DOI: 10.12688/wellcomeopenres.25511.1 ISSN: 2398-502X

Enablers and Barriers to the Implementation and Adoption of 7-1-7 Matrix: Perspectives of Stakeholders in Uganda

Josephine Bayigga, Lydia Nakiire, Benon Kwesiga, Patricia Eyu, Aggrey Byaruhanga, Sarah Elayeete, Job Morukileng, Stella M. Migamba, Ignatius Wadunde, Dorothy Aanyu, Stella Lunkuse, Allan Niyonzima Muruta, Abel W. Walekhwa, Felix Ocom, Godfrey Bwire, Michael Mwanga, Charles Olaro, Dathan M. Byonanebye, Francis Kakooza, Andrew Kambugu, Alex Riolexus Ario
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Background Timely and effective detection, notification and response are crucial to containing infectious disease outbreaks. The 7–1-7 timeliness metrics for outbreak detection, notification, and response was set to improve public health emergency management systems. Stakeholders’ perspectives on its adoption have not been widely explored in regions experiencing frequent epidemics where the use of this matrix is critically relevant. We assessed the enablers and barriers to implementing of the 7–1-7 targets in districts recently affected by epidemics in Uganda. Methods A qualitative cross-sectional study was conducted involving purposively selected key informants at national, regional, and district levels (n = 30), chosen based on their roles and influence in disease outbreak management. A Key informant interview guide was developed using the Consolidated Framework for Implementation Research (CFIR). All interviews were audio recorded and transcribed verbatim. Data was collected between August 2024 and March 2025 and analyzed using deductive thematic analysis in NVivo 14. Results The main facilitators included; appreciation of the matrix by stakeholders for enhancing performance, informing funding priorities, and improving stakeholder engagement. They felt that it aligned with existing surveillance structures, utilizes available human resources and information systems and that it had strong political support. Regarding barriers; perceived mis-alignment of 7–1-7 with other surveillance systems and local political interference were identified. They recommended awareness creation on the framework, integration with existing initiatives and building national financial capacity to support 7–1-7 operations. Conclusion Overall, stakeholders recognized the 7–1-7 matrix as a valuable tool for strengthening outbreak detection and response. Strong political backing further reinforced its potential for successful implementation. To optimize adoption and functionality of the 7–1-7 approach, stakeholders emphasized the need for widespread awareness creation, deliberate integration with existing surveillance initiatives, and strengthened national financial commitment to sustain operations.

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