Strategies for ensuring the safety of students at school during the resurgence of COVID-19 in Uganda

Introduction

Coronavirus disease 2019 (COVID-19) is firstly identified in Wuhan city, Hubei Province, China in December 2019 as pneumonia of unknown origin (1). Later, the international committee on taxonomy of Virus (ICTV) identifies the causative agent of COVID-19 as a novel coronavirus, severe acute respiratory syndrome coronavirus−2 (SARS–CoV−2) (2). COVID-19 outbreak spreads rapidly not only in China, but also worldwide, therefore, the World Health Organization (WHO) announced it as a pandemic on March 12, 2020 (3).

Cases of coronavirus disease 2019 (COVID-19) were detected, and COVID-19-associated mortality increased since the first case was confirmed in Uganda. While adherence to WHO-recommended measures to disrupt COVID-19 transmission has since been implemented, it has been reported to be sub-optimal

The COVID-19 pandemic has created the largest disruption of education systems in human history, affecting nearly 1.6 billion learners in more than 200 countries. Closures of schools, institutions, and other learning spaces have impacted more than 94% of the world’s student population. This has brought far-reaching changes in all aspects of our lives. Social distancing and restrictive movement policies have significantly disturbed traditional educational practices. Reopening schools after the relaxation of restrictions is another challenge with many new standard operating procedures put in place.

On the 18th of March 2020, H.E President directed the closure of all educational institutions with effect from 20th March 2020. Closing of Education Institutions dispersed the 15 million learners evenly into 8 million homesteads in Uganda thus reducing concentrations of young people and eminent danger of COVID19 transmission.

Education is considered to be a powerful tool for growth throughout many sectors in Uganda. The country has even labeled education as a key component for driving social growth, economic development, and transformation since becoming politically independent, as well as helping to achieve a more united nation and democratic reforms. In addition, Uganda’s vision of 2040, which provides paths to becoming a more prosperous nation, highlights education as a crucial mechanism for economic growth by providing human capital (Tumwesige,2020). However, the COVID-19 pandemic poses serious threats to access to education in Uganda, and innovative solutions are needed to support this sector and ensure the continued education of rural populations.

Uganda’s education system uses the following structure: 7 years of primary education, 6 years of secondary education, and 3-5 years of post-secondary education, and students can choose between private and public schools depending on their resources (Tumwesige 2020,). However, there are significant gaps between school enrollment in rural and urban areas. Students are more likely to complete primary school in urban areas as opposed to rural areas, and around 91% of children attend primary school in urban areas, compared to 85% in rural areas. This gap is more noticeable in secondary education, as 38% of children of secondary school age in urban areas attend school, compared to only 14% of children in rural areas. Amir K (2021)

The strategies for ensuring the safety of the students at schools during the resurgence of the Covid-19 pandemic in Uganda include the following.

Maintaining the health and safety of people and environments was more important than ever before in the aftermath of the COVID-19 school closures. To make school environments safe, additional health and hygiene measures were implemented, and school-based psychosocial and nutritional support was extended to students to strengthen their overall health and well-being in the wake of the pandemic.

The distribution of alcohol-based hand sanitizer is likely to offer an effective, scalable solution for hand hygiene for the prevention of COVID-19 transmission, especially where running water is limited. A substantial body of evidence, largely from wealthy countries, shows that young children, in particular, are more likely to use waterless hand sanitizer consistently, when available, than they are to use soap and water. (Usman I M,2020)

Psychosocial and emotional support is often needed in schools following crises. Evidence from studies of conflict, natural disasters, public health crises, and other humanitarian crises show that a child’s psychosocial well-being can be negatively impacted by shocks. A rapid systematic review of the impact of social isolation suggests that children are likely to experience high rates of depression and anxiety during social isolation and for several years after it ends. (Okello G et al,2020)

School-based temperature screening has been a part of containment for previous outbreaks, but its effectiveness against COVID-19 remains uncertain. Following the Ebola-related closures of 2014–2015, school reopening protocols included daily temperature checks at the school gate, but it is unclear whether these measures reduced transmission. (Galiwango R et al 2020)

Many universities and colleges worldwide suspended classroom teaching due to the novel coronavirus pandemic and switched to online teaching. (Usman I M,2020)

Teacher-led learning camps and remedial tutoring programs can support learning acceleration. Evidence suggests that learning camps before and between school terms can support student learning. Such camps provide focused opportunities to accelerate the mastery of basic skills.

Supporting teachers and parents Target instruction and focus on basic skills. Many schools teach students grade-level material that is far above their actual learning level, leaving them behind. Ensuring students are taught at their actual level rather than according to a curriculum or syllabus too advanced for them.

