Pioneering Community-Driven Health: Tackling Zoonotic Diseases in Uganda

In the heart of Uganda, a groundbreaking research project is shaping the future of disease surveillance and prevention. Focused on neglected zoonotic diseases, the initiative introduces a Community One Health (COH) model across four Conservation areas. Let’s delve into the project’s journey, exploring its methods, challenges, and transformative outcomes.

Building a Holistic Community One Health Model

Implemented in Bwindi Mgahinga Impenetrable Forest, Queen Elizabeth, Lake Mburo-Nakivaale, and Murchison Falls, the COH model is a collaborative triumph. Multidisciplinary teams, including experts in Animal Health, Human Health, Ecology, Anthropology, Social Sciences, and Environmental Studies, unite to address the intricate web of human-livestock-wildlife-environment interactions at the village level.

The project is empowering 127 Community One Health Volunteers (COHVs). Identified, trained, and engaged to carry out real-time disease surveillance, detection, response, and reporting, these volunteers bridge the gap between national, district, subcounty, and grassroots communities.

Simulation during Training of COHVs

Role play during the training of COHVs

The Principal Investigator of the COHRIE project Uganda handing over Field materials to the COHVs

Community One Health Volunteers graduating after a 7day residential training

Addressing Health Challenges within the One Health Framework

The project’s core objective is clear: combatting recurrent neglected zoonotic disease outbreaks with a community-based intervention. Recognizing the existing gap between national and district-level One Health frameworks, the COHVs model serves as a vital link. By providing communities with the tools to identify, collect, and report disease-related information, the initiative brings together volunteers from the Ministry of Health, the Animal Health Department, and Uganda Wildlife Authorities.

The inspiration behind this initiative stemmed from a crucial need—to close the gap between district and community understanding of the One Health approach. Limited awareness of zoonotic diseases at the village level prompted a mission to raise awareness through community-driven health initiatives. The goal: empower communities to mobilize and engage various Ministries, Departments, and Agencies concerned with One Health at the community level.

Implementing the One Health Model: A Synergistic Approach

Leveraging existing community-based health structures, the project integrates Village Health Teams, Community Animal Health Workers, and Wildlife Scouts. Consortium partners such as the Uganda Wildlife Authorities (UWA), Ministry of Health-National One Health Platform (MOH-NOHP), the Ministry of Agriculture, Animal Industries and Fisheries (MAAIF), and Conservation Through Public Health (CTPH) play a pivotal role in identifying potential COHVs among community members.

Volunteers undergo comprehensive training, equipping them with knowledge about zoonotic diseases, prevention, management, and the usage of data collection gadgets and software. Deployed to conduct household surveillance and disease detection, COHVs collect data quarterly, with immediate reporting for outbreaks. The central server at Uganda Virus Research Institute (UVRI) facilitates data management and sharing with respective partners.

However, selecting COHVs posed a challenge, balancing interest, willingness, and capability. Limited resources and financial constraints during implementation led to some demands not being met, resulting in dropouts. Additionally, challenges arose in the exclusion of certain areas due to financial limitations.

Interdisciplinary Collaboration: A Recipe for Success

Interdisciplinary collaboration proved to be the driving force behind the project’s success. Collaboration with professionals from various disciplines streamlined the selection of COHVs, development of training materials, and the integration of software, enhancing the efficiency of reporting in near real-time.

Local communities actively participated in the project through the selection of volunteers and engagement with community leaders. Prioritizing residents for COHVs roles ensured a deeper connection to community dynamics. Workshops with leaders further strengthened community support, and surveillance data collection directly from households cemented community involvement.

Transformative Outcomes: Early Wins and Community Awareness

The pivotal contributions of COHVs in early zoonotic disease detection, reporting, and health issue monitoring have been instrumental. These individuals were strategically selected to operate within their own communities, providing them with a profound understanding of local dynamics. As a result, they promptly observe and report even the subtlest changes in the environment or community members in near real-time. This timeliness enables professionals to swiftly analyze data and make informed decisions, intervening proactively to prevent potential outbreaks and mitigate more significant health disasters.

In the project’s initial phases, community members often overlooked incidents such as the discovery of a deceased dog, continuing with their routines. However, the proactive approach of COHVs has transformed this response. Even in seemingly minor instances, like the identification of a deceased stray dog, COHVs capture photographic evidence and promptly share it. This immediate reporting facilitates swift review by professionals across relevant disciplines, significantly elevating the community’s alertness to potential health issues and fostering a proactive stance.

Beyond their instrumental role in disease surveillance, COHVs have become agents of community awareness, influencing understanding in areas of community health, veterinary care, and environmental issues. Upon the project’s commencement, a qualitative analysis highlighted a general lack of awareness among community members regarding zoonotic diseases—how they are transmitted, prevented, and managed. However, the strategic training of COHVs has resulted in a remarkable shift. Armed with knowledge on zoonotic diseases, these volunteers have effectively sensitized local communities, fostering increased awareness and understanding.

In summary, the transformative outcomes achieved through the diligent efforts of COHVs underscore their indispensable role in early detection, reporting, and community education. This dual impact not only enhances the overall health surveillance system but also lays the foundation for informed and vigilant communities prepared to address health challenges effectively. COHVs have contributed to community awareness about community health, veterinary care, and environmental issues. When they first moved into the community, many people were not very much aware of these zoonotic diseases, however, after equipping the COHVs with knowledge on zoonotic diseases during their training, they have sensitized the local people in their villages hence increasing awareness.

The project team carrying out support supervision of the COHVs

COHVs support supervision

In conclusion, this transformative initiative stands as a testament to the power of community-driven health models in tackling complex health challenges. The journey unfolds with lessons learned, challenges overcome, and a vision for a healthier, more connected future for Ugandan communities.