Inside government’s move to decentralize coronavirus testing, treatment to districts

Coronavirus outbreak

The Ministry of Health has decentralized the management of coronavirus cases to various hospitals in the respective districts throughout the country, Minister, Dr.Jane Ruth Aceng has said.

Currently, there are 44 coronavirus cases in Uganda since March 21 when the first case was reported but all of these are being treated at either Mulago or Entebbe Grade B hospitals but with an increase in the number of cases, these facilities could be overwhelmed.

However, according to the Health Minister, members of the public will no longer be moved to Kampala and Entebbe but will be screened, tested and treated in their respective districts.

“People with COVID-19 symptoms are now advised to call their respective District Health Officers and District Surveillance Focal Persons. Callers will be advised to stay in their homes until a team from the District Health Office arrives to assess them and take their samples if necessary,”Aceng said.

“The suspected cases will be advised to remain in self- quarantine until lab results return.”

Health Minister, Dr. Jane Ruth Aceng

The Minister said the District Rapid Response teams will then use motorcycles to collect samples and send them to the Uganda Virus Research Institute in Entebbe through the Ministry’s hub system.

“Results will be returned to the districts within 48 hours depending on the districts proximity to Kampala,” she noted.

The Minister noted that districts have been asked to widely publicize the numbers for members of the public to call and report suspected cases.

Transportation of samples

According to minister Aceng, the ministry has in place an effective but robust mobile transport network to transport samples from the laboratory via the hub system to the Uganda Virus Research Institute in Entebbe.

“Hub systems are located at regional referral hospitals, general hospitals and health center IVs . Each district has a surveillance focal person and a laboratory focus person.”

She further explained that all alerts from the various district are directed to the surveillance focal persons or District Health Officers by the village health teams or individuals.

The surveillance focal person investigates the alert and if it meets the case definition, he   requests for sample removal.

“Once a nose or throat swab sample is collected from an individual by a laboratory specialist, it is then transported to the hub for special packaging. The specimen is transported from the hub to UVRI in Entebbe through Ministry of Health vehicles where investigations are conducted to establish the status of the sample,” Minister Aceng explained.

She added that results are communicated through an online system or via the phone.

Aceng revealed that an emergency plan has been put in place with a total of 310 ambulances  both a central and district level to support  COVID-19 response incidents and  evacuation of positive cases.

Management at districts

At district level, COVID-19 cases will be managed in designated health facilities within the district or referred as per guidelines.

Mild and moderate cases will be managed at the district health facilities whereas severe and critical cases that require oxygen therapy and Intensive Care Unit will be referred to regional referral hospitals.

According to the minister, the number of beds that can be available for COVID-19 case management in various government hospitals are 900 at Mulago National Specialized Hospital, 450 beds at the Specialized women and Neonatal hospital and 480 at the 16 regional referral hospitals.

The 50 general hospitals according to the Health Minister will provide 1000 beds and 820 beds at the 164 health centre IVs throughout the country.

“Additionally, working with the private sector and the private not for profit, bed capacity will be increased as and when required,” Minister Aceng said.

She added that there are a total of 480 ICU beds countrywide for critical cases but the number can increase with the addition from the private sector.

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