In Uganda, in 2019, UNHCR worked closely with SESEMAT (Secondary Science and Mathematics Teachers Training Programme) to train teachers on the use of online learning materials. These teachers have become “champion teachers” and since the shutdown of schools and the introduction of new teaching modalities, they have been sharing guidance on how to make use of the Kolibri platform through WhatsApp groups for teachers. In addition, several teachers who benefited from this training have appeared on national television programs to train and guide teachers on the use of online learning materials and how the platform works.

In developing the SOPs, specialists including epidemiologists, experts on educational institutions and the health sector, COIVD-19 scientists, multi-sectoral task force, UN partners, and CSOs also did participate. Before finalization, the national COVID-19 strategic meeting, as well as the Incident Management Team reviewed the SOPs. In the absence of strong scientific evidence on student and staff adherence to recommended measures in schools, the expert consensus among members of the multi-sectoral working group provided the underlying basis for the SOPs.

 

Staying Up to Date on Vaccinations

Staying up to date on routine vaccinations is essential to prevent illness from many different infections. Vaccines reduce the risk of infection by working with the body’s natural defenses to help safely develop immunity to disease. Correct wearing of recommended face masks by students, workers, and visitors in school settings, either in classes, corridors, compounds, or communal areas, and by age categories. (Ministry of Health report 2021)

Ensure only essential visits by parents or other outsiders to the education facility (for example, to collect essential personal items).

Maintain a physical and social distance of at least 2 meters between (keep a distance approach) persons during the waiting or hand washing, and on the school bus.

Install hand washing facilities at the entrance to every classroom with adequate water and liquid soap and create a daily schedule for multiple handwashing breaks for each class, especially for younger children.

Modifying classroom furniture arrangement to promote distancing and create space for desks to be at least one meter apart.

Staying Home When Sick

People with symptoms of infectious diseases, including COVID-19, influenza, respiratory syncytial virus (RSV), and gastrointestinal infections should stay home and get tested for COVID-19. People who are at risk of getting very sick with COVID-19 who test positive should consult with a healthcare provider right away for possible treatment, even if their symptoms are mild. Staying home when sick can lower the risk of spreading infectious diseases, including the virus that causes COVID-19, to other people. For more information on staying home when sick with COVID-19, including recommendations for mask use for people experiencing symptoms consistent with COVID-19

Ventilation Systems

Schools and ECE programs can optimize ventilation and improve indoor air quality to reduce the risk of germs and contaminants spreading through the air

Hand Hygiene and Respiratory Etiquette

Washing hands can prevent the spread of infectious diseases. Schools and ECE programs should teach and reinforce proper handwashing to lower the risk of spreading viruses, including the virus that causes COVID-19. Schools and ECE programs should monitor and reinforce these behaviors, especially during key times in the day (for example, before and after eating and after recess), and should also provide adequate handwashing supplies, including soap and water

Cleaning and Disinfection

Schools and ECE programs should clean surfaces at least once a day to reduce the risk of germs spreading by touching surfaces. If a facility has had a sick person or someone who tested positive for COVID-19 within the last 24 hours, the space should be cleaned and disinfected.

Masking

Wearing a well-fitting mask consistently and correctly reduces the risk of spreading the virus that causes COVID-19. Universal indoor mask use is recommended at a high COVID-19 Community Level. Anyone who chooses to wear a mask should be supported in their decision to do so at any COVID-19, including low. At a medium COVID-19 learners who are immunocompromised or at risk of getting very sick with COVID-19 should talk to their healthcare provider about the need to wear a mask and take other precautions (for example, avoiding high-risk activities).

 

 

 

 

Ventilation Improvements

According to UNICEF Report 2020), Schools can take additional steps to increase outdoor air intake and improve air filtration. For example, safely opening windows and doors.

On-campus health and safety protocols

·         Schools will be completely sanitized before reopening

·         Students will receive a brief training to make their experience 100% safe

·         Wet and dry sanitizing mats are available at the entrance of the school

·         Daily temperature measurement before entering the schools

o    Teaching remotely.

 Supporting planning to prepare for schools to reopen safely

While immediate priorities are on maintaining learning, schools must be ready for children to return as soon as it is safe. School facilities should not be used for public health interventions or as isolation units during the outbreak, to avoid the risk of contamination and delayed return to school. Lessons from West Africa’s Ebola response show that fear can linger for a long time after the outbreak is contained – e.g., parents were reluctant to let their children return to the same schools as children and teachers who had survived Ebola.

Communities in Uganda are already afraid, and significant community mobilization efforts will be needed to reassure teachers, learners, and parents when it is safe to return to school. Preparations must start early to develop guidance and materials to support catch-up classes and short-term bridging. The school calendar and holiday time will need to be revised to ensure children can still attend school for the full number of weeks.

