Center for Health Market Innovations (CHMI)

Programs

Project Bumwalukani

last updated Nov 29, 2011

Overview

Implementing organization: 
Foundation for International Medical Relief of Children (FIMRC)
Implementation Partner(s): 
Arlington Academy of Hope (AAH)
Legal Status: 
Private (not-for-profit)
Year Launched: 
2006
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Donor
Additional Source(s) of Funding: 
Government, In-kind contributions, Other 3rd party (e.g. debt, equity)
Funders: 
FIMRC university chapters, Private donors, small grant-making associations, volunteers

Scale

Personnel Employed: 
10-49
Number of Clients Served: 
The clinic serves 1000 patients per month.
Number of Facilities Operated/Networked: 
1
Replication: 
Successful programs at Project Bumwalukani have been adapted for use at FIMRC's other sites. These programs have included a Peer Health Educators program designed to teach older students to provide health education to primary students, and the CHE program.
Upscaling: 
All services have expanded in both breadth and depth since the initiation of the project. Initially, the project served the students and teachers at Arlington Academy of Hope. As the staff and programming have developed, the project has scaled up its services to provide care for patients from all over the Bududa district, which has an estimated population of 150,000.
Scope: 
The outreach program has also grown. In addition to the CHEs, the outreach program has also mobilized other volunteers in the community to provide health education to patients waiting at the clinic, home-based monitoring for HIV-positive orphans and vulnerable children, and support for pregnant women and their infant children.
Summary: 

Project Bumwalukani provides preventive and curative services for communities in Bududa. Additionally, the project runs outreach programs at the clinic, which are managed by the Health Outreach Team that conduct home-based health education and first aid, and attend bimonthly community outreaches to different villages, trading centers, and schools within the district.

Program goals/rationale: 

Project Bumwalukani works to improve pediatric health, enriching the lives of children in rural Uganda by providing access to high quality clinical care in combination with well-rounded education within the village communities, to curb the devastating spread of common endemic diseases caused by preventable microbial infections. As a result, Project Bumwalukani seeks to create an integrated system of health care that connects clinical services and health education for both patients at the clinic and to the community as a whole.

The project seeks to create a replicable model for sustainable and effective delivery of acute and preventative healthcare to members of the under served Ugandan community, and enhance a transition from a system of triage healthcare to one of continuous care by implementing biannual well-child visits for the entire community, all the while monitoring key indicators of overall health.

Key program components: 

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.

Program history: 

Project Bumwalukani is a FIMRC strategy model supplementing the lasting work done by temporary volunteers with the long-term investment of community involvement to create sustainable change beyond the clinic. FIMRC partnered with the Arlington Academy of Hope (AAH) to establish a health clinic serving the community of Bumwalukani, Uganda allowing FIMRC to administer basic healthcare to the 300 hundred students and teachers that attend the neighbouring rural school, as well as serve the needs of the surrounding region.

Although the clinic was constructed in an effort to meet the health and nutritional needs of the school, the severe lack of medical care in the dispersed rural communities at the foot of Mount Elgon, which according to the Ministry of Health has the highest prevalence of HIV infection in Uganda makes the clinic an essential resource for the approximately 10,000 to 15,000 rural inhabitants.

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