Integrating COVID-19 vaccination into routine healthcare
A feasible model for epidemic response at Mildmay Hospital Uganda, demonstrating how existing health systems can be strengthened, adapted and trusted during public health emergencies.
A practical epidemic-response model built inside routine care
As the Coronavirus Disease 2019 (COVID-19) pandemic overwhelmed healthcare systems globally, integrating vaccination into primary health services became essential to expedite immunization efforts, especially in resource-constrained settings. This report explains the multifaceted process of integrating COVID-19 vaccination services at Mildmay Hospital Uganda (MUgH), focusing on the strategies, challenges and outcomes associated with this project.
Why integration mattered
COVID-19 created urgent pressure on health systems around the world. In Uganda, the need was not only to deliver vaccines, but to do so through a model that could work within existing primary health services, respond to community needs, and remain practical in a resource-constrained setting.
Using the 7S framework to align people, systems and service delivery
MUgH implemented COVID-19 vaccination services between March 2021 and December 2022. Using the 7S framework — Structure, Systems, Shared Values, Skills, Style, Staff and Strategy — the hospital aligned resources effectively.
Structure was strengthened by creating dedicated vaccination areas. Staff were optimized through targeted training, while Skills were aligned to task-specific roles. Strong Systems supported streamlined vaccine administration, strategic management Style fostered adaptability, and collaboration with the Wakiso District unit reinforced Shared Values for public health. Social media was also used to counter misinformation and engage the community.
The operating logic behind the response
The model worked because the response was not treated as a standalone campaign. It was built into the hospital’s people, processes, spaces and public-health partnerships.
Strong uptake, public trust and a workable model
MUgH successfully administered 13,370 of 15,000 available COVID-19 vaccine doses, including 8,906 first doses, 3,568 second doses, and 84 boosters.
MUgH’s collaborative approach, reinforced by targeted media engagement and strategic partnerships with local vaccine distributors, secured a steady vaccine supply and built public trust. This demonstrated the value of a resource-efficient and adaptable model in addressing community healthcare needs.
Key challenges included labour-intensive shifts, task-shifting among staff, misinformation and hesitancy, occasional vaccine stock-outs, and managing demand from ineligible individuals.
A scalable lesson for future epidemic preparedness
Integrating COVID-19 vaccination into MUgH services using the 7S framework proved effective in enhancing healthcare resilience and public health. This adaptable model offers valuable insights for strengthening health systems and preparing resource-limited settings for future epidemic responses.
Research focus areas
Publication team
Epidemic response becomes stronger when emergency services are built into trusted routine care.
The Mildmay Hospital Uganda model highlights adaptability, collaboration and health-system resilience in a resource-limited setting.Applied research. Practical lessons. Stronger health systems.
This publication reflects MRCU’s wider commitment to generating evidence that informs real-world implementation, strengthens public-health response, and supports better health outcomes.