AFRICAN COMMUNITY CENTER FOR SOCIAL SUSTAINABILITY (ACCESS) IMPACT AND RESPONSE TO COVID-19

Every year, ACCESS focuses its attention on improving the activities in the areas of support for orphans and other vulnerable children (OVCs), medical care, education, Nursing and Midwifery training, family planning provision, Innovative and, Implementation research, global health exchanges, and human resource development.

ACCESS comprises of seven (7) department whose mandate is to work within the organization strategies to enable the organization achieve its mission and vision, the organization’s departments include; (i) Community department with the project such as Dreamgirl project, Preschool project, Elderly (Jajja) project, Nano finance project, water project, and Lighting project, (ii) International coordination and engagements, (iii) ACCESS data Management (iv) Finance department, (v) ACCESS Lifecare Clinic this includes projects such as family planning project and Noncommunicable diseases (NCD) Project, (vi) ACCESS School of Nursing and Midwifery (vii) Project and Administration. It is through these departments that the organization implements its research projects, implementation research projects, and other programs.

Like many other organizations, the outbreak of COVID – 19 pandemic disrupted the scheduled annual work plans for the organization. The national precautionary measures that targeted to curb the spread of the virus such as total lockdown of community activities, suspension of both inland and international travels, halting of school activities, and the total lockdown of the entire country by the president of the Republic of Uganda disproportionately affected the organization.

Following the national interim guideline for sustained delivery of essential health services in the context of COVID – 19 issued by the Ministry of Health Uganda, the organization managed to maintain delivery of both static and community health services working with Nakaseke district authorities. The ACCESS Lifecare clinic continued providing services to people in the community while observing all the necessary precautions. Our community health team were trained and equipped to manage the spread of the virus and were at the forefront working with ACCESS and Nakaseke district COVID – 19 taskforces to deliver community services that included community education about COVID – 19, distribution of COVID – 19 IEC materials and delivery of family planning services.

During this devastating period, the organization managed to continue supporting 500 OVCs, 50 elderly people, 275 nursing and midwifery students, 63 preschool children, supported 105 women, conducted 1,188 laboratory tests, 1080 immunization visits, and our clinic registered 16,847 patient visits including family planning clients and continued with the construction of the preschool block. In a bid to keep the ACCESS supported children with learning activities during the pandemic, we managed to distribute 84 radio sets to homes with students to access radio learning. We distributed food packages to 100 homes and provided fast-growing vegetable seedling to 60 families.

COVID – 19 Response

ACCESS Staff in COVID – 19 Preparedness Meeting

With 889 cases in Uganda by 30th June 2020, COVID 19 is posing a threat to Uganda’s health system, delivery of essential health services, and the wellbeing of our communities. ACCESS advocated for essential actions at district and community levels to save lives. We were proactive in shaping our response based on current best practices from the World Health Organization and the Uganda Ministry of Health.

Our response is focused on the following goals; protecting health workers, interrupting the spread of the virus, maintaining essential health services, and shielding the most vulnerable from socioeconomic shocks.

District Response

  1. ACCESS worked with Nakaseke district taskforce and supplied personal protective equipment (PPE) to 100 community health workers that helped to educate and distribute 7,838 Information educational and communication (IEC) materials through the house to house visit in the community. During the period of total lockdown, our trained community health workers (CHWs) distributed 18,141 condoms, 435 pills, 3,576 injectables and referred 2,078 women for long-acting reversible contraceptives (LARCs) and 18 women and men on permanent family planning (FP) methods that included 14 female sterilization and 4 male sterilization services which helped to reduce unplanned pregnancies and subsequently reducing the likelihood of violence in the community.
  2. We supported the office of district health educator (DHE) to communicate COVID -19 guidelines and precautions to the public through the weekly radio talks (12) and aggregate feedback from the public through our toll-free number and community health workers. Over 200,000 people from the area of the great Luweero triangle were reached with the messages.

Community Response

Community team organizing to distribute food packages
  1. We trained and provided personal protective equipment (PPE) to our health workers who were tasked with supporting screening at the facility and conducting community – based rapid testing once permitted.
  2. We spearheaded the distribution of facemasks to our beneficiaries and sensitization on COVID – 19 safety precautions and good handwashing habits.
  3. We distributed food packages to our vulnerable beneficiaries whose business closed due to the lockdown.
  4. ACCESS enabled orphans and other vulnerable children to continue learning through the provision of radio sets to families that lacked them so that they can access the national radio learning.
  5. We introduced and trained home gardening to families to promote the nutrition of children and the elderly in the community.
  6. ACCESS procured bulk quantities of medicines, sundries, and other commodities to maintain our medical stock and support lower partner health facilities in times of need.
  7. We conducted radio presentations and phone calls communication about COVID – 19 safety precaution to our beneficiaries and community health teams.
Home Vegetable Growing

Our impact in the area of economic empowerment

At the beginning of the year 2020, a total of 105 women were given nano finance funds and 105 businesses were started by these vulnerable women in the community, during the lockdown all finance mentorship and the weekly loan repayment collections were halted until when the business attain momentum. Eleven percent (12) of the women’s business closed during the lockdown. Among the closed business; 7 were small scale vendors, 3 were salons, and 2 bar-business.

