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Johnson-Peretz J, Chamie G, Kakande E, Christian C, Kamya MR, Akatukwasa C, Atwine F, Havlir DV, Camlin CS. Geographical, social, and political contexts of tuberculosis control and intervention, as reported by mid-level health managers in Uganda: 'The activity around town'. Soc Sci Med 2023; 338:116363. [PMID: 37944344 PMCID: PMC10878310 DOI: 10.1016/j.socscimed.2023.116363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/29/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Training district-level health officers and other mid-level health system managers revealed multiple contextual factors across political, administrative, and social axes affecting tuberculosis (TB) and TB control in Uganda. Individual relationships between local health, political, and media leaders affect efforts to inform the public and provide services, yet greater administrative coordination between national-level logistics, implementing partner funding, and local needs is required. Social challenges to TB control include high population mobility, local industries, poverty with high-density living and social venues, and misinformation about TB. Capitalizing on implementation knowledge and sharing data can overcome social geographic challenges to TB-prevention planning through strategic healthcare capacity-building at the district level.
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Affiliation(s)
- Jason Johnson-Peretz
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco (UCSF), ANSIRH Program, 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA.
| | - Gabriel Chamie
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
| | - Elijah Kakande
- Infectious Diseases Research Collaboration (IDRC), 2C Nakasero Hill Road, Kampala, Uganda.
| | - Canice Christian
- Department of Medicine, University of California, San Francisco, CA, USA.
| | - Moses R Kamya
- Infectious Diseases Research Collaboration (IDRC), 2C Nakasero Hill Road, Kampala, Uganda; Department of Medicine, Makerere University College of Health Sciences, Old Mulago Hill Road, New Mulago Hospital Complex, P.O Box 7051, Kampala, Uganda.
| | - Cecilia Akatukwasa
- Infectious Diseases Research Collaboration (IDRC), 2C Nakasero Hill Road, Kampala, Uganda.
| | - Fred Atwine
- Infectious Diseases Research Collaboration (IDRC), 2C Nakasero Hill Road, Kampala, Uganda.
| | - Diane V Havlir
- Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
| | - Carol S Camlin
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco (UCSF), ANSIRH Program, 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA; Department of Medicine, University of California, San Francisco (UCSF), Center for AIDS Prevention Studies, San Francisco, CA, USA.
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