Infection Prevention Control (IPC), Mental Health and Psychosocial Support (MHPSS) Sensitization in Uganda

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Infection Prevention Control (IPC)and Mental Health and Psychosocial Support (MHPSS) Sensitization Report

Palliative care providers usually focus on offering high quality care to their patients as well as their survival outcomes. However, with the COVID-19 pandemic, there are additional challenges of protecting themselves, their patients as well as the care givers from the dreaded virus. The President of Uganda, His Excellency Yoweri Museveni also noted in one of his addresses that Uganda was entering a dangerous stage of COVID-19, where the nation was experiencing an increase in community infections. This would challenge the palliative care services who majorly use a community service model approach.

To respond appropriately to the challenges, the Palliative Care Association of Uganda (PCAU), in collaboration with the Ministry of Health (MOH), held an Infection Prevention Control (IPC) and Mental Health and Psychosocial Support (MHPSS) sensitization in Kampala. This was from 7-8th September 2020 at Fairway Hotel. It targeted palliative care workers from hospices and palliative care organizations country wide.

Welcome remarks by PCAU Country Director, Mark Mwesiga

The sensitization came as a result of the service gap in IPC and to strengthen the capacity of palliative care providers through imparting knowledge and skills in MHPSS to achieve a high standard of service delivery during this time of the global pandemic while preventing transmission of the virus.

Objectives of the training included:

  • Share updates on current Standard Operating Procedures for IPC in response to COVID-19.
  • Equip hospices and palliative care organizations with IPC Knowledge and skills.
  • Discuss mental health and psychosocial support approaches during COVID – 19.

Dr Upenytho, Ministry of Health Uganda

Dr Upenytho George the Commissioner Health Services, Community Health at Ministry of Health presided over the sensitization and urged all to protect themselves, their communities and the patients at large from COVID-19.

He discussed IPC measures which he said were an interim guidance developed with input from Ministry of Health (MOH), World Health Organization (WHO), Centre for Disease Control (CDC), and Infectious Diseases Institute (IDI).

“With the current community transmission, everyone is now at risk.  “And so, the goal for infection prevention control now should be protect yourself, protect your community and protect your patients.” Noted Dr. Upenytho.

“All health care workers must have a high level of clinical suspicion for COVID-19, and use updated case definitions, adhere to standard operating precautions especially respiratory hygiene and hand hygiene and also ensure that patients with symptoms of suspected COVID-19 or other respiratory infection (e.g., fever, cough) are not allowed to wait among other patients seeking care at the facility.” 

In conclusion, Dr. Upenytho noted that palliative care plays a big role in breaking the chains of infection transmission using a community integration approach while paying attention to good hand hygiene practices, social distancing, good respiratory hygiene and use of appropriate PPE.

Participants demonstrate PPEs

Dr. Ajambo Miriam the senior medical officer and focal person for palliative care at the Ministry of Health noted that COVID-19 is a droplet infection thus urged palliative care providers on the cautious use of IPC measures to protect themselves and that way they can protect the patients they care for.

“Some of you may wonder why have the training now and not before, but you realize that we have increasing health worker infections, but also palliative care patients are among those at risk of suffering from severe COVID – 19 and yet they need care now more than ever since they fear to leave their homes due to public transport risks and the fear that big facilities have COVID- 19 patients,”  noted Dr. Ajambo

“We also have to remember that there is an increasing number of severe and critically ill COVID-19 patients, causing a greater need for palliative. But again, we have to emphasize IPC measures like hand hygiene which is the primary measure for reduction of infections in health care settings. Quoting the National IPC survey 2018, 2019 -Hand Hygiene Compliance at Regional Referral Hospitals remained much lower than international targets of >80%.” She highlighted.

She also urged palliative care providers to guide other health workers in as far as home-based care provision is concerned.

As a final point, she recommended system changes through strengthening, education and trainings as well as follow up to ensure the IPC measures are in place at the different hospices and palliative care organization.

At the sensitization, Standard Operating Procedures (SOPs) were discussed and let out for use by hospices and palliative care organizations. These are a set of instructions to enable efficiency and reduce the chances of transmission of COVID-19 among palliative care teams, patients, care givers and the community.

And they were developed through a consultative process to guide the provision of palliative care as a continuing essential health service during the COVID-19 pandemic.

Participants also discussed MHPSS and Dr Kalani Kenneth a psychiatrist from Ministry of Health who was the facilitator for the session acknowledged that good mental health is an important aspect in every human being. He also noted that the COVID-19 pandemic has brought about disequilibrium and several challenges amidst people the reason for psychosocial support.

“Currently because of COVID-19, people have increased anxiety, hopelessness, increased fear for loved ones, job insecurity, loneliness, cases of domestic violence, instances of children not being cared for, lack of basics like food, and being in quarantine makes it difficult to cope with the situation.” said Dr. Kalani.

“There are a range of activities that can be used to prevent psychopathology but also treat mental disorders and help to improve the well-being of individuals and communities during a time of conflict or disaster affected environments for example this COVID-19.” He added.

He highlighted the role of health workers during this pandemic as;

  • Offering psycho-social support to those affected/infected by COVID-19 for example individuals in quarantine, individuals in isolation (institutional, self), individuals with active symptoms, family members, health workers and community.
  • Preventing transmission of COVID-19 to self and others
  • Taking care of their own psychosocial health
  • Minimizing stigma and
  • Taking up leadership in the Mental Health and Psychosocial issues of COVID 19

He further discussed Psychological first aid (PFA) and equated it to bleeding emotionally but explained it as the first crisis response intervention given to people in distress to promote safety, stabilize and connect them for help and resources by MHPSS or other first responders.

In his concluding remarks, he noted that PFA doesn’t require medications but the principles involve preparing self, looking to observe safety and any distress reactions, listening to concerns and linking people to services, information and loved ones to enable them feel safe and secure.

The sensitization was closed by Mr. Mark Mwesiga PCAU Country Director who thanked Ministry of Health for working with PCAU to ensure the sensitization was a success and thanked the participants for faithfully attending the 2 days sensitization.

He thanked the participants for sharing their implementation plans and encouraged them to work with the managers and administrators at their hospices and palliative care organizations to put into place all the missing IPC measures and continue to offer MHPSS with the knowledge they had gained.

He invited Ms. Stella Agembi, the Acting Principal Nursing Officer Tororo Hospital and acting CEO Hospice Tororo to officially close the sensitization and officially handed the SOPs to hospices and palliative care organizations.

She thanked participants for attending all the sessions fully, reiterated and emphasized using the SOPs and National COVID-19 guidelines to prevent infection transmission among themselves and the communities they serve. She finally wished them journey mercies back.