Although the Ministry of Health in Uganda serves as the steward of the healthcare system that works closely with other line ministries, local governance through the district health office coordinates health care delivered by community health workers, health centres and general hospitals. Local governments have the mandate to oversee decentralised healthcare services. Local government authorities in districts cannot and should not shy away from for instance, taking part in tracing Covid-19 alerts and humanely working alongside designated response teams to gather contacts and have them quarantined for ease of monitoring. Undeniably, this phase is associated with heavy demands on human, financial and logistical resources.
Globally, Covid-19 emergence response is multi-sectorial to enable a holistic solution to the concomitant challenges. District councils, a creation of the Local Government Act are mandated to oversee health services. Other than frontline health workers, each district has a community-based services department with officers’ in-charge of probation and social welfare, social rehabilitation, children and youth affairs, gender, disability and elderly, culture, labour and many others. Since the mandate of personnel in this department is to operate in communities, these should be enlisted to respond and manage the community-component of Covid-19.
It is important to fold into the Covid-19 response the academia and civil society like; National Association of Social Workers of Uganda (NASWU) and Uganda Counselling Psychologists Association and others. In fact, civil society is knocking at doors of different Covid-19 task forces to be let-in to make a contribution. Since Covid-19 affects all aspects of human life, creating alliances and involvement of religious institutions, cultural institutions, academia, village saving groups and even SACCOs is indispensable. Other organic and even informal community-level organised groups like bereavement and/or burial groups can play a role in re-entry, integration and counselling of recovered Covid-19 cases discharged from hospitals or quarantines.
From a psycho-social perspective, it is important to note that stress and anxiety in “Covid-19 times” is still highly pervasive and expected. Awareness of these stressors if we are to manage the uncertainty at personal and community level is important. For instance, while a number of people are psycho-socially adaptive, strong and can easily remain socially connected even when keeping the recommended social distance, there are others whose coping with living amidst Covid-19 is challenging leading to maladaptive behaviour. These require help that may take the form of mental healthcare and they are more likely to impose resource demands not only on the healthcare system but the socio-economic institutions as well. Such community-level psychosocial concerns associated with Covid-19 are worthy of follow-up by community-level para-social workers and psychosocial counsellors. These are excellent providers of on-going counselling, cushioning the discharged from the awaiting stigma, intermediating and managing issues of domestic violence (which could spike during lock-downs) and many others.
It is necessary to manage the socio-economic impact of Covid-19 on people in different communities. Giving accurate, appropriate and timely Information, Communication and Education (IEC) messages about Covid-19 to people in different communities to enable awareness of available health services and rationale for lockdowns is vital. In communities, there are population groups with special needs; notably people living with mental illness, the elderly, people living with disability and many others who may not need 24-hour care by health workers but whose needs can certainly be well served or advocated for by para-social workers and psychosocial counsellors at the community level. Generally, different responses to Covid-19 has created new norms like wearing face-masks; regular hand-washing with soap and water; use of sanitizers, social distancing and may others; which will require multiple professionals to guide the population to adopt them. Lastly, it is important to sensitise leaders at all levels and arm them with conflict resolution skills because they will be needed in strained socio-economic relations arising out of Covid-19-related restrictions. Government structures at all levels need to be ready to intermediate between creditors and debtors and to lessen aggression and tension, especially in the management and release of the lockdown.
