Sustaining Functionality of Not-for-Profit Health Organisations During Pandemics: Lessons and COVID 19 Experience from Makerere University Walter Reed Project.

Not for profit health organisations (NPHOs) complement government health response efforts, hence the need for their continued functionality during pandemic situations. In this article we highlight lessons from Makerere University Walter Reed Project's (MUWRP) efforts to ensure continuity of its health mandate during the corona virus disease 2019 (COVID-19) outbreak. Our findings provide cues for other developing world NPHOs as they prepare for the next outbreak. When the first case of COVID-19 was reported in Uganda, MUWRP's leadership identified four strategic pillars of action; minimising the risk of spread of the malady, ensuring continuity of all health activities, early identification and support for casualties, and prevention. An infection prevention and control (IPC) committee was set up to lead response efforts. Innovations per pillar such as adoption of information technology to ensure virtual working and meeting, bringing vaccines to the doorsteps of interested staff, free COVID testing, alternate employee working schedules, introduction of temperature guns, and weekly IPC review meetings were implemented. Routine demographic, testing, positivity, and treatment data was exported to STATA 15.1 for analysis. By the declaration of the end of the pandemic by the WHO, the average positivity rate of COVID-19 among 196 MUWRP staff was 7%, with 95% of all cases being mild, and 94.3% cases managed through home-based care. Only three cases were referred to hospital. Overall, males 30 to 40 years were most affected. Vaccination completion was at 89%, and there were no fatalities reported. Employing the four pillars and related innovations were key to minimising the effects of COVID-19 at MUWRP and are a relevant adaptable tool for other NPHOs in the developing world, as they prepare for the next pandemic.