Geographical, social, and political contexts of tuberculosis control and intervention, as reported by mid-level health managers in Uganda: 'The activity around town'

Jason Johnson-Peretz; Gabriel Chamie; Elijah Kakande; Canice Christian; Moses R Kamya; Cecilia Akatukwasa; Fred Atwine; Diane V Havlir; Carol S Camlin

doi:10.1016/j.socscimed.2023.116363

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 Dec:338:116363. doi: 10.1016/j.socscimed.2023.116363. Epub 2023 Nov 3.

Authors

Jason Johnson-Peretz¹, Gabriel Chamie², Elijah Kakande³, Canice Christian⁴, Moses R Kamya⁵, Cecilia Akatukwasa⁶, Fred Atwine⁷, Diane V Havlir⁸, Carol S Camlin⁹

Affiliations

¹ Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco (UCSF), ANSIRH Program, 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA. Electronic address: Jason.johnson2@ucsf.edu.
² Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA. Electronic address: Gabriel.Chamie@ucsf.edu.
³ Infectious Diseases Research Collaboration (IDRC), 2C Nakasero Hill Road, Kampala, Uganda. Electronic address: ellykax@gmail.com.
⁴ Department of Medicine, University of California, San Francisco, CA, USA. Electronic address: Canice.Christian@ucsf.edu.
⁵ 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. Electronic address: mkamya@idrc-uganda.org.
⁶ Infectious Diseases Research Collaboration (IDRC), 2C Nakasero Hill Road, Kampala, Uganda. Electronic address: cakatukwasa@gmail.com.
⁷ Infectious Diseases Research Collaboration (IDRC), 2C Nakasero Hill Road, Kampala, Uganda. Electronic address: fatwine@idrc-uganda.org.
⁸ Department of Medicine, Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA. Electronic address: Diane.Havlir@ucsf.edu.
⁹ 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. Electronic address: Carol.Camlin@ucsf.edu.

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.

Keywords: DHO; HIV; IPT; Management; Tuberculosis; Uganda.

MeSH terms

Government Programs
Humans
Tuberculosis* / epidemiology
Tuberculosis* / prevention & control
Uganda / epidemiology

Grants and funding

R01 AI125000/AI/NIAID NIH HHS/United States