Exploring stakeholders' perspectives and experiences with contact tracing for COVID-19 in Uganda: A case of Kampala Capital City Authority

Abstract

Introduction: In Uganda, the Ministry of Health implemented the contact tracing strategy to deal with the fast growing spread and infection of COVID-19 within communities. Given the emerging challenges of climate change, increasing interactions between humans and wildlife among others, the risks of epidemic outbreaks in the future are increasingly becoming high. Objective: This study aimed to explore stakeholders’ perspectives and experiences with contact tracing for COVID-19 in Uganda using the case of Kampala Capital City Authority in order to develop and implement a sustainable contact tracing framework for future epidemic management. Methods: This was a qualitative research that employed a case study design using a qualitative approach to data collection. Deductive approach to qualitative data analysis was used. A total of 42 participants were interviewed. These included 16 contact tracers who were randomly selected, 8 division medical officers and district surveillance focal persons, 8 coordinators who were purposively selected and 10 COVID-19 contacts who were conveniently selected. Interviews were conducted in English and audio-recorded. The recordings were later transcribed and reviewed by the principal investigator before commencement of the analysis. Transcripts was coded in Atlas.ti 9 using a generated codebook and thematic analysis was done to produce results. Findings: Implementation of the cluster model during COVID-19 surveillance and the resulting benefits: timely reporting and flexible mitigation of contacts in the community. Some of the experiences of contact tracing reported by the respondents included: fears for exposure and risk of contracting COVID-19, the role of contact tracing in the control and management of COVID-19, and stigma and its effect on self-reporting. Key facilitators for successful contact tracing were: leadership and teamwork especially from the supervisors, and the use of the cluster model approach, and capacity building and experience of the contact tracing team. The challenges reported by both the contact tracing team and COVID-19 contacts: inadequate logistics: medical supplies, transport, and finances, negative community perception of COVID-19 and contact tracing, centralization of contact tracing and the contact tracing approach employed by Ministry of Health, and the resulting stigmatization of COVID-19 contacts. Conclusion: Conducting contact tracing potentially played a role in the reduction of the spread of COVID-19 in Kampala Capital City Authority but its successful implementation was mainly attributed to having a trained workforce that was vigilant and committed to the cause and protecting the public from the adverse effects of COVID-19. The challenges highlighted herein can be minimized and views of stakeholders’ adopted to develop a more robust contact tracing approach that is effective and inclusive of all stakeholders’ right from the inception and all through the implementation process.