A Comparative Analysis of COVID-19 Physical Distancing Policies in South Africa and Uganda - January 2020-November 2021

Abstract

Background: COVID-19 responses internationally have depended on physical distancing policies to mitigate or contain the spread of the virus, given the initial absence of treatments and limitations on vaccine availability. Across Africa, countries have varied in their COVID-19 responses and resulting local epidemiology. These jurisdictions differ based on contextual factors affecting their responses such as past epidemic experience, ratings of epidemic preparedness, and income level, among others. This study aims to explore how policy responses affected the COVID-19 epidemiology in these jurisdictions. Methods: A qualitative multiple embedded case study design was followed to examine the COVID-19 policy responses in South Africa and Uganda from January 2020 to November 2021. A documentary review was conducted using sources including government websites and reports, news articles, and peer-reviewed journal articles to obtain data on policy responses and contextual factors. Epidemiological data were collected from public sources. Key informant interviews conducted with relevant stakeholders were used to confirm findings and cover missing information. A comparative analysis was conducted to explore differences in implementation of different types of physical distancing policies and potential consequences of lifting or prolonging public health measures. Results: South African and Ugandan policy responses included physical distancing measures such as lockdown, international travel bans, school closures, public transportation measures, and curfew, in addition to relief programs, vaccinations, and enforcement of policies. Differences between jurisdiction policy responses existed in terms of overarching policy response strategy, timing, and stringency. Conclusions: This study focused on providing in-depth comparisons of COVID-19 policy responses and relevant contextual factors in South Africa and Uganda. The study showed how contextual factors such as population age, geographic distribution, and recent epidemic response experience can influence COVID-19 transmission and response. The study also showed differences in overall strategy, timing, and strictness of epidemic management policies in these jurisdictions. These findings suggest it may be important to have sustained, strict measures to limit the spread of COVID-19 and manage the course of a pandemic, which need to be further explored alongside other important social and economic pandemic outcomes.