Project Bumwalukani operates in a rural and remote region of eastern Uganda. The district where the clinic is located has poor roads, limited electricity, and a population that is almost entirely eliant on subsistence farming. Governmental and private support for education, health, economic, and infrastructure development programs has been limited in this region. As a result, many residents of Bududa district have been unable to be involved in programs to support personal or community growth. In this context, Project Bumwalukani provides high-quality clinical service exclusively targeting this population, consistently ranked in in the poorest 10% of Uganda's population.
Through the outreach program, Project Bumwalukani conducts weekly voluntary HIV testing and counseling where all positive patients are monitored at home by the Community Health Educators (CHEs), monthly immunization clinics, and health education among the primary and secondary school children in the trading centers, churches, as well as in the rest of the community through the FIMRC Acting Community Troop (FACT), a drama group that performs health related skits and songs to raise awareness about community health.
The project also initiated a maternal-child health program through which bimonthly antenatal care is provided at the clinic, a pregnant women’s health group and home-based follow-up is carried out for women enrolled in the program.
Project Bumwalukani's clinical programs include a "station system" through which all patients must pass to ensure that they are receiving a complete set of vital sign tests, diagnosis, and treatment. Additionally, all stations provide education to patients regarding their signs and symptoms and eventual diagnosis. In order to increase community ownership of the clinic and, as a result, of community requests for additional buy-in, adult patients are charged a small fee for services and medications. Services for children are free of charge. In addition, FIMRC oversees the region's only antenatal clinic, which includes necessary lab testing for expectant mothers, staffed by a local midwife and overseen by clinic officers.
Project Bumwalukani carries out outreach programs to offer HIV testing and counseling and immunization among other health services and the clinical services have been restructured to ensure maximum efficiency in patient flow.
Since its initaition, all aspects of the project's programs have undergone repeated review and evaluation to improve the quality of services provided. Evaluations have taken the form of individual staff and patient feedback and group feedback at staff meetings. To whatever degree possible, Project Bumwalukani has integrated this feedback into daily operations. Currently, the project is working on establishing a comprehensive, ongoing data-based monitoring and evaluation tool to ensure quality of services into the future.