Exploring district implementation of national guidelines and maintenance of essential health services during the COVID-19 pandemic in Uganda

Variation in implementing national-level policy across districts indicates inefficiencies or inequities across geographies in Uganda in terms of ability and capacity to respond to emergencies. Local guideline implementation also varied across health system functions, with financing and service delivery-related guidelines having the lowest implementation scores. Future emergency responses should consider how to balance local adaptations with central support by identifying which health system functions districts can more easily manage and adjust independently.