Beyond Borders: Migration Patterns and Surveillance Gaps at the West Nile Uganda-Democratic Republic of the Congo Border Entry Points

Abstract

Transboundary migration across the Uganda–Democratic Republic of the Congo (DRC) border remains a defining feature of population mobility and border governance in Uganda’s West Nile region. Daily cross-border movements support trade and social ties, and are predominantly circular and repetitive rather than permanent. Such high-frequency mobility places sustained pressure on surveillance systems that are often designed for occasional travellers, creating gaps in routine monitoring at border entry points. This study examined transboundary migration patterns in terms of volume, direction, frequency, and demographic profiles, and assessed how existing migration surveillance controls at West Nile, Uganda–DRC points of entry aligned with and responded to these movements. A cross-sectional mixed-methods study was conducted across six West Nile border districts. Quantitative data were collected through structured interviews with 292 adult cross-border travellers at gazetted and porous entry points. Qualitative 03 FGDs, 02 community in-depth individual interviews, 05 policy level executive interviews, and 05 field observations at both gazetted and porous border points of entry. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed thematically. Findings indicated that cross-border mobility was characterised by frequent and repetitive movement: 45.9% of respondents crossed the border 2–10 times in the previous three months, and 39.0% crossed more than 10 times. Although 75.7% used gazetted points of entry during their most recent crossing, 23.3% used ungazetted routes. Surveillance controls were inconsistently experienced, and only 40.4% reported observing migration-related checks. Perceived effectiveness of infectious disease monitoring was significantly associated with experiencing health checks and the presence of cross-border monitoring mechanisms, but not with general awareness of infectious diseases. In conclusion, frequent circular mobility and uneven enforcement of surveillance controls remain central challenges to effective border migration surveillance in the West Nile. Aligning migration surveillance systems with the realities of high-frequency movement is critical to strengthening routine infectious disease monitoring at both formal and informal border crossings.