Preparedness of health facilities to respond to effects of flooding on community health in Kasese District, Western Uganda

Abstract

Introduction: Climate change presents a profound threat to public health. Uganda is vulnerable to the health effects of climate change. Kasese district has experienced several recurrent floods and landslides during 2013 – 2015, 2020 and 2021 impacting on communities.

Objective: To assess the current state of preparedness of health facilities to respond to the effects of flooding on community health in Kasese District, Western Uganda. Methods: We conducted a cross-sectional study during April 2024 in Kasese district. A total of 43 health facilities (96% Response) were purposively selected and surveyed. They comprised all health centre levels – HC II, III, IV, and Hospital – from the eight flood-prone sub-counties in the district. At each health facility, the In-charge and health personnel responsible for disaster/ emergency response were interviewed. A total of 15 key informants including district health workers and stakeholders were interviewed. Quantitative data were analyzed using Stata Version 15. Univariate and bivariate analyses were performed. Qualitative data were exported to ATLAS.ti Version 6.0 and thematic analysis performed.

Findings: The study found that more than a third (35%) of the health facilities had experienced flooding during the last five years. None of the health facilities was completely prepared to respond to major flooding events. The majority (86%) of the health facilities neither had emergency plans nor did 81% have disaster management committees. Most (95%) health personnel in charge of emergencies were aware of climate change and its health effects, yet only 14% had been trained on disaster management and climate change. The main barriers to preparedness included shortages of human resources, lack of training and capacity building among health workers, shortage of medical supplies, inadequate infrastructure, and poor coordination.

Conclusion: There is a low level of preparedness of health facilities to respond to the effects of flooding characterized by lack of emergency plans, low number of personnel trained on disaster, shortage of personnel and poor coordination. There is a need for a multifaceted approach to improve training of health workers in disaster management, infrastructure, and increase funding for emergency preparedness.