Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 27;23(1):284.
doi: 10.1186/s12913-023-09217-w.

Using telehealth to support community health workers in Uganda during COVID-19: a mixed-method study

Maarten Olivier Kok  1 , Tosca Terra  2 , Raymond Tweheyo  3 , Marinka van der Hoeven  4 , Maiza Campos Ponce  4 , Marceline Tutu van Furth  5 , Elizeus Rutebemberwa  3
Affiliations

Using telehealth to support community health workers in Uganda during COVID-19: a mixed-method study

Maarten Olivier Kok et al. BMC Health Serv Res. .

Abstract

Background: At the onset of the COVID-19 pandemic, a local consortium in Uganda set up a telehealth approach that aimed to educate 3,500 Community Health Workers (CHW) in rural areas about COVID-19, help them identify, refer and care for potential COVID-19 cases, and support them in continuing their regular community health work. The aim of this study was to assess the functioning of the telehealth approach that was set up to support CHWs during the COVID-19 pandemic.

Methods: For this mixed-method study, we combined analysis of routine consultation data from the call-center, 24 interviews with key-informants and two surveys of 150 CHWs. Data were analyzed using constant comparative method of analysis.

Results: Between March 2020 and June 2021, a total of 35,553 consultations took place via the call center. While the CHWs made extensive use of the call center, they rarely asked for support for potential Covid-19 cases. According to the CHWs, there were no signs that people in their communities were suffering from severe health problems due to COVID-19. People compared the lack of visible symptoms to diseases such as Ebola and were skeptical about the danger of COVID-19. At the same time, people in rural areas were afraid to report relevant symptoms and get tested for fear of being quarantined and stigmatized. The telehealth approach did prove useful for other purposes, such as supporting CHWs with their regular tasks and coordinating the supply of essential products. The health professionals at the call center supported CHWs in diagnosing, referring and treating patients and adhering to infection prevention and control practices. The CHWs felt more informed and less isolated, saying the support from the call center helped them to provide better care and improved the supply of medicine and other essential health products.

Conclusions: The telehealth approach, launched at the start of the COVID-19 pandemic, provided useful support to thousands of CHWs in rural communities in Uganda. The telehealth approach could be quickly set up and scaled up and offers a low cost strategy for providing useful and flexible support to CHWs in rural communities.

Keywords: COVID-19; Call-center; Community Health Workers; Micro Entrepreneurship; Social Entrepreneurship; Telehealth; Uganda.

PubMed Disclaimer

Conflict of interest statement

TT works as monitoring officer at Healthy Entrepreneurs Foundation, which is registered as a not-for-profit, non-governmental organization in Uganda. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The 23 districts in which the supported CHWs are active
Fig. 2
Fig. 2
The number and topics of calls from March 2020 until June 2021
See this image and copyright information in PMC

References

    1. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Bio Medica Atenei Parm. 2020;91:157–160. - PMC - PubMed
    1. Olum R, Bongomin F. Uganda’s first 100 COVID-19 cases: Trends and lessons. Int J Infect Dis. 2020;96:517–518. doi: 10.1016/j.ijid.2020.05.073. - DOI - PMC - PubMed
    1. Sarki AM, Ezeh A, Stranges S. Uganda as a Role Model for Pandemic Containment in Africa. Am J Public Health. 2020;110:1800–1802. doi: 10.2105/AJPH.2020.305948. - DOI - PMC - PubMed
    1. Amodan BO, Bulage L, Katana E, Ario AR, Fodjo JNS, Colebunders R, et al. Level and Determinants of Adherence to COVID-19 Preventive Measures in the First Stage of the Outbreak in Uganda. Int J Environ Res Public Health. 2020;17:E8810. doi: 10.3390/ijerph17238810. - DOI - PMC - PubMed
    1. Walker PGT, Whittaker C, Watson OJ, Baguelin M, Winskill P, Hamlet A, et al. The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries. Science. 2020;369:413–422. doi: 10.1126/science.abc0035. - DOI - PMC - PubMed