52 Remote Islands, a Pandemic, and One Challenge: Optimizing Scarce Health Resources

But a notable challenge for rural areas, and especially Buvuma District’s remote islands, is where to allocate scarce human and pharmaceutical resources.

In the summer of 2020, work led by Uganda’s Ministry of Health targeted six Ugandan districts, including Buvuma, and began with data email sharing to implement use of the Continuity of Essential Health Services (CEHS) visualization application, thus helping make routine data collection more useful. Stakes were high because health officials knew maintaining essential health services would be challenging due to pandemic restrictions, which included military enforcement of curfews and restricted vehicle movement including both private vehicles and public transport.

The District Health Team moved with alacrity, line-listing households to ensure children would not miss their immunization schedules. By using the CEHS App which produces data visualizations and trend analyses at the click of a button, the team could review selected key tracer indicators that allowed them to track service continuity during the Ugandan government’s strong Covid-19 response.

“Insights are more readily available as the data is easier to digest and review—all enabling quicker and more efficient decision-making. Right now, these insights are granular down to the health facility level, and we are working to ensure they reach the last mile to the community level itself,” said Dr. Jessica Oyugi, UNICEF Uganda’s Community Health Specialist, who brings 20 years of international community health experience to the role.

Data is only useful when it does more than sit on a page or in a computer, notes Dr. Kanyike, and in this case, “already, the data is helping us integrate and plan from the district level.”

“If we see there are a lot of pregnancies, we know to dispatch a midwife,” says Ruth Nabisubi, the district’s biostatistician. “The data can also suggest where we need to dispatch essential medicines. We know where we need to send vaccines and we can monitor who is having their follow-up visits. It can make us more effective.”

That effectiveness saves lives. Justine Kisakye, 37, of Lufu island, is the mother of seven children, the youngest just two weeks old, and she is determined to make certain they are all immunized.

“When my neighbor’s child died of measles,” she says, “I became committed to preventing the killer diseases.” Those include tuberculosis, diphtheria, whooping cough, tetanus, polio, Hepatitis B, influenza, pneumonia, measles and rotavirus.

The process also serves to more closely link Buvuma District’s 122 healthcare workers, most of whom live on Buvuma Island, are connected through WhatsApp group, and will continue to receive ongoing training on data tools. It is also a chance to share best practices across the islands’ health care facilities as well as keeping close tabs on where medical supplies might be dwindling and need to be restocked.