Community-funded integrated care outreach clinics as a capacity building strategy to expand access to health care in remote areas of Uganda
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Global Health Action
Abstract
Most Ugandans live in rural, medically underserved communities where geography and
poverty lead to reduced access to healthcare. We present a novel low-cost approach for
supplemental primary care financing through 1) pooling community wealth to cover overhead
costs for outreach clinic activities and 2) issuing microfinance loans to motorcycle taxi
entrepreneurs to overcome gaps in access to transportation. The intervention described here,
which leverages community participation as a means to extend the reach of government
health service delivery, was developed and implemented by Health Access Connect (HAC),
a non-governmental organization based in Uganda. HAC began its work in August 2015 in
the Lake Victoria region and now serves over 40 sites in Uganda across 5 districts, helping
government health-care workers to provide over 1,300 patient services per month (and over
35,000 since the program’s inception) with an average administrative cost of $6.24 per
patient service in 2020. In this article, we demonstrate how integrated and appropriately
resourced monthly outreach clinics, based on a microfinance-linked model of wealth pooling
and government cooperation, can expand the capacity of government-provided healthcare
to reach more patients living in remote communities. This scalable, sustainable, and flexible
model is responsive to shifting needs of patients and health systems and presents an
alternative approach to healthcare financing in low-resource settings. More rigorous evaluation
of health outcomes stemming from such community-based models of service delivery is
warranted.
Description
Keywords
Health equity, HIV, Healthcare financing, Sub- Saharan Africa, Community health planning
Citation
Rebecca G. Kinney, Henry Zakumumpa, Joseph Rujumba, Kevin Gibbons, Anna Heard & Omar Galárraga (2021) Community-funded integrated care outreach clinics as a capacity building strategy to expand access to health care in remote areas of Uganda, Global Health Action, 14:1, 1988280, DOI: 10.1080/16549716.2021.1988280