Mobilizing communities to fight diseases that spread from animals to people in Uganda

An innovative community-first research approach in Uganda aims to prevent and manage neglected but potentially deadly diseases that naturally transmit from animals to humans. These zoonotic diseases often disproportionately impact marginalized people living in poverty.

Establishing a community of One Health volunteers to better fight diseases

The Uganda Virus Research Institute, with multidisciplinary teams of researchers, is training and empowering more than 100 community volunteers to carry out disease surveillance, collection, detection, reporting and response in four conservation areas in Uganda. They are building the capacity of volunteers to tackle diseases in communities where effective early-detection mechanisms are lacking.

To ensure a One Health lens to the project, one that takes human, animal and environmental health into consideration, the expertise of the researchers involved spans the animal health, human health, ecology, anthropology, social sciences and environmental fields.

The volunteers, referred to as Community One Health Volunteers (COHVs), come from the diverse human health, animal health and wildlife protection services sectors. They include community health extension workers, animal husbandry officers and wildlife scouts. Bringing these different volunteers together is innovative since community health programs typically only focus on strengthening the capacity of health workers or volunteers to do disease screening and health education.  

Filling data gaps for disease detection and response

The COHVs undergo comprehensive training that equips them with knowledge about zoonotic diseases, their prevention and management and the use of data collection gadgets and software. They collect data regularly by conducting household surveillance and disease detection and report outbreaks immediately. The information they collect is sent to relevant representatives at the Ministry of Health, the Ministry of Agriculture, Animal Industry and Fisheries, and the Uganda Wildlife Authority, who can deploy the necessary resources to respond to outbreaks.

Building community support and involvement

The research team prioritized residents for COHV roles to ensure a deeper connection of the project to the local communities. Community members participated in selecting volunteers and engaging with community leaders, including through workshops. Collecting surveillance data directly from households cemented community involvement.

Community engagement was not without its challenges. The project team could not afford to recruit everyone recommended by the local communities due to resource constraints. Its members needed to make tough choices that had to consider the diverse interests, enthusiasm levels and individual abilities of potential recruits. This invariably created some tension and disappointment among those who felt excluded. However, through continuous and open dialogue, the project team managed this situation successfully.

Early wins for community-level disease surveillance

So far, COHVs have shown promise in the early detection, monitoring and reporting of zoonotic diseases. Because they are locally based, COHVs promptly observe and report even the subtlest changes in the environment or among community members in near real-time. Even in seemingly minor instances, such as identifying a deceased stray dog, COHVs capture photographic evidence and promptly share it with the relevant authorities. Prior to the deployment of COHVs, community members often overlooked incidents that might lead to a disease outbreak. The presence and activities of the COHVs thus appears to be encouraging community members to be more proactive about reporting unusual events related to human, animal or environmental health.

The immediate reporting by COHVs facilitates a swift review by professionals across relevant disciplines, significantly elevating the alertness of government authorities to potential health threats. However, due to their own limited resources, government officials have often not been satisfactorily responsive to the information that COHVs share with them. This situation can be demotivating for the COHVs and local communities. Through its engagement with national policymakers, the team is continuing to make a case for more resources to be made available by the Government of Uganda to sub-national and district-level authorities to enable them to act on the information they receive from local communities.

Custodians of knowledge and agents of change

Beyond their key role in disease surveillance, COHVs have become influential agents of community health literacy. When the project began, a qualitative analysis highlighted a general lack of awareness among community members about how zoonotic diseases are transmitted, prevented and managed. Training community-based volunteers has resulted in a remarkable shift in community awareness and understanding of community health, veterinary care and environmental issues.

The future is bright for community-led One Health approaches 

This research project is a testament to the power of community-driven health models in tackling complex health challenges such as zoonotic diseases. The COHV approach has enabled a closer collaboration between national, sub-national, district-level and community actors across human, animal and environmental health sectors. As the team continues to reflect on the lessons learned and the challenges overcome, the vision of a healthier future for Ugandan communities is now closer to reality.

Find out more about IDRC’s Collaborative One Health Research Initiative on Epidemics.