To slow down the community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), context-appropriate measures are vital. The first COVID-19 cases in Kenya, Uganda and the United Republic of Tanzania were reported in March 2020. All three countries have introduced measures to slow the spread of the virus, such as encouraging washing and/or sanitizing hands frequently, staying at home, practising physical distancing when outside the home and partial lockdowns. Most of these prevention measures replicate those from high-income countries and implementation in these three countries has not been without added challenges. The blanket transfer of prevention measures to low-income countries is problematic, especially in urban informal settlements in eastern Africa, due to major contextual differences. Here we draw on examples of these three East African countries to illustrate the challenges that individuals and families face in adopting measures such as physical distancing to slow down the spread of SARS-CoV-2.