Attitudes and practices of stakeholders regarding HIV service delivery for pregnant and lactating women amid the COVID-19 Pandemic in Uganda

Background COVID-19 containment measures in Uganda disrupted HIV service delivery, posing risks to continuity of care for pregnant and breastfeeding women. These disruptions highlighted existing vulnerabilities within the health system and the need to understand how services were sustained during the pandemic. This study explored the attitudes and practices of stakeholders involved in delivering HIV services to pregnant and lactating women during the COVID-19 pandemic in central Uganda. Methods A qualitative study design was employed, involving 24 purposively selected key informants, including healthcare workers, community representatives, activists, and policymakers. Data were collected between March and July 2025 through in-depth interviews guided by the Social Ecological Model (SEM). Interviews were audio-recorded, transcribed verbatim, and analysed thematically using both inductive and deductive approaches with NVivo 12 software. Measures to ensure rigor included intercoder reliability, adherence to trustworthiness criteria, and continuous team debriefings. Results Findings revealed that fear of infection, stigma, misinformation, and psychological distress influenced service delivery at individual and interpersonal levels. Institutional challenges, including resource constraints and service interruptions, further affected care. However, adaptive strategies such as strengthened community networks, decentralized service delivery, and flexible antiretroviral therapy (ART) distribution helped mitigate these disruptions and supported continuity of care. Conclusion HIV service delivery for Pregnant and breastfeeding women during the COVID-19 pandemic was shaped by interconnected sociocultural and structural factors. Strengthening community engagement and building resilient, adaptable health systems are critical for maintaining essential services during public health emergencies.