Ten percent (10) of the women’s businesses were repurposed from the activities that were closed to other operational businesses in the community. Seventy-nine percent (83) of the women’s businesses continued operating with the initially registered business. These were operating within the national guidelines.

The pandemic had obvious and immediate effects on our community members and their families. For example, at the end of Q4 in 2019, 98% (49) of the women provided with nano finance were eating three meals a day, but by Q2 2020, the percentage of households eating three meals a day had dropped to 18% (19) households among the women benefiting from the nano finance. This was brought about by COVID – 19 pandemic and its associated impact on the rural poor who leaves on hand to mouth.

Our impact in the area of education

Preschool home schooling

All Ugandan schools were closed until further notice as a measure to curb the spread of coronavirus in the community. ACCESS being an organization whose backbone is to support orphans and other vulnerable children (OVCs) attain quality education as well as training of nurses and midwives, we were driven to developing innovative ways to ensure that our children keep engaged and learning remotely during this devastating period.

ACCESS School of Nursing and Midwifery

We worked with all tutors from ACCESS School of Nursing and Midwifery to compile notes for our 275 students, the notes were shared on one email whose password was known to each student and can log in to access notes at their own time, a WhatsApp group was formed for the students to ask questions and receive a real-time response from the tutor. We are currently trying to use online meeting application like zoom to hold classes with real classroom feeling. This is still limited by the technological challenges faced by both the students and some tutors. This remote learning will enable tutors to cover the semester’s syllabus and also keep students engaged and learning.

Preschool children and Orphans and other vulnerable children

  1. The organization managed to procure and distributed 84 radio sets to vulnerable children at home without radio sets so that they can access radio learning programs.
  2. Our social department works closely with village health teams (VHTs) who make phone calls to parents reminding them to allow children to listen to the radio provided or watch edutainment channels to keep them engaged.
  3. 500 orphans and other vulnerable children (OVCs) acquired scholastic materials including counseling from a social worker. Due to limited funding 47 OVCs are maintained on full school packages that include school fees, uniforms, shoes, and other scholastics.
  4. For our preschool children in the early childhood development program, we worked closely with their teachers to compile exercise for the children, the exercise is delivered by the teacher and the social workers who encourage the parent/guardians to spare time and help their children in doing the homework.
  5. Construction is underway for the early childhood block, ACCESS management in collaboration with Grace Promise are in the process of constructing a flat block that will be able to accommodate more than 150 children from the community.
Photo showing the construction of the preschool building

The dream girls’ program

  1. 30 at-risk girls can access vocational training and attain skills in hairdressing and tailoring. The program aims to prevent teen pregnancies.

Our impact in the area of medical care

ACCESS Lifecare Clinic triage in the tent

The ACCESS Lifecare clinic continued operating during these uncertain times, we have remained at the forefront of service provision in our community while protecting our health workers. As a centre of excellence, we are committed to providing a seamless continuity of care for our communities and standing as an example to other facilities in combating COVID – 19.

  1. At the gate entrance, we have a mandatory hand washing for all visitors entering and leaving the facility. We also have a mandatory temperature check conducted by a security personal using an infrared thermometer and from this point patients are screened in order to determine whether it is safe for a person to enter the clinical environment for non-COVID treatment
  2. The waiting area has been rearranged so as to ensure all patients waiting for care are at least 4 meters apart from each other.
  3. We also ensure that both our medical and non-medical staff have all necessary protective equipment and conduct daily spot checks to ensure consistent usage. We have also intensified handwashing and infection prevention control measures at the facility for both health care workers and patients.
  4. From march 2020, we have screened 865 individuals for COVID – 19 through using the ministry of health screening tool and temperature monitoring. Two cases were suspected and were referred to the Nakaseke hospital one of the national hubs for further investigations.
  5. By 30th June 2020, we had seen 16,847 patients at ACCESS Lifecare clinic which is a 9% increase in the total number of patients seen compared to this time last year. The increment is associated to the opening and equipping of the new ACCESS laboratory which has attracted community members to seek medical services from ACCESS Lifecare clinic.

We are very grateful to our partners and the board of directors for their timely support and guidance. We have seen our communities transformed. We have witnessed the power of unity in times of adversity and scarcity. We are sure that we will minimize the effects of the pandemic on the vulnerable people we serve.