressed this limitation by confirming absence and/or presence of names of the HCWs at facility level
Summary
The level of preparedness of the health care workers, the health facility and the entire health system determines the magnitude of the impact of an Ebola Virus Disease (EVD) outbreak as demonstrated by the West African Ebola outbreak. In 2018, Democratic Republic of Congo (DRC) reported an EVD outbreak that appears to be still active [3] Both the West African and DRC Ebola virus disease (EVD) outbreaks led countries globally to step up preparedness efforts. Half (7/14) of the priority countries had achieved heightened level of preparedness according to WHO assessment criteria [1] This WHO assessment checklist was developed for the EVD outbreak in West Africa in 2014 to look at factors such as proximity to highly affected countries, health systems developed and transport. In the wake of the DRC EVD outbreak of 2018, the World Health Organization Regional Office for Africa (WHO - AFRO) worked with nine neighboring countries including Uganda, to assess readiness and preparedness for EVD [4]. Uganda has since been tasked to scale up preparedness border districts near North Kivu that experience frequent incursions of people from Eastern DRC (including Ituri province) into Uganda
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