Research and Community Engagement During the COVID-19 Pandemic in a Resource-Limited Setting: A mixed methods study with Epidemic Preparedness Implications

Background When WHO declared the SARS-CoV-2 respiratory virus pandemic in 2020, Uganda was unprepared to prevent and control its spread or manage the COVID-19 and non-COVID patients. A community trial to assess the efficacy of an intensive community engagement and risk communication (CERC) was contemplated. However, a baseline assessment of the existing CERC status and the challenges of conducting community research in the early months of the pandemic was necessary. Methods A community baseline face-to-face mixed-methods study with a quantitative survey and qualitative research (in-depth interviews, key informant interviews, focus group discussions, and household conversations) was implemented in 15 parishes (6 and 9 in Kawempe and Nakawa divisions respectively) of Kampala Capital City Authority, Uganda. We employed a multistage sampling strategy that allocated parishes and villages based on their proportional contribution to the overall population for the planned CERC trial which was to follow. The baseline study, was conducted during the pandemic from July 2020 to February 2021. Results There were 852 respondents with median age 32 years (IQR 25–42). Majority were females (n = 610, 73·05%), and household heads (n = 391, 46·5%) followed by spouses of household heads (n = 305, 36·1%) and children (n = 68, 8%). Most were low-and middle-income workers. Some had tertiary education (n = 206, 24·2%), ordinary level (n = 195, 23·3%), primary education (n = 201, 24·01%), and no formal education (n = 142, 16%). Many potential challenges to research involving CERC were identified and were categorized into three main interrelated domains: a) implementation challenges b) social, cultural, and political context of the research, and c) budgetary and funding constraints. Conclusions The three interrelated challenges identified in this study should be considered in future plans for epidemic and pandemic preparedness. The practical application of conventional concepts like CE, risk communication, qualitative research methods must be re-examined prior to epidemics and pandemics to improve their applicability and responsiveness during complex, dynamic epidemics and pandemics.