Ensure that children are protected from harm

Given the increased risks, education activities must be closely coordinated and aligned with child protection activities. Teachers can be valuable resources tasked to identify at-risk children (such as child-headed households) who will be particularly vulnerable with schools closed and support monitoring by para-social workers.

 Ensuring that the most vulnerable children, such as refugees and children with disabilities, have access to learning

Uganda hosts 1.4 million refugees the third most in the world and 60 percent are children. The closure of schools comes at a particularly vulnerable time, as lack of funding has forced the World Food Programme to announce a 30% cut in food assistance to refugees from April, which will put a further financial strain on families. If their education stops completely now, many children are likely to have to go to work and are highly unlikely to return to education. Remote learning responses should be designed in recognition that many refugee communities have poor phone networks, which may make traditional home teaching more effective than technology-based approaches.

Other children face similar uncertainty such as children with disabilities, who already face enormous challenges accessing school, and adolescent girls who often drop out of education completely after becoming pregnant or being married off young, which is likely to increase

Adapt school policies where appropriate

Develop flexible attendance and sick leave policies that encourage students and staff to stay home when sick or when caring for sick family members. Discourage the use of perfect attendance awards and incentives. Identify critical job functions and positions, and plan for alternative coverage by cross-training staff. Plan for possible academic calendar changes, particularly about breaks and exams.

Monitor school attendance

 Implement school absenteeism monitoring systems to track student and staff absences and compare them against usual absenteeism patterns at the school. Alert local health authorities about large increases in student and staff absenteeism due to respiratory illnesses.

 

 

Promote information sharing

 Coordinate and follow guidelines from the national health and education authorities. Share known information with staff, caregivers, and students, providing updated information on the disease situation, including prevention and control efforts at school. Reinforce those caregivers should alert the school and health care authorities if someone in their home has been diagnosed with COVID-19 and keep their child at home. Utilize parent-teacher committees and other mechanisms to promote information sharing. Also be sure to address children’s questions and concerns, including through the development of child-friendly materials such as posters which can be placed on notice boards, in restrooms, and other central locations.

Implement targeted health education

Integrate disease prevention and control in daily activities and lessons. Ensure content is age-, gender-, ethnicity-, and disability-responsive and activities are built into existing subjects.

Support vulnerable populations

 Work with social service systems to ensure continuity of critical services that may take place in schools such as health screenings, feeding programs, or therapies for children with special needs. Consider the specific needs of children with disabilities, and how marginalized populations may be more acutely impacted by the illness or its secondary effects. Examine any specific implications for girls that may increase their risk, such as responsibility for taking care of the sick at home, or exploitation when out of school.

Cleaning and disinfecting school buildings, classrooms, and especially water and sanitation facilities at least once a day, particularly surfaces that are touched by many people (railings, lunch tables, sports equipment, door and window handles, toys, teaching, and learning aids.

 

 

 

Conclusion

There is both quantitative and qualitative evidence that the school closures that began in March 2020 and the subsequent hesitant restart of schools during the 2020–21 school year harmed an entire cohort of students. Previous experiences of lengthy school closures around the world indicate that this group will not easily make up for the learning losses it suffered and will not simply spring back to historic performance levels once the schools have moved out of pandemic mode. The virus-induced learning impacts will haunt these students throughout their work lives and will also result in a future Ugandan economy that will suffer from a less-skilled workforce unless a way is found to make up for the effects of the pandemic.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REFERENCES

Amir K. COVID-19 and its related stigma: A qualitative study among survivors in Kampala,        Uganda. Stigma and Health. 2021

Galiwango R, Kitayimbwa J, Kiragga AN, Atkins KE, Brown AL, Mbonye AK. Modeling the     Impact and             Public Health Response to COVID-19 in Uganda. Available at SSRN         3633199. 2020

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Matovu JK, Kabwama SN, Ssekamatte T, Ssenkusu J, Wanyenze RK. COVID-19 Awareness,      Adoption of             COVID-19 Preventive Measures, and Effects of COVID-19 Lockdown      Among            Adolescent Boys and         Young Men in Kampala, Uganda. Journal of             Community Health.    2021:1–12

Okello G, Izudi J, Teguzirigwa S, Kakinda A, Van Hal G. Findings of a Cross-Sectional Survey on             Knowledge, Attitudes, and Practices about COVID-19 in Uganda: Implications for           Public             Health Prevention and Control Measures. BioMed Research International.             2020;2020

Usman IM, Ssempijja F, Ssebuufu R, Lemuel AM, Archibong VB, Ayikobua ET, et al.    Community drivers affecting adherence to WHO guidelines against covid-19 amongst rural      Ugandan students.      Frontiers in public health. 2020; 8:340

WHO. Advice for the public: Coronavirus disease (COVID-19): World Health Organization; 2021             [November      12, 2021].

Ministry of Health Report 2021, Uganda

UNICEF Report,2020